Intussusception complicating pregnancy following laparoscopic Roux-en-Y gastric bypass.

Laparoscopic Roux-en-Y gastric bypass is the most common bariatric surgical procedure in the USA in women of reproductive age. A pregnant patient presented with nonspecific upper abdominal pain and nausea, suggesting an internal hernia. At surgery, an intussusception was identified and reduced without complications.

Blunt and penetrating trauma--has anything changed?

Management of abdominal trauma has changed significantly in the last decade. The next decade will also see significant change as imaging and minimally invasive surgical techniques evolve and more approaches are examined in well-designed prospective studies.

Percutaneous dilatational tracheostomy. A safe, cost-effective bedside procedure.

Objective: To evaluate the safety and cost-effectiveness of percutaneous dilatational tracheostomy performed in the intensive care unit.

Design: Retrospective review of 65 patients with cost-effectiveness analysis.

Setting: University-affiliated tertiary care teaching hospital with a 34-bed combined medical-surgical intensive care unit.

Management of major hepatic trauma involving interhospital transfer.

A recent 10-year experience with major liver trauma at the Maine Medical Center was reviewed in order to examine treatment options involving interhospital transfer in the management of major liver trauma in rural areas. Liver injuries of at least Grade III by the systems of Moore or Mirvis were included, except for patients admitted without vital signs. We found 98 cases of major hepatic trauma, of which 54 had been referred by 21 smaller hospitals.

Blunt traumatic thoracic aortic lacerations in the elderly: an analysis of outcome.

We found no previous work examining outcome after blunt traumatic aortic laceration (TAL) that has focused on elderly patients (age > 55 years) with this lesion. A 20-year retrospective review from two trauma centers of survival outcome for patients with TAL was performed to assess the effects of surgical therapy in the elderly cohort. Seventy-five cases were identified.