Undetected metastatic melanoma in the colon.

Colonic melanoma is a rarely detected aetiology of small bowel obstruction. This is a case of a male in his 80s with a history of treated stage IIIA melanoma on his trunk 7 years prior who presented with small bowel obstruction. He underwent urgent surgical intervention, where a partial colectomy was performed.

Readmissions to an alternate hospital in patients undergoing vascular intervention for claudication and critical limb ischemia associated with significantly higher mortality.

Background: Hospital readmissions with 30 days after vascular surgical interventions have been associated with increased morbidity, mortality, and cost. Readmission rates, now a Centers for Medicare and Medicaid Services quality measure, have been studied in databases that have excluded certain payer types and states and have not accounted for readmission to a hospital different from that of the index admission. More accurate and nationally representative data are needed, because this fragmentation of care could lead to flawed conclusions.

Nationally Representative Readmission Factors in Patients with Claudication and Critical Limb Ischemia.

Background: Hospital readmissions are associated not only with increased mortality, morbidity, and costs but also, with current health-care reform, tied to significant financial and administrative penalties. Some studies show that patients undergoing vascular surgery may have higher than average readmission rates. The recently released Nationwide Readmission Database (NRD) is the most comprehensive national source of readmission data, gathering discharge information from 22 geographically dispersed states, accounting for 51.