Emphysematous changes in pneumoperitoneum and tension pneumothorax following robot-assisted bronchoscopy: a case report.

Pneumoperitoneum is most commonly caused by perforation of a hollow viscus but can also result as an extension of pneumothorax and/or pneumomediastinum. We present a case of pneumoperitoneum preceded by intraprocedural hemoptysis and tension pneumothorax that developed during transbronchial needle aspiration using robot-assisted flexible bronchoscopy. After stabilization and management of the pneumothorax, diagnostic laparoscopy was performed and revealed no evidence of diaphragmatic or intra-abdominal perforation but showed diffuse emphysematous changes in the gastrohepatic ligament, small and large bowel mesentery, and preperitoneal space.

An inguinal hernia 'hard to stomach'.

Inguinal hernias containing the stomach are extremely rare, and have never been described in females. We are reporting the case of a 79 year old female who presented in septic shock with a left inguinal hernia containing the stomach, resulting in gastric perforation and loss of abdominal domain. She underwent emergency exploratory laparotomy with manual reduction of the hernia, wedge resection of the perforated gastric segment, abdominal washout, and closure of the abdominal fascia using biological mesh.

Endoluminal vacuum therapy for rectal anastomosis is safe and does not increase risk of strictures in a swine model.

Background: Endoluminal vacuum therapy has been experimentally used in patients with esophageal, rectal, and Roux-en-Y bypass surgery. Yorkshire pigs are good animal models for studying the safety and efficacy of endoluminal vacuum therapy and prior studies have employed these devices in rectal anastomotic defects, as rescue therapy for early anastomotic leaks, as well as prophylactic therapy as a means of protecting high risk anastomosis.

Aim: The objective of this study is to assess the effects of a prophylactic vacuum assist device on bowel tissue surrounding an intact anastomosis at 30 days post device removal.

The Rise and Fall of Percutaneous Cholecystostomy in a Community Hospital: Is It Possible to Turn the Tide of History?

Background: Laparoscopic cholecystectomy is the gold standard for treatment of acute cholecystitis. Percutaneous cholecystostomy (PC) drains are alternatives to cholecystectomy in critically ill patients in whom surgery carries an unacceptably high risk. Recently, several studies demonstrated a significant increase in complications in patients undergoing PC in comparison to laparoscopic cholecystectomy.

Operating-Room Procedures Do Not Increase Risk of COVID-19 Infection.

Background And Objectives: Operating-room procedures canceled due to the COVID-19 pandemic depleted hospital revenue and potentially worsened patient outcomes through disease progression. Despite safeguards to resume elective procedures, patients remain apprehensive of contracting COVID-19 during hospitalization and recovery. We investigated symptomatic COVID-19 infection in patients undergoing operating-room procedures during the spring 2020 outbreak in Fairfield County, CT, a heavily affected New York Metropolitan area.

Has COVID-19 Hurt Resident Education? A Network-Wide Resident Survey on Education and Experience During the Pandemic.

Purpose: As the COVID-19 pandemic continues to evolve, the healthcare system has been forced to adapt in myriad ways. Residents have faced significant changes in work schedules, deployment to COVID-19 units, and alterations to didactics. This study aims to identify the effects of the COVID-19 pandemic on resident perception of their own education within the Nuvance Health Network.

Impacts on Surgery Resident Education at a First Wave COVID-19 Epicenter.

Purpose: This study aims to identify the effects of the COVID-19 pandemic on surgical resident training and education at Danbury Hospital.

Methods: We conducted an observational study at a Western Connecticut hospital heavily affected by the first wave of the COVID-19 pandemic to assess its effects on surgical residents, focusing on surgical education, clinical experience, and operative skills development. Objective data was available through recorded work hours, case logs, and formal didactics.

Accuracy of Ultrasound in Diagnosing Gallbladder Polyps at a Community Hospital.

Background And Objectives: Polyps are reported on 1-10% of routine transabdominal ultrasound studies of the gallbladder. Prior studies have reported poor sensitivity and specificity for this diagnostic modality at determining malignant potential of polyps. The aim of this study is to determine the incidence of gallbladder polyps documented on ultrasound at a community hospital, evaluate the congruency of ultrasound with final histopathology, and explore factors which may improve ultrasound accuracy at diagnosing true adenomatous polyps.

Characteristics of the Contrast Enema Do Not Predict an Effective Bowel Management Regimen for Patients with Constipation or Fecal Incontinence.

Background: A bowel management program using large volume enemas may be required for children with anorectal malformations (ARM), Hirschsprung's disease (HD), severe medically refractive idiopathic constipation (IC), and other conditions. A pretreatment contrast enema is often obtained. We sought to determine if the contrast enema findings could predict a final enema regimen.

The morbidity of a divided stoma compared to a loop colostomy in patients with anorectal malformation.

Purpose: Loop colostomies may contaminate the genitourinary (GU) tract in patients with anorectal malformations (ARM) owing to incomplete diversion of stool. Stoma complications are also thought to be higher with a loop versus divided colostomy. We sought to compare the morbidity, including urinary tract infections (UTI), in these two types of colostomies in children with ARM.