Postoperative pneumoperitoneum on computed tomography: is the operation to blame?

Background: Postoperative radiographs demonstrating pneumoperitoneum are a vexing problem for surgeons. This dilemma stems from uncertainty regarding the length of time for resolution of gas introduced operatively via either an open or a laparoscopic approach. We attempted to quantify the duration of pneumoperitoneum after both laparoscopic and open surgery in an animal model.

Race does not impact pancreatic cancer treatment and survival in an equal access federal health care system.

Background: Black patients with pancreatic adenocarcinoma (PDAC) have been reported to undergo surgical resection less frequently and to have a shorter overall survival duration than white patients. We sought to determine whether disparities in clinical management and overall survival exist between black and white patients with PDAC treated in an equal access health care system.

Methods: Using the Department of Defense (DoD) tumor registry database from 1993 to 2007, patient, tumor, and treatment factors were analyzed to compare rates of therapy and survival between black and white patients.

Pediatric bilateral spontaneous pneumothoraces in monozygotic twins.

Primary spontaneous pneumothorax from subpleural bleb disease is an uncommon occurrence in pediatric patients. This is a rare case of monozygotic twins presenting at alternating intervals with a single-sided spontaneous pneumothorax, only to have it surgically corrected, and to present later with a subsequent contralateral pneumothorax. A review of familial spontaneous pneumothoraces occurring in children was queried for congenital or genetic syndromes.

Ultrasound-guided arterial line catheterization in the critically ill: technique and review.

Arterial line catheterization in the critically ill patient is often an arduous task. Here we identify risk factors in the critical care patient that may predict a more difficult arterial catheter insertion. We also describe our ultrasound technique and review of the literature with regard to location of access, complications, and the use of ultrasound guidance.

Presentation and management of Morgagni hernias in adults: a review of 298 cases.

Background: Morgagni hernias are a very rare form of diaphragmatic hernias. No robust studies have been performed to show the true natural history of this disease process. This study aimed to summarize clinically relevant data with respect to Morgagni hernias in adults.

Introduction to military medicine: a brief overview.

This article provides an overview of the current organization and structure of the United States military medical forces. The five levels of care are presented. The "glue" that binds the five levels of care together -- medical evacuation -- is briefly discussed.

Laparoscopic repair of a large symptomatic epiphrenic esophageal diverticulum.

Purpose: The diagnosis of symptomatic epiphrenic esophageal diverticula is uncommon. Even less common are published reports regarding the efficacy of laparoscopic repair of this malady.

Methods: We report the case of a 59-year-old male patient with Parkinsonism found to have a large, symptomatic epiphrenic diverticulum and discuss the surgical treatment performed.

Are Army-trained surgeons satisfied with their residencies?

Objective: To evaluate the perceptions of training adequacy among surgeons educated in Army general surgical residencies as a tool for surgical program directors and students considering a military surgical career.

Design: A questionnaire was sent to all general surgeons practicing in the Army during years 1999-2003 (n = 182). In addition to providing basic demographic information, subjects rated their perceptions of training experience in 13 areas on a 5-point Likert scale (1 = very dissatisfied, 2 = somewhat dissatisfied, 3 = neither satisfied nor dissatisfied, 4 = somewhat satisfied, 5 = very satisfied).