Acute Colonic Obstruction

Apr 6, 2017 by in CRITICAL CARE Comments Off on Acute Colonic Obstruction

Neoplasms (polyps, adenoma, and carcinoma) Volvulus (cecal, transverse, and sigmoid) Diverticulitis Incarcerated hernia Inflammatory bowel disease Intussusception Ischemic colitis Pseudo-obstruction (Ogilvie’s syndrome) Fecal impaction Benign stricture Foreign body Clinical Presentation…

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Diverticulitis

Apr 6, 2017 by in CRITICAL CARE Comments Off on Diverticulitis

Fig. 26.1 Diverticular disease: (left) diverticulosis, (right) diverticulitis Diverticulitis refers to inflammation or infection of a diverticulum. The patient with diverticulitis will commonly present with fever, leukocytosis, and left lower…

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Nutrition in the Surgical Patient

Apr 6, 2017 by in CRITICAL CARE Comments Off on Nutrition in the Surgical Patient

Fig. 9.1 Enteral nutrition protocol algorithm Determining Caloric Needs Caloric needs can be calculated using one of many formulas such as the Harris–Benedict equation, or measured with indirect calorimetry. Harris–Benedict…

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Lower Gastrointestinal Bleeding

Apr 6, 2017 by in CRITICAL CARE Comments Off on Lower Gastrointestinal Bleeding

Fig. 29.1 Initial assessment of lower gastrointestinal bleeding An important diagnostic caveat must be kept in mind in the evaluation of lower gastrointestinal bleeding, specifically that multiple sources of bleeding…

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The Evaluation of the Acute Abdomen

Apr 6, 2017 by in CRITICAL CARE Comments Off on The Evaluation of the Acute Abdomen

Fig. 2.1 (a) Common causes of the acute abdomen based on quadrant. (b) Common causes of the acute abdomen based on region. Illustrations courtesy of Briana Dahl The majority of…

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EMTALA Review

Apr 6, 2017 by in CRITICAL CARE Comments Off on EMTALA Review

7. McCormick B. CO public hospital dumps patients. Hospitals 1986;60(23):76 8. US House of Representatives. H.R. Rep No 241, 99th Cong, 1st Sess 5 (1985) 9. The Consolidated Omnibus Budget…

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Advanced Directives

Apr 6, 2017 by in CRITICAL CARE Comments Off on Advanced Directives

5. Rabkin MT, Gillerman G, Rice NR. Orders not to resuscitate. N Engl J Med. 1976;295(7):364–6.PubMedCrossRef 6. Kouwenhoven WB, Jude JR, Knickerbocker GG. Closed-chest cardiac massage. JAMA. 1960;173:1064–7.PubMedCrossRef 7. Symmers…

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The Open Abdomen

Apr 6, 2017 by in CRITICAL CARE Comments Off on The Open Abdomen

Moore [9] • Medical bleeding due to coagulopathy • Inaccessible major venous injury • Need for a time-consuming procedure in an under-resuscitated patient • Need for control of extra-abdominal, life-threatening injury • Inability to close…

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Metabolic and Anatomic Complications Following Bariatric Surgery

Apr 6, 2017 by in CRITICAL CARE Comments Off on Metabolic and Anatomic Complications Following Bariatric Surgery

Complications of bariatric surgery Short-term (first 30–90 days) Long-term Nausea/vomiting Fistulae •Gastro-gastric, gastro-cutaneous, etc. Dehydration Diarrhea •Maldigestion, malabsorption, bacterial overgrowth Fatigue Dumping Anastomotic stricture Reactive hypoglycemia Leaks/sepsis Failure to maintain…

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