Surgery
A Case Based Clinical Review
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Article
Predictors of poor outcomes after cholecystectomy in gallstone pancreatitis: NSQIP analysis of 30-day morbidity and mortality
Contemporary nationwide outcomes of gallstone pancreatitis (GSP) managed by cholecystectomy at the index hospitalization are limited. This study aims to define the rate of 30-day morbidity and mortality and id...
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Shortness of Breath 5 Days After Surgery
Five days after a laparoscopic left colectomy for colon cancer, a 55-year-old female presents to the emergency department with shortness of breath for the past 6 hours. She feels that she is breathing more rap...
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Postoperative Bleeding
A 50-year-old male is scheduled to undergo an elective inguinal hernia repair. He has noted pain in the hernia, which is reducible, for the past year. His past history is significant for hypercholesterolemia a...
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Gunshot Wound to the Left Neck
A 30-year-old male presents to the emergency department with a single gunshot wound (GSW) to the left neck. The patient is hemodynamically stable, with a blood pressure of 120/70 mmHg, heart rate of 100/min, r...
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Burns to the Face, Trunk, and Extremities
A 25-year-old man arrives to the emergency department an hour after sustaining burn injuries in a house fire. He weighs 70 kilograms. He is awake but appears confused and disoriented. He complains of a severe ...
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Nausea, Vomiting, and Left Groin Mass
A 65-year-old obese woman presents to the emergency department with nausea and vomiting for the past day. The frequency of vomiting has increased despite the fact that she has not eaten for the past 12 hours. ...
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Postprandial Right Upper Quadrant Pain
A 40-year-old, gravida six and para six, moderately obese Hispanic female presents to the emergency department with a 1-day history of constant epigastric and right upper quadrant (RUQ) pain. She describes the...
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Right Calf Pain with Walking
A 65-year-old male presents with a 5-month history of progressively worsening right calf pain upon walking. He describes the pain as a tightening or cram**, and it comes on after walking two blocks. The pain...
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Right Leg Pain, Swelling, and Erythema for Two Days
A 40-year-old male with diabetes mellitus and hepatitis C-related cirrhosis presents to the emergency department with a 2-day history of right leg pain, redness, and swelling. He states that he thinks he may h...
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Cold, Painful Right Lower Extremity
A 65-year-old female presents to the emergency department with a 4-hour history of sudden onset of right leg pain, coolness, weakness, and numbness. She has no prior similar history. The pain began while she w...
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Left Lower Quadrant Pain and Fever
A 55-year-old obese female presents with a 2-day history of left lower quadrant (LLQ) pain, nausea, anorexia, and low-grade fevers. The patient states that the pain is constant and moderately severe and does n...
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Postoperative Decreased Urine Output
A previously healthy 65-year-old female underwent an emergent sigmoid colectomy and proximal colostomy for perforated diverticulitis. Intraoperatively, the patient was found to have extensive fecal contaminati...
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Abdominal Pain Following Motor Vehicle Collision
A 35-year-old unrestrained male driver is brought in by paramedics following a motor vehicle collision (MVC). There were extensive passenger space intrusion and significant steering wheel deformity. On arrival...
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Pedestrian Struck by Motor Vehicle
A 30-year-old male is struck by a car while crossing the street. He is brought in by paramedics with a blood pressure of 130/70 mmHg, heart rate of 80/min, and a right knee deformity. He is awake and alert and...
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Severe Right Leg Pain After Tibia Fracture
A 30-year-old male is brought to the emergency department by paramedics after a motorcycle accident. He has an obvious deformity of the right lower extremity below the knee. Imaging reveals a fracture of the t...
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Fever and Hypotension in the Intensive Care Unit
A 57-year-old male patient develops confusion and lethargy in the intensive care unit. He is 4 days status post emergent surgery for a perforated gastric ulcer that developed as a result of daily nonsteroidal ...
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New Onset of Painless Jaundice
A 68-year-old man presents to the emergency department complaining of fatigue and intermittent vague abdominal pain. He denies nausea or vomiting, but “does not have much of an appetite these days.” He reports...
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Transient Loss of Vision in the Right Eye
A 60-year-old male presents with an episode of vision loss in his right eye. The event occurred a week ago, while he was watching television, and resolved spontaneously after about 20 minutes. He described it ...
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Right Upper Quadrant Pain, Fever, Nausea, and Vomiting
A 40-year-old female presents with a 24-hour history of right upper quadrant (RUQ) and epigastric pain associated with nausea and vomiting. She has had similar pain in the past, particularly after eating greas...
