The American Surgeon back issues from April 2008:
Invited Commentary: Current Status of Heroic Limb Salvage for Critical Limb Ischemia
Apr 01, 2008; ... The treatment of chronic lower extremity peripheral arterial disease is in a state of flux. During the past decade, vascular surgeons have assumed the responsibility for the endovascular care of patients needing vascular intervention. Once surgeons began performing these procedures, a change in ...
Invited Commentary: Pain after Mastectomy and Breast Reconstruction
Apr 01, 2008; ... Breast cancer is a potentially deadly disease affecting one in eight women. With the trend toward minimally invasive therapies for breast cancer, such as breast conserving therapies, sentinel node biopsies, and early treatments of radiation and chemotherapy, life expectancy after breast cancer ...
Abdominal Insufflation Decreases Blood Loss Without Worsening the Inflammatory Response: Implications for Prehospital Control of Internal Bleeding
Apr 01, 2008; ... Abdominal insufflation (AI) by carbon dioxide has been shown to decrease the rate of bleeding in different swine models of abdominal organ injuries. With development of appropriate tools, AI could be used to control bleeding temporarily in the prehospital setting. Concerns have been raised about ...
Panperitonitis Caused by Gangrene of the Urinary Bladder: Report of a Successfully Treated Case
Apr 01, 2008; ... The patient was a 74-year-old woman with Parkinson's disease who had a past history of total hysterectomy for uterine myoma. She was admitted for a femoral neck fracture and treated conservatively. From the third day of the illness, the patient experienced increased urinary frequency and ...
Profile and Significance of Emergency Colonic Resections
Apr 01, 2008; ... The objectives of this study are to define the distinguishing features between elective and emergency colonic surgery. The records of adult patients who underwent elective and emergent colonic resection over a 4-year period were retrospectively reviewed. Univariate analysis was performed to ...
Perils of Rib Fractures
Apr 01, 2008; ... Rib fractures (RF) are noted in 4 to 12 per cent of trauma admissions. To define RF risks at a Level 1 trauma center, investigators conducted a 10-year (1995-2004) retrospective analysis of all trauma patients. Blunt chest trauma was seen in 13 per cent (1,475/11,533) of patients and RF in 808 ...
Rett Syndrome and Gastric Perforation
Apr 01, 2008; ... Rett Syndrome is associated with decreased peristaltic esophageal waves and gastric dysmotility, resulting in swallowing difficulties and gastric dilation. Rarely, gastric necrosis and perforation occur. Our case represents the third reported case of gastric necrosis and perforation associated ...
Primary Melanoma of Small Intestine Masquerading as Gastrointestinal Stromal Tumor: A Case Report and Literature Review
Apr 01, 2008; ... Malignant melanoma of the gastrointestinal tract is a rare entity among intestinal neoplasms. Primary intestinal melanoma is difficult to differentiate from metastatic melanoma, especially given that the primary cutaneous lesion has the potential to regress and disappear. In addition, melanoma ...
Splenic Artery Embolization and Endovascular Stapler Integrity in a Porcine Model
Apr 01, 2008; ... Splenic artery embolization is often used before laparoscopic splenectomy in cases of splenomegaly to reduce blood loss and facilitate the procedure. The aim of this study was to examine the general reliability of endovascular staplers when fired at the site of embolization coil deployment using ...
Video-Assisted Transumbilical Meckel's Diverticulectomy in Children
Apr 01, 2008; ... The treatment of Meckel's diverticulum (MD) in children is resection. Some data exist for the use of laparoscopic resection. The Video-Assisted Transumbilical (VAT) single-trocar technique has been recently described for appendectomy. We also have used this technique for the resection of MD. The ...
One Snake or Two: The Symbols of Medicine
Apr 01, 2008; ... In antiquity, Asklepios was portrayed with a stout staff around which was coiled a snake. Hermes (Mercury), the messenger of the gods, was portrayed with a wand, often with wings, around which were coiled two snakes. During the Renaissance and up to modern times, in varied locales, each icon has ...
Computed Tomographic Evidence of Hepatic Portal Venous Gas after Blunt Abdominal Trauma Does Not Necessitate Surgery
Apr 01, 2008; ... Historically, hepatic portal venous gas (HPVG) seen on abdominal radiographic examination indicated serious intra-abdominal pathology requiring urgent operative intervention. The mortality attributed to HPVG is associated closely with its causative source rather than a direct effect of the ...
Mixed Ductal-Endocrine Carcinoma of the Pancreas with Synchronous Papillary Carcinoma-In-Situ of the Common Bile Duct: A Case Report and Literature Review-Synchronous Pancreatic and Bile Duct Tumors
Apr 01, 2008; ... This report is a case of a 58-year-old woman with a mixed ductal-endocrine carcinoma of the pancreas and a synchronous carcinoma-in-situ of the common bile duct. She presented with intractable itching from obstructive jaundice. Magnetic resonance imaging scan showed dilated intrahepatic biliary ...
Combined Endorectal Advancement Flap with Alloderm® Graft Repair of Radiation and Cryoablation-Induced Rectourethral Fistula
Apr 01, 2008; ... Rectourethral fistula is a potentially devastating disease for the patient and difficult management problem for the physician. We report a case of radiation and salvage cryoablation-induced rectourethral fistula for treatment of prostate cancer successfully repaired with a combined endorectal ...
Unresectable Hepatocellular Carcinoma with a Solitary Metastasis to the Mandible
Apr 01, 2008; ... Hepatocellular carcinoma (HCC) continues to pose a worldwide burden on health resources with an occurrence of 1.4 million cases annually. It represents the fifth most common cancer in men and eighth most common in women worldwide. Eighty per cent of patients have a background cirrhotic liver, ...
Disruption of the Costal Margin with Transdiaphragmatic Abdominal Herniation Induced by Coughing
Apr 01, 2008; ... We present a case of disruption of the cartilage of the costal margin resulting in herniation of abdominal contents across the diaphragm into the chest and across a gap between the ribs into the subcutaneous tissues. The literature on this condition and its management is ...
Lack of Complications in Minor Skin Lesion Excisions in Patients Taking Aspirin or Warfarin Products
Apr 01, 2008; ... Many patients undergoing surgical procedures take medications that influence the coagulation system. It is common practice to discontinue the use of aspirin and warfarin products 7 to 10 days before any major surgical procedure. However, there is some controversy as to whether these medications ...
Sigmoid Volvulus in an Air Traveler
Apr 01, 2008; ... To the Editor: Sigmoid volvulus is the twisting of the sigmoid colon around its mesentery causing partial or complete bowel obstruction. Consequences include infarction and necrosis of the bowel and perforation of the colonic wall.1 Multiple etiologies and predisposing factors have been ...
Metastatic Renal Cell Carcinoma to the Pancreas with Splenic Portal Vein Tumor Thrombus
Apr 01, 2008; ... To the Editor. Renal cell carcinoma (RCC) is the most common primary malignant tumor of the kidney. Although there is a trend toward earlier disease detection and better outcomes in patients with RCC, 25 per cent of patients have distant metastases or advanced locoregional disease at the ...
Pseudoxanthoma Elasticum: A Case of Total Gastrectomy for Gastric Hemorrhage
Apr 01, 2008; ... To the Editor: Pseudoxanthoma elasticum is a rare connective tissue disorder caused by calcification and degeneration of elastic tissue. In addition to hallmark cutaneous, ocular, and cardiovascular manifestations, gastrointestinal hemorrhage can be a significant complication. We report ...