The American Surgeon back issues from August 2008:
Invited Commentary: The Current Management of Renal Injuries
Aug 01, 2008; ... RENAL INJURY MANAGEMENT has evolved over the past decades as a result of improved radiographic techniques, advancements in hemodynamic management, validated renal injury scoring systems, and accumulated interest in genitourinary trauma. Subsequently, there has been an increase in nonoperative ...
Blood Glucose Variability Is Associated with Mortality in the Surgical Intensive Care Unit/DISCUSSION
Aug 01, 2008; ... Intensive insulin therapy has widely and rapidly been adopted as the standard of care for the treatment of hyperglycemia in the intensive care unit (ICU). Variability in blood glucose is increasingly recognized as an important factor in outcomes in the chronic diabetic in addition to hemoglobin ...
Antegrade and Retrograde Endoscopy for Treatment of Esophageal Stricture/DISCUSSION
Aug 01, 2008; ... Total or near-total esophageal stricture results from multiple processes. Traditional treatment with wire cannulation followed by serial dilation is often contraindicated due to poor visualization and the risk of perforation. We seek to demonstrate that combined antegrade and retrograde ...
Endoscopic Retrograde Cholangiopancreatography after Laparoscopic Roux-en-Y Gastric Bypass: A Case Series and Review of the Literature/DISCUSSION
Aug 01, 2008; ... Endoscopic retrograde cholangiopancreatography (ERCP) has become an important tool in the diagnosis and treatment of pancreaticobiliary pathology. ERCP in patients that have undergone Roux-en-Y gastric bypass (RYGB) is particularly challenging because traditional transoral endoscopy may be ...
Combined Open and Laparoscopic Approach to Chronic Pain after Inguinal Hernia Repair/DISCUSSION
Aug 01, 2008; ... Chronic groin pain is the most frequent long-term complication after inguinal hernia repair affecting up to 34 per cent of patients. Traditional surgical management includes groin exploration, mesh removal, and neurectomy. We evaluate outcomes of a combined laparoscopic and open approach to ...
Changes in Male Breast Cancer Over a 30-Year Period/DISCUSSION
Aug 01, 2008; ... Male breast cancer is a rare clinical entity accounting for approximately 1 per cent of all breast cancers. The present study investigated changes in patient characteristics, disease patterns, treatment, and outcomes over a 30-year period. A retrospective chart review was performed on male ...
Mesh-Free Laparoscopic Spigelian Hernia Repair/DISCUSSION
Aug 01, 2008; ... Varied Spigelian hernia mesh repair techniques have been described, although evidence suggests laparoscopy results in less morbidity and shorter hospitalization compared with open procedures. Laparoscopic suture repair of Spigelian hernias is rarely reported. Two patients with small Spigelian ...
Endometrial Stromal Sarcoma Development after Hysterectomy and Tamoxifen Therapy
Aug 01, 2008; ... Tamoxifen therapy is well known for its success in adjuvant therapy for breast carcinoma; however, despite its benefits, the agents' estrogenic influence on the uterus, and subsequent endometrial cell proliferation may result in development of invasive uterine tumors. It has been estimated that ...
Clopidogrel and Bleeding after General Surgery Procedures
Aug 01, 2008; ... Although many studies in the cardiothoracic literature exist about the relationship between clopidogrel and postoperative bleeding, there is scarce data in the general surgery literature. We assessed whether there are increased bleeding complications, morbidity, mortality, and resource ...
Receptor Characteristics of the Second Tumor in Synchronous Versus Metachronous Breast Cancer/DISCUSSION
Aug 01, 2008; ... Presently, there is no consensus on whether synchronous breast cancer has the same disease origin as the primary tumor, or if it is a completely independent second primary. This study explores this concept in both synchronous and metachronous breast cancer looking specifically at their receptor ...
Impact of Total Pancreatectomy with Islet Cell Transplant on Chronic Pancreatitis Management at a Disease-Based Center
Aug 01, 2008; ... Because of poor outcomes with traditional surgical management, total pancreatectomy with autologous islet transplantation (TPAIT) has been heralded as a breakthrough in the management of severe chronic pancreatitis intractable to medical management. To assess the impact of TPAIT on a ...
The Practice of Pancreatic Resection after Roux-en-Y Gastric Bypass
Aug 01, 2008; ... The morbid obesity epidemic in the United States has resulted in increasing numbers of patients who have undergone Roux-en-Y gastric bypass who require surgical management of nonbariatric disorders. When pancreatic resection is indicated in bariatric patients, consideration of the altered ...
Breast MR for the Evaluation of Occult Nipple Discharge
Aug 01, 2008; ... Pathologic nipple discharge often presents a diagnostic and therapeutic dilemma for clinicians. We present two patients with pathologic nipple discharge in whom breast MR facilitated preoperative identification of and management of otherwise occult index lesions. Breast MR should be considered ...
Sclerosing Mesenteritis Masquerading as a Small Bowel Mesentery Neoplasm
Aug 01, 2008; ... SCLEROSING MESENTERITIS is a disease process with many names: mesenteric lipodystrophy, mesenteric panniculitis, retractile mesenteritis, liposclerotic mesenteritis, and xanthogranulomatous mesenteritis. There are less than 300 cases that have been reported in the literature, mostly as case ...
Subcutaneous Linea Alba Fasciotomy: A Less Morbid Treatment for Abdominal Compartment Syndrome
Aug 01, 2008; ... Abdominal compartment syndrome is a cause of significant morbidity and mortality among surgical patients. It has traditionally been treated by abdominal decompression with the associated risks of chronic incisional hernia and enteroatmospheric fistula. Subcutaneous linea alba fasciotomy has ...
Eosinophilic Esophagitis: A Rare Cause of Esophageal Rupture in Children
Aug 01, 2008; ... EOSINOPHILIC ESOPHAGITIS (EoE) is a condition often confused with peptic esophagitis. First described in the 1970s, EoE appears to be a new disease with an increasing incidence of 0.91 to 1.28 per 10,000 population from 2000 to 2003. 1-3 In children, the incidence appears to be highest in those ...
Gastric Schwannoma
Aug 01, 2008; ... GASTROINTESTINAL SCHWANNOMAS are rare tumors of mesenchymal origin, which arise from Schwann cells of the neural plexus within the gastric wall. These tumors most commonly arise from Auerbachs plexus, but can develop from Meissner's plexus as well.1 Gastrointestinal schwannomas are typically ...
A Case of Dual Thoracoabdominal Impalement in Vehicular Trauma
Aug 01, 2008; ... Impalement injuries are relatively uncommon during vehicular trauma. We present a dual case report of patients sustaining simultaneous impalement injuries during a high-speed motor vehicle collision in a rural (austere) environment. After Institutional Review Board approval, we performed a ...
Pelvic Fracture Risk Assessment on Admission
Aug 01, 2008; ... Patients with pelvic fractures (PF) have high incidences of associated injuries and mortality. To identify patients with PF at the highest risk for mortality on admission to a Level I trauma center, investigators analyzed 566 PF in 12,128 patients (1996 to 2005). PF were categorized on arrival ...
All-Terrain Vehicle Trauma in the Elderly: An Analysis of a National Database
Aug 01, 2008; ... The elderly are a growing proportion of all-terrain (ATV) drivers. The purpose of this study was to determine if the outcomes of geriatric ATV trauma victims are different from those of their younger counterparts and if age is an independent predictor of mortality. ATV trauma cases in the United ...
The Death of George Washington: An End to the Controversy?
Aug 01, 2008; ... The controversy surrounding the death of George Washington was immediate, intense, and continues today. After a horse ride in sleet and snow, Washington developed fulminant acute epiglottitis that rapidly claimed his life within 24 hours. In treatment, he endured phlebotomy of over 2500 mL as ...
Pancreatic pseudocyst in the setting of chronic pancreatitis and pancreas divisum
Aug 01, 2008; ... To the Editor: A 34-year-old woman with more than 20 previous episodes of acute pancreatitis and a significant history of alcohol abuse presented with 3 weeks of sharp left upper quadrant pain with radiation to the left shoulder, early satiety, weight loss, and intermittent dyspnea. She ...
Craniofacial necrotizing fasciitis of the eyelids, and nasal region after traumatic assault to the face: Successful outcome with early intervention
Aug 01, 2008; ... To the Editor: We report a case of necrotizing fasciitis of the periorbital and nasal region that resulted in a successful outcome even after delayed presentation and advanced disease progression. A 41 -year-old man returned to the emergency department approximately 3 to 4 days after ...
Laparoscopic management of cecal perforation by an ingested foreign body
Aug 01, 2008; ... To the Editor: Laparoscopic management of ingested foreign bodies has been reported in the literature with minimal complications, shorter operative times, and shorter length of hospital stays. Intracorporeal extraction of foreign bodies that have perforated the small bowel and colon have ...
Traumatic perforation of a duodenal diverticulum
Aug 01, 2008; ... To the Editor: Although colonic diverticula are well known and commonly encountered, approximately 22 per cent of the population also exhibit the presence of duodenal diverticula.1, 2 The majority of these patients remain asymptomatic with fewer than 2 per cent requiring surgical ...