Clinical Challenges in Minimally Invasive Surgery: Acute Gastric Volvulus and Duodenal Perforation

Behind The Knife: The Surgery Podcast

Science, Health & Fitness, Medicine, Education

4.8 • 1.4K Ratings

🗓️ 6 June 2022

⏱️ 36 minutes

🔗️ Recording | iTunes | RSS

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Summary

It’s 1AM and the emergency department is calling about *insert terrifying foregut problem you haven’t seen since you were an intern here* and you wake up in a cold sweat to realize it was just a dream…this time. Tune in to this clinical challenge episode for some tips and tricks for managing foregut nightmares with Drs. Mike Weykamp, Nicole White, Andrew Wright, and Nick Cetrulo from the University of Washington’s Minimally Invasive Surgery team.

Referenced articles and videos:

1. Rodriguez-Garcia HA, Wright AS, Yates RB. Managing obstructive gastric volvulus: challenges and solutions. Open Access Surgery. 2017
https://www.dovepress.com/getfile.php?fileID=35414
2. Yates RB. Giant PEH: Management Principles for Unique Clinical Circumstances. 2017 SAGES Annual Meeting. Houston, TX. 2017
https://www.youtube.com/watch?v=vq6cZL2-pho
3. Millet I, Orliac C, Alili C, Guillon F, Taourel P. Computed tomography findings of acute gastric volvulus. Eur Radiol. 2014.
https://pubmed.ncbi.nlm.nih.gov/25278244/
4. Mazaheri P, Ballard DH, Neal KA, Raptis DA, Shetty AS, Raptis CA, Mellnick VM. CT of Gastric Volvulus: Interobserver Reliability, Radiologists' Accuracy, and Imaging Findings. AJR Am J Roentgenol. 2019.
https://pubmed.ncbi.nlm.nih.gov/30403524/
5. Barmparas G, Alhaj Saleh A, Huang R, Eaton BC, Bruns BR, Raines A, Bryant C, Crane CE, Scherer EP, Schroeppel TJ, Moskowitz E, Regner JL, Frazee R, Campion EM, Bartley M, Mortus JR, Ward J, Margulies DR, Dissanaike S. Empiric antifungals do not decrease the risk for organ space infection in patients with perforated peptic ulcer. Trauma Surg Acute Care Open. 2021.
https://pubmed.ncbi.nlm.nih.gov/34079912/
6. Horn CB, Coleoglou Centeno AA, Rasane RK, Aldana JA, Fiore NB, Zhang Q, Torres M, Mazuski JE, Ilahi ON, Punch LJ, Bochicchio GV. Pre-Operative Anti-Fungal Therapy Does Not Improve Outcomes in Perforated Peptic Ulcers. Surg Infect (Larchmt). 2018.
https://pubmed.ncbi.nlm.nih.gov/30036134/
7. Wee JO. Gastric Volvulus in Adults. In: UpToDate, Louie BE (Ed), UpToDate, Waltham, MA. (Accessed on May 15, 2022.)
https://www.uptodate.com/contents/gastric-volvulus-in-adults

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Transcript

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0:00.0	Behind the Night, the Surgery Podcast.
0:09.2	Relevant and engaging content designed to help you dominate the day.
0:15.9	Hey everyone, it's great to be back on Behind the Night with the Minimally-Based Surgery
0:27.1	team from the University of Washington for our second clinical challenge episode.
0:30.9	I'm Mike Wyhamp, here again with Doctors Nicole White, Andrew Wright, and Nick Citruo,
0:36.0	and we have another great episode for you all in which we'll cover some forgot emergencies.
0:39.7	We'll work through some clinical scenarios that are within the scope of those taking general
0:43.8	surgery call, but occur with a low enough frequency and most practices that they tend
0:47.7	to create some certain anxiety.
0:49.7	Acute gastric volulose and duodenal perforation.
0:53.6	Those that are interested in other 4got emergencies, Doctors Bingham and McClellan did an awesome
0:58.2	two-part series on the management of emergencies following bariatric surgery back in October
1:03.9	2021 that I encourage you all to check out if you haven't already.
1:07.8	As usual, we have no conflicts of interest to disclose, but some of the articles and videos
1:11.7	in our show notes come from our institution and Doctor Wright is a co-author on one of
1:15.6	them.
1:16.6	All right, enough with the preamble, Dr. Citruo, do you want to start things off with our
1:19.6	first case?
1:20.8	We're going to start with the discussion of a 60-year-old man with a history of GERD and
1:25.3	no prior surgical history who we from the emergency general surgery department have been
1:31.1	called to evaluate overnight in the emergency department at 1am for nausea, vomiting, increasing
1:38.1	peel intolerance over the past two days.
	...

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