Using modern surgical techniques including laparoscopy, repair of Morgagni hernia can be performed safely with a short hospital stay and with little morbidity or mortality.

Using modern surgical techniques to include laparoscopy, repair can be performed safely, with a short hospital stay, and with minimal morbidity or mortality.

No abstract

Bullet emboli can prove to be a clinical challenge. Adjuncts such as X-ray, computed tomography, transthoracic, and/or transesophageal echocardiography help establish the emboli location. While observation in the asymptomatic patient is reasonable in some circumstances, most patients undergo removal. Removal of bullet cardiac emboli is safe with the availability of modern techniques.

In an equal-access healthcare system, African American race is not associated with an increase in mortality. African American patients undergo surgery and chemotherapy is administered at rates equal to whites for all stages of colon cancer.

The 48th CSH supported military and humanitarian operations with an ongoing process of re-evaluation, adaptation, and medical education that resulted in low morbidity and mortality rates.

W hile pancreatic injuries are relatively uncommon, the morbidity and mortality associated with such injuries are high. Of all pancreatic injuries, most result from penetrating rather than blunt trauma. 1Y5 It is estimated that 6% of abdominal gunshot wounds and 2% of abdominal stab wounds result in a pancreatic injury. 1,6 The mortality associated with pancreatic injuries ranges from 20% to 45%, while the pancreas-specific complication rate is higher than 35%. 1,3 Involvement of the pancreatic duct is the main determinant of morbidity and mortality from a pancreatic injury. 1 Not surprisingly, a delay in diagnosis of a main pancreatic ductal injury over 6 hours to 12 hours further contributes to the high complication and death rate of pancreatic injuries. 7,8 Furthermore, diagnosis of pancreatic ductal involvement requires operative resection rather than placement of drains or nonoperative management. 9Y11 However, determining whether the pancreatic duct is involved in the injury remains one of the greatest challenges in trauma surgery. Diagnosing pancreatic ductal injuries often requires a multimodal imaging approach by a multidisciplinary team. Unfortunately, intraoperative cholecystocholangiopancreatography is often nondiagnostic, gastroenterologists may not be available for endoscopic retrograde cholangiopancreatography (ERCP), and the patient may be excluded from magnetic resonance cholangiopancreatography (MRCP) because of skeletal traction equipment or previous metal implants. Surgeon-controlled intraoperative pancreatic ultrasound (US) may overcome these limitations. In this article, we describe our use of intraoperative US as an adjunct to evaluate for ductal involvement in pancreatic injuries.

All injected thrombi were trapped by the absorbable filters and held through resorption, requiring 1-4 weeks for autologous thrombolysis, resulting in 100% capture efficiency. There were no instances of pulmonary embolism, filter migration, caval penetration, or tilt greater than 14 degrees. Severe infrarenal caval narrowing occurred in one subject following filter mal-deployment that subsequently resolved. Necropsy results revealed (i) neointimal hyperplasia encased the stent portion of the filter at 2 weeks, (ii) filter baskets were intact at 12 weeks, (iii) filter suture not humanly visible at 24 weeks, and (iv) polydioxanone remnants measuring less than 0.1mm were observed with 10x magnification at 32 weeks. Blood count, gases, chemistry, coagulation and liver panels remained normal throughout the study. Conclusions: Preliminary large animal results suggest that an absorbable polydioxanone vena cava filter can be both safe and effective in trapping iatrogenically administered autologous thrombus through resorption with minimal presence of the filter at 32 weeks.* An "interaction" was defined as a strut touching, impressing, or perforating any other organ