Surgical Site Infection
11 results
1 - 11
Perioperative- A 42-year-old man with a body mass index (BMI) of 34 has stricturing Crohn’s and will need to undergo an ileocecectomy. He smokes a half pack of cigarettes per day. He has previously failed azathioprine and 6-mercaptopurine (6-MP), and he is currently on infliximab and a prednisone taper. What modifiable risk factor would be the most helpful to mitigate to decrease his chances of postoperative infectious complications?
- A 45-year-old man is diagnosed with sigmoid colon cancer on screening colonoscopy. Staging workup shows no evidence of metastatic disease. Which of the following combinations, in addition to standard intravenous antibiotic prophylaxis, is recommended to decrease surgical site infection after segmental colectomy?
- A 75-year-old man with hypertension, chronic obstructive pulmonary disease (COPD), chronic kidney disease, and diabetes is about to undergo an emergent open sigmoid resection for a large bowel obstruction. Which of the following measures has been shown to decrease postoperative surgical site infection (SSI)?
- Miscellaneous
- Malignancy
- An otherwise healthy 50-year-old patient reports rectal fullness and pain while sitting. On examination, the rectal mucosa is smooth; however, you can palpate a large firm mass that appears extraluminal and extends to the tip of your examining finger. Cross-sectional imaging reveals a large heterogeneous presacral mass that measures 7 cm x 10 cm. The best next step in management is
- A 56-year-old obese man with locally advanced distal rectal cancer is treated with total neoadjuvant chemoradiation therapy. His is a 45-pack-per-year smoker. Restaging reveals no sign of metastasis. Magnetic resonance imaging (MRI) rectal protocol reveals partial clinical response and flexible sigmoidsociopy that shows a 3-cm tumor involving the sphincteric complex. What is the best surgical approach in his care?
- Benign Disease
- A 56-year-old man with a remote history of uncomplicated sigmoid diverticulitis presents with pneumaturia, fecaluria, and frequent urinary tract infections. Colonoscopy showed sigmoid diverticulosis. Computed tomography (CT) of the abdomen and pelvis showed air in the bladder. Cystoscopy showed 1.5 cm defect in the bladder. The best next step in the management of this patient is
- A 29-year-old patient with prior history of a total colectomy and end ileostomy for fulminant ulcerative colitis presents with peristomal skin irritation and difficulty with leakage around the stoma. Painful, ulcerated purple nodules with violaceous borders are seen around the stoma site, as shown in the image below. Biopsy of the lesion shows neutrophil infiltration and perivascular lymphocytic infiltration and no infection. What is the best next step in management for this patient?
- A 65-year-old man who underwent a recent colostomy for fecal incontinence presents to your office with a symptomatic parastomal hernia, despite multiple appliance changes. What is the best step for definitive treatment?
- Anorectal Disease
- A 20-year-old male patient with a history of a previous incision and drainage of pilonidal abscess presents to the office with gluteal cleft pain and intermittent bleeding and drainage from several midline pits with no improvement with conservative management. He is a college student with a summer internship while at home and would like to address the problem before he goes back to school. What is the best recommendation for this patient at this time?
- A 27-year-old male patient presents for evaluation of new anal lesion 2 weeks after anal intercourse with a new male partner. The lesion is at the anal verge, round, ulcerated, and non-tender (see figure below). The optimal therapy for this patient is