General Postoperative Complications
9 results
1 - 9
Perioperative- A 53-year-old man who weighs 70 kg is taken to the operating room for an excisional hemorrhoidectomy under monitored conscious sedation and local anesthesia. What is the maximum volume of 1% lidocaine with epinephrine that should be used?
- A 52-year-old man with a body mass index of 26 kg/m2 is undergoing an elective laparoscopic sigmoid colectomy for recurrent diverticulitis tomorrow at 9:30 am. What is an indication to delay or cancel his surgery?
- A 56-year-old man undergoes a low anterior resection after neoadjuvant chemoradiation for a T3N0M0 rectal cancer located 9 cm from the anal verge. Eight days later, he presents to the emergency department with mild abdominal pain and a temperature of 102.2°F (39°C). Laboratory results are significant for a white blood cell count of 14,000/µL (14×109/L). Computed tomography of the abdomen and pelvis shows pneumoperitoneum with contrast extravasation into the pelvis. Abdominal examination shows focal peritonitis in the left lower quadrant. Intraoperative findings demonstrate a 3-mm anastomotic disruption anteriorly. In addition to abdominal washout, what is the best surgical option for this patient?
- A 42-year-old woman underwent an open right colectomy 4 days ago. Her surgery required an extensive adhesiolysis. She has mild nausea and anorexia, complaining of lower abdominal discomfort. She is tender to palpation in the bilateral lower abdominal quadrants. She has a temperature of 101.1°F (38.4°C), a heart rate of 98 beats/min, and a blood pressure of 110/50 mm Hg; her white blood cell count is 14,000/μL. The best next step in management is:
- Malignancy
- Benign Disease
- A 43-year-old morbidly obese man is undergoing a Hartmann procedure for Hinchey IV perforated diverticulitis. Two days postoperatively, the ostomy has retracted below the skin and appears purple. The patient remains afebrile and hemodynamically normal without peritonitis. Intubation of the colostomy with a test tube reveals black mucosa proximal to the fascia. What is the next step in management?
- A 53-year-old male renal transplant recipient receiving tacrolimus and prednisone presents with acute sigmoid diverticulitis with specks of free air and a 5-cm pelvic abscess which is not amenable to percutaneous drainage. His vital signs are a temperature of 102.0°F (38.9°C), heart rate 105 beats/min, blood pressure 110/80 mm Hg, and white blood cell count 18,000/µL (18109/L). The best next step in management is:
- A 45-year-old man with fibrostenotic Crohn’s disease and a 30-lb (13.6-kg) weight loss is admitted with a diagnosis of severe malnutrition. He is taken to the operating room for an ileocectomy and end ileostomy. After resumption of a regular diet, the patient experiences confusion, diplopia, and respiratory depression requiring intubation. The expected electrolyte abnormality is:
- Pelvic Floor