Big Tubes, Small Thinking
In the management of stable trauma patients, the automatic choice of large-bore chest tubes is driven more by habit, training, and perceived safety than by proven clinical superiority. Although larger tubes cause significantly more pain, current evidence suggests smaller tubes offer comparable outcomes without increasing complications, making default maximal invasiveness unnecessary in non-emergency cases.
Straightening the Roller Coaster
Sigmoid volvulus is quite a frequent event in elderly patients. However, its management is not always clear, and sometimes acting without a clear plan may lead to avoidable complications. Here, we try to retrace the management of a frail patient presenting with a sigmoid volvulus.
The Feeling of Having Another Pit in the Stomach – Part 2
Surgery is usually required in the case of duodenal perforations. Many different surgical techniques and approaches have been described along the years... Let's analyze them...
The Feeling of Having Another Pit in the Stomach – Part 1
Duodenal perforations may happen because various possible causes, and they are encountered quite often in the life of an acute care surgeon. Knowing how to correctly manage them improve significantly the patients' outcomes.
Tug of War
The short bowel syndrome is a complex and fearsome consequence of extensive intestinal resection. In some cases, this disease becomes inevitable in order to save the life of a patient. However, it is mandatory to manage this condition in the best possible way to decrease long-term mortality and increase the quality of life of these patients.
