Medicine and Health Sciences Commons^™

Successful Hepatectomy, Anhepatic State, And Liver Transplant On Ecmo, Jenna Miller, Kari L. Davidson, Bhargava Mullapudi, Richard J. Hendrickson, Ryan T. Fischer, Lisa Conley, Wes Ware, Michelle Mckain, Tara Benton

Presentations

We discuss the case of a 13-month-old previously healthy male who presented with acute liver failure (ALF) of unknown etiology. He progressed to fulminant cardiopulmonary failure requiring mechanical ventilation and high dose inotropes with persistent lactate >20. He was cannulated to VA ECMO and tandem continuous renal replacement therapy (CRRT) with single pass albumin dialysis (SPAD) and plasma exchange (PLEX) therapies. He required high dose inotropes on ECMO and had persistently elevated lactate despite maximal medical therapy. Limited imaging studies suggested cirrhotic liver and possible intestinal pneumatosis. Due to evidence of fulminant ALF and potential for a reversible process, he …

Meta-Narrative Synthesis: The Effectiveness Of Diagnosing And Treating Melanoma With Micrographically Oriented Histograph Surgery Mohs Technique, Gabriella Casas Ms, Nida Mubeen Ms, Nicole Rivera Ms, Tan Thien Tang Mr., Mark A. Bailey Mr, Mary Coolbaugh-Murphy Mrs., Denise M. Juroske Short Mrs

Research Methods Poster Session 2024

This meta-narrative synthesis highlights the effectiveness of diagnosing and treating melanoma with Micrographically Oriented Histography Surgery (MOHS) technique. Initiating the questions: What techniques does MOHS surgery involve when diagnosing and treating non-metastasized Melanoma? How will it provide positive outcomes for the patient? The significance of using MOHS excision technique and diagnosis of localized facial melanoma compared to traditional cancer excision techniques is designed to remove affected tissue while preserving anatomical facial structure in an aesthetic fashion. Providing an overview of the technique’s diagnostic professional capabilities as well as its strengths, limitations, improvement for upcoming studies, and potential prognosis. Melanoma, a …

Primary Resection Of Duodenal Neuroendocrine Tumor With Suspected Lymph Node Metastasis: A Case Report, Raleigh Payton, David Bassa, Furrukh Jabbar, Hassan Ahmed

North Texas Research Forum 2024

Introduction: Duodenal neuroendocrine carcinomas are an uncommon variant of Neuroendocrine tumors (NETs) that are typically non-functional with locoregional spread at the time of diagnosis. Management of these tumors is dependent on size, grade, stage, functional status and location. Summary: A 66-year-old male presented with an incidental finding of low grade 3 centimeter duodenal NET on esophagogastroduodenoscopy (EGD) located in the second segment of the duodenum with evidence of lymphadenopathy on staging scans. In patients with suspected lymph node metastases, the first choice for curative intent is a pancreaticoduodenectomy (PD), also known as Whipple Procedure. We achieved surgical resection with free …

Multidisciplinary Simulation-Based Trauma Education For General Surgery Interns, Jennifer Austin, April Miller, Jeremiah Avarana, Alicia Lay

North Texas Research Forum 2024

Introduction: According to the American Society of Gastroenterology Endoscopy (ASGE), choledocholithiasis is defined as the presence of gallstones in biliary tree. Choledocholithiasis is concomitantly present in approximately 1 to 10 percent of patients with cholelithiasis. Choledocholithiasis can be described as small <15 mm, large >15 mm, and difficult due to anatomic location, impaction, or unusual hardness/ shape. Choledocholithiasis is managed endoscopically with large balloon papillary dilation, cholangioscopy-guided intraductal laser and electrohydraulic lithotripsy (EHL), and escalation to laparoscopic common bile duct exploration, if endoscopic procedures fail. Thus far, there are sparse studies that show the requirement of choledochotomy in large and difficult choledocholithiasis …

Survival After Emergency Clamshell Thoracotomy With Bilateral Atrial Appendage Injuries, Jennifer Austin, Enrique Alvarez, Alicia Lay, Christian Minshall

North Texas Research Forum 2024

INTRODUCTION: The probability of survival is poor in patients who require a resuscitative thoracotomy, reported in the literature to be 9-20%. Outcomes are worse in patients who have suffered blunt trauma compared to penetrating trauma reported between 2-7%. Many studies have been done to evaluate clinical predictors of survival versus mortality. We present a case of high-mechanism blunt trauma with a high injury severity score of 34 who survived after an emergency clamshell thoracotomy with full neurological recovery. CASE PRESENTATION: This case highlights a 28-year-old male who arrived as a transfer to a level 1 trauma center following high mechanism …

Partial Anomalous Pulmonary Venous Return: To Fix Or Not To Fix?, Akshaj Pole, Jennifer Austin, Amnah Andrabi

North Texas Research Forum 2024

Patient is a 56-year-old male with a past medical history of type 2 diabetes, hypertension, prior MVA with chest trauma, and coronary artery disease with 2 prior stents in the obtuse marginal and right coronary artery who was brought to the ED for severe chest pain. Patient was immediately taken to the cath lab for cardiac intervention. Patient was identified to have 90-95% stenosis of his left circumflex but was unable to be stented due to tortuosity of the vessel and tight lesion. Due to patient’s multivessel coronary artery disease and newly diagnosed diabetes, patient was referred to cardiothoracic surgery …

Colovaginal Fistula In A Patient Without A Hysterectomy, Austin Moore, Mollie Ahn, Anthony Macaluso

North Texas Research Forum 2024

Introduction: A majority of case reports and review studies exploring the incidence of colovaginal fistulas typically involve patients of older age with a history of both a hysterectomy and at least one episode of symptomatic diverticular disease. Colovaginal fistulas rarely occur in patients who have not had a prior hysterectomy. Case Description: A 52 year old female presented to colorectal surgery clinic with a history of multiple episodes of sigmoid diverticulitis who now had passage of air and stool from her vagina. She was confirmed to have evidence of a colovaginal fistula from her sigmoid colon to her …

Analysis Of Ecmo Usage In Trauma Patients At A Major Level 1 Trauma Center, April Miller, Megan Post, Crescens Pellachia, John Bini

North Texas Research Forum 2024

INTRODUCTION: ECMO has been used for decades in patients where adequate oxygenation could not be achieved using traditional efforts. Despite its increasing use in the trauma setting, there is a lack of published data to support its use and safety. This review will seek to answer among trauma patients who receive ECMO what their common demographics, injuries, co-morbidities, outcomes and adverse events are. METHODS: This is a single-center retrospective chart review conducted at an Level 1 trauma center between 2020 and 2023. Designation as trauma and ECMO utilization were the inclusion criteria. Patients under age 18 and non-trauma ECMO patients …

Preoperative Predictors Of Arthroscopic Partial Meniscectomy Outcomes: The Apm Index Score, Natalie Lowenstein, Yuchiao Chang, Hanna Mass, Angela M. Mercurio, Chierika Ukogu, Jeffrey N. Katz, Elizabeth G. Matzkin

Alpha Omega Alpha Research Symposium Posters

Problem Statement:

- Arthroscopic partial meniscectomy (APM) has been shown to be the most common meniscal surgical treatment in the United States

- Pre-op risk factors known to contribute to poor outcomes after APM:

• Symptom duration and radiographic OA at baseline

• Baseline knee functional score, location of meniscal tear, BMI, activity level, age, sex, and chondral damage on MRI

Project AIM:

To create an index score using easily available preoperative risk factors such as Kellgren-Lawrence (KL) grade, age, duration of symptoms, BMI, activity level, and preoperative outcome scores to predict the …

Treatment Of Hyperkinetic Gallbladder With Cholecystectomy: A Case Report And Literary Review, Rachel Wright, Duyen Quach, Kayla Nguyen, Gabriella Tavera, Mike Liang

Gulf Coast Division Research Day 2024

No abstract provided.

Comparative Analysis Of Md And Do Candidates To A Surgical Residency Program, Duyen Quach, Rachel Wright, Vishal Patel, Scott Zimmerle, Brendan Rosamond, Jonathan Lall, Said Maldonado, Zuhair Ali, Rajeev Raghavan, Mike Liang

Gulf Coast Division Research Day 2024

No abstract provided.

Gallstone Illeus And Intra Operatrively Diagnosed Crohn's Disease, Joseph Daodu, Ali Siddiqui, Horeb Antonio Cano Gonzalez, Kendall Sowards

Gulf Coast Division Research Day 2024

No abstract provided.

Foreign Body Removed Through Laparotomy: A Case Report And Literature Review, Kayla Nguyen, Duyen Quach, David Ortiz, Dominique Norris, Srinivas Ramireddy, Jody Smith

Gulf Coast Division Research Day 2024

No abstract provided.

Horner’S Syndrome, A Rare Complication Of Transcarotid Artery Revascularization, Mollie Ahn, April Miller, Shonda Banegas, Edic Stephanian

North Texas Research Forum 2024

Extracranial carotid artery aneurysm is a rare sequela of atherosclerosis, trauma, and conditions of chronic inflammation. Standard treatments include antiplatelet medications, open resection, or endovascular stenting. Transcarotid artery revascularization (TCAR) has become a well-recognized alternative treatment in the past few decades. This case study documents the first reported case of Horner’s syndrome post-TCAR for an internal carotid artery (ICA) aneurysm. A 68 year-old male with intermittent double vision was referred to vascular surgery clinic with brain CT angiography showing a 9mm saccular aneurysm with dissection flap of the right cervical ICA. Prior attempts by neuro-interventional radiology were unsuccessful due to …

Implementation Of Multipronged Approach In Patients With Chest Trauma Reduces Vap And Unplanned Admission To The Icu, Julie Donnelly, Msn, Rn, Trcn, Kristen Firely, Msn, Rn, Nicole Olszewski, Bsn, Rn, Jessica Byrne, Msn, Rn-Bc, Tiffani Stanley, Cstr, Joshua A. Marks, Md, Facs, Fccm, George Koenig

Department of Surgery Posters

Problem

The incidence of pulmonary complications in trauma patients with chest trauma has been reported to be as high as 49% (Ruibel L, 2022). However, all trauma patients are at risk for developing pulmonary complications due to a multitude of factors some pre-existing while others injury related sequela. Within our institution, we observed an increase in pulmonary complications through review of our TQIP (Spring 2020) and state registry data.

Penyembuhan Luka: Aspek Seluler Dan Biomolekuler, Yefta Moenadjat

Department of Surgery Teaching Materials and Monographs

Mengulas aspek seluler dan molekuler penyembuhan luka di setiap fase, dimulai dari hemostasis, inflamasi dan resolusi inflamasi, proliferasi, dan maturasi. Pada bagian terakhir dulas pula gangguan proses penyembuhan luka (luka kronik, non–healing wound) yang kerap dijumpai di klinik.

Robotic Vs. Laparoscopic Bariatric Surgery, Chloe Aiken, Abigail Reera

Nurse Residency

Background: As OR nurses, we have seen an increase in the number of robot-assisted bariatric surgeries instead of being performed laparoscopically. In the United States, the first surgical robotic telepresence system became available in 1987. From there, IntuitiveSurgical, Inc. reworked that system to create numerous prototypes leading to the DaVinci series that we utilize at SMHC.

Clinical Practice Panel: Stand By Me: Using An Enhanced Recovery After Surgery (Eras)Checklist To Guide Early Mobility Of Postoperative Craniotomy Patients On A Progressive Care Unit, Alyssa Mooney, Jerome Codilla, Joanna Arraiza, Sohl Chapman, Nkiru Chukwudi, Ronald Rosales

2023 South Division Nursing Research Conference

No abstract provided.

Sindrom Respons Inflamasi Sistemik, Yefta Moenadjat

Department of Surgery Teaching Materials and Monographs

Materi perkuliahan memuat uraian respons inflamasi pascatrauma yang berkembang menjadi sindrom respons inflamasi sistemik, berakhir dengan kegagalan organ multipel ditinjau dari aspek biomolekuler.

Buku ini merupakan bagian pertama dari seri inflamasi yang disusun dalam bentuk digital dan dipublikasi menurut konsep lisensi Commons Attribution-NonCommercial 4.0 International License untuk tujuan diseminasi.

Conversion Total Hip Arthroplasty: Perioperative And Postoperative Outcomes With The Able Approach, Bailey Shevenell, Johanna Mackenzie, Sarah Hearns, George Babikian, Brian J. Mcgrory, Adam Rana

Costas T. Lambrew Research Retreat 2023

The ABLE™ Approach for Conversion Total Hip Arthroplasty decreases surgical duration and length of stay

Shortening The Postoperative Length Of Stay Following Total Knee Arthroplasty Does Not Negatively Impact Short-Term Patient Outcomes; A Retrospective Review Of The Response To The Covid-19 Pandemic, Bailey Shevenell, Johanna Mackenzie, Cassandra Lieblein, Brian J. Mcgrory, Michael Becker, Nicholas Colacchio, Adam Rana

Costas T. Lambrew Research Retreat 2023

Safely Decreasing Postoperative Length of Stay for Total Knee Arthroplasty (TKA) Patients Following the COVID-19 Pandemic

The Use Of The Ipack Block With The Adductor Canal Block (Acb) Decreases 48-Hour Narcotic Usage And Postoperative Pain Following Total Knee Arthroplasty, Bailey Shevenell, Johanna Mackenzie, Matthew Hersch, Michael Becker, Brian J. Mcgrory, Nicholas Colacchio, Adam Rana, Ryan Mountjoy, Rob Hubbs

Costas T. Lambrew Research Retreat 2023

Adductor Canal and iPACK Blocks reduce pain levels and narcotic consumption following Total Knee Arthroplasty

Low-Grade Adenosquamous Carcinoma Of The Breast In A Pregnant Patient: Case Report And Literature Review, David Bassa, Makenzie Morrissey, Adewuni Ojo, Adeel Raza

North Texas Research Forum 2023

Low-grade Adenosquamous Carcinoma of the Breast: Case Report and Literature Review Authors: David Bassa DO, MaKenzie Morrissey MD, Adewuni Ojo MD, Adeel Raza MD Abstract: Introduction: Low-grade adenosquamous carcinoma (LGASC) is a rare variant of metaplastic carcinomas of the breast. It is characterized by its clinical indolence and low-grade cytomorphology. Presentation is typically asymptomatic with indeterminate imaging characteristics with diagnosis dependent solely on histopathology findings. We herein describe a case of LGASC presenting in a young premenopausal female, an extremely rare occurrence. Case presentation: A 23-year-old woman presented to the breast clinic with a left breast ultrasound demonstrating a heterogeneous …

Non-Nec Pneumatosis And Pneumoperitoneum, Arham Aslam, Alexander Soutter

South Atlantic Division Research Day 2023

No abstract provided.

A Pilot Study Of A Low Cost Simulation To Teach And Assess Breast Cancer Communication And Procedural Skills, Kimberly Helseth, Alexandra Marcelli, Ena Novakovic, Natalie Laguttuta, Rachel Attebury, Darwin Ang, Joseph Love, Alene Wright, Scott Lind

South Atlantic Division Research Day 2023

No abstract provided.

Hepatitis B Virus Screening In Asian Immigrants: Community-Based Campaign To Increase Screening And Linkage To Care, Aziza Win

South Atlantic Division Research Day 2023

No abstract provided.

A Case Of Type 1 Cryoglobulinemia With Waldenstrom’S Macroglobulinemia/Lymphoplasmocytic Lymphoma And Dry Gangrene, Abhinav Rao, Diego Garrido, Fahim Syed, Kody Dhaliwal, Charles Holladay, Julia Saylors, Matthew Madden, Jason Clark

South Atlantic Division Research Day 2023

No abstract provided.

Cardiovascular Collapse And Nstemi Following Initiation Of Vancomycin Infusion, Brandon Cunningham, Kamran Khattak, Saptarshi Biswas

South Atlantic Division Research Day 2023

No abstract provided.

A Metabolic, Mechanical, Multi-Organ Masterpiece: Dural Device Support Bridge To En-Bloc Heart-Liver Transplantation In Propionic Acidemia, Rebecca Juhl, Brian Birnbaum, Aliessa P. Barnes, William Gibson, Bhargava Mullapudi, Beth Lang, Megan Faseler, Daniel E. Heble, Victoria Urban, Ryan T. Fischer, Jennifer L. Gannon, David Sutcliffe

Posters

Introduction: Propionic Acidemia (PA) is a disorder related to abnormal protein and lipid metabolism resulting in progressive neurological injury and dilated cardiomyopathy (DCM). Interventions for PA and secondary disease manifestations can require multi-organ transplantation. Herein we report the case of a child with PA and end-stage DCM requiring left ventricular assist device (LVAD) support with eventual heart-liver transplant. Case Report: A 17 year old male diagnosed in childhood with PA developed chronically progressive DCM culminating in end stage heart failure with acute decompensations. In a recurrent admission, he progressed to require dual inotropic support and systemic anticoagulation for new LV …

Parent Satisfaction With Same Day Discharge After Laparoscopic Appendectomy For Non Perforated Appendicitis, Nelimar Cruz-Centeno, James Fraser, Shai Stewart Md, Derek Marlor, Rebecca M. Rentea, Pablo Aguayo, David Juang, Richard J. Hendrickson, Charles L. Snyder, Bhargava Mullapudi, Shawn D. St.Peter, Jason D. Fraser, Tolulope A. Oyetunji

Presentations

Background: Same-day discharge (SDD) after laparoscopic appendectomy for acute non-perforated appendicitis is safe, without an increased rate of postoperative complications, emergency department visits, or re-admissions. We aimed to evaluate caregiver satisfaction with this protocol. Materials and Methods: Patients discharged on the day of laparoscopic appendectomy for non-perforated acute appendicitis were identified between January 2022-August 2022. Surveys to evaluate satisfaction with the protocol were distributed to the caregivers via e-mail or text message 96 hours after discharge. Telephone surveys were conducted if there were no responses to the initial online survey. The surveys assessed comfort with SDD, post-operative pain control adequacy, …