We present a 36-year-old woman, BMI 19, with a history of deep vein thrombosis (on Apixaban), rheumatoid arthritis and Crohn’s disease status post previous left hemicolectomy,11 years ago and completion proctocolectomy with end ileostomy ,10 years ago Furthermore, the patient was dependent on total parenteral nutrition given chronic entero-vaginal and enterocutaneous fistulas. The patient was admitted with evidence of a pelvis abscess, surgical intervention was deemed necessary. An exploratory laparotomy with small bowel resection, fistula takedown with an entero-entero anastomosis was performed. The post-operative course was complicated by a pelvic enteric leak, resulting in another exploratory laparotomy, small bowel resection with double barrel jejunostomy. Intra-abdominal wound cultures revealed Vancomycin-Resistant Enterococci and Enterobacter cloacae, hence Meropenem and Daptomycin were initiated.

My greatest fear is having a case I was involved in presented at M&M. Like the inevitability of a wet tap, I could not avoid the experience, but I still find myself wondering what exactly happened to this patient. 

The Seraph® 100 Microbind® Affinity Blood Filter (Seraph 100) is a single-use extracorporeal broad-spectrum sorbent hemoperfusion device authorized by FDA under Emergency Use Authorization (EUA) for multi-organ failure in COVID-19. According to recent studies, the filter has been shown to decrease morbidity, mortality, and intensive care unit (ICU) length of stay (LOS) in both adult and pediatric populations and has mainly been assessed for its efficacy in the management of COVID-19.

Introduction

This case report describes a young man who developed a tracheal-esophageal fistula (TEF) from endotracheal intubation with prolonged elevated cuff pressure after a traumatic fall. This case report describes the intra-operative management of profound hypoxia, shedding light on crucial pre-operative indicators that could serve as vital cues to prevent the occurrence of this potentially serious complication.

Introduction:

Acute right ventricular failure (RVF) due to post-left ventricular assist device (LVAD) placement is challenging to treat with the management often limited to placement of either surgical or percutaneous mechanical circulatory devices. The Protek Duo® (LivaNova) is a percutaneous right ventricular support device (RVAD), which due to its relative ease of placement, has been a breakthrough in the management of post-LVAD implantation acute RVF. ¹

Cardiac perforation from placement of a Protek Duo cannula is a rare but potentially lethal complication. This case is the first to describe a patient who developed cardiac tamponade from a Protek Duo cannula perforation of the right ventricle. The report discusses preoperative and intraoperative management of this condition and relevant transesophageal echocardiography (TEE) imaging that aided in the diagnosis and surgical repair of the perforation.

Introduction

Hemorrhage from or around a tracheostomy is a relatively common and possibly life-threatening complication. Complications from a tracheostomy can be early or late and can be related to the placement of the tube, prolonged time duration of tracheostomy tube requirement, or abnormal healing at the surgical site. Tracheo-arterial fistulas represent a rare but often lethal complication from tracheostomies. This case report describes a patient who developed a fistula between a mature tracheostomy site and the innominate artery. The report discusses important practical considerations for preoperative and intraoperative management of this condition and describes the most common risk factors, diagnostic approach, and surgical technique.

Loss of domain is a situation in which the majority of the viscera are outside of the abdominal wall, as may occur with large hernias. In this report, we discuss the surgical approach to repair of the abdominal wall and reduction of the abdominal viscera, and we highlight the significant anesthetic challenges associated with these repairs.

Bedside percutaneous tracheostomy is a common, well-tolerated bedside procedure for critically-ill patients with prolonged respiratory failure. In this report, we present an uncommon and potentially dangerous complication of this procedure.