Emergency General Surgery has become a cornerstone of Acute Care Surgery over the past decade. Once the scope of community general surgeons, the growing complexity of patients with acute surgical diseases has increasingly driven their care to tertiary referral centers. The aging population confounds this problem further as these patients present with more complex comorbidities, life-threatening physiology, and progressively severe anatomic disease severity. To ensure better outcomes, the practice has evolved to focus on evidence-based practice management guidelines in order to standardize care and optimize outcomes.
The purpose of this text is to be a comprehensive volume for patients with acute surgical diseases. There will be three sections, each comprised of multiple chapters. The first section will be a comprehensive analysis of the background of Emergency General Surgery. The goal of this section will be to provide the reader background into the acute surgical practice and to introduce the reader to the important concepts discussed in the remainder of the textbook.
The second section will be the largest and will discuss specific acute surgical diseases. Individual chapters will outline the diagnostic approach, current treatment standards, operative approaches, and expected outcomes with an emphasis on practice management guideline implementation into practice. As acute surgical diseases and surgical critical care are integral to each other, the last section will be Critical Care for the Acute Care Surgeon. These topics will focus on the critical care concepts essential to surgeons who care for acute diseases.
This comprehensive text is targeted to any surgeon who takes emergency call for any of the listed diseases including community and referral general and vascular surgeons. In addition, this would be an excellent resource for all general surgery residents. Lastly, this would also serve as a resource to intensivists who care for acute surgical patients.
History and Evolution of Emergency General Surgery.- Examination of the Acute Abdomen.- Development of the AAST Disease Severity Stratification System.- Infectious Disease Considerations.- Primer on Practice Management Guidelines.- Concepts in Emergency Research (Exception from Informed Consent).- Inter-hospital Transfers of Emergency General Surgery Patients.- Emergency General Surgery as a Team Sport.- Small Bowel Obstruction.- Large Bowel Obstruction.- Abdominal Wall Hernias.- Acute Cholecystitis.- Appendicitis.- Acute Colonic Diverticulitis.- Intestinal Ischemia.- Perforated Peptic Ulcer.- Gastrointestinal Hemorrhage.- Complications of Acute Pancreatitis.- Acute and Chronic Enterocutaneous Fistula Management.- Soft Tissue Infection.- Perirectal Abscess.- Sepsis Resuscitation.- Hemorrhage Resuscitation.- Ventilator Management.- Nutrition Considerations.- Geriatrics and End of Life Care.
Dr. Martin Zielinski is the Chief of Trauma and Acute Care Surgery at Baylor College of Medicine in Houston, Texas. After a successful Division I NCAA college swimming career, he stayed at the University of Minnesota for medical school. Upon graduation, he moved 90 miles south to Rochester, MN with his wife, Dr. Lorenz, where they began their respective intern years in surgery and medicine at Mayo Clinic. He stayed in Rochester for next 18 years including surgery residency and surgical critical care fellowship training and as an attending surgeon in the Division of Trauma, Critical Care, and General Surgery. After 12 rewarding years, ultimately becoming Professor of Surgery, he and his family moved south to pursue challenging opportunities within the Texas Medical Center at Ben Taub, Baylor St. Lukes, and the Michael E. DeBakey VA Medical Center hospitals.
Dr. Oscar D. Guillamondegui is the chief of the division of Acute Care Surgery at Vanderbilt University Medical Center. His General Surgery training occurred at Oklahoma University Medical Center. After completing his fellowship in Trauma and Surgical Critical Care at UPenn he moved to Nashville, Tennessee to join the trauma team at VUMC. His entire career has developed through the Vanderbilt system, including completing a Master in Public Health at Vanderbilt and directing the critical care program at the Nashville VA for several years. Focusing on patient outcomes in every aspect of acute care surgery, his particular areas of interest are the long term results of small bowel obstruction and traumatic brain injury.
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