- 2019 ASCRS Practice Guidelines Update. See Table 9 for further details.
- Recent advances in multimodality treatment of appendiceal neoplasm with peritoneal involvement including surgery and intraperitoneal chemotherapy.
- Current trends in intraperitoneal chemotherapy: hyperthermic intraperitoneal chemotherapy (HIPEC) versus early postoperative intraperitoneal chemotherapy (EPIC).
- Recent advances in understanding low-grade appendiceal neoplasm and the focus of current and future clinical trials.
Latest Updates
Pediatric Abdominal Emergencies
- Pediatric surgical emergencies occur at characteristic ages, and emergency physicians need to be aware of this on presentation.
- Diagnosis of incarcerated inguinal hernia is a clinical diagnosis.
- Ultrasonography is the initial imaging modality of choice for midgut volvulus, pyloric stenosis, intussusception, and appendicitis.
- Hydrostatic and pneumatic enema is the therapeutic method of choice for reduction of ileocolic intussusception.
- In children with suspected appendicitis, the application of a staged algorithm, including a scoring system and ultrasonography, can improve test characteristics.
Pediatric Abdominal Emergencies
- Pediatric surgical emergencies occur at characteristic ages, and emergency physicians need to be aware of this on presentation.
- Diagnosis of incarcerated inguinal hernia is a clinical diagnosis.
- Ultrasonography is the initial imaging modality of choice for midgut volvulus, pyloric stenosis, intussusception, and appendicitis.
- Hydrostatic and pneumatic enema is the therapeutic method of choice for reduction of ileocolic intussusception.
- In children with suspected appendicitis, the application of a staged algorithm, including a scoring system and ultrasonography, can improve test characteristics.
Pediatric Abdominal Emergencies
- Pediatric surgical emergencies occur at characteristic ages, and emergency physicians need to be aware of this on presentation.
- Diagnosis of incarcerated inguinal hernia is a clinical diagnosis.
- Ultrasonography is the initial imaging modality of choice for midgut volvulus, pyloric stenosis, intussusception, and appendicitis.
- Hydrostatic and pneumatic enema is the therapeutic method of choice for reduction of ileocolic intussusception.
- In children with suspected appendicitis, the application of a staged algorithm, including a scoring system and ultrasonography, can improve test characteristics.
Psychiatric Diseases in Pregnancy
- In March 2019, the U.S. Food and Drug Administration approved Zulresso (Brexanolone) injection for intravenous (IV) use for the treatment of postpartum depression (PPD) in adult women. This is the first drug approved by the FDA specifically for treatment of PPD and is currently available only under a restricted distribution program due to concerns about serious risks including excessive sedation or sudden loss of consciousness during administration. Specific restrictions and requirements are planned to be detailed on the medication’s associated black box warning label.
- All women should be screened multiple times during pregnancy and in the postpartum period for depression, regardless of their risk factors or medical history. Many tools such as the Edinburgh Postnatal Depression Scale form are available to assist in screening.
- When considering intrapartum pain management in women with opioid use disorder, it is important to avoid drugs with an opioid antagonist component, such as nalbuphine, as this can precipitate withdrawal symptoms. Use of other medications such as NSAIDs can reduce the amount of opioids required.
- The effect of marijuana use in pregnancy is unclear, as studies are confounded due to co-existing mental health disorders, socioeconomic status, parental education, and cigarette smoking. Despite these limitations, several studies have demonstrated an association with preterm labor, low birth weight, NICU admission, and stillbirth. As with any drug of abuse, abstinence during pregnancy should be encouraged.
Approach to the Patient with Shock
- New Sepsis-3 criteria for evaluating sepsis and septic shock using the SOFA score (replacing the previous SIRS score).
- FAST and EFAST examination to determine causes of shock in trauma patients.
- Intra-aortic balloon pump placement for assist in cases of cardiogenic shock.
Approach to the Patient with Shock
- New Sepsis-3 criteria for evaluating sepsis and septic shock using the SOFA score (replacing the previous SIRS score).
- FAST and EFAST examination to determine causes of shock in trauma patients.
- Intra-aortic balloon pump placement for assist in cases of cardiogenic shock.
Approach to the Patient with Shock
- New Sepsis-3 criteria for evaluating sepsis and septic shock using the SOFA score (replacing the previous SIRS score).
- FAST and EFAST examination to determine causes of shock in trauma patients.
- Intra-aortic balloon pump placement for assist in cases of cardiogenic shock.
