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Chapter 5. Postoperative Complications

All the following are true of surgical site infections except:

A. Antiseptic technique helps prevent surgical site infections.

B. Development of an intra-abdominal phlegmon is indicative of poor wound healing.

C. Surgical technique does not play a role in leading to infection.

D. Wound dehiscence is a consequence of surgical site infection.

The correct answer is C. Surgical technique does not play a role in leading to infection

A 45-year-old woman developed fever, chills, and worsening abdominal pain 7 days after a small-bowel resection for Crohn disease. She complained of persistent nausea and vomiting. Her abdomen was distended and diffusely firm with peritonitis on examination. Her vital signs are a temperature of 102.3oF, heart rate of 117 beats/min, blood pressure of 98/56 mm Hg, and respiratory rate of 23 breaths/min on 2L nasal cannula. CT of the abdomen/pelvis showed anastomotic stranding with trace free fluid. What is the next best step?

A. Take her back to the operating room.

B. Consult interventional radiology for drain placement.

C. Initial management requires a nasogastric tube placement, IV fluids, and supportive management.

D. Start empiric antibiotics.

E. Both A and D.

F. Both B and C.

G. None of the above.

The correct answer is E. Both A and D

A 74-year-old 100-kg man with rectal cancer underwent a laparoscopic low anterior resection with diverting loop ileostomy. Preoperatively, he received a regional block per ERAS protocol. Intraoperatively, he received 2-L of IV crystalloid for a 5-hour case and received multimodal pain control with Toradol and Tylenol. On postoperative day 1, 200 mL of urine was collected from his Foley catheter over 12 hours, accompanied by an elevation from his baseline creatinine. He was given 40 mL/h of crystalloid over the same time period. What is the most likely cause of his oliguria?

A. Inadequate fluid resuscitation.

B. High ileostomy output.

C. Urinary tract obstruction.

D. Low cardiac output.

E. Bladder dysfunction.

The correct answer is A. Inadequate fluid resuscitation

A 25-year-old man is 6 ...

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