Clinical Challenges in Emergency General Surgery: C Diff - When to Pull the Operative Trigger

About this episode

The episode discusses the critical decision-making process in emergency general surgery regarding fulminant Clostridioides difficile infection and when to opt for surgical intervention.

It’s hospital day five. The patient looked better yesterday… but now she’s hypotensive, on vasopressors, acidotic, and spiraling toward multi-organ failure. The CT scan doesn’t show perforation or megacolon, but your gut tells you this is going south. Do you keep pushing medical therapy… or is it time to operate? Join Drs. Rushabh Dev, Jeffrey Coughenour, Kevin Bartow, Raymond Okeke, and Desra Fletcher from the Emergency General Surgery team in Tiger Country at Mizzou as they tackle one of the deadliest and most challenging diseases acute care surgeons face: fulminant Clostridioides difficile infection . In this Clinical Challenges episode, the panel discusses diagnostic stewardship, ASCRS recommendations, timing of operative intervention and technique, subtotal colectomy versus diverting loop ileostomy with lavage, and physiology that should push surgeons toward definitive source control. Through a real-world high-risk case vignette, the team explores the hardest question in emergency general surgery: when to stop hoping medical therapy will work and pull the operative trigger. Hosts Dr. Rushabh Dev FACS (Moderator, Surgical Attending) – Assistant Professor of Surgery, Associate…

People in this episode

Hosts: Dr. Rushabh Dev, Dr. Jeffrey Coughenour, Dr. Kevin Bartow

Topics covered

• emergency general surgery
• Clostridioides difficile infection
• operative intervention
• diagnostic stewardship
• surgical techniques
• multi-organ failure

Keywords

• C Diff
• surgery
• vasopressors
• multi-organ failure
• subtotal colectomy
• diverting loop ileostomy
• diagnostic stewardship

Mentioned in this episode

Organizations: University of Missouri SOM, United States Navy Reserve

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