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EPIDEMIOLOGY Increasing diabetes mellitus by 38% since 2004. Financial burden of foot ulcer is approximately $20,000 dollars within 2 years of diagnosis and lifetime cost of an amputation is approximately $50,000. PATHOPHYSIOLOGY - Direct bacterial invasion from skin ulcer break in the skin barrier - Oxidative stress, poor nutrition, impaired neutrophil function, ischemia from vascular insufficiency - Peripheral neuropathy leads to risk of developing foot ulcers. Sensory neuropathy leads to loss of protective sensation. Motor neuropathy leads to deformities that leading developing pressure points. Autonomic ...

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Abdominal adhesions are pathological bands of scar tissue that forms between two previously separated structures within an abdomen. They may be between omentum, abdominal wall or intestinal loops. ETIOLOGY - Congenital or Acquired - Iotragenic; trauma, surgery or postinflammatory RISK FACTORS - Emergent surgeries - Lower GI procedures - H/o abdominal abscess, surgery or trauma CLINICAL FINDINGS - Crampy abdominal pain - Nausea and/or vomiting - Minimal to no flatus - Borborygmi (loud bowel sounds) - Abdominal distention and tenderness - Vitals: fever, tachycardia - Peritoneal signs; guarding, rebound and rigidity INVESTIGATIONS - WBC, Lactate, Electrolytes, BUN/Cr - ...

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