Episode
Clinical Challenges in Emergency General Surgery: C Diff - When to Pull the Operative Trigger
- Published
- Jun 1, 2026
- Duration seconds
- 1952
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- https://audioboom.com/posts/8908447
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Summary
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 PD ACS & SCCM Fellowship, SICU Medical Director, Lieutenant Commander United States Navy Reserve Dr. Jeffery Coughenour FACS (Surgical Attending) – Professor of Surgery and Emergency Medicine, Trauma Medical Director at the University of Missouri SOM Dr. Kevin Bartow FACS (Surgical Attending) –Professor of Surgery, Minimally Invasive Surgeon and General Surgery. Department of General Surgery at the University of Missouri SOM Raymond Okeke – Acute Care Surgery/Surgical Critical Care Fellow, University of Missouri School of Medicine Desra Fletcher – PGY 3 General Surgery Resident, University…