NASHVILLE, TN – A general surgeon at Vanderbilt University, Dr. James Cavalier, has successfully removed an inflamed and perforated appendix from his copy of Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice (18th Edition). His textbook is currently in stable condition.
“I was flipping through the textbook, but realized it was looking acutely ill,” explained Cavalier, relieved that the laparoscopic appendectomy went smoothly. “It had impressive tenderness in the right lower quadrant with rebound and guarding, so I knew something was wrong.”
With the help of Radiology, several critically-ill patients were bumped from the queue so Sabiston could get a stat CT, which ultimately revealed a contained perforation, confirming initial suspicions. The textbook’s vital signs were becoming unstable, forcing Cavalier to make a decision.
“It was becoming septic,” he said. “I had no choice but to go in there and remove the appendix.” Thanks to the help of Hospital Medicine, the textbook was immediately cleared for surgery. With the exception of a few adhesions due mostly to ketchup stains, the operation went without a hitch.
Cavalier is both relieved and saddened by today’s events.
“I’m relieved because I get to keep my current copy of Sabiston, which I love, instead of ordering another one off of Amazon,” he explained. “But I’m sad because it doesn’t have an appendix now. It was a great appendix. One of the great joys of a textbook and in particular this textbook was reading all the additional information contained in the appendix. But let’s be real: all that appendix contained now was a giant phlegmon. That wouldn’t be fun to read.”
Pathology confirmed that most of the pages in the appendix had a hole in it, even a few tears. There was also a lot of purulent material.
Sabiston is expected to be extubated later today. By tomorrow, Cavalier hopes to remove the Foley, start incentive spirometry, and encourage Sabiston to walk several laps around the floor so it doesn’t catch a blood clot.
“Hopefully it doesn’t need placement,” added Cavalier.