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Highlights Pancreatic pseudocysts (PP) are known sequelae of acute and chronic pancreatitis. Pseudocyst extension into the psoas muscles have been rarely described. Pancreatic pseudocyst can also masquerade as complicated diverticulitis. This is a rare case of PP successfully managed with percutaneous drainage.

Trauma patients are seen at nearly every facility with varying degree of intensity and frequency, and management of the trauma patient is reliably within the expected knowledge and scope of a perioperative intensivist. The range of clinical issues potentially seen in the trauma patient span all systems and frequently necessitate a risk benefit assessment in a systematic manner in order to optimal manage a complex patient. Keeping that in mind, there are fundamental concerns that are frequently encountered in trauma patients, and a systematic and thorough approach to this population is necessary in order to provide excellent care. This chapter is structured to provide a review of common concerns in the management of trauma and to reveal common pitfalls of trauma and disaster management that are easily testable.

Background The Focused Assessment with Sonography in Trauma (FAST) exam is an important component to the evaluation of trauma patients. With advances in technology and meeting limitations due to COVID-19, remote instruction and learning have gained popularity. We sought to determine whether remote instruction of FAST exams was feasible as sustainable surgical education and a possible alternative to traditional in-person teaching. Methods General surgery residents completed a baseline survey and skills assessment on FAST exams and were then randomized to remote or in-person instruction. The remote group participated in an instructional session with a content expert through video conference and then practiced on a simulated mannequin while the expert remotely provided feedback. The in-person group received the experience with the content expert in the room. Both groups completed a post-course survey immediately after the session and a follow-up survey and objective assessment at six-months. Results were compared with two-way analysis of variance (ANOVA). Results 14 residents underwent the curriculum, seven in each group. There was a significant increase in self-reported confidence when comparing pre- and immediate post-course results for both the remote and in-person groups. At six months, confidence scores remained elevated and skill assessment scores improved, although the latter did not reach significance. There was no significant difference in post-course results between the groups. Conclusions Remote instruction of FAST exams was feasible. Pilot data demonstrated an increase in confidence and suggest outcomes that are similar to in-person instruction, which has positive implications for future remote educational and potentially clinical initiatives.