ABCRS case studies
ABCRS · Put your knowledge to work in context.
The American Board of Colon and Rectal Surgery (ABCRS) certifying examination is the assessment through which surgeons who have completed an accredited colon and rectal surgery residency or fellowship demonstrate that they can practice independently as specialists. It follows the qualifying examination and is the final step toward board certification in the specialty. The ABCRS case studies are 8 cases and about 3,038 words.
1The 62-Year-Old with an 8 cm Sigmoid Mass and a Stented Left Colon
A 62-year-old man presents with a 3-day history of colicky left-sided abdominal pain and distension. CT shows an obstructing 8 cm sigmoid mass with proximal colonic dilation to 9 cm and no free air.
466 words, about 2 min2Acute Severe Colitis Failing First-Line Steroids at 72 Hours
A 28-year-old woman with a 4-year history of pan-ulcerative colitis presents with 9 bloody stools per day, temperature 38.4°C, heart rate 112, hemoglobin 8.9 g/dL, CRP 68 mg/L, and albumin 2.6 g/dL. Flexible sigmoidoscopy shows deep ulcers and loss of vascular pattern to the splenic flexure; biopsies show no CMV inclusions but she is on no antivirals.
453 words, about 2 min3The Recurrent Fistula-in-Ano with Incontinence Concerns
A 44-year-old woman with a 2-year history of recurrent perianal sepsis has had two prior incision and drainage procedures. She now has a chronic discharging tract at the posterior midline with induration extending toward the coccyx.
397 words, about 2 min4Postpartum Fecal Incontinence After a Fourth-Degree Tear
A 31-year-old woman, 9 months postpartum after a forceps delivery complicated by a fourth-degree perineal tear repaired in the delivery room, reports daily urgency and incontinence to liquid stool, worse with coughing. She has had one prior vaginal delivery and wants more children.
420 words, about 2 min5Damage-Control Laparotomy in a Hypotensive Patient with a Gunshot Wound
A 24-year-old man arrives after a gunshot wound to the left lower quadrant. He is tachycardic at 128, systolic BP 84, and unresponsive to 1 L crystalloid.
336 words, about 2 min6ERAS Protocol Conflict in an Elderly Patient on Anticoagulation
A 78-year-old woman on apixaban for atrial fibrillation is scheduled for elective right hemicolectomy for a T2 cecal cancer. She lives alone, has mild cognitive impairment, and a CHA2DS2-VASc score of 5.
325 words, about 2 min7Robotic Low Anterior Resection in a Narrow Male Pelvis
A 58-year-old obese man (BMI 36) with a mid-rectal T2N0 adenocarcinoma after neoadjuvant chemoradiation has a narrow, deep pelvis on MRI. The surgeon is deciding between laparoscopic and robotic low anterior resection.
296 words, about 1 min8A Colleague's Intraoperative Error and the Pressure to Stay Quiet
During a laparoscopic cholecystectomy, a resident under your supervision makes a small but unrecognized bile duct injury that you notice on the final cholangiogram. The attending of record is a senior partner who is rushing to finish and suggests 'we'll watch it, no need to document it fully.' The patient is stable.
345 words, about 2 min