General Surgery

General Surgery Referral Guidelines for MAP Handbook

Scope

• Seeing referrals from MAP outpatient clinics
• Follow-up of surgical and trauma patients
• For specific questions please email
  • kellison@ascension.org (Seton Surgical Group APN)
  • juecker@ascension.org (Attending Surgeon)
  • dfielder@ascension.org (Attending Surgeon)

Brief summary of appropriate ER referrals:

• Appendicitis
• Bowel obstruction

Summary of appropriate ROUTINE referrals:

• • Abdominal mass
  • Anal fissure/abscess
  • Colon mass/tumor
  • Recurrent/refractory diverticulitis (post-acute, for elective surgical planning)
  • Gallstones/gallbladder / cholecystitis / biliary colic (please have abdominal ultrasound and LFTs)
  • GERD that is not-responsive to medical management (Dr. Uecker, 512-324-GERD)
  • Hiatal/paraesophageal hernias (with imaging/EGD diagnosis)/achalasia (Dr. Uecker, 512-324-GERD)
  • Groin hernia/mass
  • Guaiac/hemoccult positive/blood in stool (may consider referral to GI clinic)
  • Hemorrhoids (must have failed medical management)
  • Hidradenitis
  • Inguinal hernia/mass
  • Liver/hepatic mass/tumor (may consider referral to GI clinic)
  • Lymph node biopsy/lymphadenopathy (please order ultrasound imaging prior to referral)
  • Pancreatic cyst/pseudocyst/mass/tumor/nodule
  • Parathyroid hyperplasia/adenoma
  • Pilonidal cyst/abscess
  • Port-a-cath placement/removal/chemotherapy access
  • Rectal mass/tumor
  • Splenomegaly (please order imaging and labs prior to referral)
  • Stomach mass/tumor/ulcer (with EGD/imaging)
  • Thyroid cancer with tissue diagnosis/symptomatic goiters (if pt does not meet these criteria please send to endocrinology)
  • Umbilical hernia/mass
  • Ventral hernia/Incisional hernia
  • Any hospital follow-up from general / trauma surgical service

 Please do NOT refer the following patients:

• Breast Masses/Breast Disease (Refer to Cancer Care Collaborative)
• Cancer (Refer to Seton Infusion Center)
• Patient requesting cosmetic surgery evaluation
• Cystocele/Rectocele/Pelvic Prolapse (refer to Urogynecology)
• Hydrocele (refer to Urology)
• Hyperhydrosis
• Melanoma (refer to Surgical Oncology at Seton Infusion Center)
• Pediatric patients (refer to Specially for Children)
• Screening Colonoscopy
• Small lipomas, cysts, or skin lesions less than 4 cm (refer to Dermatology)
• Testicular Masses (refer to Urology)
• Vague abdominal pain
• Varicose Veins

Documentation required for scheduling an appointment:

• Past Medical History (PMH)
• Current medication list
• Most recent progress note describing condition for which patient is being referred.
• Include H&H and stool Guaiac if referring for GI bleeding
• Recent pertinent scans or imaging reports