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General Surgery

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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