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Annals of the Royal College of Surgeons of England

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https://www.readbyqxmd.com/read/28300422/an-oral-lesion-as-the-primary-clinical-manifestation-of-sarcoidosis
#1
I Gill, J Siddiqi
An oral lesion as the first clinical presentation of sarcoidosis is extremely rare. We present the case of a 39-year-old woman who was referred to the oral and maxillofacial surgery department with a persistent asymptomatic nodular lesion in the hard palate. This was located adjacent to a grossly carious upper first molar and a provisional diagnosis of chronic periapical granuloma was made. An incisional biopsy of the lesion was carried out, which unexpectedly revealed the presence of a non-caseating granulomatous inflammatory reaction...
March 16, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28071951/spontaneous-extrusion-of-gallstones-after-percutaneous-drainage
#2
D Hariharan, D N Lobo
There have been reports of late discharge of gallstones through operative wounds after spillage into the peritoneal cavity during laparoscopic cholecystectomy and after the development of spontaneous cholecystocutaneous fistulae. However, spontaneous discharge of gallstones from the tract of a percutaneous cholecystostomy or percutaneous drainage of a perforated gall bladder has not, to the best of our knowledge, been reported previously. We report a case in which a patient who had a percutaneous drain inserted for a perforated gall bladder discharged 34 gallstones from the tract after removal of the 7-F pigtail catheter...
January 10, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28071949/lateral-thyroid-cartilage-thyrotomy-approach-to-an-embedded-paraglottic-fishbone
#3
H T Wong, S Y Tham, K Elangkumaran, Wsj Ng, K J Sia
Fishbones are of particular interest to otolaryngologists. Most fishbones can be removed transorally or via endoscopic guidance. Transcervical neck exploration is occasionally necessary, especially in cases of an embedded foreign body. Computed tomography is the most sensitive and specific imaging modality for identifying embedded fishbones. To our knowledge, this is the first reported case of a laryngeal foreign body embedded in the paraglottic space that was removed using an open approach via a lateral thyroid cartilage window...
January 10, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28071948/current-practice-of-antibiotic-prophylaxis-during-elective-laparoscopic-cholecystectomy
#4
Caw Macano, E A Griffiths, R S Vohra
INTRODUCTION Current guidelines do not recommend antibiotic prophylaxis in elective laparoscopic cholecystectomy. Despite this, there is wide variation in antibiotic prophylaxis during cholecystectomy in population-based studies. The aim of this survey was to establish the current rationale for antibiotic prophylaxis in elective laparoscopic cholecystectomy. METHODS A short questionnaire was designed and disseminated across collaborators for a population-based study investigating outcomes following cholecystectomy and via the Association of Upper Gastrointestinal Surgeons, Researchgate and Surginet membership...
January 10, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28071947/presacral-abscess-as-a-rare-complication-of-sacral-nerve-stimulator-implantation
#5
A Gumber, S Ayyar, H Varia, S Pettit
A 50-year-old man with intractable anal pain attributed to proctalgia fugax underwent insertion of a sacral nerve stimulator via the right S3 vertebral foramen for pain control with good symptomatic relief. Thirteen months later, he presented with signs of sepsis. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a large presacral abscess. MRI demonstrated increased enhancement along the pathway of the stimulator electrode, indicating that the abscess was caused by infection introduced at the time of sacral nerve stimulator placement...
January 10, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28252352/fundoplication-for-laryngopharyngeal-reflux-despite-preoperative-dysphagia
#6
G L Falk, H Van der Wall, L Burton, M G Falk, H O'Donnell, S J Vivian
INTRODUCTION Fundoplication for laryngopharyngeal disease with oesophageal dysmotility has led to mixed outcomes. In the presence of preoperative dysphagia and oesophageal dysmotility, this procedure has engendered concern in certain regards. METHODS This paper describes a consecutive series of laryngopharyngeal reflux (LPR) patients with a high frequency of dysmotility. Patients were selected for surgery with 24-hour dual channel pH monitoring, oesophageal manometry and standardised reflux scintigraphy. RESULTS Following careful patient selection, 33 patients underwent fundoplication by laparoscopy...
March 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28252351/patellar-reconstruction-following-previous-patellectomy-a-review-of-the-literature-and-a-case-series-using-distal-femoral-autograft-during-total-knee-arthroplasty
#7
D A George, A Dosani, R Morgan-Jones
During total knee arthroplasty, the reconstruction of the patella following a previous patellectomy is challenging, and is undertaken to improve functional outcomes and patient satisfaction. In this case series, we have reconstructed the patella using a femoral condyle resected during total knee arthroplasty. The resected femoral condyle with best available bone stock is selected and secured to the extensor mechanism. We reviewed the preoperative indications and postoperative outcomes of two patients who underwent the above procedure at our Institute, and compared this to the literature...
March 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28252350/an-alternative-technique-for-optimal-exposure-of-the-pericardium-in-cardiac-surgery
#8
M N Acharya, S Garg, M Husain, S K Bhudia
No abstract text is available yet for this article.
March 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28252349/a-late-presentation-of-loeys-dietz-syndrome-associated-with-an-aortic-root-aneurysm
#9
A Harky, M Garner, N Roberts
Loeys-Dietz syndrome (LDS) is characterised by a mutation in the transforming growth factor beta receptor, and is strongly associated with aortic aneurysms and rupture. Most cases of LDS present in the second decade of life, with the average life expectancy being 37 years. We report a case of suspected LDS (owing to significant family history of the disorder) that presented in the seventh decade of life. Our patient had aortic root dilation and was initially believed to have Marfan syndrome. However, subsequent tests were negative...
March 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28252348/an-unusual-haemorrhagic-complication-of-an-anastomotic-leak-and-a-novel-method-of-controlling-the-haemorrhage
#10
S Martin, A Armstrong
Introduction Restorative proctocolectomy (RP) is undertaken for patients with familial adenomatous polyposis (FAP) and ulcerative colitis, but is associated with a risk of anastomotic leak. Case history A 20-year-old male with a family history of FAP had a RP with a double-stapled J-pouch and covering loop ileostomy. At ileostomy reversal 21 months later, he presented with significant anal bleeding. He proceeded to theatre for endoscopy. Pouchoscopy showed a pouch full of blood and a foreign object trapped in a diverticulum...
March 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28252347/an-unusual-cause-of-tonsillar-asymmetry
#11
D Karamchandani, S K El-Shunnar, J M Fussey, S F Ahsan, S Bhatia
We present the first reported case of tonsillar asymmetry secondary to a mandibular osteoma. Computed tomography rather than tonsillectomy for histology prevented the distress and risk of unnecessary surgery, and the patient was managed conservatively.
March 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28252346/lymphangioma-of-the-jejunal-mesentery-and-jejunal-polyps-presenting-as-an-acute-abdomen-in-a-teenager
#12
Jasb Jayasundara, E Perera, M V Chandu de Silva, A A Pathirana
Cystic lymphangioma of the small bowel mesentery is a rare clinical entity, especially after childhood. Medical literature reveals a limited number of such cases presenting as acute abdomen due to bowel obstruction, small bowel volvulus and bleeding into the tumour. We present the management experience of an 18-year-old woman who presented with rapid onset diffuse peritonism and raised inflammatory markers. Computed tomography showed a mass in the small bowel mesentery with suspicion of segmental bowel ischaemia...
March 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27659373/complications-of-biliary-enteric-anastomoses
#13
R S Kadaba, K A Bowers, S Khorsandi, R R Hutchins, A T Abraham, S-J Sarker, S Bhattacharya, H M Kocher
INTRODUCTION Biliary-enteric anastomoses are performed for a range of indications and may result in early and late complications. The aim of this study was to assess the risk factors and management of anastomotic leak and stricture following biliary-enteric anastomosis. METHODS A retrospective analysis of the medical records of patients who underwent biliary-enteric anastomoses in a tertiary referral centre between 2000 and 2010 was performed. RESULTS Four hundred and sixty-two biliary-enteric anastomoses were performed...
March 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28145779/scan-directed-mini-incision-focused-parathyroidectomy-how-accurate-is-accurate-enough
#14
I M Shapey, S Jabbar, Z Khan, J E Nicholson, R J Watson
INTRODUCTION Mini-incision focused parathyroidectomy (MI-FP) is advocated as an alternative to bilateral neck exploration (BNE), owing to its reduced morbidity. The site and side of the affected gland is identified preoperatively using a combination of ultrasound and sestamibi scans. However, the acceptable degree of inter-scan concordance required to prompt MI-FP without compromising accuracy is undetermined. METHODS Accuracy of preoperative imaging was determined both individually and in combination for all parathyroidectomies (2007-2014)...
February 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28145777/liver-abscess-secondary-to-an-endoscopic-tattoo-in-the-colon
#15
Y M Aawsaj, S Kelly, B Slater
Introduction Endoscopic tattooing of colonic lesions has been used safely for their localization. CASE HISTORY We report a 61-year-old female who had left hemicolectomy in 2006 for adenocarcinoma of the left colon (pT3, pN0, M0). Cancer in the transverse colon was discovered during annual colonoscopy surveillance. The lesion was tattooed 5cm proximal to the lesion. Twenty-four days after tattooing, she was admitted to the emergency department with increased levels of inflammatory markers. CT showed an abscess in the left lobe of the liver adjacent to the tattoo site...
February 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28071952/the-decline-of-elective-operating-at-major-trauma-centres
#16
A Memarzadeh, H Taki, E K Tissingh, P Hull
INTRODUCTION Major trauma is a leading cause of death in those aged under 40 years. In order to improve the care for multiply injured patients, the major trauma network was activated in April 2012 in England. Its goal was to link all district hospitals to major trauma centres (MTCs) and allow for rapid transfer of patients. Anecdotally, this has affected elective orthopaedic operating at MTCs. The aim of this study was to compare the number of lower limb arthroplasty procedures performed before and after the establishment of the trauma network...
February 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28071950/reporting-individual-surgeon-outcomes-does-not-lead-to-risk-aversion-in-abdominal-aortic-aneurysm-surgery
#17
A Saratzis, A Thatcher, M F Bath, D A Sidloff, M J Bown, J Shakespeare, R D Sayers, C Imray
INTRODUCTION Reporting surgeons' outcomes has recently been introduced in the UK. This has the potential to result in surgeons becoming risk averse. The aim of this study was to investigate whether reporting outcomes for abdominal aortic aneurysm (AAA) surgery impacts on the number and risk profile (level of fitness) of patients offered elective treatment. METHODS Publically available National Vascular Registry data were used to compare the number of AAAs treated in those centres across the UK that reported outcomes for the periods 2008-2012, 2009-2013 and 2010-2014...
February 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28052686/henoch-sch%C3%A3-nlein-purpura-as-a-rare-cause-of-an-acute-abdomen
#18
M Davies, M Nanda Kumar, V Shetty, P Mitchell
A 52-year-old man presented with a purpuric rash affecting his legs and hypertension. He was diagnosed with Henoch-Schönlein purpura and discharged with non-steroidal anti-inflammatory drugs. Three weeks later, he presented again with loss of appetite and vomiting before developing abdominal pain with pyrexia of 38.5°C and rigors. On examination, he was hypotensive with a distended abdomen and a national early warning score of 6. Computed tomography revealed enteropathy of Henoch-Schönlein purpura. The patient deteriorated and went for an emergency laparotomy, where 30cm of ischaemic small bowel was resected...
February 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27917670/neuroendocrine-tumour-arising-inside-a-tailgut-cyst
#19
I Mora-Guzmán, A Alonso-Casado, A Rodríguez Sánchez, E Bermejo Marcos
Tailgut cysts are rare benign retrorectal cysts arising from persistent remnants of an embryonic hindgut. Malignant transformation inside this lesion is very uncommon and occurrence of neuroendocrine tumours in this context is extremely rare. We report the case of a 56-year-old woman who underwent surgical excision of a presacral tailgut cyst, which was found incidentally to include a neuroendocrine tumour.
February 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27917667/prophylactic-antibiotics-in-acute-pancreatitis-endless-debate
#20
M M Mourad, Rpt Evans, V Kalidindi, R Navaratnam, L Dvorkin, S R Bramhall
INTRODUCTION The development of pancreatic infection is associated with the development of a deteriorating disease with subsequent high morbidity and mortality. There is agreement that in mild pancreatitis there is no need to use antibiotics; in severe pancreatitis it would appear to be a logical choice to use antibiotics to prevent secondary pancreatic infection and decrease associated mortality. MATERIALS AND METHODS A non-systematic review of current evidence, meta-analyses and randomized controlled trials was conducted to assess the role of prophylactic antibiotics in acute pancreatitis and whether it might improve morbidity and mortality in pancreatitis...
February 2017: Annals of the Royal College of Surgeons of England
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