This study analyses the trends in inguinal hernia repairs (IHRs) rates in Australia over a 15‐year period. Population data revealed decreasing IHR rates per 100 000 population, with an increase in laparoscopic surgery and a subsequent decline in open IHRs. Abstract Background An inguinal hernia is one of the most common surgical pathologies, and therefore the repair of an inguinal hernia is one of the most common general surgical procedures. The aim of this study was to assess the trend...
Fri Jul 31, 2020 22:52
By comparing reversed hypothyroid patients with euthyroid patients, we found well‐controlled overt hypothyroidism did not increase the risk of total knee arthroplasty (TKA), except for perioperative blood loss. Surgeons should be aware that even if hypothyroidism is reversed, the risk of more perioperative blood loss still exists and consequently, perioperative blood management is still essential in this population. Abstract Background Overt hypothyroidism is widely accepted as a risk...
Fri Jul 31, 2020 22:49
This is the first large series of patients undergoing MIVAT from Singapore. We present our learning experience, results and cosmetic satisfaction in Asian patients. Abstract Background Minimally invasive video‐assisted thyroidectomy (MIVAT) although well established in Europe has not yet gained widespread acceptance in Asia. We describe our learning experience in the first reported series of 105 cases from Singapore. Methods A retrospective analysis of outcomes in 105 patients...
Fri Jul 31, 2020 22:44
Bedside ultrasound performed by surgical registrars and emergency medicine physicians is accurate for finding the presence or absence of gallstones, but less so for an imaging diagnosis of acute cholecystitis. This has the potential to improve the efficiency of surgical assessment of patients. Abstract Background Acute gallstone disease, primarily biliary colic and acute cholecystitis, represents a significant burden on surgical services. Prolonged waiting times for ultrasonography to...
Fri Jul 31, 2020 22:43
Magnetic resonance enterography (MRE) has become the mainstay imaging modality for assessing patients with small bowel Crohn's disease. Understanding the clinical indications for ordering MRE in these patients is important in guiding clinician decision‐making. This study highlights the current utilization and radiological findings of MRE in Crohn's disease at a quaternary inflammatory bowel disease centre, particularly in surveillance patients. Abstract Background Magnetic resonance...
Fri Jul 31, 2020 22:34
The aim of this study was to summarize the evidence available on abdominal actinomycosis (AA). A systematic review was conducted. After scrutinizing titles and abstracts, checking duplications and in‐depth analysis of the studies selected, 221 articles including 406 subjects with AA were included. The abdominal structures usually involved were abdominal wall, colon and appendix, with the most common presentations being abdominal mass (39.2%) or suspected malignancy (18.9%). Evidence about AA is...
Thu Jul 30, 2020 12:40
This is a large, contemporary, Australian study of the recurrence rates in stage I–III rectal cancer. Recurrence occurred in 24.2%, being predominantly distant, and independent associated with higher grade, stage and distal tumour location. Abstract Background As treatments for rectal cancer improve with developments in surgical techniques, radiotherapy and chemotherapy, the nature of recurrences are evolving. We used a comprehensive database of a large Australian population with stage...
Thu Jul 30, 2020 12:35
This study evaluated hip fracture transfer times, delays to definitive surgery affecting mortality and the negative impact of patient transfer on outcomes. Abstract Background Transfer time for patients with fractured hips is a significant problem in Australia. Current guidelines support operative management of hip fractures within 48 h with delays to surgery resulting in worse outcomes. The aim of study is to evaluate transfer times and delays and their effect on outcomes. Methods...
Thu Jul 30, 2020 12:34
AbstractThe occurrence of multiple mechanical complications after myocardial infarction in the same patient may be extremely rare, and the surgical strategy may be very complex because each mechanical complication can be extremely fatal. The case of a patient who underwent repair of a ventricular septal perforation by venoarterial extracorporeal membrane oxygenation (VA-ECMO), then mitral valve replacement and VA-ECMO for papillary muscle rupture 2 weeks after the ventricular septal perforation repair,...
Fri Jul 31, 2020 03:00
AbstractA 57-year-old male presented to the emergency department with right upper quadrant pain and constitutional symptoms. Initial investigation revealed biliary sepsis with features of chronic cholecystitis, multiple liver abscesses and a fistulous connection between the gallbladder and colon. He was subsequently diagnosed with a cholecysto-colonic fistula, an unusual complication of biliary pathology, with an incidence of 0.06–0.14% at cholecystectomy. It is the second most common form of cholecystoenteric...
Fri Jul 31, 2020 03:00
AbstractThe prevalence and natural history in adults of Morgagni hernias have been relatively poorly characterized. A case is presented of a 31-year-old man where the hernia recurred following a laparoscopic mesh repair. In the era of minimally invasive surgery, debate concerns whether the peritoneal sac should be excised and if the insertion of mesh is superior to primary diaphragmatic repair.
Fri Jul 31, 2020 03:00
AbstractMost cases of peritoneal dissemination of colorectal cancers are from T3 or T4 tumors. A 61-year-old woman was admitted for examination of a positive fecal occult blood test. Colonoscopy showed an ascending colon tumor that was diagnosed as an adenocarcinoma with massive submucosal invasion. Imaging modality revealed numerous nodules throughout the abdominal cavity. Peritoneal dissemination of the ascending colon or ovarian cancer and pseudomyxoma peritonei were considered in the preoperative...
Fri Jul 31, 2020 03:00
AbstractDuring laparoscopic cholecystectomy, gallbladder perforation may occur leading to gallstone spillage and despite being rare, early or late complications may therefore develop. We report a case of a 79-year-old female, with a past medical history of a laparoscopic cholecystectomy 3 years earlier for symptomatic gallstones, admitted in the emergency department with a subcutaneous right lumbar abscess confirmed by computed tomography. Emergent abscess surgical drainage was performed and a gallstone...
Fri Jul 31, 2020 03:00
AbstractOur patient was a 59-year-old woman with past history of hysterectomy, bilateral salpingo-oophorectomy, regional lymphadenectomy and omentectomy performed for advanced ovarian cancer. She was experiencing abdominal pain over the past 2 days and visited our hospital owing to pain exacerbation. Contrast-enhanced computed tomography revealed free air around the liver, ascites and duodenal perforation; thus, emergent abdominal surgery was performed. The 5-mm duodenal perforation at the anterior...
Fri Jul 31, 2020 03:00
Pararenal aortic aneurysm in situs inversus totalis: open repair with right retroperitoneal approach
AbstractSitus inversus totalis (SIT) refers to a mirror-image reversal of the internal organ position. The coexistence of abdominal aortic aneurysm and SIT is extremely rare; very short series have been reported; therefore its prevalence has never been estimated. The presence of anatomical anomalies could increase operative risk. The authors describe a case of successfully repaired pararenal abdominal aortic aneurysm with a right retroperitoneal approach in situs inversus totalis.
Fri Jul 31, 2020 03:00
AbstractCystic lymphangioma (CL) in adult is a very rare pathology. Its etiology remains unclear, but it is supposed to be congenital or to be a result of obstruction and lymph fluid retention of developing lymphatic vessels. It generally occurs in the head and neck region, probably because of the rich lymphatics in this area. It can be easily misdiagnosed with other cervicofacial masses. We present the case of a 56-year-old-female presented with a right-sided painless cervical swelling. Ultrasonography...
Fri Jul 31, 2020 03:00
AbstractEsophageal lipoma is a rare neoplasm with heterogeneous and sometimes life-threatening clinical presentation. We report the case of two patients, a 77-year-old man and a 69-year-old woman presenting with heartburn and dysphagia, and with recurrent vomiting and asphyxia, respectively. Upper gastrointestinal endoscopy and computed tomography were highly suggestive of the diagnosis of esophageal lipoma and identified an intramural and an intraluminal pedunculated mass originating, respectively,...
Fri Jul 31, 2020 03:00
AbstractA 35-years-old female post-endoscopic gastroplasty presented to the emergency department complaining of epigastric abdominal pain. The abdominal examination showed epigastric and tenderness. On abdomen computerized axial tomography (CAT) scan she had small bowel obstruction with twisting of mesenteric vessel. The patient taken to the operating room for diagnostic laparoscopy and proceed, laparoscopic examination showed proximal dilatation of small intestine with collapse of distal part of...
Fri Jul 31, 2020 03:00
AbstractIntussusception in adults is, especially with ulcerative colitis (UC), rare and only described in a few cases. Most adult patients with intussusception develop abdominal pain or other symptoms of bowel obstruction. This case describes an 18-year-old male with UC who treated with 5-aminosalycilicacid and underwent annual screening colonoscopies. Two attempts revealed that it was impossible to achieve total surveillance through the colonoscopy because multiple polyps were preventing the colonoscope...
Fri Jul 31, 2020 03:00
AbstractBreast carcinoma is the most frequently diagnosed cancer in women. In up to 30%, distant metastases will occur; however, ileocecal metastases are rare. Although there have been cases reported that demonstrate ileocecal metastases of breast carcinoma, PET/CT-negative cases have never been described. We present a patient with a small bowel obstruction, preoperatively complicated by pulmonary embolisms. The patient underwent placement of an inferior vena cava filter followed by hemicolectomy....
Fri Jul 31, 2020 03:00
AbstractIt is extremely rare for malignant mesothelioma to present as gastrointestinal polyps. This case report documents the presentation of malignant mesothelioma in a 72-year-old as rectal bleeding and weight loss. Endoscopically, there were multiple gastric and colonic polyps. Histopathologically, there were atypical cells in the lamina propria with benign surface epithelium. The cells tested positive for cytokeratin, calretinin and D2–40 and negative for CD45, CD117, Ber-EP4 and CEA, confirming...
Fri Jul 31, 2020 03:00
Abstract Background Surgical resection of head and neck (H&N) neoplasms requiring osseous reconstruction have underdefined complication profiles. This study aimed to characterize postoperative outcomes of patients with H&N neoplasia undergoing osteocutaneous flap (OCF) or bare bone flap (BBF) reconstructions. Materials and methods Retrospective analysis of the National Surgical Quality Improvement Program (NSQIP) 2005–2017 databases. Queried for diagnosis and procedural codes extracted...
Thu Jul 30, 2020 18:06
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