Md. Sumon Rahman, Z. Hossain, H. Banna, Mozammel Haque Milon
Great toe injury is common in athletes. Besides violence, the sports injuries to the great toe vary according to the sharing force or impact. However, some great toe injuries can seriously affect the daily activities and some could also remain unnoticed. This case report documents an athlete with an unnoticed avulsion fracture of distal phalanx of the left great toe during karate practice on regular mat. J Curr Surg. 2019;9(1):6-8 doi: https://doi.org/10.14740/jcs372
大脚趾损伤在运动员中很常见。除暴力外，大脚趾的运动损伤也因作用力或冲击力的不同而不同。然而，一些严重的脚趾损伤会严重影响日常活动，有些也可能不被注意。本病例报告记录了一名运动员在常规垫上进行空手道练习时，左大脚趾远端指骨未被注意到的撕脱骨折。J Curr surgery . 2019;9(1):6-8 doi: https://doi.org/10.14740/jcs372
{"title":"Avulsion Fracture in Distal Phalanx of Left Great Toe: A Rare Unnoticed Karate Sports Injury","authors":"Md. Sumon Rahman, Z. Hossain, H. Banna, Mozammel Haque Milon","doi":"10.14740/jcs372","DOIUrl":"https://doi.org/10.14740/jcs372","url":null,"abstract":"Great toe injury is common in athletes. Besides violence, the sports injuries to the great toe vary according to the sharing force or impact. However, some great toe injuries can seriously affect the daily activities and some could also remain unnoticed. This case report documents an athlete with an unnoticed avulsion fracture of distal phalanx of the left great toe during karate practice on regular mat. J Curr Surg. 2019;9(1):6-8 doi: https://doi.org/10.14740/jcs372","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81083345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The present study aims to evaluate the efficacy of early endoscopic evaluation with balloon dilatation performed during non-symptomatic post-operative period with the intent of preventing benign post-operative esophagojejunal anastomotic strictures in patients who receive total gastrectomy for gastric cancer. Methods: First, we retrospectively compared the prevalence of benign esophagojejunal anastomotic stricture occurred 1 month after total gastrectomy for gastric cancer in early endoscopic evaluated group using balloon dilatation (n = 61) with non-evaluated group (n = 148); and then we reviewed the relationship between benign anastomotic stricture and other clinicopathological parameters, including gender, age, body mass index (BMI), and tumor, node, metastasis (TNM) stage. Results: The total number of patients was 209, with 139 men and 70 women, and with an average age of 57.8 years. The endoscopic evaluation with or without balloon dilatation on the 10th post-operative day (POD) was performed in 61 out of 209 patients. Of them, benign post-operative anastomotic stricture was found in 17 patients (27.9%). In the remaining 148 patients, benign post-operative anastomotic stricture occurred in 14 (9.5%) patients. In the 61 patients who received early endoscopic evaluation, 16 received preventive balloon dilatation at the same time and four of them showed benign stricture (4/16, 25%). Of the remaining 45 patients who was endoscopically evaluated without balloon dilatation, 13 had benign strictures (13/45, 28.9%). Preventive endoscopic balloon dilatation (EBD) on the 10th POD was not statistically related to post-operative stricture in a total of 209 patients (P = 0.260) and in early gastrofiberscopy (GFS) sub-group (P = 1.000). A multivariable logistic regression analysis showed that pre-operative BMI (P = 0.014) and endoscopy on the 10th POD (P = 0.001) were independent predictors of post-operative anastomotic stricture. Conclusions: Endoscopic procedure with balloon dilatation, which we had expected to prevent stenosis by widening the internal diameter of the anastomosis site in early post-operative period after total gastrectomy, does not prevent stenosis but rather promotes post-operative stricture. In addition, the lower the pre-operative BMI is, the more frequent post-operative benign anastomotic stricture will be. J Curr Surg. 2019;9(1):1-5 doi: https://doi.org/10.14740/jcs370
{"title":"Effect of Early Endoscopic Evaluation With Balloon Dilatation on Preventing Esophagojejunal Strictures Following Total Gastrectomy for Gastric Cancer","authors":"K. W. Choi, W. Lee","doi":"10.14740/JCS370","DOIUrl":"https://doi.org/10.14740/JCS370","url":null,"abstract":"Background: The present study aims to evaluate the efficacy of early endoscopic evaluation with balloon dilatation performed during non-symptomatic post-operative period with the intent of preventing benign post-operative esophagojejunal anastomotic strictures in patients who receive total gastrectomy for gastric cancer. Methods: First, we retrospectively compared the prevalence of benign esophagojejunal anastomotic stricture occurred 1 month after total gastrectomy for gastric cancer in early endoscopic evaluated group using balloon dilatation (n = 61) with non-evaluated group (n = 148); and then we reviewed the relationship between benign anastomotic stricture and other clinicopathological parameters, including gender, age, body mass index (BMI), and tumor, node, metastasis (TNM) stage. Results: The total number of patients was 209, with 139 men and 70 women, and with an average age of 57.8 years. The endoscopic evaluation with or without balloon dilatation on the 10th post-operative day (POD) was performed in 61 out of 209 patients. Of them, benign post-operative anastomotic stricture was found in 17 patients (27.9%). In the remaining 148 patients, benign post-operative anastomotic stricture occurred in 14 (9.5%) patients. In the 61 patients who received early endoscopic evaluation, 16 received preventive balloon dilatation at the same time and four of them showed benign stricture (4/16, 25%). Of the remaining 45 patients who was endoscopically evaluated without balloon dilatation, 13 had benign strictures (13/45, 28.9%). Preventive endoscopic balloon dilatation (EBD) on the 10th POD was not statistically related to post-operative stricture in a total of 209 patients (P = 0.260) and in early gastrofiberscopy (GFS) sub-group (P = 1.000). A multivariable logistic regression analysis showed that pre-operative BMI (P = 0.014) and endoscopy on the 10th POD (P = 0.001) were independent predictors of post-operative anastomotic stricture. Conclusions: Endoscopic procedure with balloon dilatation, which we had expected to prevent stenosis by widening the internal diameter of the anastomosis site in early post-operative period after total gastrectomy, does not prevent stenosis but rather promotes post-operative stricture. In addition, the lower the pre-operative BMI is, the more frequent post-operative benign anastomotic stricture will be. J Curr Surg. 2019;9(1):1-5 doi: https://doi.org/10.14740/jcs370","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75165909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sang Lee, P. Hanna, D. Barbash, Manrique A. Guerrero, Jamshed Zuberi, Scott Wessner
An abdominal wall mass can arise from a large number of etiologies, but it has not been reported as a complication of a ventral hernia repair. The most common complication of a hernia repair is recurrence. Here, we report an unusual case of a 47-year-old male who presented with a benign abdominal mass 12 years after undergoing a ventral hernia repair, and describe our recommended surgical management. J Curr Surg. 2018;8(3-4):41-43 doi: https://doi.org/10.14740/jcs357w
腹壁肿块可由多种病因引起，但尚未报道为腹疝修补术的并发症。疝修补术最常见的并发症是复发。在这里，我们报告一个不寻常的病例，一位47岁的男性，他在接受腹疝修补手术12年后出现了一个良性腹部肿块，并描述了我们推荐的手术处理。contemporary surgery . 2018;8(3-4):41-43 doi: https://doi.org/10.14740/jcs357w
{"title":"Abdominal Wall Mass: An Unusual Complication of a Ventral Hernia Repair","authors":"Sang Lee, P. Hanna, D. Barbash, Manrique A. Guerrero, Jamshed Zuberi, Scott Wessner","doi":"10.14740/JCS357W","DOIUrl":"https://doi.org/10.14740/JCS357W","url":null,"abstract":"An abdominal wall mass can arise from a large number of etiologies, but it has not been reported as a complication of a ventral hernia repair. The most common complication of a hernia repair is recurrence. Here, we report an unusual case of a 47-year-old male who presented with a benign abdominal mass 12 years after undergoing a ventral hernia repair, and describe our recommended surgical management. J Curr Surg. 2018;8(3-4):41-43 doi: https://doi.org/10.14740/jcs357w","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"23 6 1","pages":"41-43"},"PeriodicalIF":0.0,"publicationDate":"2018-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90211073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
With advanced technology and improved training of surgeons, laparoscopic and other minimally invasive surgical techniques have become the standard of treatment for many general surgical and gynecological diseases. As with any surgical procedure, there are complications that can be directly attributed to the surgical technique. We present a case of an 84-year-old female who presented with symptoms of small bowel obstruction secondary to a 5-mm port site hernia (PSH) 1 week post-laparoscopic bilateral salpingo-oophorectomy for ovarian cysts. J Curr Surg. 2018;8(3-4):35-37 doi: https://doi.org/10.14740/jcs353w
随着技术的进步和外科医生培训的提高，腹腔镜等微创手术技术已成为许多普通外科和妇科疾病的治疗标准。与任何外科手术一样，有一些并发症可以直接归因于手术技术。我们报告一个84岁的女性病例，她在腹腔镜双侧输卵管卵巢切除术后1周出现了5毫米端口疝(PSH)继发的小肠阻塞症状。contemporary surgery . 2018;8(3-4):35-37 doi: https://doi.org/10.14740/jcs353w
{"title":"Five-Millimeter Port Site Hernia: A Rare Case","authors":"Daria Abolghasemi, J. Arena, A. Camerota","doi":"10.14740/JCS353W","DOIUrl":"https://doi.org/10.14740/JCS353W","url":null,"abstract":"With advanced technology and improved training of surgeons, laparoscopic and other minimally invasive surgical techniques have become the standard of treatment for many general surgical and gynecological diseases. As with any surgical procedure, there are complications that can be directly attributed to the surgical technique. We present a case of an 84-year-old female who presented with symptoms of small bowel obstruction secondary to a 5-mm port site hernia (PSH) 1 week post-laparoscopic bilateral salpingo-oophorectomy for ovarian cysts. J Curr Surg. 2018;8(3-4):35-37 doi: https://doi.org/10.14740/jcs353w","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"167 9 Suppl 1","pages":"35-37"},"PeriodicalIF":0.0,"publicationDate":"2018-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83357257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Khanam, N. Akter, Tarana Tabashum, A. Raza, A. Hosna, F. Rahman, A. Begum
Background: The expected and significant role of cytological diagnosis is to distinguish benign from malignant processes. Fine needle aspiration cytology (FNAC) of the breast has two main goals. One is to confirm a radiological and clinical benign lesion and avoid unnecessary surgery and the other is to confirm a malignant diagnosis and allow definite treatment planning. Methods: In breast lesions, rapid diagnosis by aspiration cytology can be particularly useful for allaying the apprehension and anxiety of the patient whose apparent solid mass may turn to be a cyst, thus reducing the anguish and morbidity associated with unnecessary surgical procedures. If the lesions turn out to be malignant, the patient can be referred for immediate treatment on priority so that treatment is not unnecessarily delayed. Thus, aspiration cytology is used more and more in the diagnosis of benign and malignant lesions of the breast. It is a cost-effective and safe method that can differentiate benign and malignant lesions accurately. In advanced carcinoma or unwilling patients for surgery, it can form the basis of management. The objective of this study was to analyze cases of FNAC of breast lesions. Results: This study was a cross-sectional study including all the patients with breast lump who attended Dhaka Community Medical college Hospital for FNAC. A total 50 cases of all ages and both sexes were included in this study. Smears made from aspirated material were collected and examined. Most of the aspirates were from females. There were more benign lesions (43 cases) as compared to malignant cases (seven cases). Fibroadenomas were the most benign lesion of breast. The age of malignant cases ranged from 21 to 60 years with a majority of cases in the age group of 41 - 50 years (four cases, 57.1%). Conclusion: FNAC is less time-consuming, safe, useful and highly accurate technique for breast masses and can segregate benign and malignant lesions with accuracy. Triple assessment by clinical, radiological and pathological examination is a standard approach in the evaluation of breast lumps. The clinical and radiological presentations of both benign and malignant lesions can be similar - as a hypoechoic focal mass, occasionally inflammatory lesions may mimic mass-like lesions or appears as non-homogenous regions on radiographs. Here, FNAC can play a major decisive diagnostic role and minimizing the requirement of biopsy. J Curr Surg. 2018;8(3-4):27-31 doi: https://doi.org/10.14740/jcs366w
{"title":"A Clinicopathologic Study of Various Breast Lesions by Fine Needle Aspiration Cytology (FNAC)","authors":"K. Khanam, N. Akter, Tarana Tabashum, A. Raza, A. Hosna, F. Rahman, A. Begum","doi":"10.14740/JCS366W","DOIUrl":"https://doi.org/10.14740/JCS366W","url":null,"abstract":"Background: The expected and significant role of cytological diagnosis is to distinguish benign from malignant processes. Fine needle aspiration cytology (FNAC) of the breast has two main goals. One is to confirm a radiological and clinical benign lesion and avoid unnecessary surgery and the other is to confirm a malignant diagnosis and allow definite treatment planning. Methods: In breast lesions, rapid diagnosis by aspiration cytology can be particularly useful for allaying the apprehension and anxiety of the patient whose apparent solid mass may turn to be a cyst, thus reducing the anguish and morbidity associated with unnecessary surgical procedures. If the lesions turn out to be malignant, the patient can be referred for immediate treatment on priority so that treatment is not unnecessarily delayed. Thus, aspiration cytology is used more and more in the diagnosis of benign and malignant lesions of the breast. It is a cost-effective and safe method that can differentiate benign and malignant lesions accurately. In advanced carcinoma or unwilling patients for surgery, it can form the basis of management. The objective of this study was to analyze cases of FNAC of breast lesions. Results: This study was a cross-sectional study including all the patients with breast lump who attended Dhaka Community Medical college Hospital for FNAC. A total 50 cases of all ages and both sexes were included in this study. Smears made from aspirated material were collected and examined. Most of the aspirates were from females. There were more benign lesions (43 cases) as compared to malignant cases (seven cases). Fibroadenomas were the most benign lesion of breast. The age of malignant cases ranged from 21 to 60 years with a majority of cases in the age group of 41 - 50 years (four cases, 57.1%). Conclusion: FNAC is less time-consuming, safe, useful and highly accurate technique for breast masses and can segregate benign and malignant lesions with accuracy. Triple assessment by clinical, radiological and pathological examination is a standard approach in the evaluation of breast lumps. The clinical and radiological presentations of both benign and malignant lesions can be similar - as a hypoechoic focal mass, occasionally inflammatory lesions may mimic mass-like lesions or appears as non-homogenous regions on radiographs. Here, FNAC can play a major decisive diagnostic role and minimizing the requirement of biopsy. J Curr Surg. 2018;8(3-4):27-31 doi: https://doi.org/10.14740/jcs366w","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"56 1","pages":"27-31"},"PeriodicalIF":0.0,"publicationDate":"2018-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86998415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The sentinel lymph node biopsy is an alternative to axillary dissection for many breast cancer patients. Cases of anaphylactic reaction to the isosulfan blue dye used during sentinel lymph node biopsy have recently been reported. To prospectively reduce the incidence and severity of adverse reactions to isosulfan blue dye, we evaluated the incidence of severe anaphylactic reactions to isosulfan blue dye during the performance of sentinel lymph node biopsy for breast cancer at our institution. Methods: A retrospective chart review study enrolled 1,456 consecutive patients with breast cancer at our institution. Sentinel lymph node biopsy was performed using both isosulfan blue dye and technetium-99m sulfur colloid. Cases of anaphylaxis were reviewed in detail. Results: Overall, 12 (0.8%) of the 1,456 patients had severe anaphylactic reactions. All 12 patients experienced cardiovascular collapse (profound hypotension and tachycardia) and skin reactions; and patients required admission to an intensive care unit bed or equivalent setting for postoperative monitoring. No deaths or permanent disability occurred. Conclusions: Prompt recognition and aggressive treatment of anaphylactic reactions to isosulfan blue are critical to prevent an adverse outcome. Lymphatic mapping with blue dye should be performed in a setting where personnel are trained to recognize and treat anaphylaxis. J Curr Surg. 2018;8(3-4):32-34 doi: https://doi.org/10.14740/jcs365w
背景:前哨淋巴结活检是许多乳腺癌患者腋窝清扫的替代方法。最近报道了前哨淋巴结活检中使用异硫丹蓝染料的过敏反应病例。为了前瞻性地降低异硫丹蓝染料不良反应的发生率和严重程度，我们评估了在我们机构进行乳腺癌前哨淋巴结活检期间异硫丹蓝染料严重过敏反应的发生率。方法:一项回顾性图表回顾研究纳入了我院连续1456例乳腺癌患者。前哨淋巴结活检使用异硫丹蓝染料和锝-99m硫胶体进行。详细回顾了过敏反应的病例。结果:总体而言，1456例患者中有12例(0.8%)发生严重过敏反应。所有12例患者均出现心血管衰竭(深度低血压和心动过速)和皮肤反应;患者需要进入重症监护病房或类似的环境进行术后监测。没有发生死亡或永久残疾。结论:及时识别和积极治疗异硫丹蓝过敏反应是防止不良后果的关键。用蓝色染料进行淋巴测图时，应在人员接受过识别和治疗过敏反应培训的环境中进行。contemporary surgery . 2018;8(3-4):32-34 doi: https://doi.org/10.14740/jcs365w
{"title":"Anaphylactic Reactions to Isosulfan Blue Dye During Sentinel Lymph Node Biopsy for Breast Cancer","authors":"Tao-Yuang Wang, Debin Xu, Z. Liao","doi":"10.14740/JCS365W","DOIUrl":"https://doi.org/10.14740/JCS365W","url":null,"abstract":"Background: The sentinel lymph node biopsy is an alternative to axillary dissection for many breast cancer patients. Cases of anaphylactic reaction to the isosulfan blue dye used during sentinel lymph node biopsy have recently been reported. To prospectively reduce the incidence and severity of adverse reactions to isosulfan blue dye, we evaluated the incidence of severe anaphylactic reactions to isosulfan blue dye during the performance of sentinel lymph node biopsy for breast cancer at our institution. Methods: A retrospective chart review study enrolled 1,456 consecutive patients with breast cancer at our institution. Sentinel lymph node biopsy was performed using both isosulfan blue dye and technetium-99m sulfur colloid. Cases of anaphylaxis were reviewed in detail. Results: Overall, 12 (0.8%) of the 1,456 patients had severe anaphylactic reactions. All 12 patients experienced cardiovascular collapse (profound hypotension and tachycardia) and skin reactions; and patients required admission to an intensive care unit bed or equivalent setting for postoperative monitoring. No deaths or permanent disability occurred. Conclusions: Prompt recognition and aggressive treatment of anaphylactic reactions to isosulfan blue are critical to prevent an adverse outcome. Lymphatic mapping with blue dye should be performed in a setting where personnel are trained to recognize and treat anaphylaxis. J Curr Surg. 2018;8(3-4):32-34 doi: https://doi.org/10.14740/jcs365w","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"62 5","pages":"32-34"},"PeriodicalIF":0.0,"publicationDate":"2018-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72498213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The differential diagnosis of inguinal mass such as hernia, hydrocele, spermatocele, undescended testes, spermatic cord cyst, lymphangioma, lymphadenopathy, and abscess varies. Mesothelial cysts of inguinal area are extremely rare. We report the cases of a 66-year-old woman with a slowly enlarging mass in the left groin for several years, and a 58-year-old man with a 7-day history of right groin pain and swelling. Excision of cystic mass was done and the mass was pathologically confirmed mesothelial cyst which is a rare cause of inguinal mass. The literature on preoperative diagnosis of mesothelial cyst in groin is also reviewed. J Curr Surg. 2018;8(3-4):38-40 doi: https://doi.org/10.14740/jcs350w
{"title":"A Mesothelial Cyst Presenting as Inguinal Mass: Two Case Reports and Literature Review","authors":"K. W. Choi, W. Lee","doi":"10.14740/JCS350W","DOIUrl":"https://doi.org/10.14740/JCS350W","url":null,"abstract":"The differential diagnosis of inguinal mass such as hernia, hydrocele, spermatocele, undescended testes, spermatic cord cyst, lymphangioma, lymphadenopathy, and abscess varies. Mesothelial cysts of inguinal area are extremely rare. We report the cases of a 66-year-old woman with a slowly enlarging mass in the left groin for several years, and a 58-year-old man with a 7-day history of right groin pain and swelling. Excision of cystic mass was done and the mass was pathologically confirmed mesothelial cyst which is a rare cause of inguinal mass. The literature on preoperative diagnosis of mesothelial cyst in groin is also reviewed. J Curr Surg. 2018;8(3-4):38-40 doi: https://doi.org/10.14740/jcs350w","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"5 1","pages":"38-40"},"PeriodicalIF":0.0,"publicationDate":"2018-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79406147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Acute appendicitis (AA) is one of the most common causes of acute non-traumatic abdominal pain. The use of computed tomography (CT) in facilitating the diagnosis of AA in patients above the age of 50 where right iliac fossa (RIF) pain may represent a wide spectrum of differentials is well established. However, few studies have explored the value of low radiation, unenhanced focused abdominal computed tomography (FACT) in adolescent patients where AA represents the main differential for RIF pain. In this study, we aimed to examine the diagnostic accuracy of FACT scan in diagnosing AA in adolescent patients at a tertiary teaching children’s hospital. Methods: The study was based on cross-sectional design and occurred over a 6-month period between November 2008 and May 2009. A prospective cohort of 95 patients between the ages of 10 - 21 years with clinically suspected AA satisfied the inclusion criteria. Patients with recent abdominal surgery or those who were pregnant were excluded from the study. The necessary institutional ethical approval was granted prior to study commencement. Results: There was slight male preponderance of 51 patients (54%) and 44 females (46%). The mean age of AA was 12.75 ± 2.7 years (range 10 - 21). Statistical analysis showed FACT scan was 97.32% sensitive, 88.42% specific, with a positive predictive value of 98.8% and a negative predictive value of 80.0% in diagnosis of AA. The overall diagnostic accuracy of FACT scan in our study was 96.8%. Conclusions: Unenhanced FACT scan is rapid, cost-effective and safe in diagnosis of adolescent AA. J Curr Surg. 2018;8(1-2):7-12 doi: https://doi.org/10.14740/jcs339w
{"title":"Focused Abdominal Computed Tomography in Clinically Suspected Adolescent Acute Appendicitis","authors":"M. Aslam, M. O. Karim, S. Abbas, Ashifa Khan","doi":"10.14740/JCS339W","DOIUrl":"https://doi.org/10.14740/JCS339W","url":null,"abstract":"Background: Acute appendicitis (AA) is one of the most common causes of acute non-traumatic abdominal pain. The use of computed tomography (CT) in facilitating the diagnosis of AA in patients above the age of 50 where right iliac fossa (RIF) pain may represent a wide spectrum of differentials is well established. However, few studies have explored the value of low radiation, unenhanced focused abdominal computed tomography (FACT) in adolescent patients where AA represents the main differential for RIF pain. In this study, we aimed to examine the diagnostic accuracy of FACT scan in diagnosing AA in adolescent patients at a tertiary teaching children’s hospital. Methods: The study was based on cross-sectional design and occurred over a 6-month period between November 2008 and May 2009. A prospective cohort of 95 patients between the ages of 10 - 21 years with clinically suspected AA satisfied the inclusion criteria. Patients with recent abdominal surgery or those who were pregnant were excluded from the study. The necessary institutional ethical approval was granted prior to study commencement. Results: There was slight male preponderance of 51 patients (54%) and 44 females (46%). The mean age of AA was 12.75 ± 2.7 years (range 10 - 21). Statistical analysis showed FACT scan was 97.32% sensitive, 88.42% specific, with a positive predictive value of 98.8% and a negative predictive value of 80.0% in diagnosis of AA. The overall diagnostic accuracy of FACT scan in our study was 96.8%. Conclusions: Unenhanced FACT scan is rapid, cost-effective and safe in diagnosis of adolescent AA. J Curr Surg. 2018;8(1-2):7-12 doi: https://doi.org/10.14740/jcs339w","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"49 1","pages":"7-12"},"PeriodicalIF":0.0,"publicationDate":"2018-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74594625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The Macintosh laryngoscope enables safer and easy intubation. However, the mechanism of laryngeal exposure remains unclear. I hypothesized that extension of the hyoepiglottic ligament contributes to elevation of the epiglottis, and laryngoscope maneuvers that pull the hyoid bone rostrally will effectively elevate the epiglottis and expose the glottides. Methods: To test this hypothesis, I developed a model in which the epiglottis and hyoid bone were connected with a Velcro tape to allow flexible movement and applied different maneuvers to investigate their effects on epiglottis and hyoid bone movement. Results: A comparison of the original Macintosh maneuver, a modified Macintosh maneuver and the McCoy maneuver found that the McCoy maneuver elevated the epiglottis most, and was associated with rostral and anterior displacement of the hyoid bone. When the model was adjusted so that the hyoid bone was positioned caudal to the epiglottic vallecula, the hyoepiglottic ligament was shortened and the original Macintosh maneuver failed to elevate the epiglottis. Based on these results, a modified Macintosh maneuver was applied that elevated the hyoid bone rostrally and anteriorly and enhanced epiglottis elevation. Conclusions: The position of the hyoid bone should be considered to achieve epiglottic elevation and a good view of the glottides when performing laryngeal exposure. The position of the hyoid bone relative to the epiglottic vallecula could determine the response of the hyoepiglottic ligament and epiglottis elevation. Increased understanding of the mechanism of laryngeal exposure enables development of improved intubation devices and training models. J Curr Surg. 2018;8(1-2):1-6 doi: https://doi.org/10.14740/jcs348w
{"title":"The Macintosh Laryngoscope: the Mechanism of Laryngeal Exposure and the Optimal Maneuver","authors":"H. Nakao","doi":"10.14740/JCS348W","DOIUrl":"https://doi.org/10.14740/JCS348W","url":null,"abstract":"Background: The Macintosh laryngoscope enables safer and easy intubation. However, the mechanism of laryngeal exposure remains unclear. I hypothesized that extension of the hyoepiglottic ligament contributes to elevation of the epiglottis, and laryngoscope maneuvers that pull the hyoid bone rostrally will effectively elevate the epiglottis and expose the glottides. Methods: To test this hypothesis, I developed a model in which the epiglottis and hyoid bone were connected with a Velcro tape to allow flexible movement and applied different maneuvers to investigate their effects on epiglottis and hyoid bone movement. Results: A comparison of the original Macintosh maneuver, a modified Macintosh maneuver and the McCoy maneuver found that the McCoy maneuver elevated the epiglottis most, and was associated with rostral and anterior displacement of the hyoid bone. When the model was adjusted so that the hyoid bone was positioned caudal to the epiglottic vallecula, the hyoepiglottic ligament was shortened and the original Macintosh maneuver failed to elevate the epiglottis. Based on these results, a modified Macintosh maneuver was applied that elevated the hyoid bone rostrally and anteriorly and enhanced epiglottis elevation. Conclusions: The position of the hyoid bone should be considered to achieve epiglottic elevation and a good view of the glottides when performing laryngeal exposure. The position of the hyoid bone relative to the epiglottic vallecula could determine the response of the hyoepiglottic ligament and epiglottis elevation. Increased understanding of the mechanism of laryngeal exposure enables development of improved intubation devices and training models. J Curr Surg. 2018;8(1-2):1-6 doi: https://doi.org/10.14740/jcs348w","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"26 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2018-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85870861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mustafa Ozturk, O. Sogut, M. Yiğit, O. Kaplan, Ozlem Tataroglu, Demet Taş
Hyoid fractures in victims of strangulation and hanging are well defined. Nevertheless, an isolated hyoid bone fracture caused by blunt neck trauma is extremely rare and accounts for only 0.002% of all fractures. The diagnosis of a patient with a hyoid bone fracture can be difficult. This type of fracture may go unseen during a physical examination, causing a life-threatening airway obstruction. We present a case of a young male with an isolated fracture of the hyoid bone induced by direct blunt neck trauma. The patient complained of anterior neck pain. A physical examination revealed tenderness in the neck, but no respiratory distress or limited range of motion of the neck was detected. A cervical computed tomography scan revealed a bony fracture involving the right greater horn of the hyoid bone with adjacent soft tissue swelling. A hyoid bone fracture should be considered when neck tenderness and pain are detected following blunt trauma to the neck region. J Curr Surg. 2018;8(1-2):18-21 doi: https://doi.org/10.14740/jcs346e
{"title":"An Extremely Rare Isolated Hyoid Bone Fracture in a Patient Involved in a Traffic Accident","authors":"Mustafa Ozturk, O. Sogut, M. Yiğit, O. Kaplan, Ozlem Tataroglu, Demet Taş","doi":"10.14740/JCS346E","DOIUrl":"https://doi.org/10.14740/JCS346E","url":null,"abstract":"Hyoid fractures in victims of strangulation and hanging are well defined. Nevertheless, an isolated hyoid bone fracture caused by blunt neck trauma is extremely rare and accounts for only 0.002% of all fractures. The diagnosis of a patient with a hyoid bone fracture can be difficult. This type of fracture may go unseen during a physical examination, causing a life-threatening airway obstruction. We present a case of a young male with an isolated fracture of the hyoid bone induced by direct blunt neck trauma. The patient complained of anterior neck pain. A physical examination revealed tenderness in the neck, but no respiratory distress or limited range of motion of the neck was detected. A cervical computed tomography scan revealed a bony fracture involving the right greater horn of the hyoid bone with adjacent soft tissue swelling. A hyoid bone fracture should be considered when neck tenderness and pain are detected following blunt trauma to the neck region. J Curr Surg. 2018;8(1-2):18-21 doi: https://doi.org/10.14740/jcs346e","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"148 1","pages":"18-21"},"PeriodicalIF":0.0,"publicationDate":"2018-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73418921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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