Articles

Synchronous multiple small bowel intussusceptions in an adult with blue rubber bleb naevus syndrome: Report of a case and review of literature

Blue rubber bleb naevus syndrome (BRBNS), is an uncommon condition characterised by cavernous haemangiomas of skin and gastrointestinal tract. The most common complication of this syndrome is gastrointestinal ...

Authors: Clement Lee, Debasish Debnath, Tara Whitburn, Mark Farrugia and Federico Gonzalez

A benchmarking study of two trauma centres highlighting limitations when standardising mortality for comorbidity

A continuous process of trauma centre evaluation is essential to ensure the development and progression of trauma care at regional, national and international levels. Evaluation may be by comparison between po...

Authors: Henry R Budd, Laurence M Almond, Peter A Oakley, Gilbert McKenzie and Peter Danne

Is it more dangerous to perform inadequate packing?

Peri-hepatic packing procedure, which is the basic damage control technique for the treatment of hepatic hemorrhage, is one of the cornerstones of the surgical strategy for abdominal trauma. The purpose of thi...

Authors: Unal Aydin, Pinar Yazici, Murat Zeytunlu and Ahmet Coker

Deep vein thrombosis and pulmonary embolus associated with a ruptured popliteal aneurysm – a cautionary note

Popliteal artery aneurysms representing 80% of peripheral artery aneurysms rarely rupture (a reported incidence of 0.1–2.8 %) and second commonest in frequency after aorto-iliac aneurysms. They usually present...

Authors: Pandanaboyana Sanjay and Mike H Lewis

Comparison of APACHE II and Imrie Scoring Systems in predicting the severity of Acute Pancreatitis

There has been an increasing amount of work worldwide in search for tests not only to be able to absolutely diagnose acute pancreatitis, but more importantly to prognosticate patients at admission. While the t...

Authors: Savio G Barreto and Jude Rodrigues

Hematochezia in a patient with liver cirrhosis

Although commonly detectable in patients with cirrhosis, rectal varices only infrequently cause significant hematochezia (0.5–3.6%). While they may be expected to resolve with treatment of the concomitant port...

Authors: Ronan A Cahill, Suzanne Norris and Richard B Stephens

Nasoendotracheal tube obstruction by a nasal polyp in emergency oral surgery: a case report

Nasal polyps can make nasoendotracheal intubation difficult. We present a case of complete obstruction of a nasoendotracheal tube by a nasal polyp during a blind nasoendotracheal intubation in emergency oral s...

Authors: Tatjana Goranovic, Morena Milic and Predrag Knezevic

Recurrent laryngeal nerve palsy due to impacted dental plate in the thoracic oesophagus: case report

Retained oesophageal foreign bodies must be urgently removed to prevent potentially serious complications. Recurrent laryngeal nerve palsy is rare and has not been reported in association with a foreign body i...

Authors: Robert P Sutcliffe, Ashish Rohatgi, Matthew J Forshaw and Robert C Mason

We still need to operate at night!

In the past the National Confidential Enquiry into Peri-operative deaths (NCEPOD) have advocated a reduction in non-essential night-time operating in NHS hospitals. In this study a retrospective analysis of th...

Authors: Omar Faiz, Saswata Banerjee, Paris Tekkis, Savvas Papagrigoriadis, John Rennie and Andrew Leather

Tourniquets for the control of traumatic hemorrhage: a review of the literature

Authors: Stephen L Richey

Laparoscopic repair of strangulated Morgagni hernia

A 73 year old man presented with vomiting and pain due to a strangulated Morgagni hernia containing a gastric volvulus. Laparoscopic operation allowed reduction of the contents, excision of necrotic omentum an...

Authors: Michael D Kelly

What clinical and laboratory parameters determine significant intra abdominal pathology for patients assessed in hospital with acute abdominal pain?

Abdominal pain is a common cause for emergency admission. While some patients have serious abdominal pathology, a significant group of those patients have no specific cause for the pain. This study was conduct...

Authors: Saleh M Abbas, Troy Smithers and Etienne Truter

Ischemic colitis or melanosis coli: a case report

Melanosis Coli is described as black or brown discolouration of the mucosa of the colon. Its a benign condition, which arises from anthraquinone laxative abuse and has no symptoms of its own. The main importan...

Authors: Baber N Chaudhary, Hemant Sharma, Mohammed Nadeem and Mohammed H Niayesh

Regional variability in use of a novel assessment of thoracolumbar spine fractures: United States versus international surgeons

Considerable variability exists in clinical approaches to thoracolumbar fractures. Controversy in evaluation and nomenclature contribute to this confusion, with significant differences found between physicians...

Authors: John Ratliff, Neel Anand, Alexander R Vaccaro, Moe R Lim, Joon Y Lee, Paul Arnold, James S Harrop, Raja Rampersaud, Christopher M Bono and Ralf H Gahr

Ultrasound assessment of haemoperitoneum in ectopic pregnancy: derivation of a prediction model

To derive an ultrasound-based prediction model for the quantification of haemoperitoneum in ectopic pregnancy (EP).

Authors: Arnaud Fauconnier, Ali Mabrouk, Laurent J Salomon, Jean-Pierre Bernard and Yves Ville

Dying from cardiac tamponade

To determine the causes of cardiac tamponade (CT), focussing especially on haemopericardium (HP), as a terminal mode of death, within a 430,000 rural English population.

Authors: Aravind Swaminathan, Karikalan Kandaswamy, Manish Powari and Joseph Mathew

Necrotising colitis related to clozapine? A rare but life threatening side effect

We report here a case of a 34-year-old gentleman who developed right-sided necrotising colitis after clozapine usage. Anticholinergic activity is believed to the cause. We believe that in patients who have bee...

Authors: Quor M Leong, Kutt S Wong and Dean C Koh

An apricot story: view through a keyhole

Very few cases of small bowel obstruction due to ingested fruits have been described in literature, and most of these have managed by a laparotomy. Laparoscopic assisted surgery can effectively deal with such ...

Authors: Tushar Samdani, Tarun Singhal, Santosh Balakrishnan, Abdulzahra Hussain, Starlene Grandy-Smith and Shamsi El-Hasani

Necrotizing fasciitis: strategies for diagnosis and management

Necrotizing fasciitis (NF) is uncommon and difficult to diagnose, and it cause progressive morbidity until the infectious process is diagnosed and treated medically and surgically. The literature addressed NF ...

Authors: Korhan Taviloglu and Hakan Yanar

Utility of esophageal gastroduodenoscopy at the time of percutaneous endoscopic gastrostomy in trauma patients

The utility of esophagogastroduodenoscopy (EGD) performed at the time of percutaneous endoscopic gastrostomy (PEG) is unclear. We examined whether EGD at time of PEG yielded clinically useful information impor...

Authors: James M Haan, Grant V Bochicchio and Thomas M Scalea

Emergency endovascular repair of ruptured visceral artery aneurysms

Visceral artery aneurysms although rare, have very high mortality if they rupture.

Authors: Umar Sadat, Nadim Noor, Tjun Tang and Kevin Varty

Pre-operative risk scores for the prediction of outcome in elderly people who require emergency surgery

The decision on whether to operate on a sick elderly person with an intra-abdominal emergency is one of the most difficult in general surgery. A predictive risk-score would be of great value in this situation.

Authors: Thomas E Rix and Tom Bates

Group A streptococcal septicaemia presenting as an acute abdomen in a child

We present an unusual case of group A streptococcal septicaemia referred to a paediatric surgical unit as acute appendicitis and highlight the importance of remembering this condition as part of a differential...

Authors: Melissa Short and Anne Lawson

Hollow viscus injury in children: Starship Hospital experience

Starship Children's Hospital in Auckland, New Zealand, serves a population of 1.2 million people and is a tertiary institution for pediatric trauma. This study is designed to review all cases of abdominal inju...

Authors: Saleh M Abbas and Vipul Upadhyay

The effect of erythropoietin on healing of obstructive vs nonobstructive left colonic anastomosis: an experimental study

Anastomotic leakage is an important problem following primary resection in the left colon and is even more prominent when obstruction is present. We aimed to evaluate the possible effects of erythropoietin on ...

Authors: Munevver Moran, M Mahir Ozmen, A Polat Duzgun, Riza Gok, Nurten Renda, Selda Seckin and Faruk Coskun

Laparoscopic resection of a torted ovarian dermoid cyst

Torsion or rupture of an ovarian cyst may present as an acute abdomen. A case is presented where the diagnosis was made at laparoscopy and laparoscopic resection was done. Controlled aspiration of the cyst con...

Authors: Katie M Williams, Charles J Bain and Michael D Kelly

WJES and case reports/case series

Authors: Luca Ansaloni, Fausto Catena and Ernest E Moore

Experiences with waterjet hydrosurgery system in wound debridement

Recently, a new device, the Versajet™, involving "Hydrosurgery Technology" which combines lavage and sharp debridement instrumentation has been described for soft tissue debridement.

Authors: Raffi Gurunluoglu

Contemporary management of drug-packers

Experience with management of drug-packers (mules) is variable among different centres. However, despite a recorded increase in drug trafficking in general, as yet, no unified, clear guidelines exist to guide ...

Authors: J Kelly, M Corrigan, RA Cahill and HP Redmond

Distal thoracic oesophageal perforation secondary to blunt trauma: Case report

Traumatic perforation of the distal oesophagus due to blunt trauma is a very rare condition and is still associated with a significant morbidity and mortality. This is further exacerbated by delayed diagnosis ...

Authors: Dirk C Strauss, Ruchi Tandon and Robert C Mason

A critical appraisal of epidemiological studies comes from basic knowledge: a reader's guide to assess potential for biases

Scientific literature may be biased because of the internal validity of studies being compromised by different forms of measurement error, and/or because of the selective reporting of positive and 'statistical...

Authors: Stefania Boccia, Giuseppe La Torre, Roberto Persiani, Domenico D'Ugo, Cornelia M van Duijn and Gualtiero Ricciardi

A case of elbow hyperextension leading to complete brachial artery rupture

To our knowledge there are no cases in the literature of traumatic vascular injury of the brachial artery by elbow hyperextension without elbow dislocation based on either clinical or radiological evidence.

Authors: Deva S Jeyaretna, Michael Butler, Huw G David and Alasdair J Walker

Isolated right atrial appendage (RAA) rupture in blunt trauma – a case report and an anatomic study comparing RAA and right atrium (RA) wall thickness

Heart chambers rupture in blunt trauma is uncommon and is associated with a high mortality. The determinant factors, and the incidence of isolated heart chambers rupture remains undetermined. Isolated rupture ...

Authors: Adoniram M Figueiredo, Renato S Poggetti, Fabio G Quintavalle, Belchor Fontes, Moise Dalva, Riad N Younes, Fabio B Jatene and Dario Birolini

Are upright lateral cervical radiographs in the obtunded trauma patient useful? A retrospective study

The best method for radiographic "clearance" of the cervical spine in obtunded patients prior to removal of cervical immobilization devices remains debated. Dynamic radiographs or MRI are thought to demonstrat...

Authors: Craig H Rabb, Jeffrey L Johnson, David VanSickle, Kathryn Beauchamp, Gene Bolles and Ernest E Moore

World Journal of Emergency Surgery (WJES), World Society of Emergency Surgery (WSES) and the role of emergency surgery in the world

Authors: Fausto Catena and Ernest E Moore Jr

Intra-abdominal pressure in severe acute pancreatitis

Hospital mortality in patients with severe acute pancreatitis (SAP) remains high. Some of these patients develop increased intra-abdominal pressure (IAP) which may contribute to organ dysfunction. The aims of ...

Authors: Paivi Keskinen, Ari Leppaniemi, Ville Pettila, Anneli Piilonen, Esko Kemppainen and Marja Hynninen

State of the art: noninvasive imaging and management of neurovascular trauma

Neurotrauma represents a significant public health problem, accounting for a significant proportion of the morbidity and mortality associated with all traumatic injuries. Both blunt and penetrating injuries to...

Authors: Charles E Ray Jr, Shaun C Spalding, C Clay Cothren, Wei-Shin Wang, Ernest E Moore and Stephen P Johnson

The effect of Bosentan on healing of colonic anastomosis

Ischemia is the most important factor compromises wound healing in colonic anastomosis. Mesenteric vessels are ligated at first while performing colonic resection and following anastomosis. Therefore blood sup...

Authors: Ziya Cetinkaya, Kazim Esen, Ibrahim Hanefi Ozercan, Bilal Ustundag, Refik Ayten and Erhan Aygen

Emergency surgery in a severe penetrating skull base injury by a screwdriver: case report and literature review

Very few cases of severe penetrating injuries to the skull base with a seemingly innocuous object have been described in the literature. Of the cases reported, only ten involve a penetrating screwdriver. Howev...

Authors: Antonio De Tommasi, Pasquale Cascardi, Claudio De Tommasi, Sabino Luzzi and Pasqualino Ciappetta

Large B- Cell lymphoma presenting as acute abdominal pain and spontaneous splenic rupture; A case report and review of relevant literature

Spontaneous rupture of the spleen is an uncommon dramatic abdominal emergency that requires immediate diagnosis and prompt surgical treatment to ensure the patients survival. Infections have been cited in most...

Authors: Saptarshi Biswas, Judith Keddington and James McClanathan

Cough induced rib fracture, rupture of the diaphragm and abdominal herniation

Cough can be associated with many complications. In this article, we present a 59 year old male patient with a very rare combination of a cough related stress fracture of the ninth rib, a traumatic rupture of ...

Authors: Andreas Hillenbrand, Doris Henne-Bruns and Peter Wurl

Terrorist bombing

Bombings and explosion incidents directed against innocent civilians are the primary instrument of global terror. In the present review we highlight the major observations and lessons learned from these events...

Authors: Ami Mayo and Yoram Kluger

History and development of trauma registry: lessons from developed to developing countries

A trauma registry is an integral component of modern comprehensive trauma care systems. Trauma registries have not been established in most developing countries, and where they exist are often rudimentary and ...

Authors: Benedict C Nwomeh, Wendi Lowell, Renae Kable, Kathy Haley and Emmanuel A Ameh

Guidelines for emergency laparoscopy

Acute abdominal pain is a leading symptom in many surgical emergency patients. Laparoscopy allows for accurate diagnosis and immediate therapy of many intraabdominal pathologies. The guidelines of the EAES (Eu...

Authors: Edmund AM Neugebauer and Stefan Sauerland

The role of diagnostic VATS in penetrating thoracic injuries

Penetrating chest injuries account for 1–13% of thoracic trauma hospital admissions and most of these are managed with a conservative approach. Nevertheless, 18–30% of cases managed only with tube thoracostomy...

Authors: Massimiliano Paci, Guglielmo Ferrari, Valerio Annessi, Salvatore de Franco, Guido Guasti and Giorgio Sgarbi

Metabolic changes after polytrauma: an imperative for early nutritional support

Major trauma induces marked metabolic changes which contribute to the systemic immune suppression in severely injured patients and increase the risk of infection and posttraumatic organ failure. The hypercatab...

Authors: Erik Hasenboehler, Allison Williams, Iris Leinhase, Steven J Morgan, Wade R Smith, Ernest E Moore and Philip F Stahel

Arch vessel injury: geometrical considerations. Implications for the mechanism of traumatic myocardial infarction II

Various types of vascular injury have been reported in the medical literature; the isthmic part of the aorta is at particularly high risk of traumatic rupture. Early diagnosis results in better survival, justi...

Authors: Rovshan M Ismailov

The consequences of obesity on trauma, emergency surgery, and surgical critical care

The era of the acute care surgeon has arrived and this "new" specialty will be expected to provide trauma care, emergency surgery, and surgical critical care to a variety of patients arriving at their institut...

Authors: Carlos VR Brown and George C Velmahos

Spectrum of perforation peritonitis in India-review of 504 consecutive cases

Perforation peritonitis is the most common surgical emergency in India. The spectrum of etiology of perforation in Tropical countries continues to be different from its Western counterpart. The objective of the s...

Authors: Rajender Singh Jhobta, Ashok Kumar Attri, Robin Kaushik, Rajeev Sharma and Anupam Jhobta

Peritonitis – the Western experience

Peritonitis is a common surgical emergency. This manuscript will provide an overview of recent developments in the management of peritonitis in the Western world. Emphasis is placed on the emergence of new tre...

Authors: Mark A Malangoni and Tazo Inui