International journal of surgery
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In response to the recommendations of the National Confidential Enquiries into Perioperative Deaths many UK hospitals have introduced a half day (morning or afternoon) planned list for emergencies. We have compared two district general hospitals (DGH A and DGH B) within the same Trust with an afternoon and a morning list, respectively, and examine whether there is any effect on the emergency and urgent laparotomy workload. ⋯ Less than one-third of laparotomies were performed on the emergency list, suggesting underutilisation. The seniority of the surgeon and the level of supervision were similar at both sites. Neither morning nor afternoon proved better in terms of service provision or training opportunities. By accommodating laparotomies onto an elective list DGH A reduced the number of laparotomies performed in the evening.
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We report a case of an iatrogenic foreign body in the airway. An 80-year-old patient who had undergone major head and neck surgery several weeks early presented as an inpatient with a persistent cough and recurrent chest infections. ⋯ This foreign body presented indolently as it was cannulated. We suggest that in such patients, readers should be aware of this possible underlying iatrogenic cause of respiratory complications.
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Inter-hospital transfer of trauma patients in a developing country: a prospective descriptive study.
There is no standardised protocol for the transfer of injured patients in Jamaica, a process that is well known to be potentially hazardous. We undertook this study to evaluate the inter-hospital transfer process of injured patients in this developing country. ⋯ The transfer of injured patients is not being performed in a manner consistent with modern medical practice. There is urgent need for implementation of a standardised protocol for the transfer of such patients in Jamaica.
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Laparoscopic appendicectomy is gradually being accepted as a procedure of choice in the management of suspected acute appendicitis. (in female of childbirth and obese patients, working class, children and elderly). The aim of this study is to assess the feasibility and safety of laparoscopic appendicectomy for perforated appendicitis and to assess our simple technique to reduce postoperative infective complications of perforated appendicitis. ⋯ Perforated appendicitis can be managed effectively and safely using a laparoscopic technique. Timing of intervention and operative technique which includes four abdominal quadrants copious irrigation is important to prevent postoperative intra-abdominal abscesses.