Annals of the Royal College of Surgeons of England
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Ann R Coll Surg Engl · Oct 2009
Case ReportsPenetrating missile injuries during the Iraqi insurgency.
Since the invasion of Iraq in 2003, the conflict has evolved from asymmetric warfare to a counter-insurgency operation. This study investigates the pattern of wounding and types of injuries seen in casualties of hostile action presenting to a British military field hospital during the present conflict. ⋯ The current insurgency in Iraq illustrates the likely evolution of modern, low-intensity, urban conflict. Improvised explosive devices employed against both military and civilian targets have become a major cause of injury. With the current global threat from terrorist bombings, both military and civilian surgeons should be aware of the spectrum and emergent management of the injuries caused by these weapons.
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Ann R Coll Surg Engl · Oct 2009
Introduction of a day-case laparoscopic cholecystectomy service in the UK: a critical analysis of factors influencing same-day discharge and contact with primary care providers.
The objective of this study was to determine the safety and acceptability of the implementation of a day-case laparoscopic cholecystectomy (LC) service in a large UK teaching hospital, and analyse factors influencing contact with primary care providers. Wide-spread introduction of day-case LC in the UK is a major target of healthcare providers. However, few centres have reported their experience. In the US, out-patient surgery for LC has been reported, though many groups have utilised 24-h observation units to facilitate discharge. Concerns remain amongst surgeons regarding the feasibility and acceptability of the introduction of day-case LC in the UK. ⋯ Introduction of day-case LC in the UK is feasible and acceptable to patients. The potential burden to primary care providers needs further study.
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Ann R Coll Surg Engl · Oct 2009
Case ReportsSuperior mesenteric artery syndrome in association with an abdominal aortic aneurysm.
Superior mesenteric artery (SMA) syndrome, also known as Wilkie syndrome, is a rare condition characterised by compression of the third part of the duodenum against the aorta by the SMA. This can cause symptomatic duodenal obstruction. It is rarely associated with an abdominal aortic aneurysm (AAA). ⋯ SMA syndrome was diagnosed with imaging and was then successfully treated by aneurysm repair. This is the smallest AAA associated with SMA syndrome in the literature. We propose an anatomical mechanism for SMA syndrome in this case.