Annals of the Royal College of Surgeons of England
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Ann R Coll Surg Engl · May 2012
Case ReportsSmall bowel obstruction induced by spontaneous partial deflation of an intragastric balloon.
The intragastric balloon (IGB) has been used for decades as a temporary measure for weight reduction in the morbidly obese. Serious complications related to the device remain rare. We present the case of a 23-year-old Caucasian man who developed signs of bowel obstruction following spontaneous partial deflation of an air filled IGB with subsequent migration and impaction in the jejunum. We discuss the role of the IGB in the treatment of obesity, side effects and the serious complications that can occur.
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Ann R Coll Surg Engl · May 2012
Case ReportsA perforated duodenal ulcer presenting as inferior lead ST elevation following amphetamine use.
Typical symptoms of duodenal ulcers include epigastric pain, nausea, vomiting, chest pain and shortness of breath. Here we present the case of a 39-year-old man who had a sudden onset of chest and epigastric pain following the use of recreational amphetamines. ⋯ Following double contrast computed tomography of the abdomen and an urgent laparotomy, a diagnosis of a perforated duodenal ulcer was made. We discuss the aetiologies, presentation, investigation and treatment of the disorder, and make recommendations on the management.
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Ann R Coll Surg Engl · May 2012
Review Meta AnalysisEffectiveness of a gentamicin impregnated collagen sponge on reducing sternal wound infections following cardiac surgery: a meta-analysis of randomised controlled trials.
Gentamicin impregnated collagen sponges are licensed for use after cardiac surgery in over 50 countries but their effectiveness at preventing sternal wound infections (SWIs) remains uncertain. The aim of this meta-analysis was to assess the current evidence for effectiveness of such sponges at preventing SWIs in patients after cardiac surgery. ⋯ There is insufficient evidence of the effectiveness (or otherwise) of gentamicin impregnated sponges in preventing SWIs following cardiac surgery. However, some evidence does exist that such sponges can reduce the incidence of deep infections in high risk patients.