World journal of surgery
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World journal of surgery · Oct 2010
Clinical TrialRoutine ultrasound and limited computed tomography for the diagnosis of acute appendicitis.
Acute appendicitis continues to be a challenging diagnosis. Preoperative radiological imaging using ultrasound (US) or computed tomography (CT) has gained popularity as it may offer a more accurate diagnosis than classic clinical evaluation. The optimal implementation of these diagnostic modalities has yet to be established. The aim of the present study was to investigate a diagnostic pathway that uses routine US, limited CT, and clinical re-evaluation for patients with acute appendicitis. ⋯ A diagnostic pathway using routine US, limited CT, and clinical re-evaluation for patients with acute abdominal pain can provide excellent results for the diagnosis and treatment of appendicitis.
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World journal of surgery · Sep 2010
Packing for damage control of nontraumatic intra-abdominal massive hemorrhages.
The Damage Control Surgery (DCS) approach to massive intraperitoneal hemorrhage has been shown to significantly reduce the morbidity and mortality in severely injured trauma patients. We applied the same principles to patients who developed a massive hemorrhage and the "lethal triad" (acidosis, hypothermia, coagulopathy) during a surgical procedure in order to assess feasibility and efficacy of DCS on nontraumatic grounds. ⋯ Intra-abdominal packing was shown to be feasible, safe, and effective for patients with intra-abdominal nontraumatic massive hemorrhage, and the application of the principles of DCS may improve survival in cases of surgical hemorrhage with development of the lethal triad.
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World journal of surgery · Sep 2010
Percentage of cesarean sections among total surgical procedures in sub-Saharan Africa: possible indicator of the overall adequacy of surgical care.
The aim of this study was to assess emergency and essential surgical care in low-income countries, review of the literature to obtain data on the number of cesarean sections, and compare the results with the total number of all operations. This cesarean section/total operations ratio was much higher for low-income countries than for high-income countries. We recommend more research into the validity of this tool for use as a possible proxy indicator for overall adequacy of emergency and essential surgical care.
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World journal of surgery · Sep 2010
Early cholecystectomy after acute admission with cholecystitis: how much work?
This study was designed to determine the number of cases and amount of operating room time required, for a population of 600,000, to provide definitive treatment in the form of cholecystectomy for all patients admitted as an emergency with cholecystitis. ⋯ A population of 600,000 could be expected to generate enough emergency cholecystectomies to require more than one operating session per day. A significant increase in emergency operating room availability would be necessary to allow the provision of definitive treatment for all emergency admissions with cholelithiasis.
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World journal of surgery · Aug 2010
ReviewPulmonary contusion: an update on recent advances in clinical management.
Pulmonary contusion is a common finding after blunt chest trauma. The physiologic consequences of alveolar hemorrhage and pulmonary parenchymal destruction typically manifest themselves within hours of injury and usually resolve within approximately 7 days. Clinical symptoms, including respiratory distress with hypoxemia and hypercarbia, peak at about 72 h after injury. ⋯ The clinical diagnosis of acute parenchymal lung injury is usually confirmed by thoracic computed tomography, which is both highly sensitive in identifying pulmonary contusion and highly predictive of the need for subsequent mechanical ventilation. Management of pulmonary contusion is primarily supportive. Associated complications such as pneumonia, acute respiratory distress syndrome, and long-term pulmonary disability, however, are frequent sequelae of these injuries.