Canadian journal of surgery. Journal canadien de chirurgie
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The long-term complications of diabetes mellitus occur despite insulin therapy. One of these complications is gangrene of an extremity which is a prime cause of morbidity and mortality in diabetic patients. ⋯ The author describes six diabetic patients with gangrene of an extremity treated at the Riverside Hospital in Ottawa to illustrate how this condition may be managed by revascularization with no amputation or with conservative amputation and debridement. Major amputation was avoided in all six patients.
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The authors reviewed and analysed the records of 75 patients with omental and bowel evisceration as a result of abdominal stab wounds to discover whether omental prolapse makes laparotomy mandatory. Major intraabdominal injuries were found in 82.7% of the total group, 82.9% in those with omental protrusion and 82.5% in patients with bowel prolapse. ⋯ Negative laparotomy did not cause important morbidity. The authors conclude that omental herniation after stab wounds of the abdomen should routinely prompt exploratory celiotomy.