Acta Chir Belg
-
Case Reports
Necrotizing fasciitis of the abdominal wall following an emergency colostomy: a case report.
Necrotizing soft-tissue infections (NSTIs) are acute surgical conditions that demand prompt and multi-faceted treatment. Early recognition, appropriate resuscitation measures, aggressive surgical debridement, and targeted antimicrobial therapy significantly affect the overall outcome and survival of NSTI patients. ⋯ A 51-year-old woman presented with necrotizing fasciitis of the abdominal wall following colostomy for obstructive colon carcinoma. In this particular case, stoma relocation was necessary because of the need for large parietal surgical debridement.
-
Urgent laparoscopic cholecystectomy has become the gold standard for the treatment of acute gallstone disease. Since 2005 we have implemented a consultant-delivered urgent surgical service for this condition. In an attempt to increase the capacity of this service, we have recently introduced a new policy of also allowing selected trainee surgeons to perform urgent laparoscopic cholecystectomy with consultant assistance available on request. The purpose of this study was to audit our initial experience of this new service. ⋯ Urgent laparoscopic cholecystectomy may be performed independently by appropriately skilled trainees within a consultant-led service. Although consultant intervention is often not required, the requirement for consultant assistance cannot be easily predicted based on pre-operative data.