S Afr J Surg
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There is increasing awareness of the value of day case paediatric surgery in fulfilling the needs of the community. Is this cost effective, are there hidden complications and is there a need for routine follow-up? Seven hundred and thirty-one children attending the Red Cross War Memorial Children's Hospital day surgery unit over a 32-month period, and undergoing 912 procedures confined to the inguinoscrotal region, were enrolled in the study. Surgical procedures performed included inguinal herniotomy, orchidopexy and circumcision. ⋯ Our trial confirms that wound sepsis is an infrequent but significant complication of day case groin surgery. Routine follow-up by surgical day units of minor surgical cases is not warranted and will incur unnecessary cost. Only 1.5% of postoperative cases will require further medical attention and septic lesions in the lymphatic drainage area should be regarded as risk factors.
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A 61-year-old woman was admitted to hospital with features of subacute bowel obstruction. Contrast enema and computed tomography (CT) scanning showed evidence of a diaphragmatic hernia. The patient underwent thoraco-laparotomy which revealed a sliding hiatal hernia with transverse colon in the hernial sac. Repair of the defect and segmental resection of the colon were performed, with good postoperative recovery.