S Afr J Surg
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Case Reports
Blunt injury of the infrarenal inferior vena cava--imaging and conservative management.
Isolated rupture of the infrarenal segment of the inferior vena cava due to blunt trauma is relatively rare. It may be missed clinically and even diagnostic peritoneal lavage may prove negative. The mainstay of diagnosis remains a high degree of clinical suspicion together with sectional imaging. If the patient is haemodynamically stable after initial resuscitation and there is no other indication for exploratory surgery, these lesions can be managed conservatively with good outcome as shown in the case described in this report.
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The major complication of hydatid disease of the liver is intrabiliary rupture of the cyst. The purpose of this study was to evaluate the outcome of patients with intrabiliary ruptured hydatid disease of the liver. ⋯ If bile-stained cystic fluid and a dilated CBD is found in patients with hydatid disease of the liver, choledochal exploration should be performed during operation. T-tube drainage may be preferred in the management of intrabiliary ruptured hydatid disease because of low morbidity, the ability to decompress intrabiliary pressure, easier monitoring of the biliary drainage and smaller alteration of the anatomy.
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There is an apparent high incidence of tracheal stenosis in the Bloemfontein area. The aim of this study was to determine intensive care unit (ICU) staff knowledge of the use and care of endotracheal and tracheostomy tube cuffs. ⋯ ICU staff had misconceptions regarding the function and care of endotracheal/tracheostomy tube cuffs. The concept of a higher cuff pressure for better stabilisation of the tube is probably an important factor that could have caused the increase in tracheal stenosis in the Bloemfontein area. Critical care nursing needs to emphasise the use of current techniques, discourage routine cuff deflation, and encourage collaboration with ICU physicians on standards of care. A protocol that could be used in the ICUs regarding the use and care of an endotracheal/tracheostomy tube cuff is proposed.
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Penetrating abdominal trauma (PAT) is seen daily in our trauma ward. We present a retrospective study of the patients managed in our hospital (Polokwane Hospital, Limpopo) from January 1999 to March 2000. Epidemiology, mechanism of injury, patterns of injury, management, morbidity and overall mortality were recorded for analysis. Morbidity and mortality were commonly associated with peritonitis and multiple organ dysfunction syndrome.
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The abuse of alcohol and drugs is a major public health problem and intoxication is one of the most important risk factors for violence and other causes of injury. The aim of the current study was to evaluate the prevalence of drug and alcohol use associated with injury in adult trauma patients in an inner city trauma unit in Johannesburg. ⋯ Alcohol and cannabis are commonly misused by trauma patients in Johannesburg; the degree of misuse of other drugs appears to be low. Intoxication is a significant risk factor for violence and accidents and the resultant injuries are a massive burden on our society. Doctors have a responsibility to highlight the association between substance misuse and trauma and should also attempt to persuade individual trauma patients to reduce future alcohol consumption.