Surg J R Coll Surg E
-
Several options exist with regard to flexible pharyngo-laryngoscope sterilisation. We audited the use of disposable sheaths in our department over a six-month period. ⋯ We have found chlorine dioxide wipes to be a satisfactory alternative means of nasendoscope disinfection. Possible time constraints aside, there are no advantages of sheath use over our current method. Chlorine dioxide wipes are also preferable from a financial point of view.
-
Surg J R Coll Surg E · Feb 2006
Women presenting with lower abdominal pain: a missed opportunity for chlamydia screening?
Many young women presenting with lower abdominal pain are referred to general surgeons with possible appendicitis. For some of these patients there will be a gynaecological cause for their pain. There has been a steady increase in the incidence of Chlamydia infections and pelvic inflammatory disease (PID) among the general population. Therefore, are general surgeons considering this as a diagnosis for lower abdominal pain in women? ⋯ Current guidelines for Chlamydia trachomatis screening produced by the Chief Medical Officer (CMO) include screening in women presenting with lower abdominal pain as well as those with post-coital or intermenstrual bleeding. Most women who present with classical symptoms of PID will present to gynaecological specialities for further management. However, a significant number of women presenting atypically will be referred to surgeons to exclude gastrointestinal causes for their lower abdominal pain. These women could and probably should be screened for Chlamydia trachomatis.
-
Surg J R Coll Surg E · Oct 2005
ReviewA review of the current management of severe traumatic brain injury.
Traumatic brain injury accounts for up to half of trauma related fatalities. This review describes current management practices including pre-hospital care, surgical interventions and various treatment modalities for intracranial hypertension. The lack of class I evidence for the majority of interventions is highlighted.
-
Splenic injury following colonoscopy is rare, with only 28 cases reported so far in the English language literature. Direct trauma during colonoscopy or traction on the spleno-colic ligament is the proposed mechanism of injury. Computed tomography (CT) of the abdomen is usually considered to be the most sensitive and specific modality for diagnosis. ⋯ She underwent an emergency laparotomy with splenectomy and made a satisfactory recovery post-operatively. We wish to highlight that there should be a high index of suspicion of splenic rupture in patients presenting with abdominal pain and demonstrating a positive Kehr's sign following colonoscopy. Only two case reports from the United Kingdom have been published, raising the possibility of under-reporting of such cases.
-
Surg J R Coll Surg E · Aug 2005
Is the landmark technique safe for the insertion of subclavian venous lines?
The complications of central venous line insertion have been highlighted by the recent NICE report advising that ultrasound guidance should be used for central line insertion. ⋯ A low complication rate can be achieved for central line insertion for parenteral nutrition. It is likely that this is due to the small number of experienced operators.