Journal of the Royal College of Surgeons of Edinburgh
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Scalds caused by domestic hot tap water constitute a significant but preventable hazard in childhood. We have reviewed some of the factors contributing to such injuries, and the experience of a regional paediatric burn unit in their treatment. There were 91 children with bath water scalds and 667 children with thermal injuries from other sources included in this study. ⋯ First aid application made no significant difference to eventual burn area or hospital stay. It appears from this study that reduction of domestic hot water temperature is necessary. Statutory control is likely to offer the best solution to the problem of domestic hot tap water scalds in childhood.
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J R Coll Surg Edinb · Aug 1991
ReviewReview of the histopathological findings in appendices removed for acute appendicitis in Nigerians.
The vermiform appendix is a frequent surgical specimen in most routine histopathology laboratories. This is because acute appendicitis is one of the commonest reasons for undertaking emergency laparotomy in most hospitals, even in developing countries. Three hundred and sixteen appendices removed for acute appendix in our hospital over a 10-year period were analysed, of which 37 (11.7%) were found to be normal while 221 (69.9%) showed histopathological evidence of acute inflammation. ⋯ Of these, schistosomal appendicitis was observed in three cases (0.95%) and tuberculous appendicitis was seen in one case. Of the 33 cases classified as miscellaneous, intraluminal ova of parasites with phlegmonous eosinophilic infiltration of the appendix was observed in 17 cases (5.4%) and Toxoplasma appendicitis was observed in five cases. Carcinoid tumour was diagnosed in three cases (0.95%), and in two of these the tumour had spread beyond the appendix.
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C-reactive protein (CRP) and full blood counts were performed on 60 consecutive patients admitted with right iliac fossa pain. Of these, 31 patients had appendicitis and six had a negative appendicectomy. ⋯ In 30 (97%) patients who had appendicitis the CRP or white blood cell count was elevated. CRP is of value in indicating acute pathology and its routine performance may decrease the negative appendicectomy rate.
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J R Coll Surg Edinb · Apr 1991
Modified Ramstedt's pyloromyotomy for the treatment of infantile hypertrophic pyloric stenosis.
Thirty-seven infants with hypertrophic pyloric stenosis had a modified Ramstedt pyloromyotomy performed. The incidence of postoperative vomiting was low (16%), with no infant suffering sustained vomiting requiring re-exploration for incomplete pyloromyotomy. The modified Ramstedt's pyloromyotomy is a simple procedure and may confer an advantage in the postoperative course of the recovering infant.
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A prospective study of 100 trauma patients admitted to the resuscitation room was performed. Acute gastric dilatation was confirmed radiologically in 17 patients. The mechanism of injury was blunt trauma in 91 patients and penetrating in nine. ⋯ Of 28 patients secondarily transferred from another hospital, three (11%) had undergone nasogastric intubation before transfer, five (18%) had acute gastric dilatation on admission and four (14%) had radiological evidence of pulmonary aspiration. Complications associated with acute gastric dilatation included gastric haemorrhage in six patients (35%), pulmonary aspiration in two (12%) and prolonged ileus in one (6%). Placement of a nasogastric tube in the absence of a clear contraindication, either before inter-hospital transfer or soon after admission to the resuscitation room is strongly recommended in the management of the multiply injured patient.