ANZ journal of surgery
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Acute colonic pseudo-obstruction is an uncommon but potentially morbid complication of pregnancy. The aim of the study was to review a single institution's experience with acute colonic pseudo-obstruction in post-partum patients and develop an algorithm for management based on a literature review. ⋯ Acute colonic pseudo-obstruction occurs in post-partum patients more frequently than suspected (one in 1500 deliveries). The management needs to be active with early correction of electrolyte abnormalities, avoidance of narcotic pain relief and early mobilization. Timely administration of neostigmine or endoscopic decompression can reduce the incidence of colonic ischaemia and perforation and the need for surgical intervention.
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ANZ journal of surgery · Oct 2015
Emergency left colonic resections on an acute surgical unit: does subspecialization improve outcomes?
Left-sided colonic pathologies requiring emergency resection are commonly encountered on an acute surgical unit. Subspecialist colorectal (CR) management of these patients may result in decreased morbidity, mortality and stoma rates. This study is the first of its kind comparing outcomes between CR surgeons and general surgeons on an acute surgical unit. ⋯ Subspecialist CR management of patients undergoing emergency left-sided colonic resection on an acute surgical unit is associated with a similar level of morbidity and mortality while safely achieving significantly higher rates of primary anastomosis and lower stoma rates.
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ANZ journal of surgery · Oct 2015
Functional and return to work outcomes following major trauma involving severe pelvic ring fracture.
There is limited evidence describing the long-term outcomes of severe pelvic ring fractures. The aim of this study was to describe the longer term independent living and return to work outcomes following severe pelvic ring fracture. ⋯ Despite the severity of the injuries sustained, 77% of severe pelvic ring fracture patients were living independently and 59% had returned to work, 2-years post-injury. Fracture type and management were not key predictors of outcome. Large-scale multi-centre studies are needed to fully understand the burden of severe pelvic ring fractures and to guide clinical management.