ANZ journal of surgery
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The median arcuate ligament syndrome (MALS) is an infrequent cause of abdominal pain. This diagnosis is made after exclusion of other more common causes of upper abdominal symptoms. Mesenteric duplex and a computerized tomography mesenteric angiography demonstrate dynamic compression of the coeliac axis during expiration. ⋯ A minimally invasive procedure is the treatment of choice in selected patients with MALS.
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ANZ journal of surgery · Mar 2012
Massive transfusion in trauma: blood product ratios should be measured at 6 hours.
Most potentially preventable haemorrhagic deaths occur within 6 h of injury. Conventionally, blood component therapy delivery is measured by 24-h cumulative totals and ratios. The study aim was to examine the effect of a massive transfusion protocol (MTP) on early (6 h) balanced component therapy. ⋯ Implementation of MTP resulted in earlier balanced transfusion. The difference between the FFP/PRBC ratios of the two types of resuscitations levelled by 24 h. The efficacy of component therapy delivery should be measured earlier than 24 h.
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ANZ journal of surgery · Jan 2012
Meta Analysis Comparative StudyA meta-analysis comparing laparoscopic partial versus Nissen fundoplication.
For proven gastro-oesophageal reflux disease, partial fundoplication is considered as effective as Nissen, but with fewer side effects. The aim of this meta-analysis was to compare the effect of laparoscopic partial fundoplication (LPF) with laparoscopic Nissen fundoplication (LNF). ⋯ Both LPF and LNF are effective for the treatment of proven gastro-oesophageal reflux disease. LPF enables a decreased post-operative dysphagia and gas-related side effects, while LNF is more successful in controlling reflux symptoms, particularly heartburn, than LPF. A balance should be found between anti-reflux and side effects.
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ANZ journal of surgery · Jan 2012
Randomized Controlled Trial Comparative StudyLow-dose computed tomography versus plain abdominal radiography in the investigation of an acute abdomen.
To compare low-dose abdominal computed tomography (LDCT) with plain abdominal radiography (AR) in the primary investigation of acute abdominal pain to determine if there is a difference in diagnostic yield, the number of additional investigations required and hospital length of stay (LOS). ⋯ LDCT demonstrates a superior diagnostic yield over AR and reduces the number of subsequent imaging tests for a minimal cost in radiation exposure. However, there is no difference in the overall hospital LOS between the two imaging strategies.