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Displaying all articles - ( Showing 1 to 10 of 240 )

Title: BJS at the 2015 Vascular Society Annual Scientific Meeting in Bournemouth, UK

  • Authors: J.J. Earnshaw, R.J. Hinchliffe, M. Gough, B. Campbell and M. Bjørck
  • Legend:

    Click here to watch a discussion of the BJS Special Issue on surgery in the elderly. Three scenarios on vascular interventions in the elderly are discussed and are included in a Leading Article on the subject entitled "Vascular interventions in the elderly" by J.J. Earnshaw and R.J. Hinchliffe.

  • Published: Jan 15, 2016

Title: Special Issue on Surgery in the Elderly (103:2)

  • Authors: B.P.L. Wijnhoven, R.A. Audisio and E.H.J. Hulzebos
  • Legend:

    Three authors included in the special issue on surgery in the elderly (due out mid-January 2016), discuss the issues surrounding treatment and care of the older patient. Click here to listen.

  • Published: Jan 08, 2016

Title: Transanal total mesorectal excision

  • Authors: R. A. Cahill and R. Hompes
  • Legend:

    State-of-the-art lecture on transanal total mesorectal excision by R. Hompes detailing the evolution of the access approach as well as evidence, technique and next steps required. Click here to watch the video (Supporting Information) and read the article.

  • Published: Nov 26, 2015

Title: Snapshot quiz 15/12

  • Authors: Teague WJ, King SK
  • Legend:

    The forceps is not holding anything. Rather, the appendix is being tented up by magnetic attraction between intraluminal magnets and the instrument’s handle. A teenager underwent minilaparotomy to remove swallowed magnets, which were arrested in the right lower quadrant on serial radiographs. To minimize procedural morbidity, the magnetic attraction between the intraluminal foreign bodies and an extraluminal metal instrument was exploited. Thus, the magnets were dragged from the right colon back into the appendix. From this point, simple appendicectomy allowed easy and clean removal of the magnets. The patient was discharged the following day.

  • Published: Nov 23, 2015

Title: Snapshot quiz 15/11

  • Authors: Chugh A, Agarwal P, Singh R, Mishra A
  • Legend: Rectal prolapse can be treated by an abdominal or perineal approach. As it occurs mostly in elderly women, the choice depends on overall medical condition. Abdominal rectopexy (Ripstein procedure) has a recurrence rate of less than 10 per cent. Perineal rectosigmoidectomy (Alteimeier procedure) has a higher recurrence rate. Reefing of the rectal mucosa (Delorme procedure) is effective in limited prolapse but also has a high recurrence rate (around 30 per cent). Reduction of perineal hernia and closure of cul-de-sac (Moschowitz procedure) has been abandoned.
  • Published: Oct 28, 2015

Title: Snapshot quiz 15/10

  • Authors: Bishay M,Woodward M
  • Legend: An oedematous gonad is shown. A herniated ovary is occasionally encountered during hernia surgery in girls, and reduction and hernia repair are generally straightforward. A herniated testicle may be seen in 1–2 per cent of phenotypically normal girls, indicating a diagnosis of complete androgen insensitivity syndrome in a child with an XY karyotype. If a testicle is encountered, or if the nature of the gonad is unclear as in this example, the gonad should still be reduced, the hernia repaired and blood taken for a karyotype. This girl had a normal XX karyotype and the gonad was an oedematous ovary.
  • Published: Oct 07, 2015

Title: Bleeding in surgery

  • Authors: T. Richards, R. M. Pearse and R. J. Hinchliffe
  • Legend:

    In the October 2015 issue of BJS, two randomized clinical trials, a systematic review and a review on the subject of bleeding in surgery are published. Click on the podcast logo to the right.

  • Published: Sep 11, 2015

Title: Snapshot quiz 15/9

  • Authors: Murtaza G, Vitone LJ, Monk D
  • Legend:

    The picture shows an interstitial hernia, causing small bowel obstruction. A 76-year-old woman with a history of previous total abdominal hysterectomy was admitted with symptoms and signs of small bowel obstruction. An emergency laparotomy was carried out and a large left-sided interstitial hernia containing distal jejunum was found. The small bowel was bruised but viable with an obvious transition point. A primary suture repair of the interstitial hernia was performed with complete obliteration of the interstitial space.

    An interstitial hernia is a rare type of hernia that passes between the layers of the abdominal wall. Classically, as shown here, an interstitial hernia passes through a defect in the transversus abdominus and internal oblique muscles, but not through the intact aponeurosis of the external oblique. These hernias may not present with an obvious lump and may go unrecognized. There should be a high index of suspicion in a patient with previous abdominal surgery presenting with symptoms and signs of small bowel obstruction. Meticulous closure of the abdominal wall at the time ofinitial surgery remains the best way of avoiding interstitial hernia formation.

  • Published: Sep 04, 2015

Title: Snapshot quiz 15/8

  • Authors: Flood M, Ng KC, O’Leary DP,Waldron B, Hughes P
  • Legend:

    This woman presented with a 1-month history of abdominal swelling and discomfort. She was otherwise healthy with regular menstruation. CT revealed a large (32 × 24 × 13 cm) unilocular cystic intra-abdominal mass. Differentials included either a mesenteric, ovarian or peritoneal inclusion cyst. At laparoscopy, the cyst was arising from the right ovary. The cyst was decompressed laparoscopically and resected along with the right ovary. The specimen was retrieved via a Pfannenstiel incision.

  • Published: Jul 29, 2015

Title: Snapshot quiz 15/7

  • Authors: Rance C, Jones A
  • Legend:

    This 50-year-old woman presented wtih a flare-up of her ulcerative colitis and a painful pretibial skin lesion. Pyoderma gangrenosum (PG) was diagnosed. PG is an uncommon inflammatory and ulcerative skin condition that typically affects young and middle-aged adults, with a female preponderance. It presents with an inflammatory pustule which rapidly progresses to a painful skin ulcer that has a characteristic violacious border. More than half of patients who develop PG have associated systemic disease, notably inflammatory bowel disease. However, unlike erythema nodosum, which is more commonly seen in inflammatory bowel disease than PG, ulcer severity is less likely to be linked directly to disease activity.

    Diagnosis is based on history and clinical examination. Biopsy typically shows dermal neutrophilia, accompanied by a mixed inflammatory cell infiltrate with or without lymphocytic vasculitis. Treatment is of the underlying systemic disease. PG lesions usually regress rapidly following treatment with systemic corticosteroids.

  • Published: Jul 06, 2015
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