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Annals of the Royal College of Surgeons of England

F Chierigo, H M Alnajjar, A Haider, M Walkden, T Shaikh, A Muneer
Sarcoidosis is a systemic granulomatous disease, with genitourinary tract involvement being very rare (0.2% of all sarcoidosis cases). Genitourinary sarcoidosis may present with a scrotal mass with or without testicular pain, often mimicking epididymo-orchitis or malignancy. Only 8 cases of genitourinary sarcoidosis have been reported in the literature in the last 14 years. We describe the case of a 25-year-old man who was referred with testicular pain. Scrotal ultrasonography demonstrated multiple bilateral hypoechoic testicular lesions that were of similar size and distributed unusually throughout the testicular parenchyma...
March 25, 2019: Annals of the Royal College of Surgeons of England
Pjj Herrod, H Boyd-Carson, B Doleman, Jem Blackwell, Ejo Hardy, F Harper, J N Lund
INTRODUCTION: Public awareness campaigns have led to increasing referrals of patients to colorectal surgery for possible cancer. Change in bowel habit, is traditionally described as a symptom of a left sided bowel cancer. If this is the case in practice, it raises the potentially attractive option of investigating such patients with flexible sigmoidoscopy only. This study sought to systematically review the literature describing tumour location of patients with bowel cancer presenting with left-sided symptoms to establish the safety of potential investigation of these patients with flexible sigmoidoscopy alone...
March 11, 2019: Annals of the Royal College of Surgeons of England
B D Chatterton, Ajf Bing
No abstract text is available yet for this article.
March 11, 2019: Annals of the Royal College of Surgeons of England
D W Neilly, M Smith, A Woo, V Bateman, I Stevenson
INTRODUCTION: Necrotising fasciitis is a life-threatening rapidly progressing bacterial infection of the skin requiring prompt diagnosis and treatment. Optimum care warrants a combination of surgical debridement, antibiotics and intensive care support. All cases of necrotising fasciitis in 10 years in the North East of Scotland were reviewed to investigate and improve patient care. METHODS: Cases between August 2006 and February 2016 were reviewed using case notes and electronic hospital records...
March 11, 2019: Annals of the Royal College of Surgeons of England
K Richards, C Sethu, E Tiernan
Collagenase injection was approved in Europe for use in the treatment of Dupuytren's disease in 2011. Reported adverse effects include skin tears, swelling, pain and complex regional pain syndrome. Here, we present a case of a rare complication of phalangeal fracture following treatment with collagenase clostridium and the resultant digital amputation. An 81-year-old man was treated for a 25-year history of progressively disabling Dupuytren's disease of his left middle and ring fingers. Nine days post-manipulation he presented with persistent pain and swelling and was diagnosed with a displaced fracture of the proximal phalanx of his ring finger...
March 11, 2019: Annals of the Royal College of Surgeons of England
L O'Connell, S Walsh, D Evoy, A O'Doherty, C Quinn, J Rothwell, J Geraghty, E W McDermott, R Prichard
INTRODUCTION: Although close radial margins after breast-conserving surgery routinely undergo re-excision, appropriate management of patients with close anterior margins remains a topic of controversy. An increasing body of literature suggests that re-excision of close anterior margins yields low rates of residual malignancy and may only be necessary in selected patients. The aim of this study was to examine the management of close anterior margins after breast conserving surgery in a single institution and to analyse the rate of residual disease in re-excised anterior margins...
March 11, 2019: Annals of the Royal College of Surgeons of England
N Mamoowala, N A Johnson, J J Dias
INTRODUCTION: This observational study investigated the incidence of distal radius fractures in children, to determine whether the rate is rising, the effect of seasonal variation on incidence and whether fracture type and rate of surgical intervention has changed, to help in determining costs for secondary care and to aid resource allocation. MATERIALS AND METHODS: All paediatric patients(n = 6529) who sustained a distal radius fracture over an eight-year period (2007-2014) were identified...
March 11, 2019: Annals of the Royal College of Surgeons of England
A Shayah, L Wickstone, E Kershaw, F Agada
INTRODUCTION: Nasopharyngeal carcinoma is a rare neoplasm in the UK. The current gold standard for detection is endoscopic examination under anaesthesia of the nasopharynx with biopsy. Many clinicians are now advocating cross-sectional imaging as the primary investigation. The objective of this study is to evaluate the role of cross-sectional imaging in detecting nasopharyngeal carcinoma and ultimately to avoid unnecessary biopsy. MATERIAL AND METHODS: This is a retrospective uncontrolled case series review of patients who were investigated for suspected nasopharyngeal carcinoma between 2009 and 2017 at York Teaching Hospital NHS Foundation Trust...
March 11, 2019: Annals of the Royal College of Surgeons of England
C Samian, S Ghaffar, V Nandapalan, S Santosh
INTRODUCTION: Malakoplakia is a rare chronic inflammatory disorder, predominantly affecting the urinary tract. In the head and neck region, it is very rare and may confuse the clinicians during investigations, as features may mimic malignancy. MATERIALS AND METHODS: We report a case of malakoplakia involving the parotid gland and review of the reported cases of malakoplakia in head and neck region. RESULTS: Histologically, this is the first classic case report of malakoplakia involving the parotid gland in the world literature...
March 11, 2019: Annals of the Royal College of Surgeons of England
B A Marson, J Ng, Y Myint, Djc Grindlay, B J Ollivere
INTRODUCTION: This study aimed to review the literature to establish whether there is a best treatment for low-risk ankle fractures in children. MATERIALS AND METHODS: A systematic review and meta-analysis of trials was undertaken, which compared interventions for 'low-risk' ankle fractures in children. A meta-analysis was performed using a random effects model. RESULTS: Four trials were identified reporting outcomes from 256 patients. All trials reported results using a device that permitted ankle motion compared with more rigid immobilisation...
March 11, 2019: Annals of the Royal College of Surgeons of England
D Liu, J Zhang, T Li, C Li, X Liu, J Zheng, Z Su, X Wang
Chronic osteomyelitis with proliferative periostitis is a rare form of osteomyelitis that is characterised by new bone formation with periosteal reaction. It is also traditionally known as Garre's osteomyelitis. The common sources of infection of the jaw include dental caries associated with periapical periodontitis, periodontitis, fractures and nonodontogenic infections. Chronic osteomyelitis with proliferative periostitis mainly presents in younger patients. Here, we present a case of a 12-year-old patient with chronic osteomyelitis with proliferative periostitis with no definitive infection source such as pericoronitis, caries and periodontitis...
March 11, 2019: Annals of the Royal College of Surgeons of England
S K Kamarajah, S Kharkhanis, M Duddy, J Isaac, R P Sutcliffe, H Mehrzad, Bvm Dasari
Pancreaticoduodenal and gastroduodenal artery aneurysms are rare but require early radiological or surgical intervention due to a high risk (61%) of rupture. A 71-year-old woman presented with an incidental 30-mm aneurysm arising from the inferior pancreaticoduodenal artery associated with coeliac axis stenosis. She underwent embolisation of the pancreaticoduodenal aneurysm, but the coeliac axis stenosis was not amenable to radiological intervention. She remained well at six months of follow-up and a repeat computed tomography angiogram six months later reported stable appearances...
March 11, 2019: Annals of the Royal College of Surgeons of England
J On, J Shim, E H Aly
INTRODUCTION: The 'watch and wait' approach has recently emerged as an alternative approach for managing patients with complete clinical response in rectal cancer. However, less is understood whether the intervention is associated with a favourable outcome among patients who require salvage therapy following local recurrence. MATERIALS AND METHODS: A comprehensive systematic search was performed using EMBASE, PubMed, MEDLINE, Journals@Ovid as well as hand searches; published between 2004 and 2018, to identify studies where outcomes of patients undergoing watch and wait were compared with conventional surgery...
March 11, 2019: Annals of the Royal College of Surgeons of England
V Celentano, F Luvisetto, S Toh
INTRODUCTION: The high rate of recurrence following ileocaecal resection for Crohn's disease may lead to repeat surgery in 20-30% of patients at five years after surgery. Recurrence usually occurs at the anastomosis and the neoterminal ileum and the association of a strictureplasty to widen the bowel lumen in the regions immediately proximal ('anastomotic inlet') and distal ('anastomotic outlet') to the anastomosis may delay or reduce the risk of surgical recurrence. MATERIALS AND METHODS: A side to side isoperistaltic anastomosis, with an associated V-modified strictureplasty on the anti-mesenteric border at the level of the anastomosis inlet and outlet has been designed...
March 11, 2019: Annals of the Royal College of Surgeons of England
J M Ali, I Wolff, F Falconieri, G Aresu, A S Coonar, Y Joshi, A Peryt
Acute ischaemic stroke is a devastating postoperative complication that significantly impacts upon a patient's quality of life. Endovascular retrieval of thromboembolic material from proximal cerebral arteries by mechanical thrombectomy is the new standard of care for patients presenting with a proximal artery occlusion. We report the case of a patient developing an acute ischaemic stroke following pulmonary lobectomy, who was transferred to the regional neurosciences unit, despite the absence of an established referral pathway, to undergo mechanical thrombectomy, with significant prognostic neurological benefit...
March 11, 2019: Annals of the Royal College of Surgeons of England
I V Papachristos, R B Dalal
Hindfoot intramedullary devices are increasingly used in tibiotalocalcaneal arthrodesis after failed total ankle arthroplasty or as a salvage procedure after complex trauma. Nail breakage is a well-described complication and numerous techniques for removal of broken parts can be found in the literature, especially for femoral and tibial nails. There is a relative paucity regarding techniques solving the challenge of removing a broken hindfoot intramedullary nail. We describe a novel technique using a curved thin hook from the Moreland hip revision set to remove the distal part of a broken tibiotalocalcaneal intramedullary nail...
March 11, 2019: Annals of the Royal College of Surgeons of England
B N Keser, Ü N Kırman, G Aktemur, O Alimoĝlu
Solitary fibrous tumours are rare mesenchymal tumours which mostly arise from pleura. Such tumours occurring in the mesocolon are exceptionally rare. A 35-year-old man was referred to the general surgery department with a painless and nonpalpable mass in the right quadrant of the abdomen, which was detected incidentally on magnetic resonance imaging. The patient had no symptoms and the physical examination revealed no findings. The patient underwent surgical resection and excisional biopsy results revealed an intra-abdominal solitary fibrous tumour originating from the ascending mesocolon...
March 11, 2019: Annals of the Royal College of Surgeons of England
N H Ta, A Addison, B Beigi, C Philpott
Ossifying fibromas are mainly found in the mandible and maxilla. Reports of them arising in the ethmoid sinuses and orbits are rare. We present a case of an otherwise healthy 20-year-old man with gradual onset of right visual disturbance signified by right relative afferent pupillary defect due to a large unilateral ossifying fibroma arising from the ethmoid sinus compressing the medial half of the right orbit. We emphasise the multidisciplinary combined endoscopic endonasal and external approach to ensure a successful debulking of the fibroma...
March 11, 2019: Annals of the Royal College of Surgeons of England
G Soppa, P Theodoropoulos, R Bilkhu, D A Harrison, R Alam, R Beattie, D Bleetman, A Hussain, S Jones, L Kenny, M Khorsandi, A Lea, Ka Mensah, T N Hici, A C Pinho-Gomes, L Rogers, A Sepehripour, S Singh, D Steele, H Weaver, A Klein, N Fletcher, M Jahangiri
INTRODUCTION: We examine the influence of variations in provision of cardiac surgery in the UK at hospital level on patient outcomes and also to assess whether there is an inequality of access and delivery of healthcare. Cardiothoracic surgery has pioneered the reporting of surgeon-specific outcomes, which other specialties have followed. We set out to identify factors other than the individual surgeon, which can affect outcomes and enable other surgical specialties to adopt a similar model...
March 11, 2019: Annals of the Royal College of Surgeons of England
Aky Lam, J Black, B Parnell, C T West
A 37-year-old woman presented with an incarcerated hernia at a previous umbilical laparoscopic port site. This was found to contain an ischaemic appendix, which was managed successfully with open appendicectomy and a mesh repair. Previous imaging from a year prior to these events demonstrated a degree of intestinal malrotation with the caecal pole lying just under the umbilicus. Finding the appendix within an incisional port site is very rare, for this to occur at the umbilicus is unique.
March 11, 2019: Annals of the Royal College of Surgeons of England
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