Annals of the Royal College of Surgeons of England
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Ann R Coll Surg Engl · May 2012
Changing incidence and management of penetrating neck injuries in the South East London trauma centre.
A total of 17 cases of penetrating neck injury were managed by the otolaryngology team at King's College Hospital over a 3-year period in the 1980s. In April 2010 King's College Hospital became the major trauma centre for South East London. This prospective cohort study compares the incidence, changing demographic features and treatment outcomes of penetrating neck trauma in South East London over the previous 23 years. ⋯ The increased incidence of penetrating neck injury is a reflection of more interpersonal violence rather than a consequence of the larger South East London trauma centre catchment area. Tackling this problem requires focus on wider issues of community prevention. Sharing of data between the four London trauma centres and the police is needed to help prevent interpersonal violence and develop a universal treatment algorithm for other institutions to follow.
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Ann R Coll Surg Engl · May 2012
Case ReportsA perforated duodenal ulcer presenting as inferior lead ST elevation following amphetamine use.
Typical symptoms of duodenal ulcers include epigastric pain, nausea, vomiting, chest pain and shortness of breath. Here we present the case of a 39-year-old man who had a sudden onset of chest and epigastric pain following the use of recreational amphetamines. ⋯ Following double contrast computed tomography of the abdomen and an urgent laparotomy, a diagnosis of a perforated duodenal ulcer was made. We discuss the aetiologies, presentation, investigation and treatment of the disorder, and make recommendations on the management.
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Ann R Coll Surg Engl · May 2012
Case ReportsThe oldest reported mirror hand? The curse of the coal-house frog!
Despite being one of the rarest congenital upper limb abnormalities, a wide spectrum of the typical mirror hand has been described in the literature. We report a very interesting case of a new variant of mirror hand presenting in a 78-year-old man. The unique features of the case include the age at diagnosis, the anatomical features present and the acquired function despite no form of reconstructive surgery.
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Ann R Coll Surg Engl · Apr 2012
Case ReportsAcute neck pain referred to the surgeon: Lemierre's syndrome as a differential diagnosis.
Lemierre's syndrome is usually reported in the young and in fit individuals. We report a case of an 81-year-old woman who presented with thrombophlebitis of the internal jugular vein with a pulmonary embolism.