Annals of the Royal College of Surgeons of England
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Ann R Coll Surg Engl · Jul 2011
Comparative StudyIntraoperative cell salvage versus postoperative autologous blood transfusion in hip arthroplasty: a retrospective service evaluation.
A number of ways of reducing blood loss in arthroplasty have been explored, including preoperative autologous transfusion, intraoperative cell salvage and postoperative autologous transfusions. Both intraoperative blood salvage and postoperative retransfusion drains have been shown to be effective in reducing blood loss in total hip arthroplasty. In our department there was a change in practice from using postoperative retransfusion drains to intraoperative cell salvage. To our knowledge no study has directly compared using intraoperative blood salvage and postoperative retransfusion drains alone in total hip arthroplasty. ⋯ We feel that intraoperative cell salvage provides a more efficient method of reducing blood loss than postoperative retransfusion in primary total hip replacement. A prospective randomised study would be useful to ascertain any clinical difference between the two methods.
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Ann R Coll Surg Engl · Jul 2011
Patients' misunderstanding of common orthopaedic terminology: the need for clarity.
Patients' understanding of their medical problems is essential to allow them to make competent decisions, comply with treatment and enable recovery. We investigated patients' understanding of orthopaedic terms to identify those words surgeons should make the most effort to explain. ⋯ Care should be taken by surgeons when using basic and common orthopaedic terminology in order to avoid misunderstanding. Educating patients in clinic is a routine part of practice.
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Ann R Coll Surg Engl · Jul 2011
Case ReportsIsolated gallbladder perforation following blunt abdominal trauma in a six-year-old child.
Isolated perforation of the gallbladder secondary to blunt trauma is rare. Furthermore, only a few cases exist in the infant age group. ⋯ We report the case of a six-year-old boy who fell on to the handlebars of his scooter, sustaining an isolated gallbladder perforation. The authors highlight the importance of interpreting the volume of intraperitoneal fluid and early diagnostic laparoscopy.
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Ann R Coll Surg Engl · May 2011
Case ReportsIsolated right testicular pain for six days: an unusual presentation of occult abdominal aortic aneurysm leak.
Abdominal aortic aneurysm (AAA) rupture commonly presents with abdominal or lower back pain and haemodynamic instability. There have been case reports of co-existing left testicular pain;(1) however, very few cases describe right testicular pain as the sentinel symptom. We discuss the case of a 75-year-old man who presented to the on-call urologists with a 6-day history of right testicular pain. ⋯ The patient was stable and a CT scan demonstrated a large AAA extending into the right iliac vessels, with suggestion of leakage. Attempted emergency repair was unsuccessful and the patient died in theatre. This atypical presentation of occult aneurysm leak highlights the need for clinical vigilance in the older patient with seemingly benign groin symptoms, including isolated right testicular pain.