Int Surg
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Randomized Controlled Trial
Effectiveness of multiple neurectomies to prevent chronic groin pain after tension-free hernia repair.
The question of which nerve--the ilioinguinal or the iliohypogastric--most often causes chronic groin pain after hernia repair remains to be answered. We sought to evaluate the effects of prophylactic neurectomies on the incidence of persistent groin pain after Lichtenstein repair. Two hundred forty patients were randomized to 1 of 4 groups: the all-nerve preservation group, the ilioinguinal neurectomy group, the iliohypogastric neurectomy group, and the neurectomies group. ⋯ No statistically significant differences in quality of life were noted in any of the groups. In conclusion, both nerves seem to be responsible for neuropathic postherniorrhaphy pain. Elective excision of the nerves can be done safely during tension-free hernia repair.
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Abdominal ultrasound has been proposed as a tool for the evaluation of blunt abdominal trauma. The aim of this study was to evaluate ultrasound's ability to identify intraabdominal injuries that require surgical treatment. ⋯ Hemoperitoneum and abdominal visceral injury were correctly detected by ultrasound with 88% sensitivity and 96.8% specificity. The results are in accordance with the international literature.
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A 4-year-old girl presented with pain and disability of right side hip of about 1-week duration. High-grade fever and upper respiratory tract infection were also noted. A pelvic computed tomography scan showed a dislocated hip accompanied by a huge intrapelvic abscess. ⋯ Thereafter, intravenous antibiotics were given for 6 weeks. The infection was resolved. At a 2-year follow-up, the clinical result was fair and the radiography showed persisting hip damage.
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Case Reports
Gallstone impacted in the rectosigmoid junction causing a biliary ileus and a sigmoid perforation.
A gallstone ileus is an unusual form of bowel obstruction. Colonic gallstone ileus is rare, difficult to diagnose, and still has a high mortality rate. ⋯ A Hartmann's procedure was performed to treat the perforation and the obstruction. Cholecystectomy and closure of the cholecysto-colonic fistula were delayed until restoration of the intestinal continuity.
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This study profiles the all-terrain vehicle (ATV) accident victims who were admitted at a level II trauma center. We retrospectively reviewed the trauma registry data for 111 patients who were admitted to the Parkview Hospital Level II Trauma Center following ATV crashes between January 1996 and June 2003. Forty-four percent of the patients were < or =16 years of age, and the average age overall was 22.49 years. ⋯ Although they only make up 14% of the driver population, children <16 years of age account for almost 40% of all ATV-related injuries and >35% of all ATV-related deaths in the United States. Helmets can reduce the risk of head injury, but only 21 states have helmet laws. Safety legislation should be adopted and would likely save lives and prevent injuries.