Geographic distribution of pancreaticobiliary malignancy in central South Africa presenting to the Universitas Academic Hospital Complex
The burden and prognosis of pancreatic cancer remains a concern. Currently, pancreatic cancer is the seventh most common cause of global cancer-related deaths and is predicted to be the second most common cause by the year 2030. In addition, pancreatic cancer continues to have the worst 5-year mortality rate.
An audit of traumatic haemothoraces in a regional hospital in KwaZulu-Natal, South Africa
Haemothorax (HTX) is a frequent consequence of chest injuries that occurs in approximately 60% of all polytrauma cases. Traumatic HTX can be due to either blunt or penetrating injury. Penetrating injuries to the thorax are a common presentation in emergency departments in South Africa due to an increase in interpersonal trauma and violent crime.
Surgical exploration for penetrating neck trauma – an audit of results in 145 patients
Selective non-operative management (SNOM) is the current gold standard for the treatment of patients with penetrating neck trauma (PNT). The selection of patients for surgical exploration based on clinical presentation (haemodynamic instability, hard signs) or investigations with the liberal use of computed tomography angiography (CTA) in those who are haemodynamically stable, irrespective of the anatomical zone of injury, are the cornerstones of this policy. This strategy is designed to reduce the incidence of negative and non-therapeutic interventions and their potential complications in patients with PNT.
The mortality rate of patients with open abdomen and contributing factors – a three-year audit in a major academic trauma unit
South Africa is a country with a high level of trauma caused by blunt and penetrating mechanisms. In the context of abdominal trauma, a laparotomy remains one of the effective ways of assessing and treating an intra-abdominal injury. Damage control surgery (DCS) is a well-known and widely used approach in trauma. Open abdomen has become one of the cornerstones in severe trauma, compartment syndrome and severe contamination.
The clinical utility of PET/CT scan and tissue biopsy in the management and follow-up of paediatric Hodgkin lymphoma in South Africa
Paediatric lymphomas are a major cause of morbidity and mortality in children. Lymphomas are the second most common paediatric cancer in Africa, with approximately 25% of paediatric lymphoma cases occurring in Africa. This incidence is proportional to the African contribution to the total population. However, a paucity of cancer registries and the underdiagnosis of malignancies in low- and middle-income countries (LMICs) indicates that the reported incidence may be underestimated.
Concordance of fine needle aspiration cytology and final histology of salivary gland tumours
Salivary gland tumours are rare, accounting for 0.4–13.5 cases annually per 100 000.1 The majority of salivary gland tumours are benign, with a malignant incidence of 21.7%.2,3 The aetiology of salivary gland tumours is unknown. Distinguishing benign from malignant tumours is the main challenge which influences the management of salivary gland tumours.
Hydrothorax and air fluid levels in the right chest – a diagnostic dilemma
A 49-year-old female with well-controlled hypertension presented with a two-day history of vomiting, diarrhoea and central abdominal pain with no history of blunt or penetrating trauma. Her vitals were within normal limits, but the glucose level was elevated. She had reduced air entry on the right chest compared to the left with no adventitious breath sounds.
Trans-anal small bowel evisceration in a patient with a perforated rectal prolapse
An 85-year-old female with chronic constipation presented to the emergency department with prolapsed loops of bowel through the anus. She reported having taken laxatives in the evening prior to presentation. The patient noticed the prolapse after an episode of strained defecation, soon after which she developed severe abdominal pain. She had no prior history of recurrent rectal prolapse.
A rare occurrence of multiple intestinal atresias, with successful one-procedure resection and primary anastomosis
A female of 30 weeks gestation was born via normal vertex delivery. The baby had a birth weight of 1 400 g and normal Apgar scores. She was admitted for supportive oxygen therapy to the referral hospital intensive care unit (ICU). At the booking visit, the baby’s 27-year-old mother's blood group was O positive and had normal antenatal bloods, however, there were no antenatal ultrasounds performed. She had two previous children with no congenital anomalies.