The interplay between diabetes Mellitus and soft tissue infections in general surgical patients.

Background: Diabetes mellitus (DM) is a worldwide pandemic affecting 500 million people. It is known to be associated with increased susceptibility to soft tissue infections (STI). Despite being a major public health burden, the literature relating the effects of DM and the presentation, severity and healing of STIs in general surgical patients remain limited.

Ectopic parathyroid gland within carotid sheath.

During operative exploration of the neck for parathyroid surgery, the surgeon should always consider possible ectopic locations of the glands and have a reasonable surgical strategy for locating these ectopic glands.

Impact of Jaundice on Outcomes Following Emergency Laparoscopic Cholecystectomy in Patients with Choledocholithiasis.

Introduction: Traditional teaching dictates that it may not be prudent to take the jaundiced patient to theatre for emergency laparoscopic cholecystectomy as they may experience worse outcomes following surgery.

Methods: A prospective cohort of 104 patients undergoing emergency laparoscopic cholecystectomy was stratified into two groups using a serum total bilirubin of above 50 μmol/L (2.9 mg/dL) to define the jaundiced group.

Is the acute surgical unit model feasible for Australian regional centres?

Background: A significant proportion of general surgery emergency procedures are conducted after-hours in regional centres. The acute surgical unit (ASU) model reduces the number of after-hours operations performed. We review the burden of emergency surgery in a regional centre and assess what components of the ASU model would benefit regional hospitals.

Left paraduodenal hernia causing small bowel obstruction.

A case of small bowel obstruction secondary to a left paraduodenal hernia is illustrated together with its radiological features and intra-operative appearance. Paraduodenal hernias are rare congenital causes of small bowel obstruction, and various approaches to surgical treatment are available including conventional open and minimally invasive laparoscopic techniques. This case presents one possible option for surgical management and briefly reviews the literature for the various surgical techniques and strategies available to the surgeon when faced with a left paraduodenal hernia.

Management of choledocholithiasis in an emergency cohort undergoing laparoscopic cholecystectomy: a single-centre experience.

Introduction: Minimally-invasive options for the management of choledocholithiasis in patients undergoing laparoscopic cholecystectomy include laparoscopic and endoscopic approaches. This study reviews the effectiveness of both approaches in an emergency setting.

Methods: A retrospective chart review was performed for a cohort of patients who underwent laparoscopic cholecystectomy.

Impact of an acute care surgery model on appendicectomy outcomes.

Background: Monash Medical Centre introduced the acute surgical unit (ASU) in July 2011. The ASU is modelled on the concept of acute care surgery (ACS). This study reviews the impact of the ASU on the outcomes in an appendicectomy population.

Management of CBD stones in patients having laparoscopic cholecystectomy in a private setting in Australia.

Introduction: Laparoscopic bile duct exploration at the time of laparoscopic cholecystectomy has been promoted as being equally successful as endoscopic bile duct clearance. Further, if successful it offers the possibility of reducing the number of interventions required and therefore reducing overall costs. However, there is little in the literature that describe current treatment patterns in the Australian environment.

Inhibition of Akt pathway phosphorylation as a mechanism in the pathogenesis of functional intestinal obstruction in carcinomatosis peritonei.

Background And Objectives: The purpose of this study was to confirm our hypothesis that the development of functional intestinal obstruction in carcinomatosis peritonei (CP) is related to cytokine-mediated inhibition of the Akt pathway and to investigate the phenomenon of relative adrenal insufficiency in CP.

Methods: Human adrenocortical cells (NCI-H295R) were treated with serum derived from eight cancer patients who had intestinal obstruction and functional adrenal insufficiency. Serum from three normal healthy subjects and three who had CP but without intestinal obstruction or adrenal insufficiency were used as controls.