Publications by authors named "Buitendag J"

Background: Serum albumin levels decrease following major trauma, for various reasons. We postulated that the serum albumin nadir (SAN) level would correlate negatively with severity of physiological insult.

Methodology: This retrospective cohort study included all patients with abdominal trauma admitted to the Trauma Intensive Care Unit at Inkosi Albert Luthuli Central Hospital during 2017 and 2018.

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Background: The surgical management of penetrating hollow visceral injuries includes primary repair or exteriorization. Tissue perfusion at the site of gastrointestinal suture repair may be challenging to assess and is vulnerable to local energy transfer-related injury, micro- or macro-circulatory insufficiency, or splanchnic vasoconstriction for various reasons. Breakdown of suture lines can lead to potentially life-threatening complications.

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Introduction: The 6 categories of the Bethesda System for Reporting Thyroid Cytology (TBSRTC) with associated risk of malignancy (ROM) provide evidence-based clinical management guidelines. This study aimed to determine the ROM and accuracy of FNAB in South Africa (SA).

Methods: Thyroid specimens from 3 pathology laboratories registered between January 2015 and December 2019 were considered for inclusion.

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We present a case of a young male patient with no previously known medical, surgical or psychiatric history, who was referred to our institution as an irreducible left inguinal hernia with signs of strangulation. Intraoperative findings, however, revealed a retained foreign body at the rectosigmoid junction, which had previously perforated through the floor of the inguinal canal, essentially sealing off the contamination into the inguinal canal and contributing to the clinical presentation of a left inguinal hernia. This is, to our knowledge, the first published case report locally and internationally concerning rectosigmoid-inguinal canal perforation with the working end of a screwdriver.

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Background: This study aimed to ascertain the microbiology, severity stratification, and clinical outcomes of cellulitis based on our current management for comparison with international reports.

Methods: A retrospective chart review was conducted of all patients with cellulitis treated by the department of surgery at Ngwelezana Hospital over an 18-month period. Severity of cellulitis was graded, and a comparison was made of the Eron and Modified Dundee classifications.

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Penetrating junctional torso trauma with multiple and complex injuries presents the clinician with many investigational and management decisions. This situation has been termed double jeopardy in the literature. The management of this multiple gunshot victim's injuries - massive haemothorax and severe liver and kidney injuries - describes how this pathway can be negotiated with a successful outcome.

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Introduction: There is no conclusive evidence to guide surgical management in the presence of multiple colonic injuries as opposed to a single colonic injury, and whether multiple colonic suture lines are associated with worse outcomes than single suture lines.

Aim: We reviewed the outcomes of penetrating colonic trauma in relation to whether patients had single versus multiple colonic suture lines (primary repair or anastomosis) following laparotomy.

Methods: A retrospective study was conducted at a major trauma centre in South Africa from 2012-2020 for all patients over 18 years who had sustained penetrating colon injury.

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Introduction: This study reviews our cumulative experience with the management of patients presenting with a retained knife following an abdominal stab wound (SW).

Methods: A retrospective study was conducted at a major trauma centre in South Africa over a 15-year period from July 2006 to December 2020 including all patients who presented with a retained knife in the abdomen following a SW.

Results: A total of 42 cases were included: 37 males (93%) with a mean age of 26 years.

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Introduction: There is limited evidence to suggest that patients with penetrating colon injury have higher complication rates when there is concomitant small bowel (SB) injury.

Aim: We performed a retrospective study looking at outcomes of penetrating colonic trauma in patients with- and without concomitant SB injury.

Methods: We interrogated our electronic registry over an eight-year period (2012-2020) for all patients over 18 years who had sustained penetrating colon injury and who had survived beyond 72 h.

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Background: Snakebites are common among rural communities. The aim of this study was to ascertain the differences between paediatric and adult snakebite patients regarding severity, management and outcome.

Methods: This study included a total of 878 patients admitted to Ngwelezana Hospital, with a snakebite or snakebite-related complication, from September 1, 2008 to December 31, 2014.

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Introduction: This study reviews our experience with the management a retained knife in the setting of thoracic stab wounds.

Methods: A retrospective study was conducted at a major trauma in South Africa over a 15-year period from January 2004 to December 2018.

Results: There were 40 patients, of whom 37 were males (93%).

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Background & Aims: South Africa's inequitable history has contributed to a malnourished population, further aggravated by high levels of violence and economic uncertainty culminating in a population suffering the sequelae of poverty. The perceived notion is that malnutrition places the South African population at greater risk for development of refeeding syndrome. This study aimed to identify the incidence of refeeding syndrome in the South African population.

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Background: There is limited evidence to suggest that the more distal a penetrating colonic injury, the poorer its expected outcome, prompting consideration of diversion rather than anastomosis when faced with left colonic injury. The clinical outcomes of penetrating colonic trauma in relation to their anatomical location within the colon were reviewed.

Methods: A review was performed over eight years (2012-2020) of all patients over 18 years who had sustained penetrating colon injury and presented to our trauma centre in South Africa.

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Background: Snakebites are an underappreciated health concern in middle- and lower-income countries. The lack of national data vastly impacts funding for this health crisis, as well as strategies for treatment and prevention. Children are particularly vulnerable to snakebite and data in this group is limited.

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Background: This project reviews our experience with managing pancreatic trauma from 2012 to 2018.

Methods: All patients over the age of 15 years with a pancreatic injury during the period December 2012-December 2018 were retrieved from the Hybrid Electronic Medical Registry at Grey's Hospital and reviewed.

Results: During the study period 161 patients sustained a pancreatic injury.

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Background: The management of colon injuries in damage control surgery (DCS) remains controversial.

Methods: A retrospective study investigating outcomes of penetrating colonic trauma in patients who survived beyond the initial repeat laparotomy (IRL) after DCS was performed. Patients over 18 years with penetrating colon injury and who underwent DCS from 2012 to 2020 were included from our electronic trauma registry.

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Background: Myorenal or crush syndrome often develops following soft-tissue traumatic injury. It is a spectrum of disease that may result in severe renal dysfunction and kidney injury requiring renal replacement therapy.

Objectives: To review a large cohort of patients with so-called myorenal or crush syndrome and assess the biochemical markers of venous bicarbonate and creatine kinase as predictors for the development of acute kidney injury (AKI).

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Background: Falanga is a punishment that involves hitting the bare soles of a person's feet. The consequences of this punishment may be limb and life-threatening. Post-traumatic acute kidney injury (AKI) secondary to rhabdomyolysis is a well-documented complication.

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Hypertriglyceridaemia is associated with severe disease such as coronary disease, cerebral vascular accidents and acute pancreatitis. Severe hypertriglyceridaemia is defined as a serum triglyceride value of >55 mmol/L. Hypertriglyceridaemic acute pancreatitis, often found in pregnancy, has a higher mortality rate than the other causes of acute pancreatitis.

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Article Synopsis
  • Cytotoxic snakebite envenomation is a significant issue in Kwazulu-Natal, particularly affecting children, and can lead to serious physical disabilities.
  • The study examined 51 children who experienced varying severities of symptoms after snakebites, finding that most cases had a correlation between the severity of symptoms and the patients’ International Normalized Ratio (INR) levels.
  • A worrying 22% of these patients developed acute kidney injury, and complications such as allergic reactions and anaphylaxis were observed after antivenom treatment, highlighting the need for better healthcare access and education on snakebite management.
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Hepatic herniation through the diaphragm is a rare finding. It generally occurs due to a congenital diaphragmatic abnormality or blunt trauma resulting in a diaphragmatic defect. Making the diagnosis is difficult, as there are few definitive clinical signs and chest radiograph (CXR) findings may be non-specific.

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Background: Hanging is a common form of self-harm, and emergency care physicians will not infrequently be called upon to manage a survivor.Despite the relative frequency of the injury, there is a paucity of literature on the topic and the spectrum and incidence of associated injuries are poorly described.

Objectives: To review experience with management of victims of hanging at a major trauma centre in South Africa.

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Background: There is growing realisation that human error contributes significantly to morbidity and mortality in modern healthcare. A number of taxonomies and classification systems have been developed in an attempt to categorise errors and quantify their impact.

Objectives: To record and identify adverse events and errors as they impacted on acute trauma patients undergoing a computed tomography (CT) scan, and then quantify the effect this had on the individual patients.

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Background: Humans come into contact and interact with an array of animals in a number of areas and environments. We set out to review our experience with animal-related injuries in Pietermaritzburg, KwaZulu-Natal, South Africa.

Method: All patients who sustained an injury secondary to an interaction with an animal in the period December 2012-December 2017 were identified from the Hybrid Electronic Medical Registry (HEMR).

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