Rare causes of abdominal pain: a primer for the admitting general surgeon.

The broad uptake of the acute surgical unit (ASU) model of surgical care in Australia has resulted in general surgeons becoming increasingly involved in the management of patients with acute abdominal pain (AAP), some of whom will be labelled as having non-specific abdominal pain (NSAP) (Kinnear N, Jolly S, Herath M, et al. The acute surgical unit: An updated systematic review and meta-analysis. review.

Use of Temporary Abdominal Closure in Non-Trauma Surgery: A Cohort Study.

Background: Damage control surgery in trauma is widely used but the evidence for the use of laparostomy in non-trauma abdominal emergencies is limited. This study aimed to characterise outcomes in emergency abdominal surgery by comparing laparostomy to one-stage laparotomy for patients of similar illness severity.

Methods: A retrospective study of adult patients requiring emergency abdominal surgery and post-operative intensive care stay was performed between 2016 and 2020 at a major Australian metropolitan hospital.

An algorithm for the management of traumatic abdominal wall hernia based on a 9-year review.

Background: Traumatic abdominal wall hernia (TAWH) is a rare consequence of blunt abdominal trauma, usually in the setting of multitrauma, with little consensus or guidelines for management. We present a case series of patients with traumatic herniae over a 9-year period and a suggested management algorithm.

Method: Retrospective review of all patients with TAWH from 1st January 2011 to 31st December 2019 at a Level 1 adult Major Trauma Centre.

Massive gastric distension due to bulimia nervosa: a hotpot emergency.

Acute massive gastric distension is a rare but potentially life-threatening surgical complication of bulimia nervosa. This results from repeated binge eating and is likely compounded by increased gastric compliance and delayed gastric emptying. We describe a case of acute massive gastric distension in a 26-year-old female with undiagnosed bulimia nervosa who underwent a laparotomy and anterior gastrotomy after failed conservative measures for gastric decompression.

Validity and Utility Testing of a Criteria-led Discharge Checklist to Determine Post-operative Recovery after Abdominal Surgery: an International Multicentre Prospective Cohort Trial.

Background: Criteria-led discharge (CLD) has promising potential to reduce unnecessary hospital stay after abdominal surgery; however, the validity and utility of CLD is uncertain as studies are limited to small single-centre studies involving predominantly elective colorectal surgery.

Methods: This prospective international multicentre cohort study explored the relationship between a CLD checklist, post-operative recovery, and hospital length of stay using patient-level data from four clinical trials involving 1071 adults undergoing all types of emergency and elective abdominal surgery at five hospitals across Australia and New Zealand. Patients were assessed daily for 21 post-operative days using a standardised CLD checklist.

Traumatic diaphragmatic rupture with underlying lung laceration and tension pneumoperitoneum.

Tension pneumoperitoneum is commonly caused by gastrointestinal perforation and pulmonary causes are extremely rare. We present a case of a 47-year-old male post motor vehicle accident with a suspected left-sided haemopneumothorax on initial chest x-ray. CT of the chest post chest tube insertion showed a left-sided diaphragmatic rupture and an extensive diaphragmatic hernia.

Compliance of antithrombotic management at a tertiary paediatric hospital with international guidelines: a 100-Day audit.

Introduction: Thromboembolic disease is a growing problem in paediatric care. American College of Chest Physicians (ACCP) guidelines for antithrombotic therapy in paediatric patients provide consensus recommendations regarding appropriate antithrombotic therapy.

Materials And Methods: This study assessed antithrombotic management practices in a tertiary paediatric centre and the level of agreement of current practice with consensus guidelines across a 100-day prospective chart audit.

Clinical outcomes of management of CVAD occlusions.

Central venous access device (CVAD) occlusions are commonly treated with tissue plasminogen activator (tPA). Eighty-seven patients with 97 catheters at The Royal Children's Hospital, Melbourne were given tPA as per clinical practice guidelines. Restoration of CVAD patency and long-term CVAD survival were measured.