The intragastric balloon - smoothing the path to bariatric surgery.

Background: Intragastric balloon placement in association with diet for weight reduction is steadily gaining popularity. However, long-term follow-up studies on the effect of this method in maintaining weight loss are lacking. This study evaluated the long-term outcome following balloon removal in morbidly obese patients who had selected this method for weight loss.

Case control study of environmental factors in the etiology of the first attack of acute pancreatitis: a pilot study.

The aim of this case control study was to assess environmental factors in the etiology of the first attack of acute pancreatitis (AP) in Soweto, South Africa, in the light of modern developments. The study group consisted of 30 patients presenting with a first attack of AP, and 30 healthy age- and gender-matched controls. Fruit intake was found to be a protective factor (odds ratio [OR] 5.

Physical examination and selective conservative management in patients with penetrating injuries of the neck.

This prospective study of 335 patients with penetrating injuries of the neck examined the decision whether to operate or observe according to a protocol based mainly on physical examination. Emergency angiography was performed in only three patients. Sixty-six patients (20 per cent) were subjected to emergency operation because of signs and symptoms suggestive of significant injury (60 patients) or because of positive investigations (six).

Penetrating external injuries of the oesophagus and pharynx.

Fifty-one instances of oesophageal perforation were discovered when the records of 10,143 [corrected] patients with external penetrating injuries of the neck, chest and abdomen were reviewed. Of these, 33 resulted from stab wounds, 17 from bullets and one from hyperextension of the neck. There were 15 perforations of the pharynx and 36 of the oesophagus.

Iatrogenic oesophageal perforations in patients with cancer of the oesophagus.

The records of 780 patients who had 917 sessions of rigid oesophagoscopy and instrumentation for advanced cancer of the oesophagus were reviewed. Forty-three cases of iatrogenic perforation of the oesophagus were identified. Of 19 patients who were treated with immediate Celestine tube introduction, 13 survived.

Gunshot wounds of the colon: role of retained bullets in sepsis.

The role in the development of local sepsis of retained bullets that have passed through the colon was investigated. Of 84 patients with gunshot wounds of the colon, the bullet was retained in the body in 40 and had left or was removed from the body in 44. The groups were similar with regard to Revised Trauma Score, Injury Severity Score, Penetrating Abdominal Trauma Index and type of colonic trauma.

Gunshot wounds of the colon: role of primary repair.

This is a prospective study of 100 patients with bullet injuries of the colon. Primary repair was performed except in cases of severe colonic damage requiring colectomy or in the presence of disseminated gross peritoneal contamination. Primary repair was performed in 76% with an incidence of abdominal sepsis of 11.

Colonic pH: a comparison between patients with colostomies due to trauma and colorectal cancer.

Colonic pH is important in the regulation of colonic cell growth, control of absorption and secretion, and bile acid degradation, which may be a key step in the development of colon cancer. This study determined the mucosal, luminal, and fecal pH in right and left colons of otherwise healthy patients who underwent colostomies because of trauma. The pH was evaluated while patients consumed a western diet.

Role of prophylactic antibiotics in open and basilar fractures of the skull: a randomized study.

The aim of this study was to investigate the controversial issue of the use of prophylactic antibiotics in open and basilar fractures of the skull. A series of 157 patients were randomized to receive no antibiotics (group A = 46 patients) or ceftriaxone for 3 days (group B = 50 patients), or the combination ampicillin/sulphadiazine for 3 days (group C = 61 patients). The incidence of meningitis was similar in both the antibiotic and non-antibiotic groups.

Control of life-threatening haemorrhage from the neck: a new indication for balloon tamponade.

We report the use of a Foley catheter, placed through the wound, to provide balloon tamponade of major bleeding from the neck and supraclavicular fossae. In 10 consecutive explorations for exsanguinating injury in these regions balloon tamponade was used eight times, and was judged to be fully effective in four patients, partly effective in one, and ineffective in three patients.

Antibiotic prophylaxis in penetrating injuries of the chest.

Most prospective studies recommend antibiotic prophylaxis whilst a thoracostomy tube is in place or even longer. We conducted a randomised study of 188 patients with penetrating chest injuries requiring a chest drain. Of these patients, 95 received a single dose of ampicillin before insertion of the chest tube, the remaining 93 patients received additional antibiotic prophylaxis for as long as the drain was in place.

Gunshot wound of the abdomen: role of selective conservative management.

This prospective study includes 146 patients with gunshot wounds of the abdomen. One hundred and five patients (72 per cent) had an acute abdomen on admission and were operated on immediately. The remaining 41 patients (28 per cent) had minimal or equivocal abdominal signs and were observed with serial clinical examinations.

Short-course antibiotic prophylaxis in penetrating abdominal injuries: ceftriaxone versus cefoxitin.

This was a prospective, randomized study of 123 patients with penetrating abdominal injuries. The patients received ceftriaxone or cefoxitin for 24 h (in the presence of colonic injury, 48 h). The overall incidence of abdominal sepsis was 7.

Pneumopericardium following penetrating chest injuries.

The presence of pneumopericardium following penetrating injuries of the chest is highly suggestive of a cardiac injury. For this reason, it is generally considered that its presence should be an indication for surgery. In the present study 20 patients with pneumopericardium were selected for conservative treatment.

The management of penetrating injuries of the back. A prospective study of 230 patients.

This is a prospective study of 230 patients with penetrating injuries of the back. The decision to operate or observe was taken exclusively on the abdominal physical findings. One hundred ninety-five patients (85%) did not require operation, 30 (13%) underwent a therapeutic laparotomy, four (1.