Clostridial myonecrosis is a necrotizing soft tissue infection characterized by muscular necrosis and, by extension, that of the surrounding tissue. If this infection develops quickly, it can cause septic shock and death if treatment is delayed. This infection does not occur frequently in civil medicine but nor is it exceptional after traumatic injuries or as a septic infection resulting from certain surgical interventions. Spontaneous development of clostridial myonecrosis is not uncommon (most commonly produced by the Clostridium septicum genus), propagated mainly from the colon in patients with neoplasia and in poor health. Consequently, in patients of bacteremia caused by C. septicum, colonic tumor must be ruled out. We present a new case of C. septicum myonecrosis of the abdominal after elective inguinal hernia repair.
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http://dx.doi.org/10.1016/s0009-739x(07)71272-1 | DOI Listing |
Importance: Routine preoperative blood tests and electrocardiograms before low-risk surgery do not prevent adverse events or change management but waste resources and can cause patient harm. Given this, multispecialty organizations recommend against routine testing before low-risk surgery.
Objective: To determine whether a multicomponent deimplementation strategy (the intervention) would reduce low-value preoperative testing before low-risk general surgery operations.
Surg Endosc
January 2025
Department of Surgery 1, General (Endoscopic) Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama Chuouku, Hamamatsu, Shizuoka, 431-3192, Japan.
Background: The impact of completely reducing or transecting a hernia sac on seroma formation in laparoscopic surgery for lateral inguinal hernias remains debated. To date, no studies have compared the incidence of seroma in hernia sacs left untouched versus other surgical approaches. Abandoning the hernia sac involves avoiding manipulation of the inguinal canal, unlike the manipulation required for transection or reduction of the hernia sac.
View Article and Find Full Text PDFBMJ Case Rep
January 2025
Radiology Department, Eric Williams Medical Sciences Complex, Mt. Hope, Trinidad and Tobago.
Amyand hernias are unusual inguinal hernias that contain the vermiform appendix. Rarely, an Amyand hernia can be complicated by acute appendicitis and present a diagnostic dilemma. Herein, we present the case of a complicated Amyand hernia that was initially diagnosed as an incarcerated inguinal hernia.
View Article and Find Full Text PDFAnesthesiology
February 2025
Department of Anaesthesia and Pain Management, Royal Children's Hospital, Melbourne, Victoria, Australia; Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.
Background: The general anaesthesia or awake-regional anaesthesia in infancy (GAS) trial demonstrated evidence that most neurodevelopmental outcomes at 2 and 5 yr of age in infants who received a single general anesthetic for elective inguinal herniorrhaphy were clinically equivalent when compared to infants who did not receive general anesthesia. More than 20% of the children in the trial had at least one subsequent anesthetic exposure after their initial surgery. Using the GAS database, this study aimed to address whether multiple (two or more) general anesthetic exposures compared to one or no general anesthetic exposure in early childhood were associated with worse neurodevelopmental outcomes at 5 yr.
View Article and Find Full Text PDFJ Med Case Rep
January 2025
Dept. of General Surgery, Fortis Hospital, Sector 62, Noida, UP, 201309, India.
Introduction: Amyand's hernia, an uncommon condition characterized by the presence of the appendix within an inguinal hernial sac (< 1% incidence), poses diagnostic and therapeutic challenges. Often it is an intraoperative finding, with almost no clinical symptoms.
Case Presentation: This is a case of an Indian male in his early 80 years, diagnosed with bilateral direct inguinal hernias, one of which contained a noninflamed appendix.
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