Surgery in South Africa - challenges and barriers
CONCLUSION: Despite high career satisfaction, South African surgeons face numerous barriers to pursuing and challenges in sustaining a career in surgery and often experience burnout. These barriers and challenges disproportionately affect female surgeons and can be mitigated through formalised mentorship programmes, flexible work schedules, funding for postgraduate training, and training in diversity and discrimination.PMID:34515420 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: P Naidu I Buccimazza Source Type: research

Surgery in South Africa - the attitudes toward mentorship in facilitating general surgical training
CONCLUSION: Eighty-three per cent of participants reported the importance of mentorship however two-thirds lacked a mentor. Most participants advocated for a mentorship group to facilitate surgical training. Establishing formalised mentorship programmes could mitigate the barriers to pursuing a surgical career.PMID:34515421 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: P Naidu I Buccimazza Source Type: research

Surgical rib fixation as an alternative method of treatment for multiple rib fractures: an audit of results compared with traditional medical management
CONCLUSIONS: Our preliminary results suggest that rib fixation should be considered a treatment alternative in patients with multiple rib fractures.PMID:34515422 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: B I Monzou L M Fingleson M S Moeng Source Type: research

The spectrum of blunt abdominal trauma in Pietermaritzburg
CONCLUSION: BAT is common in South Africa. Whilst the vast majority of patients require non-operative treatment, a welldefined subset require a laparotomy. Imaging is central to the management of patients with BAT.PMID:34515423 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: P Rhimes S Moffatt V Y Kong J L Bruce M T D Smith W Bekker G L Laing D L Clarke Source Type: research

The correlation between full moon and admission volume for penetrating injuries at a major trauma centre in South Africa
CONCLUSION: The correlation between full moon and trauma admission is unfound in our setting. The perpetuating notion that 'it must be full moon tonight' is likely to be an urban myth with no scientific evidence for such a claim.PMID:34515424 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: V Y Kong A A Keizer M M Donovan R D Weale N S Rajaretnam J L Bruce A Elsabagh D L Clarke Source Type: research

An analysis of paediatric snakebites in north-eastern South Africa
CONCLUSION: The majority of snakebites are cytotoxic in nature. One-fifth of the paediatric population require antivenom and one-fifth require a surgical procedure post envenomation. Adverse effects post antivenom use are common but manageable. Prevention programmes are needed to help reduce this burden of disease and a nationwide snakebite registry is long overdue.PMID:34515425 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: J J P Buitendag S Variawa D Wood G Oosthuizen Source Type: research

An audit of patients clinically deemed as high risk for malignant breast pathology at the Helen Joseph Hospital Breast Clinic
CONCLUSION: BI-RADS findings correspond to similar studies, however, a large number of benign breast disease was diagnosed. This may indicate heightened clinical awareness of breast cancer diagnosis and early detection. A significant percentage of malignancies presented as locally advanced. Except for a lower number of invasive lobular carcinoma, the histological spectrum of malignant disease is similar to comparative studies.PMID:34515426 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: H-M Brink G Rubin C-A Benn S Lucas Source Type: research

The surgical burden of breast disease in KwaZulu-Natal province
CONCLUSION: Breast sepsis accounts for almost 50% of the surgery and is mainly dealt with at hospitals above district level. One-third of breast surgery in KZN province is for non-benign disease. There is a paucity of breast-conserving surgery. Elucidation of these observations can guide improvement in the provincial breast care service.PMID:34515427 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: V U Ehlers C F Kohler E Lutge A Tefera D L Clark I Buccimazza Source Type: research

An audit of patients presenting with clinically benign breast disease to the Helen Joseph Hospital Breast Imaging Unit
CONCLUSION: There is a vast spectrum of benign conditions presenting in this population group with only 3.6% confirmed malignancies, confirming an accurate triage system utilised at the breast clinic. Radiological imaging is highly sensitive but less specific, emphasising the triad of clinical, radiological and histological assessment as the gold standard with regard to diagnosis of breast disease.PMID:34515428 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: N C Christofides G Rubin C-A Benn Source Type: research

Clinicopathological spectrum of small bowel obstruction and management outcomes in adults - experience at a regional academic hospital complex
The objective was to evaluate clinical presentation and treatment outcome of SBO.METHOD: Prospective cohort study between 2013-2014. Adult patients presenting with SBO were included. Demographics, clinical details, investigations, operative findings, in-hospital progress and outcomes were documented.RESULTS: There were 156 patients (median age 37 [IQR 27-54 years]) with early (44) and delayed (112) presentation. M:F ratio was 1.4:1. Common causes of obstruction were adhesions (94; 60.3%) and hernias (31; 19.9%). Non-operative management was feasible in 59 patients (37.3%) with a success rate of 71.2%. Nonviable bowel was p...
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: M R Mthethwa C Aldous T E Madiba Source Type: research

The spectrum of abdominal wall desmoid fibromatosis and the outcomes of its surgical treatment
CONCLUSION: Striking features of DF tumours at Chris Hani Baragwanath Academic Hospital (CHBAH) were their location, rapid growth, female gender and large size. Biological implant without complex plastic surgery techniques result in good outcomes, though the rate of progression of eventration to hernia is unknown.PMID:34515430 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: I Bombil L Ngobese Source Type: research

A 7-year retrospective review of renal trauma in paediatric patients in Johannesburg
CONCLUSION: Renal injuries in haemodynamically stable patients should be managed non-operatively. A 93% renal preservation rate was achieved in this cohort of patients with nephrectomy performed only in haemodynamically unstable patients with Grade V injuries, in keeping with international norms.PMID:34515431 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: N Z Mashavave A Withers T Gabler V Lack D Harrison J Loveland Source Type: research

Diabetes and lower extremity amputation - rehabilitation pathways and outcomes at a regional hospital
CONCLUSION: Over half the amputations were associated with DM, which was also a risk factor for multiple amputations. Although referral and attendance for physiotherapy were very poor, mobility in those who attended was excellent, indicating a dire need to improve hospital referral pathways.PMID:34515432 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: P Manickum S S Ramklass T E Madiba Source Type: research

Factors affecting bacteriology of hand sepsis in South Africa
CONCLUSION: Staphylococcus aureus infection was the most common. Streptococcus spp. occurred more frequently in patients with traumatic injury and diabetes mellitus. The latter required further surgical procedures and an increased hospital stay. Amoxicillin-clavulanic acid is the preferred empiric antimicrobial agent.PMID:34515433 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: M Van der Vyver A Madaree Source Type: research

Cardiac tamponade following post-pericardiotomy syndrome
We describe the first PPS with acute tamponade, weeks after diagnostic SPW for a PCI.PMID:34515434 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: K Gandhi J S K Reinders P H Navsaria Source Type: research

An inguinal hernia imposter
S Afr J Surg. 2021 Sep;59(3):130d-130e.ABSTRACTThis is a report of one of the many imposters of an irreducible inguinal hernia, a dermoid cyst. It is a rare entity that should be considered in the differential diagnosis of a groin lump when an atypical clinical presentation or groin examination occurs. Complete excision with histological evaluation remains the mainstay of surgical treatment.PMID:34515435 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: R R Patel S Tu J Plaskett Source Type: research

The role of surgery in Conn's syndrome - a case of refractory hypertension secondary to an aldosterone secreting adenoma
S Afr J Surg. 2021 Sep;59(3):131a-131c.ABSTRACTPrimary aldosteronism, eponymously known as Conn's syndrome, has recently gained recognition as the most common cause of endocrine hypertension. Unilateral subtypes, such as aldosterone secreting adenomas, are managed surgically and are potentially curable. The background of refractory hypertension and hypokalaemia in a forty-year-old man raised suspicions of Conn's syndrome which was localised to an aldosterone secreting adenoma in the right adrenal gland. The patient underwent a laparoscopic intraperitoneal right adrenalectomy which resulted in normalisation of his plasma al...
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: M D Carides N T Sishuba I Bombil C Christofides Source Type: research

Biliary tract anatomical variance - the value of MRCP
We report a case of a patient presenting with choledocholithiasis and type Va duplicated extrahepatic bile duct that was missed on ultrasonography. The atypical course prompted further imaging with magnetic resonance cholangiopancreatography (MRCP), which identified the aberrant bile duct and assisted in safe preoperative and operative management. This case highlights the importance of accurate pre-interventional imaging and agrees with the reclassification of duplications of the CBD.PMID:34515437 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: C Ferreira C B Noel W C Coetzee Source Type: research

Surgery in South Africa - challenges and barriers
CONCLUSION: Despite high career satisfaction, South African surgeons face numerous barriers to pursuing and challenges in sustaining a career in surgery and often experience burnout. These barriers and challenges disproportionately affect female surgeons and can be mitigated through formalised mentorship programmes, flexible work schedules, funding for postgraduate training, and training in diversity and discrimination.PMID:34515420 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: P Naidu I Buccimazza Source Type: research

Surgery in South Africa - the attitudes toward mentorship in facilitating general surgical training
CONCLUSION: Eighty-three per cent of participants reported the importance of mentorship however two-thirds lacked a mentor. Most participants advocated for a mentorship group to facilitate surgical training. Establishing formalised mentorship programmes could mitigate the barriers to pursuing a surgical career.PMID:34515421 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: P Naidu I Buccimazza Source Type: research

Surgical rib fixation as an alternative method of treatment for multiple rib fractures: an audit of results compared with traditional medical management
CONCLUSIONS: Our preliminary results suggest that rib fixation should be considered a treatment alternative in patients with multiple rib fractures.PMID:34515422 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: B I Monzou L M Fingleson M S Moeng Source Type: research

The spectrum of blunt abdominal trauma in Pietermaritzburg
CONCLUSION: BAT is common in South Africa. Whilst the vast majority of patients require non-operative treatment, a welldefined subset require a laparotomy. Imaging is central to the management of patients with BAT.PMID:34515423 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: P Rhimes S Moffatt V Y Kong J L Bruce M T D Smith W Bekker G L Laing D L Clarke Source Type: research

The correlation between full moon and admission volume for penetrating injuries at a major trauma centre in South Africa
CONCLUSION: The correlation between full moon and trauma admission is unfound in our setting. The perpetuating notion that 'it must be full moon tonight' is likely to be an urban myth with no scientific evidence for such a claim.PMID:34515424 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: V Y Kong A A Keizer M M Donovan R D Weale N S Rajaretnam J L Bruce A Elsabagh D L Clarke Source Type: research

An analysis of paediatric snakebites in north-eastern South Africa
CONCLUSION: The majority of snakebites are cytotoxic in nature. One-fifth of the paediatric population require antivenom and one-fifth require a surgical procedure post envenomation. Adverse effects post antivenom use are common but manageable. Prevention programmes are needed to help reduce this burden of disease and a nationwide snakebite registry is long overdue.PMID:34515425 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: J J P Buitendag S Variawa D Wood G Oosthuizen Source Type: research

An audit of patients clinically deemed as high risk for malignant breast pathology at the Helen Joseph Hospital Breast Clinic
CONCLUSION: BI-RADS findings correspond to similar studies, however, a large number of benign breast disease was diagnosed. This may indicate heightened clinical awareness of breast cancer diagnosis and early detection. A significant percentage of malignancies presented as locally advanced. Except for a lower number of invasive lobular carcinoma, the histological spectrum of malignant disease is similar to comparative studies.PMID:34515426 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: H-M Brink G Rubin C-A Benn S Lucas Source Type: research

The surgical burden of breast disease in KwaZulu-Natal province
CONCLUSION: Breast sepsis accounts for almost 50% of the surgery and is mainly dealt with at hospitals above district level. One-third of breast surgery in KZN province is for non-benign disease. There is a paucity of breast-conserving surgery. Elucidation of these observations can guide improvement in the provincial breast care service.PMID:34515427 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: V U Ehlers C F Kohler E Lutge A Tefera D L Clark I Buccimazza Source Type: research

An audit of patients presenting with clinically benign breast disease to the Helen Joseph Hospital Breast Imaging Unit
CONCLUSION: There is a vast spectrum of benign conditions presenting in this population group with only 3.6% confirmed malignancies, confirming an accurate triage system utilised at the breast clinic. Radiological imaging is highly sensitive but less specific, emphasising the triad of clinical, radiological and histological assessment as the gold standard with regard to diagnosis of breast disease.PMID:34515428 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: N C Christofides G Rubin C-A Benn Source Type: research

Clinicopathological spectrum of small bowel obstruction and management outcomes in adults - experience at a regional academic hospital complex
The objective was to evaluate clinical presentation and treatment outcome of SBO.METHOD: Prospective cohort study between 2013-2014. Adult patients presenting with SBO were included. Demographics, clinical details, investigations, operative findings, in-hospital progress and outcomes were documented.RESULTS: There were 156 patients (median age 37 [IQR 27-54 years]) with early (44) and delayed (112) presentation. M:F ratio was 1.4:1. Common causes of obstruction were adhesions (94; 60.3%) and hernias (31; 19.9%). Non-operative management was feasible in 59 patients (37.3%) with a success rate of 71.2%. Nonviable bowel was p...
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: M R Mthethwa C Aldous T E Madiba Source Type: research

The spectrum of abdominal wall desmoid fibromatosis and the outcomes of its surgical treatment
CONCLUSION: Striking features of DF tumours at Chris Hani Baragwanath Academic Hospital (CHBAH) were their location, rapid growth, female gender and large size. Biological implant without complex plastic surgery techniques result in good outcomes, though the rate of progression of eventration to hernia is unknown.PMID:34515430 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: I Bombil L Ngobese Source Type: research

A 7-year retrospective review of renal trauma in paediatric patients in Johannesburg
CONCLUSION: Renal injuries in haemodynamically stable patients should be managed non-operatively. A 93% renal preservation rate was achieved in this cohort of patients with nephrectomy performed only in haemodynamically unstable patients with Grade V injuries, in keeping with international norms.PMID:34515431 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: N Z Mashavave A Withers T Gabler V Lack D Harrison J Loveland Source Type: research

Diabetes and lower extremity amputation - rehabilitation pathways and outcomes at a regional hospital
CONCLUSION: Over half the amputations were associated with DM, which was also a risk factor for multiple amputations. Although referral and attendance for physiotherapy were very poor, mobility in those who attended was excellent, indicating a dire need to improve hospital referral pathways.PMID:34515432 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: P Manickum S S Ramklass T E Madiba Source Type: research

Factors affecting bacteriology of hand sepsis in South Africa
CONCLUSION: Staphylococcus aureus infection was the most common. Streptococcus spp. occurred more frequently in patients with traumatic injury and diabetes mellitus. The latter required further surgical procedures and an increased hospital stay. Amoxicillin-clavulanic acid is the preferred empiric antimicrobial agent.PMID:34515433 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: M Van der Vyver A Madaree Source Type: research

Cardiac tamponade following post-pericardiotomy syndrome
We describe the first PPS with acute tamponade, weeks after diagnostic SPW for a PCI.PMID:34515434 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: K Gandhi J S K Reinders P H Navsaria Source Type: research

An inguinal hernia imposter
S Afr J Surg. 2021 Sep;59(3):130d-130e.ABSTRACTThis is a report of one of the many imposters of an irreducible inguinal hernia, a dermoid cyst. It is a rare entity that should be considered in the differential diagnosis of a groin lump when an atypical clinical presentation or groin examination occurs. Complete excision with histological evaluation remains the mainstay of surgical treatment.PMID:34515435 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: R R Patel S Tu J Plaskett Source Type: research

The role of surgery in Conn's syndrome - a case of refractory hypertension secondary to an aldosterone secreting adenoma
S Afr J Surg. 2021 Sep;59(3):131a-131c.ABSTRACTPrimary aldosteronism, eponymously known as Conn's syndrome, has recently gained recognition as the most common cause of endocrine hypertension. Unilateral subtypes, such as aldosterone secreting adenomas, are managed surgically and are potentially curable. The background of refractory hypertension and hypokalaemia in a forty-year-old man raised suspicions of Conn's syndrome which was localised to an aldosterone secreting adenoma in the right adrenal gland. The patient underwent a laparoscopic intraperitoneal right adrenalectomy which resulted in normalisation of his plasma al...
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: M D Carides N T Sishuba I Bombil C Christofides Source Type: research

Biliary tract anatomical variance - the value of MRCP
We report a case of a patient presenting with choledocholithiasis and type Va duplicated extrahepatic bile duct that was missed on ultrasonography. The atypical course prompted further imaging with magnetic resonance cholangiopancreatography (MRCP), which identified the aberrant bile duct and assisted in safe preoperative and operative management. This case highlights the importance of accurate pre-interventional imaging and agrees with the reclassification of duplications of the CBD.PMID:34515437 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: C Ferreira C B Noel W C Coetzee Source Type: research

Surgery in South Africa - challenges and barriers
CONCLUSION: Despite high career satisfaction, South African surgeons face numerous barriers to pursuing and challenges in sustaining a career in surgery and often experience burnout. These barriers and challenges disproportionately affect female surgeons and can be mitigated through formalised mentorship programmes, flexible work schedules, funding for postgraduate training, and training in diversity and discrimination.PMID:34515420 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: P Naidu I Buccimazza Source Type: research

Surgery in South Africa - the attitudes toward mentorship in facilitating general surgical training
CONCLUSION: Eighty-three per cent of participants reported the importance of mentorship however two-thirds lacked a mentor. Most participants advocated for a mentorship group to facilitate surgical training. Establishing formalised mentorship programmes could mitigate the barriers to pursuing a surgical career.PMID:34515421 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: P Naidu I Buccimazza Source Type: research

Surgical rib fixation as an alternative method of treatment for multiple rib fractures: an audit of results compared with traditional medical management
CONCLUSIONS: Our preliminary results suggest that rib fixation should be considered a treatment alternative in patients with multiple rib fractures.PMID:34515422 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: B I Monzou L M Fingleson M S Moeng Source Type: research

The spectrum of blunt abdominal trauma in Pietermaritzburg
CONCLUSION: BAT is common in South Africa. Whilst the vast majority of patients require non-operative treatment, a welldefined subset require a laparotomy. Imaging is central to the management of patients with BAT.PMID:34515423 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: P Rhimes S Moffatt V Y Kong J L Bruce M T D Smith W Bekker G L Laing D L Clarke Source Type: research

The correlation between full moon and admission volume for penetrating injuries at a major trauma centre in South Africa
CONCLUSION: The correlation between full moon and trauma admission is unfound in our setting. The perpetuating notion that 'it must be full moon tonight' is likely to be an urban myth with no scientific evidence for such a claim.PMID:34515424 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: V Y Kong A A Keizer M M Donovan R D Weale N S Rajaretnam J L Bruce A Elsabagh D L Clarke Source Type: research

An analysis of paediatric snakebites in north-eastern South Africa
CONCLUSION: The majority of snakebites are cytotoxic in nature. One-fifth of the paediatric population require antivenom and one-fifth require a surgical procedure post envenomation. Adverse effects post antivenom use are common but manageable. Prevention programmes are needed to help reduce this burden of disease and a nationwide snakebite registry is long overdue.PMID:34515425 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: J J P Buitendag S Variawa D Wood G Oosthuizen Source Type: research

An audit of patients clinically deemed as high risk for malignant breast pathology at the Helen Joseph Hospital Breast Clinic
CONCLUSION: BI-RADS findings correspond to similar studies, however, a large number of benign breast disease was diagnosed. This may indicate heightened clinical awareness of breast cancer diagnosis and early detection. A significant percentage of malignancies presented as locally advanced. Except for a lower number of invasive lobular carcinoma, the histological spectrum of malignant disease is similar to comparative studies.PMID:34515426 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: H-M Brink G Rubin C-A Benn S Lucas Source Type: research

The surgical burden of breast disease in KwaZulu-Natal province
CONCLUSION: Breast sepsis accounts for almost 50% of the surgery and is mainly dealt with at hospitals above district level. One-third of breast surgery in KZN province is for non-benign disease. There is a paucity of breast-conserving surgery. Elucidation of these observations can guide improvement in the provincial breast care service.PMID:34515427 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: V U Ehlers C F Kohler E Lutge A Tefera D L Clark I Buccimazza Source Type: research

An audit of patients presenting with clinically benign breast disease to the Helen Joseph Hospital Breast Imaging Unit
CONCLUSION: There is a vast spectrum of benign conditions presenting in this population group with only 3.6% confirmed malignancies, confirming an accurate triage system utilised at the breast clinic. Radiological imaging is highly sensitive but less specific, emphasising the triad of clinical, radiological and histological assessment as the gold standard with regard to diagnosis of breast disease.PMID:34515428 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: N C Christofides G Rubin C-A Benn Source Type: research

Clinicopathological spectrum of small bowel obstruction and management outcomes in adults - experience at a regional academic hospital complex
The objective was to evaluate clinical presentation and treatment outcome of SBO.METHOD: Prospective cohort study between 2013-2014. Adult patients presenting with SBO were included. Demographics, clinical details, investigations, operative findings, in-hospital progress and outcomes were documented.RESULTS: There were 156 patients (median age 37 [IQR 27-54 years]) with early (44) and delayed (112) presentation. M:F ratio was 1.4:1. Common causes of obstruction were adhesions (94; 60.3%) and hernias (31; 19.9%). Non-operative management was feasible in 59 patients (37.3%) with a success rate of 71.2%. Nonviable bowel was p...
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: M R Mthethwa C Aldous T E Madiba Source Type: research

The spectrum of abdominal wall desmoid fibromatosis and the outcomes of its surgical treatment
CONCLUSION: Striking features of DF tumours at Chris Hani Baragwanath Academic Hospital (CHBAH) were their location, rapid growth, female gender and large size. Biological implant without complex plastic surgery techniques result in good outcomes, though the rate of progression of eventration to hernia is unknown.PMID:34515430 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: I Bombil L Ngobese Source Type: research

A 7-year retrospective review of renal trauma in paediatric patients in Johannesburg
CONCLUSION: Renal injuries in haemodynamically stable patients should be managed non-operatively. A 93% renal preservation rate was achieved in this cohort of patients with nephrectomy performed only in haemodynamically unstable patients with Grade V injuries, in keeping with international norms.PMID:34515431 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: N Z Mashavave A Withers T Gabler V Lack D Harrison J Loveland Source Type: research

Diabetes and lower extremity amputation - rehabilitation pathways and outcomes at a regional hospital
CONCLUSION: Over half the amputations were associated with DM, which was also a risk factor for multiple amputations. Although referral and attendance for physiotherapy were very poor, mobility in those who attended was excellent, indicating a dire need to improve hospital referral pathways.PMID:34515432 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: P Manickum S S Ramklass T E Madiba Source Type: research

Factors affecting bacteriology of hand sepsis in South Africa
CONCLUSION: Staphylococcus aureus infection was the most common. Streptococcus spp. occurred more frequently in patients with traumatic injury and diabetes mellitus. The latter required further surgical procedures and an increased hospital stay. Amoxicillin-clavulanic acid is the preferred empiric antimicrobial agent.PMID:34515433 (Source: South African Journal of Surgery)
Source: South African Journal of Surgery - September 13, 2021 Category: Surgery Authors: M Van der Vyver A Madaree Source Type: research