Introduction

The negative appendicectomy rate at Charlotte Maxeke Johannesburg Academic Hospital – a 10-year review

Acute appendicitis is one of the most common causes of an acute surgical abdomen. The diagnosis may be difficult as the presentation can be atypical and the differential diagnosis for an acute abdomen encompasses a variety of abdominal and pelvic organ pathologies. A good history, clinical examination with appropriate biochemical and radiological investigations are needed to make the diagnosis.

Outcomes for open and laparoscopic appendicectomy for complicated appendicitis in children

With increasing experience with laparoscopic surgery in children, laparoscopic appendectomy (LA) has become an established surgical approach for complicated appendicitis (CA) (gangrenous perforated or necrotic appendicitis with or without local or diffuse peritonitis or abscess formation).

The influence of HIV status on the duration of chemoradiotherapy for anal squamous cell carcinoma

An increase in the incidence of anal squamous cell carcinoma (ASCC) has been reported in recent years. The human immunodeficiency virus (HIV) epidemic has altered the demographics and clinical progression of this disease, changing it from one that mainly  involved women over the age of 58 to a disease of young people. The introduction of highly active antiretroviral therapy (HAART) has improved the survival rate and the immune function of people living with HIV (PLWH). There has also been an increase of non-AIDS defining cancers, including ASCC among PLWH.

Microsatellite instability in north Indian colorectal cancer patients and its clinicopathological correlation

Colorectal cancer (CRC) is the most commonly diagnosed cancer worldwide. This lethal malignant disease is the leading cause of cancer-related deaths around the world. According to global cancer statistics 2020, CRC ranked third in terms of new cases and fourth in terms of mortality. In India, the number of new cases of CRC in males were 40 408 (6.3%) and in females were 24 950 (3.7%) of total cancers.

Immunohistochemical determination of mismatch repair gene product in colorectal carcinomas in a young indigenous African cohort

South Africa has a low incidence of colorectal cancer (CRC), with age standardised incidence rates of 11.29/100 000 in males and 7.27/100 000 in females, according to the South African National Cancer Registry 2017. The incidence rate in the indigenous Black African population of South Africa is even lower at 4.8 in males and 3.46 /100 000 in females). Little is known about inherited CRCs in this population.

Patient perceptions of surgical training in the private sector in South Africa – a single centre survey

Academic hospitals are responsible for the training of surgeons and the subsequent surgical sub-specialties. Most surgical training programmes function as an apprenticeship where the trainee (either a registrar or fellow) is given progressive responsibility as they demonstrate increased competence. Initially, trainees will observe or assist during the surgical procedure, progressing to the position where they operate as the primary surgeon, and perform complex and critical parts of the procedure, while supervised by the consultant surgeon.

Surgical training during the COVID-19 pandemic – a single institution’s trainee survey

South Africa is the epicentre of COVID-19 in Africa, with 1 774 312 COVID-19 cases as of 17 June 2021, accounting for over half the cases on the continent. During the height of the pandemic, the public healthcare system restructured and redeployed staff to maximise intensive care facilities and provide an increased number of physicians to meet a rise in COVID-19 patient numbers. This was achieved by suspending non-urgent services, such as out-patient clinics and elective surgery, resulting in 71% of elective operations being cancelled.

A South Africa tertiary centre experience with redo mitral valve replacement

Acute rheumatic fever and rheumatic heart disease (RHD) remain major public health concerns worldwide, resulting in over 233 000 deaths annually. While the incidence has significantly decreased in high-income countries (HICs), it remains a major health burden in low- and middle-income countries (LMICs) and continues to cause significant morbidity and mortality.

Brachial artery injuries – the impact of the anatomical site of injury on postoperative outcomes

Brachial artery injuries were previously uncommon in Libyan society and were mainly caused by industrial and road traffic accidents. However, during the past decade, due to the political changes in the country, there has been widespread acquisition of weapons in the hands of unauthorised individuals, which has led to the start of armed civilian conflicts.

Organ transplantation during the COVID-19 pandemic – impact on deceased organ donor referrals and consent rates in the Western Cape, South Africa

The organ donation pathway is dependent on adequate health care resources allowing patients to access high level medical care (ventilator support) and their clinicians to take the time to counsel families at the end of life, and then to refer on to the transplant coordinator to make an approach for consent.

Double jeopardy avoided by thorough investigation

A 35-year-old man with multiple torso gunshot wounds presented to our large trauma unit. The gunshot wounds traversed the right chest and right flank. The patient was resuscitated according to advanced trauma life support (ATLS) guidelines. A right-sided intercostal drain (ICD) had been inserted at the referring clinic.

Profile of paediatric tuberculosis mastoiditis – a case series

Extrapulmonary TB (EPTB) constitutes about 15–20% of new TB cases in immunocompetent patients and accounts for more than 50% of new TB cases in HIV-positive individuals, potentially affecting any site of the body. Children may be at greater risk of developing EPTB. Diagnosis may be challenging, especially in children, where specimens obtained from relatively inaccessible sites are typically paucibacillary in nature.

The value of MRCP in children with biliary symptomatology – an essential adjunct for safe cholecystectomy

A 7-year-old girl presented with a 24-hour history of right upper quadrant pain. She had no significant medical or surgical history. Abdominal ultrasound suggested a bile duct cyst. Examination revealed mild tenderness in the right upper abdomen. Magnetic resonance imaging (MRI) and magnetic retrograde cholangiopancreatography (MRCP) showed a spherical cystic structure with sediment in the proximal portion of the gallbladder (GB) and connected to the common bile duct by a duct (Figure 1) in keeping with double GB. 

Accreditation

Health Professions Council of South Africa

MDB015/136/01/2022

3 Clinical

Certification

Attempts allowed: 2

70% pass rate





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South African Journal of Surgery - March 2022 - Vol 60 No 1

3.0 CPD Points