Biomedical subjects
Publications and source records attributed to P Ridings.
Many different pathological processes can present as an incarcerated inguinal hernia. We present an unusual case of sigmoid diverticular abscess presenting as a left incarcerated inguinal hernia and review the literature on this subject. This was treated with open drainage of the abscess cavity and laparotomy with segmental sigmoid resection and primary anastomosis.
Laparoscopic inguinal hernia repair is a new but accepted method of treatment for this common condition. It has several distinct advantages over traditional open types of repair but also has the potential for complications not found with open repair. We have performed over 1700 laparoscopic repairs in our unit and modified the technique over the last 5 years whilst auditing our results. We present a description of the technique and describe the common complications we have experienced and the methods we have employed to reduce these complications.
AIMS: To review from the evidence, with special reference to axillary node management, whether the incidence of lymphoedema following breast cancer treatment is falling in modern breast practice. CONCLUSIONS: The incidence of lymphoedema does seem to be reducing with modern approaches to breast cancer management. Axillary treatment seems to determine its development but more studies looking specifically at this problem are needed.
The development of a haematoma after wide excision of breast tumours is not uncommon. Suction drainage is commonly used to prevent this but often increases the hospital stay and can create unsightly wounds. Argon beam coagulation is a new technique which permits large 'raw' areas to be coagulated with minimal tissue damage. We believe that this technique may reduce the development of haematomas and seromas after breast surgery. We present our initial results using argon beam coagulation after wide excision of breast tumours in 80 patients without suction drainage. One patient required a single aspiration of a seroma at the site of breast lump excision and none required surgical drainage. Argon beam coagulation appears a useful adjunct in breast surgery and may help reduce hospital stay.
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Compartment syndrome in the upper arm is uncommon, but early recognition and treatment is as essential as it is in other sites. A case of compartment syndrome in the upper arm is reported.
There is a high incidence of postoperative nausea and vomiting after surgical correction of prominent ears. A prospective, randomized study was performed to determine if the method of dressing the ears influenced the incidence of postoperative vomiting. Avoidance of packing the external auditory meatus and concha produced a significant reduction in postoperative nausea (83% vs 30%; P < 0.005) and vomiting (63% vs 22%; P < 0.01).
A patient is described presenting with an acute lower gastrointestinal haemorrhage as a result of extensive colonic varices. Further investigation revealed that there were no oesophageal varices or splenomegaly. Liver biopsy showed grade II fatty change only, with no other specific or significant pathological features. Transhepatic portography showed a raised portal pressure (20 mm/Hg) but the portal system was patent throughout. There was an abnormal leash of vessels in the caecum thought to represent a variceal plexus. This patient was diagnosed as having idiopathic colonic varices. This case is discussed together with nine other reports of idiopathic colonic varices from the published literature. Four of these reports describe idiopathic colonic varices in more than one member of the same family. Possible modes of inheritance, aetiology of variceal change, natural history, and prognosis are discussed.