Canadian Journal of Surgery articles from June 2009

Canadian Journal of Surgery archives from June 2009

Canadian health care is not universal/le systeme de sante du Canada n'est pas universel.(EDITORIAL)(Report)
June 1, 2009... Canadian health care was front and centre in the minds of the American media this month. Unfortunately, it was not because the new Democratic Party government of Barack Obama was going to adopt some of the ideas and principles behind our...

Catastrophe surgery: response to multiple casualties or individual patients with devastating injuries.(QUILL ON SCALPEL/PLUME ET SCALPEL)(Report)
June 1, 2009... Picture this: you are a surgeon-on-call in a town in Saskatchewan and you receive word that a school bus has been in a head-on collision with another bus. Or the town is in British Columbia and a passenger train has derailed. Maybe you are in...

Update on managing diaphragmatic rupture in blunt trauma: a review of 208 consecutive cases.(RESEARCH/RECHERCHE)(Clinical report)
June 1, 2009... Blunt diaphragmatic rupture (BDR) occurs in up to 5% of trauma patients admitted to hospital. (1) The condition is rare and represents a challenge to diagnosis and management, particularly for the general surgeon who does not see this injury...

Outpatient thyroid surgery: Should patients be discharged on the day of their procedures?(RESEARCH/RECHERCHE)(Report)
June 1, 2009... The advent and betterment of outpatient surgery has dramatically changed the landscape of the profession. Just as other innovations such as antibiotics and improved anesthetics have led to better outcomes for surgical patients, outpatient...

Block to succeed: the Canadian orthopedic resident research experience.(RESEARCH/RECHERCHE)(Report)
June 1, 2009... Research has become an integral part of residency training across all specialties. In Canada, the CanMEDS initiative dictates the graduate to "contribute to the development, dissemination and translation of new knowledge and practices" as a...

Does general surgery residency prepare surgeons for community practice in British Columbia?(RESEARCH/RECHERCHE)(Report)
June 1, 2009... In Canada, there has historically been a great need for "generalists" or comprehensive general surgeons practising in the community setting, but Canadian training programs have been slow to address this need. (1,2) A generalist could be defined...

Detected peritoneal fluid in small bowel obstruction is associated with the need for surgical intervention.(RESEARCH/RECHERCHE)(Clinical report)
June 1, 2009... In the United States, hospital admissions for adhesive small bowel obstruction are responsible for nearly 1 million inpatient days and cost more than $1 billion annually. (1) Predicting the clinical course and timing of surgical intervention...

Substantial variation of both opinions and practice regarding perioperative fluid resuscitation.(RESEARCH/RERCHERCHE)(Report)
June 1, 2009... Perioperative fluid administration is integral to surgical care. Intravenous fluids maintain hydration while patients are unable to drink and replace losses that occur as a result of surgery. Severity of illness, magnitude and duration of...

Postoperative bedrest improves the alignment of thoracolumbar burst fractures treated with the AO spinal fixator.(RESEARCH/RECHERCHE)(Report)
June 1, 2009... Burst fractures comprise about 15% of all thoracolumbar spinal injuries. (1-4) Treatment options include nonoperative management, posterior surgery, anterior surgery and combined anterior and posterior surgery, and there is much controversy...

A biomechanical study of conventional acetabular internal fracture fixation versus locking plate fixation.(RESEARCH/RECHERCHE)(Report)
June 1, 2009... Recently, a new generation of internal fracture fixation has been developed using locking plates and screws. This technology has theoretical advantages over conventional internal fixation relating both to fracture biology and fracture...

Bariatric surgery waiting times in Canada.(RESEARCH/RECHERCHE)(Report)(Survey)
June 1, 2009... Obesity is now recognized as a chronic disease with multiple associated disorders. (1) According to the World Health Organization, obesity is reaching epidemic proportions with more than 1 billion adults who are overweight, 300 million who have...

The role of positron emission tomography in the management of non-small cell lung cancer.(Report)
June 1, 2009... Despite many advances in the diagnosis, staging and treatment of non-small cell lung cancer (NSCLC), the overall 5-year survival rate of patients with resectable NSCLC is less than 50%. (1) This suboptimal survival rate is likely due to many...

Computed tomographic angiography for the diagnosis of blunt cervical vascular injury.(CAGS AND ACS EVIDENCE-BASED REVIEWS IN SURGERY. 29)(Clinical report)
June 1, 2009... SELECTED ARTICLE Eastman AL, Chason DP, Perez CL, et al. Computed tomographic angiography for the diagnosis of blunt cervical vascular injury: Is it ready for primetime? J Trauma 2006;60:925-9. COMMENTARY Although BCVIs were...

Musculoskeletal case 44.(RADIOLOGY FOR THE SURGEON)(Clinical report)
June 1, 2009... A 63-year-old man had a 20-pack-year cigarette-smoking history but stopped smoking 16 years ago. On presentation, his initial chest radiograph showed abnormal shadows in the upper lobe of his left lung. We made a definitive diagnosis of lung...

Combined large Hill--Sachs and bony Bankart lesions treated by Latarjet and partial humeral head resurfacing: a report of 2 cases.(CASE SERIES)(Clinical report)
June 1, 2009... The bony conformity of the glenoid and humeral head articular surfaces provides some of the stability of the shoulder. Frequently, patients with recurrent dislocations have bony deficits in one or both of these surfaces. Glenohumeral...

Online case notes.(CONTINUING MEDICAL EDUCATION/FORMATION MEDICALE CONTINUE)(Bibliography)(List)
June 1, 2009... Case notes appear in full text online only and not in the print version of the Canadian Journal of Surgery. These case notes are available at www.cma/cjs and will be indexed in PubMed. Les notes de cas sont affichees en texte integral...

Clarification of the Simmonds-Thompson test for rupture of an Achilles tendon.(CASE NOTE)(Report)
June 1, 2009... The Simmonds-Thompson test, described in 1957 and 1962, (1-3) respectively, remains the principal clinical test for rupture of an Achilles tendon. However, there is some discrepancy in the literature regarding its mechanical significance. A...

Giant mesenteric cystic lymphangioma in an infant presenting with acute bowel obstruction.(CASE NOTE)(Clinical report)
June 1, 2009... Abdominal cystic lymphangiomas (ACLs) are rare congenital benign malformations of the lymphatic system that are usually located in the small-bowel mesentery, followed by the omentum, mesocolon and retroperitoneum. (1) Most lymphangiomas are...

Cemented bipolar hemiarthroplasty in osteoporosis for failed femoral neck fixation.(CASE NOTE)(Clinical report)
June 1, 2009... Osteopetrosis refers to a group of disorders characterized by severe impairment of osteoclast-mediated bone resorption. Other terms that are often used for this disease are marble bone disease, which describes the solid radiographic appearance...

Monitoring placement of high thoracic pedicle screws by triggered electromyography of the intercostal muscles.(CASE NOTE)(Clinical report)
June 1, 2009... Pedicle screw-based constructs provide a stronger basis for spinal instrumentation and fusion than hooks. Placement of the screws within the pedicles is a technically challenging procedure. The orientation of the pedicles with respect to...

Colonic large-cell neuroendocrine tumours.(CASE NOTE)(Disease/Disorder overview)(Clinical report)
June 1, 2009... Neuroendocrine tumours (NETs) are rare neoplasms originating from the neuroendocrine system. They are classified into 3 different subtypes: well-differentiated NETs (carcinoid), well-differentiated endocrine carcinomas (malignant carcinoid) and...

Hibernoma of the neck: a rare benign tumour.(CASE NOTE)(Clinical report)
June 1, 2009... Hibernoma is a rare benign tumour arising from remnants of fetal brown adipose tissue. Clinically, and on magnetic resonance imaging (MRI), the non-lipoma like hibernoma subtype can look like a malignant tumour. We present a case showing the...

Teratoma of the greater omentum.(CASE NOTE)(Clinical report)
June 1, 2009... Mature teratomas (benign cystic teratomas or dermoid cysts) are among the most common ovarian tumours; however, teratomas of the omentum and mesentery are extremely rare. (1) The first omental dermoid cyst was described by Lebert in 1734. (2)...

Incidental carcinoma in bullous emphysema.(CASE NOTE)(Clinical report)
June 1, 2009... Bullous disease of the lung and pneumothorax are both frequent conditions in thoracic surgery. (1) Lung cancer may develop in patients with bullous emphysema, (1,2) lung cysts (3) and pneumothorax, (4) which are usually treated as benign...

Incidental malignant carcinoid within Crohn ileitis.(CASE NOTE)(Clinical report)
June 1, 2009... The association of Crohn disease and adenocarcinoma of the small intestine and colon has been well established. (1) However, malignant carcinoid of the small intestine associated with Crohn disease is rare. We describe the case of a patient...

Inflammatory myofibroblastic tumour.(CASE NOTE)(Clinical report)
June 1, 2009... Inflammatory myofibroblastic tumours (IMTs), previously accepted as a subtype of the group of tumours called inflammatory pseudotumours, are now recognized to comprise their own, discrete diagnosis. Since IMTs can arise from various anatomic...

Intrathoracic scapular impaction: an unusual complication of scapular fractures.(CASE NOTE)(Clinical report)
June 1, 2009... Scapular fractures make up 5% of shoulder fractures and require significant force to occur. Patients often have associated injuries, leading to a mortality of 10% for this patient population. (1,2) Most scapular fractures can be treated...

Lisfranc injury caused by a pedal brake perforating the foot.(CASE NOTE)(Clinical report)
June 1, 2009... The tarsometatarsal joint or Lisfranc joint is a complex articulation whose stability is provided by the osseous, capsular and ligamentous attachments. Lisfranc lesions (LFLs) are commonly fracture-dislocations of the Lisfranc joint and are...

Breast cancer infiltration by cardiothoracic surgery.(CASE NOTE)(Clinical report)
June 1, 2009... Carcinoma of the breast is the most common site-specific cancer in women and is one of the leading causes of death among women. Concomitant coronary artery disease with breast carcinoma is not an infrequent clinical entity. In the literature,...

Carcinoma in the fourth part of the duodenum.(CASE NOTE)(Clinical report)
June 1, 2009... Cancer of the small intestine makes up 2% of all malignant tumours of the gastrointestinal tract, with 40% of them being adenocarcinomas. (1) Of these adenocarcinomas of the small intestine, 45%-55% lie within the duodenum. (2) Because the...

Cholecystic adenosquamous carcinoma mimicking Mirizzi syndrome.(CASE NOTE)(Clinical report)
June 1, 2009... Mirizzi syndrome is a rare form of benign obstructive jaundice that is caused by a stone impacted either in the gallbladder neck or in the cystic duct, impinging on the right side of the common hepatic duct. (1) This entity is often difficult...

Mature cystic teratoma in the posterior mediastinum.(CASE NOTE)(Clinical report)
June 1, 2009... Mediastinal tumours tend to occur in particular subregions (superior, anterior, middle and posterior), according to their histology, and tumour location is considered to be an important differentiating criterion. (1) Tumours in the anterior...

Persistent nonhealing skin fistulous tract after congenital diaphragmatic hernia repair.(CASE NOTE)(Clinical report)
June 1, 2009... Infectious complications after surgical treatment for congenital diaphragmatic hernia (CDH) are rare. (1) We present the case of a patient with a nonhealing skin fistula following surgical treatment for CDH. CASE REPORT A newborn boy...

Perforated obturator Littre hernia.(CASE NOTE)(Clinical report)
June 1, 2009... Meckel diverticulum and obturator hernia are rare causes of intestinal obstruction. We present the unique case of an elderly woman with acute abdomen secondary to the coexistence of both these conditions. CASE REPORT A 75-year-old...