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Surgery
Published in Andrew Schofield, Paul Schofield, The Complete SAQ Study Guide, 2019
Andrew Schofield, Paul Schofield
A 19-year-old man is seen by his GP for a swelling in his left groin. He noticed it shortly after he began going to the gym. On examination, a mass is palpable in the left groin, which has a cough impulse. The diagnosis of a left inguinal hernia is made. What is the definition of a hernia? (1)With relation to the pubic tubercle, how do you differentiate between inguinal and femoral hernias? (1)With relation to the inferior epigastric vessels, how do you differentiate between indirect and direct inguinal hernias? (1)Using embryology, explain how indirect inguinal hernias occur. (2)Give two risk factors for inguinal hernias. (2)What is the difference between an obstructed and a strangulated inguinal hernia? (1)Give two complications following inguinal herniotomy surgery. (2)
Neonatal and General paediatric Surgery
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
Irreducible hernias will usually reduce spontaneously or with ‘taxis’ following the administration of the analgesia. A strangulated hernia requires urgent resuscitation followed by surgical reduction of viable contents, resection of necrotic intestine, followed by herniotomy. The ipsilateral testis may be congested due to obstruction of the venous return.
Abdominal wall, hernia and umbilicus
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
In children who have lateral hernias with a persistent processus, it is sufficient just to remove and close the sac. This is called a herniotomy. In adult surgery, herniotomy alone has a high recurrence rate and some form of muscle strengthening is added (herniorrhaphy).
Estimating the Lumbar Puncture Needle Depth in Children
Published in Journal of Investigative Surgery, 2021
Derya Celik, Ozkan Onal, Seza Apiliogullari, Inci Kara, Jale Bengi Celik
A lumbar puncture (LP) has long been used for diagnostic purposes and sometimes treatment in various disciplines. LP is an important diagnostic way for the central nervous system infectious diseases such as meningitis [1]. In addition, intrathecal drugs are applied using LP in the treatment of children with acute lymphoblastic leukemia and meningeal metastases [2]. Intrathecal opioid use in cancer pains is quite effective in children [3]. The first report of spinal anesthesia was in 1898, when August Bier administered spinal block to six patients, two of whom were children [4]. In 1899, Bainbridge used this technique in a herniotomy operation in a 3-month old infant [5]. After 1984, the popularity of spinal anesthesia increased, especially among children who may be at risk from general anesthesia [6]. The accuracy of the location of a LP is confirmed by a constant flow of cerebrospinal fluid (CSF) from the LP needle [7].
Surgical antimicrobial prophylaxis and its dose appropriateness among paediatric patients in a Nigerian teaching hospital
Published in Journal of Chemotherapy, 2019
Kazeem Adeola Oshikoya, Ibrahim Abayomi Ogunyinka, Comfort Adamaigbo, Ahmed Olowo-Okere
Of the 303 surgical patients, 296 (97.7%) received 550 prescriptions for antimicrobial agents. The remaining seven patients who had herniotomy (n = 3) or circumcision (n = 4) did not receive any antimicrobial agent. Majority of the patients (249; 82.2%) were prescribed two antimicrobial agents, 44 (14.9%) were prescribed a single antimicrobial, and only 3 (1.0%) were prescribed three antimicrobials.