Sri Lanka Journal of Surgery最新文献

{"title":"Gallstone-ileus: an uncommon presentation of cholelithiasis","authors":"S. Madawanarachchi, N. N. Wijesundera, T. Indika","doi":"10.4038/sljs.v39i3.8791","DOIUrl":"https://doi.org/10.4038/sljs.v39i3.8791","url":null,"abstract":"Introduction Cholelithiasis is the commonest biliary pathology seen in surgical practice. The majority of patients remain asymptomatic while others present with biliary colics, acute cholecystitis and gallstone pancreatitis. Gallstone ileus is one such uncommon presentation, in which there is a mechanical obstruction of the intestines by an impacted gallstone that has migrated through a bilio-enteric fistula. This condition is seen in elderly patients who have a history of neglected gallstones disease and it carries high morbidity and mortality.","PeriodicalId":227431,"journal":{"name":"Sri Lanka Journal of Surgery","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128470390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the climate emergency editorial relevant to surgeons?","authors":"Jay G. Fernando","doi":"10.4038/sljs.v39i3.8916","DOIUrl":"https://doi.org/10.4038/sljs.v39i3.8916","url":null,"abstract":"Introduction The sequence of anthropogenic greenhouse gas (GHG) emissions causing climate change is now universally accepted[1]. To highlight the urgent need to reverse climate change, editors of 231 leading international medical journals[2] published a common climate emergency editorial[3] in their September 2021 issues. The signatory journals include those with a widespread reach as well as surgical journals.","PeriodicalId":227431,"journal":{"name":"Sri Lanka Journal of Surgery","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115000845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of refeeding syndrome after right hemicolectomy","authors":"D. R. Samarathunga, W. Wickramarachchi, Kokulan Thavarasa, S. Sivaganesh","doi":"10.4038/sljs.v39i3.8804","DOIUrl":"https://doi.org/10.4038/sljs.v39i3.8804","url":null,"abstract":"Case presentation A 53-year-old previously healthy male presented with episodes of abdominal colics, bilious vomiting and progressive anorexia of six months duration. He had been on a low-calorie liquid diet due to his symptoms over the previous two months duration and lost 20 kg in weight during this period. Past surgical history was unremarkable. He was wasted with a body mass index (BMI) of 15.1 kg/m2. The mid-arm circumference was 16.5 cm. The abdomen was scaphoid but otherwise normal except for visible peristalsis. Other systems were normal. Key biochemical parameters from admission to discharge are shown in figure 1.","PeriodicalId":227431,"journal":{"name":"Sri Lanka Journal of Surgery","volume":"72 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122784842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Future direction of surgical training and services in Sri Lanka","authors":"Sljs Editorial Team","doi":"10.4038/sljs.v39i3.8919","DOIUrl":"https://doi.org/10.4038/sljs.v39i3.8919","url":null,"abstract":"Future directions of breast surgery in Sri Lanka Breast surgery has traditionally remained primarily within the scope of general surgeons and Oncological Surgeons in Sri Lanka. While this has ensured the availability of surgical treatment for diseases of the breast at all secondary and tertiary care hospitals, a relative lack of advancements and availability of newer techniques were observed in Sri Lanka, especially when compared with other branches of general surgery including gastrointestinal and hepatobiliary surgery. For instance, sentinel lymph node biopsy (SLNB) and wide local excision (WLE) for breast cancer are not offered on a regular basis in Sri Lanka at present [1], although SLNB and WLE have been the routine practice and included as the standard of care in most guidelines for over two decades [2, 3]. Many factors are known to have contributed to this situation including lack of training, heavy workload, lack of availability of mammography and other advanced imaging and lack of pathology services for intraoperative assessment of sentinel lymph nodes [4].","PeriodicalId":227431,"journal":{"name":"Sri Lanka Journal of Surgery","volume":"379 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131767854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A synopsis of surgical training in Sri Lanka: the past","authors":"P. Chandrasinghe","doi":"10.4038/sljs.v39i3.8917","DOIUrl":"https://doi.org/10.4038/sljs.v39i3.8917","url":null,"abstract":"","PeriodicalId":227431,"journal":{"name":"Sri Lanka Journal of Surgery","volume":"124 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134464274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoracoscopic resection of neurogenic tumours in two children","authors":"M. Hettiarachchi, K. Galketiya","doi":"10.4038/sljs.v39i3.8758","DOIUrl":"https://doi.org/10.4038/sljs.v39i3.8758","url":null,"abstract":"Conventionally thoracic neurogenic tumours are resected through open thoracotomy but with the availability of miniature endoscopic instruments and improved laparoscopic skills, Video-Assisted Thoracoscopic Surgery(VATS) is increasingly being accomplished with similar long term results[2,3]. Here we report two children who underwent thoracoscopic resection of thoracic neuroblastoma and neurofibroma.","PeriodicalId":227431,"journal":{"name":"Sri Lanka Journal of Surgery","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134044969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Live donor kidney transplantation in a COVID 19 positive patient: case report and literature review","authors":"J. Arudchelvam, R. Samarasinghe, L. Nazar","doi":"10.4038/sljs.v39i3.8862","DOIUrl":"https://doi.org/10.4038/sljs.v39i3.8862","url":null,"abstract":"Introduction Coronavirus disease 2019 [COVID-19] has become a pandemic resulting in a large number of deaths. The complications of COVID-19 are severe in posttransplantation patients on immunosuppression, resulting in more mortality. Therefore renal transplantations [KT] were stopped temporarily in Sri Lanka during the peak of the COVID-19 epidemic. And a few months later when the KT was restarted only patients who were real-time polymerase chain reaction [PCR] test negative was accepted for KT. This case report describes a live donor KT done on a patient who recovered from COVID-19 infection but had persistently positive PCR test. Case presentation A 29-year-old male with end-stage renal failure due to chronic kidney disease of unknown aetiology underwent a live donor KT. He had COVID-19 infection more than 4 weeks before the KT and was asymptomatic with normal chest X-ray [CXR] and white cell count [WBC]. But his PCR was positive. The donor was a 41-year-old male. The KT was done on 2nd February 2021. He had no significant postoperative complications. Discussion and conclusions The main diagnostic tests for COVID-19 infection are PCR and Rapid antigen tests. PCR detects the viral genomic RNA. It is known that patients who clinically recover from COVID19 infection continue to excrete RNA particles. These are detected by PCR. Therefore it is suggested that if a patient clinically recovers from COVID-19 and has normal WBC, CXR and 6 weeks after the onset of initial infection can undergo KT safely despite having a positive PCR. Correspondence: Arudchelvam Joel E-mail: joelaru@yahoo.com https://orcid.org/0000-0002-4371-4527 Received: 07-09-2021 Accepted: 27-11-2021 DOI: http://doi.org/10.4038/sljs.v39i3.8862 The Sri Lanka Journal of Surgery 2021; 39(3): 71-74 7","PeriodicalId":227431,"journal":{"name":"Sri Lanka Journal of Surgery","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132824913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Whitmore's disease: an uncommon urological infectious disease","authors":"M. Sivashankar, A. Nandasena","doi":"10.4038/sljs.v39i3.8681","DOIUrl":"https://doi.org/10.4038/sljs.v39i3.8681","url":null,"abstract":"Introduction Melioidosis is one of the rare infectious diseases in humans, and it is caused by a gram-negative bacteria called Burkholderia pseudomallei [1]. This infectious disease is common in Australia and Southeast Asia; however, the number of newly reported cases in Sri Lanka has increased over recent years [2]. The spectrum of disease can affect any organ in the body, and it can be range from pure benign skin and soft tissue infections to fatal septicemia. Isolated prostate abscess due to melioidosis is uncommon. This case scenario aims to share our experience in the identification and management of primary melioidotic prostatic abscesses.","PeriodicalId":227431,"journal":{"name":"Sri Lanka Journal of Surgery","volume":"119 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123250410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autonomously functioning thyroid nodule: a patient-based review","authors":"D. Pinto, Ranil Fernando","doi":"10.4038/sljs.v39i3.8857","DOIUrl":"https://doi.org/10.4038/sljs.v39i3.8857","url":null,"abstract":"Autonomously Functioning Thyroid Nodule (AFTN) is a rare cause of hyperthyroidism. AFTN, first described by Emil Goetsch in 1918, is the presence of a single hyperfunctioning thyroid nodule, which is not under the control of the pituitary/thyroid axis. The current theory on the development of hyperfunctioning nodules is the constitutive activation of Thyroid Stimulating Hormone Receptor (TSHR) due to a somatic point mutation and mutations of Gsa. The reported incidence of AFTN is about 1% on the investigation of thyroid nodules. Only about 10% 30% become hyperfunction. Due to the rarity and lack of understanding of its characteristic clinical behaviour, AFTNs are often overlooked and undertreated. The ensuing review is based on a 36-year-old female who underwent left hemithyroidectomy for an AFTN and is well to date. There are two main issues in the diagnosis and management of AFTN. The first is that the diagnosis is not always made as most patients with AFTNs are functionally euthyroid. The other is the paucity of data in the literature to offer evidencebased individualized management for patients. As there are no tissue diagnostic criteria for AFTN; clinical, biochemical and radiological assessments to establish TSH independent nodular hyperfunction will clinch the diagnosis. Surgery and Radioiodine ablation remain the main forms of treatment for AFTN. Other methods such as percutaneous ethanol injection therapy (PEIT), laser ablation (LA), radiofrequency ablation (RFA) have a limited role in the management of an AFTN. The newer methods alluded to above will need further evaluation and a better definition of exact roles in the management of an AFTN. Correspondence: M. D. P. Pinto E-mail: d.pinto@kln.ac.lk https://orcid.org/0000-0002-3892-2997 Received: 02-07-2021 Accepted: 18-09-2021 DOI: http://doi.org/10.4038/sljs.v39i3.8857 The Sri Lanka Journal of Surgery 2021; 39(3): 49-54 49 Introduction Hyperthyroidism usually refers to increased synthesis and secretion of thyroid hormone from the thyroid gland. Thyrotoxicosis refers to the clinical syndrome of excess circulating thyroid hormones, due to any cause. The incidence of hyperthyroidism in iodine–sufficient western world is 0.2% 1.3% [1]. The common causes of Hyperthyroidism are diffuse toxic goitre (Graves Disease), toxic nodular goitre (Plummer Disease), and toxic phase of autoimmune thyroiditis. Rarely, an Autonomously Functioning Thyroid Nodule (AFTN) will cause hyperthyroidism. Hyperfunctioning malignant thyroid metastases, drug-induced hyperthyroidism and factitious ingestion of excess thyroid hormone are rare causes of toxic symptoms, especially in the iodine sufficient regions. AFTN is the presence of a single hyperfunctioning thyroid nodule, which is not under the control of the pituitary/thyroid axis using Thyroid Stimulating Hormone (TSH). AFTN was first described by Emil Goetsch in 1918. Goetsch demonstrated a high concentration of mitochondria in hyperfunctioning thyroid nodules. ","PeriodicalId":227431,"journal":{"name":"Sri Lanka Journal of Surgery","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116887532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sri Lanka Journal of Surgery : chronicles of half a century","authors":"Nuwanthika Karunarathne, A. Malalasekera","doi":"10.4038/sljs.v39i3.8920","DOIUrl":"https://doi.org/10.4038/sljs.v39i3.8920","url":null,"abstract":"History is made on pillars of time and perseverance. It's built with hope, knowledge, wisdom and modesty. Such was our beginning, as the Sri Lanka journal of Surgery in 1970. A wonderful mix of all that and more. The College of Surgeons was founded in 1971 in the era of bell-bottoms and disco and also amidst brewing political unrest. It had a rather muted commencement without any assets but the eagerness of the generation of surgeons in that era.","PeriodicalId":227431,"journal":{"name":"Sri Lanka Journal of Surgery","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121810506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}