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- Volume 10, Issue 2, 2012
South African Gastroenterology Review - Volume 10, Issue 2, 2012
Volume 10, Issue 2, 2012
Author Sandie ThomsonSource: South African Gastroenterology Review 10 (2012)More Less
After a year and a half at UCT as the "Surgeon" Head of Medical Gastroenterology, I have just filled in my probationary report card, and I was wondering if it was good enough to confirm my appointment. As I was in need of recharging my surgical orientated batteries, I was therefore looking forward to attending the International HepatoBiliary Association Congress in Paris which, courtesy of Professor Bornman, I had been an invited speaker.
Author Keith NewtonSource: South African Gastroenterology Review 10, pp 5 –7 (2012)More Less
Welcome to Durban and to the celebration of the 50th SAGES congress.
The first SAGES congress was held in 1962 on the sidelines of the annual Medical Association of South Africa congress. We have had a further 48 congresses since then, and now celebrate the milestone of our 50th SAGES congress. To mark this important anniversary we have produced a "celebration booklet" with contributions of messages and memories of previous congresses. We hope you enjoy it.
Author Robert BaigrieSource: South African Gastroenterology Review 10 (2012)More Less
As always, it is a real pleasure to welcome you to the SAGES/SASES meeting. But it gives us particular pleasure this year to contribute to the successful celebration of our sister society's 50th anniversary meeting. This is a fine achievement for generations of SAGES office bearers and members, and we are grateful to them all.
Source: South African Gastroenterology Review 10, pp 13 –15 (2012)More Less
In November 2011 a 66-year-old man presented acutely unwell to the surgical team with abdominal pain, back pain and urinary symptoms. His abdomen was tender but not peritonitic with a palpable suprapubic mass. On plain abdominal radiographs he had a segmental large bowel dilatation of the right colon with transition to normal caliber colon at the hepatic flexure. On abdominal CT scan he had a small supra renal aortic arch aneurysm with no evidence of a retroperitoneal leak, a large bladder mass was noted as were three small liver lesions. Though he remained clinically stable his abdominal signs failed to abate and a decision was made to perform a laparotomy. At operation a right hemi colectomy for a non-perforated ischaemic bowel segment was performed and an ileostomy fashioned. One of the liver lesions was biopsied and found to be benign and a transurethral resection of the bladder tumor performed. The bladder histology was that of a non-invasive papillary transitional cell carcinoma. He recovered well. At this juncture his aneurysm was to be monitored only and he was anticoagulated.
Source: South African Gastroenterology Review 10, pp 17 –18 (2012)More Less
A 62 year old female was diagnosed with Crohn's colitis and complex perianal disease, in April 2010. Colonic involvement to the splenic flexure was confirmed on endoscopy and subsequent colonic biopsies demonstrated active non-necrotising granulomatous inflammation. Sigmoid diverticulosis was noted on the index endoscopy, in addition to the index contrasted abdominal computerized tomography scan (CT). A perianal fistula and peri-natal cleft ulceration was confirmed during examination under anaesthesia and a seton was inserted through the fistulous tract. The initial therapeutic regimen included systemic and topical corticosteroids, in addition to concurrent oral Azathioprine. However, both Azathioprine and then 6-mercaptopruine, resulted in severe gastrointestinal side effects, necessitating a change to intramuscular Methotrexate at a dose of 25 mg weekly. This sequence of therapeutic setbacks resulted in poor overall control of the disease.
Faecal transplantation for the treatment of recurrent clostridium difficile associated diarrhoea : reviewAuthor K.A. KarlssonSource: South African Gastroenterology Review 10 (2012)More Less
A 63 year old lady with a past diagnosis of ulcerative proctitis presented with a recurrence of her symptoms. Two years previously she had been successfully treated with asacol suppositories and 1 year previously she discontinued all therapy and did not return for follow up. Chronic conditions include hypertension, hyperthyroidism.
Source: South African Gastroenterology Review 10, pp 21 –22 (2012)More Less
A 28 year old male presented to the emergency unit with a month history of periumbilical abdominal pain. It was gripping did not radiate, had no relieving nor aggravating factors and was associated with a weight loss of approximately 6kg. He had drenching night sweats, nausea and vomiting for two weeks. There was no significant past medical or family history. He denied the use of illicit drugs, alcohol and other medications. He weighed 55kg, was afebrile and his eyes appeared normal with no evidence of exophthalmos, lid retraction or lid lag. The following (FBC, serum amylase and lipase, TSH, Ca, PTH, D dimer and CRP) initial blood tests performed were normal. His blood, stool and sputum investigations were normal. His electrocardiogram (ECG) showed a sinus tachycardia. Gastroscopy showed fundal gastritis. Chest and abdominal radiographs were normal as was a trans-abdominal ultrasound.
Author S.R. ThomsonSource: South African Gastroenterology Review 10, pp 23 –24 (2012)More Less
Since my arrival 18 months ago, I have rekindled Emeritus Prof Philip Bornman's desire to tidy up his outstanding contributions to surgery. One of these is the collation of his own life time cohort of Zollinger Ellison Syndrome patients. This is because, he and I believe his data and insights deserve to be on record rather than ending up as simple personal recollections only he can take to his retirement home at Britannia Bay on the West Coast.
Source: South African Gastroenterology Review 10 (2012)More Less
Chronic pancreatitis (CP) is defined as a continuing inflammatory disease of the pancreas characterised by irreversible morphological changes, often associated with pain and with the loss of exocrine and/or endocrine function that may be clinically relevant. Alcohol is the predominant cause of CP in the western world and is particularly prevalent in South Africa, especially in the indigent patient. CP ranks high among intractable diseases of the gastrointestinal tract. The tendency for substance abuse in the alcohol-induced group poses major psychological and socioeconomic problems.
Returning to ethics is the only way to reclaim ownership of our profession : private practice reportAuthor Darian Van LoggerenbergSource: South African Gastroenterology Review 10 (2012)More Less
Many people have taken to complaining of their lot in a world so obsessed with commercialism and conspicuous consumption that it leads to people committing criminal acts in order to enrich themselves. We have become so immersed in it that we have forgotten that even so called "small" breaches of ethics are criminal acts. This article therefore begins with the reminder that the Ethical Rules of the Health Professions Council are the Regulations of the Health Professions Act, and therefore represent the law that doctors are obligated to obey in the execution of their duties.
Author Trevlyn BurgerSource: South African Gastroenterology Review 10 (2012)More Less