Hernie interne du ligament falciforme: une cause rare d'occlusion intestinale

Les hernies internes sont une cause rare d'occlusion intestinale aiguë. La hernie à travers le ligament falciforme est une forme exceptionnelle dont le diagnostic est souvent fait en peropératoire. La tomodensitométrie abdominale, pratiquée en urgence, peut aider au diagnostic en préopératoire et permet de guider l'attitude thérapeutique. Aussi, nous a-t-il paru opportun de rapporter ce cas colligé dans le service de chirurgie viscérale A du CHU Hassan II de Fès. Nous rapportons l'observation d'un patient âgé de 48 ans, sans antécédent particulier, admis aux urgences avec un tableau d'occlusion évoluant depuis 4 jours. La radiographie d'abdomen sans préparation objectivait de multiples niveaux hydro-aériques de type grêlique dont certains se projetaient en regard de l'air hépatique, ainsi que la présence d'une anse intestinale plate en continuité avec un segment intestinal distendu. La tomodensitométrie abdominale n'a pas été réalisée vu une fonction rénale qui était altérée. Le patient était alors opéré en urgence après mise en condition et le diagnostic d'une hernie interne du ligament falciforme était fait en peropératoire. La hernie interne à travers le ligament falciforme est une cause rare d'occlusion intestinale aiguë de l'adulte dans notre pratique quotidienne. Le diagnostic est le plus souvent fait en peropératoire. Il faut savoir y penser devant le jeune âge, l'absence d'antécédents de chirurgie abdominale ou de processus infectieux intra péritonéal et la présence de niveaux hydro-aériques dans l'hypocondre droit

Experimental determination of the induced activity in activation detectors of a complex geometric shape

The paper presents the results of experimental determination of the induced activity in copper-/aluminum-based activation detectors when irradiated with neutrons with energies of about 14 MeV. The activation detectors were square-shaped metal plates with a thickness from 1.0 to 1.5 mm and a side size about 5.0 cm. These dimensions significantly exceed those of the detectors that are used in the research of high-intensity neutron fluxes. The detectors described in this work can be used for studying low-intensity neutron fluxes (with a flux density of up to 106 n/cm2∙s). It is shown that, when working with such detectors, it is possible to apply the usual methods for calculating the induced activity in thin activation detectors, with corrections that take into account the emerging features of the ‘neutron source - activation detector’ and ‘activation detector - secondary radiation detector’ geometries. The effects of absorption of primary and secondary radiation by the detector substance are also revealed. The Geant4 tools were used for calculating the geometric factors and theoretical induced activity. The study confirms the applicability of such activation detectors for solving the problem of determining the yield of neutrons with energies of about 14 MeV from a neutron generator target. The results of the experiments coincide, within the margin of error, with the results of simulations performed using the Geant4 tools

BJS commission on surgery and perioperative care post-COVID-19

Background: Coronavirus disease 2019 (COVID-19) was declared a pandemic by the WHO on 11 March 2020 and global surgical practice was compromised. This Commission aimed to document and reflect on the changes seen in the surgical environment during the pandemic, by reviewing colleagues experiences and published evidence. Methods: In late 2020, BJS contacted colleagues across the global surgical community and asked them to describe how severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had affected their practice. In addition to this, the Commission undertook a literature review on the impact of COVID-19 on surgery and perioperative care. A thematic analysis was performed to identify the issues most frequently encountered by the correspondents, as well as the solutions and ideas suggested to address them. Results: BJS received communications for this Commission from leading clinicians and academics across a variety of surgical specialties in every inhabited continent. The responses from all over the world provided insights into multiple facets of surgical practice from a governmental level to individual clinical practice and training. Conclusion: The COVID-19 pandemic has uncovered a variety of problems in healthcare systems, including negative impacts on surgical practice. Global surgical multidisciplinary teams are working collaboratively to address research questions about the future of surgery in the post-COVID-19 era. The COVID-19 pandemic is severely damaging surgical training. The establishment of a multidisciplinary ethics committee should be encouraged at all surgical oncology centres. Innovative leadership and collaboration is vital in the post-COVID-19 era

BJS commission on surgery and perioperative care post-COVID-19

Coronavirus disease 2019 (COVID-19) was declared a pandemic by the WHO on 11 March 2020 and global surgical practice was compromised. This Commission aimed to document and reflect on the changes seen in the surgical environment during the pandemic, by reviewing colleagues' experiences and published evidence