The history of paediatric trauma care in Cape Town

No Abstract. South African Medical Journal Vol. 96(9) (Part 2) 2006: 874-87

The history of paediatric trauma care in Cape Town

Trauma is a leading cause of morbidity, mortality and disability in childhood. In most developed countries where 18% of the population are in the age group 0 - 15 years, injury exceeds all other causes of childhood mortality. In the developing countries of Africa, however, children aged 0 - 15 years constitute 43% of the population and trauma has an even bigger impact on child health.There is an erroneous perception that trauma is not a major health problem in Africa, derived from undue emphasis on mortality statistics alone. Yet, the impact of trauma ought to be measured not only in terms of death, but also the tremendous morbidity and disability caused by injuries, and their socioeconomic consequences

New horizons for the repair of skin defects

Pigmented skin-equivalent grafts for patients with darker skins have been achieved successfully in experimental circumstances, but have not been subject to clinical trials. This is an essential regenerative concept with wide therapeutic and practical advantages for the future.

Situs inversus abdominalis and duodenal atresia

Fewer than 20 patients born with situs inversus and duodenal atresia have been reported in the literature. We present a patient with this condition. A newborn baby presented shortly after birth with persistent bilious vomiting. An abdominal radiograph showed a right-sided stomach bubble and a second bubble on the left - typical of duodenal atresia but with mirror image configuration. Laparotomy confirmed the diagnosis of situs inversus abdominalis, which was also demonstrated by contrast studies and ultrasound. Duodenoduodenostomy was performed and the patient discharged on day 8 postoperatively. Situs inversus is associated with other congenital malformations including splenic malformations, left-sided liver and cardiac abnormalities; it is rarely associated with duodenal atresia. Duodenal obstruction in the presence of situs inversus has been described, including obstruction due to a web, stenosis, pre-duodenal portal vein and complete atresia. The patient presented in this paper had a duodenal web in the second part of the duodenum. Before undertaking surgery it is important to establish the presence of associated gastrointestinal and cardiac abnormalities

Situs inversus abdominalis and duodenal atresia. A case report and review of the literature

Fewer than 20 patients born with situs inversus and duodenal atresia have been reported in the literature. We present a patient with this condition. A newborn baby presented shortly after birth with persistent bilious vomiting. An abdominal radiograph showed a right-sided stomach bubble and a second bubble on the left - typical of duodenal atresia but with mirror image configuration. Laparotomy confirmed the diagnosis of situs inversus abdominalis, which was also demonstrated by contrast studies and ultrasound. Duodenoduodenostomy was performed and the patient discharged on day 8 postoperatively. Situs inversus is associated with other congenital malformations including splenic malformations, left-sided liver and cardiac abnormalities; it is rarely associated with duodenal atresia. Duodenal obstruction in the presence of situs inversus has been described, including obstruction due to a web, stenosis, pre-duodenal portal vein and complete atresia. The patient presented in this paper had a duodenal web in the second part of the duodenum. Before undertaking surgery it is important to establish the presence of associated gastrointestinal and cardiac abnormalities

Our surgical heritage: the role of the Department of Paediatric Surgery in the development of paediatric surgery in Cape Town, in Africa, and around the world

The Department of Paediatric Surgery at the University of Cape Town has made a remarkable contribution to the academic body of knowledge of Paediatric Surgery both in South Africa and around the world. It has played a key role in the development of the specialty in South Africa and through the South African diaspora has trained many paediatric surgeons who have made their mark internationally. More recently it has become a major focus of teaching and training for African paediatric surgeons. This article traces this legacy through its origins in the early 1920s to its current prominent position in the world paediatric surgical community

The case of the exploding egg

The vast majority of paediatric burns occur in developing countries, and many of these injuries are entirely preventable. In general, four paediatric injury patterns have been identified in toddlers and infants, who are at a significantly increased risk of burn injuries. Children <2 years of age are often innocent bystanders, but as they grow older physical mobility, social independence and gender-specific high-risk activities come into play

An evaluation of nutritional practice in a paediatric burns unit

Introduction. Burn injuries evoke a systemic metabolic response with profound effects on organ function, susceptibility to infection

‘Getting under our skin’: Introducing banked allograft skin to burn surgery in South Africa

Deceased donor skin possesses many of the properties of the ideal biological dressing, and a well-stocked skin bank has become a critically important asset for the modern burn surgeon. Without it, managing patients with extensive burns and wounds becomes far more challenging, and outcomes are significantly worse. With the recent establishment of such a bank in South Africa, the challenge facing the medical fraternity is to facilitate tissue donation so that allograft skin supply can match the enormous demand