BACKGROUND Although the standard treatment for appendicitis (since 1883) is an appendectomy, this is not always possible in a maritime or military setting. To avoid relying on improvisation in such situations this study examines the evidence for conservative management of appendicitis. MATERIAL AND METHODS PubMed was searched for studies on conservative treatment of appendicitis. Both prospec...

Acute appendicitis is a common surgical presentation for which surgical intervention, an appendicectomy, has remained a largely unchallenged primary treatment modality. Traditionally, it has been felt that the pathophysiological progressive nature of appendicitis ultimately leads to perforation. A number of recent studies, however, suggest that the process of appendiceal inflammation may follo...

Traumatic pneumatoceles are a rare complication of blunt chest trauma in children. Although they characteristically present as small, regular shaped lesions which can be safely treated nonoperatively, larger traumatic pneumatoceles pose diagnostic and management difficulties for clinicians. This case study reports one of the largest traumatic pneumatoceles reported to date in the paediatric pop...

Presented in this report is apparently the first case of its kind in the medical literature where an 11 year old prepubescent girl who had co-existent presence of hypothyroidism and multiple large ovarian cysts not only had remarkable improvement in her physical appearance with conservative management with L-Thyroxine alone but also had disappearance of her large ovarian cysts without the need ...

not submitted for publication O49 Rehabilitation in adult scoliosis: introduction

Placenta increta, a rare complication of pregnancy, is associated with significant postpartum hemorrhage often requiring emergency hysterectomy. We report a case of conservative management, with a combination of parenteral methotrexate, serial ultrasound and β-hCG assessment. Serum β-hCG levels were undetectable after 8 weeks of therapy. A scan at 6 months showed complete involution of the uter...

Spontaneous chylothorax, without a predisposing factor is an uncommon cause of pleural effusion beyond the neonatal period. We present a case of left sided spontaneous chylothorax in a 20-month-old boy. We report successful management of this difficult problem with thoracoscopic ligation of thoracic duct after a failed trial with conservative management.

It is uncertain whether arthroscopic partial meniscectomy is better than physical therapy in patients who have a symptomatic torn meniscus on top of osteoarthritis of the knee. The Meniscal Repair in Osteoarthritis Research (METEOR) trial concluded that physical therapy is acceptable at first, and that surgery is not routinely needed. In patients assigned to physical therapy who eventually need...

CASE SERIES SUMMARY Three cats with suspected Fournier's gangrene had an acute onset of clinical signs and bloodwork changes consistent with sepsis. All cases had similar progression of wounds that were managed without aggressive surgical debridement, which is the currently accepted treatment of choice. All cats survived and have maintained an excellent long-term quality of life. RELEVANCE AN...

Abnromalities of placentation, including placenta accreta, represent a major source of morbidity and mortality among women. Traditional management consists of peripartum hysterectomy at the time of delivery, although more conservative treatments have also been developed recently. In this review we describe the available literature describing the operative approach and considerations for managem...