Jonathan M. Hemli

Ludwig's Angina: Report of a Case and Review of Management Issues

Ludwigs angina, although uncommon, remains a potentially life-threatening condition because of the risk of impending airway obstruction. Effective treatment is based on early recognition of the clinical process, with the appropriate use of parenteral antibiotics, airway protection techniques, and formal surgical drainage of the infection. We present a case of Ludwigs angina together with a brief review of the relevant literature.

LEARNING THE SURGICAL CRAFT: A REVIEW OF SKILLS TRAINING OPTIONS

Surgical practice is undergoing fundamental changes, and this is having a significant effect on the training of surgeons. Learning the craft of surgery is threatened by reduced elective operative exposure and general service cuts within public teaching hospitals, safer working hour legislation and pressures to accelerate the training of young surgeons. Rapid technological changes mean that ‘old dogs’ have to teach ‘young dogs’ many new tricks in a relatively adverse environment. This review outlines the great variety of resources available for skills‐based training outside the operating room. These resources are ready to be used as a necessary adjunct to the training of competent surgeons in Australasia.

Papillary carcinoma of the thyroid arising in struma ovarii – report of a case and review of management guidelines

Struma ovarii, a cystic teratoma of the ovary predominantly composed of thyroid tissue, is an infrequently encountered clinical entity. Malignant transformation of these tumors is even more uncommon. We report a case of malignant struma ovarii containing foci of papillary carcinoma of the thyroid, which was incidentally found at laparotomy undertaken for repair of an infrarenal abdominal aortic aneurysm.

Methysergide-induced valvular heart disease: a report of 2 cases.

Methysergide is a serotonin antagonist and is used as a long-term prophylactic treatment for migraine. Although many patients experience adequate control of migraine episodes, methysergide has been reported to cause retroperitoneal and pleuropulmonary fibrosis. Cardiovascular side effects mainly in the form of valvular fibrosis have been less recognized. We report 2 cases of methysergide-related mitral valve fibrosis.

CT16 HYBRID OPEN AND ENDOVASCULAR PROCEDURES FOR COMPLEX AORTIC PATHOLOGY IN THE HIGH-RISK SURGICAL PATIENT

Purpose  The management algorithm for the complex aorta in the high‐risk patient continues to evolve, especially given increasing applicability of endovascular solutions to these cases. We present three examples of aortic pathology managed in a staged fashion utilising hybrid open/endovascular techniques, as alternatives to classic aortic procedures.