ORCID Profile
0000-0002-9794-8791
Current Organisations
Canberra Hospital
,
Concord Repatriation General Hospital
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Publications
Calcifying fibrous pseudotumour of jejunal diverticulitis in a young male patient
Publisher: Wiley
Date: 29-09-2022
DOI: 10.1111/ANS.17240
Hürthle cell carcinoma in an extraordinary location: A case report
Publisher: Jaypee Brothers Medical Publishing
Date: 2020
The Yield of Fever, Inflammatory Markers and Ultrasound in the Diagnosis of Acute Cholecystitis: A Validation of the 2013 Tokyo Guidelines
Publisher: Springer Science and Business Media LLC
Date: 26-07-2016
DOI: 10.1007/S00268-016-3660-5
Abstract: Each year, 1-4 % of people with known gallstones become symptomatic, either presenting with biliary colic or as acute cholecystitis. The distinction between both diagnoses remains challenging. To aid the proper diagnosis, the revised 2013 Tokyo Guidelines (TG 2013) were proposed with a self-acclaimed diagnostic accuracy of over 90 %. However, this accuracy has not been verified by others so far. To determine the accuracy of the TG 2013 guidelines in the diagnosis of acute cholecystitis both in its single components of fever, inflammatory markers and US features and of the combined application of the TG 2013 guidelines as a whole. A 5-year retrospective analysis equal to the TG 2013 validation process of all emergency cholecystectomies for acute cholecystitis or persistent biliary pain with an ultrasound performed during the same admission. Acute cholecystitis at histology was the golden standard. Inclusion criteria were met by 169 patients with a prevalence of acute cholecystitis of 52.7 %. The in idual features of fever, gallbladder wall thickening and probe tenderness were not significant in univariate analysis. In multivariate analysis only, neutrophil count was an independent predictor. The combined application of the TG 2013 guidelines led to a better sensitivity of 83.1 % at the cost a reduced specificity of 37.5 % compared to neutrophil count alone. The accuracy was therefore only 60.3 %, which was well below the TG 2013 report. The 2013 Tokyo Guidelines were slightly better in predicting acute cholecystitis but over diagnosed two-thirds of normal gallbladders compared to neutrophil count alone.
When you hear hoofbeats, think horses before zebras – a case of recurrent small bowel obstructions with a twist
Publisher: Oxford University Press (OUP)
Date: 10-2023
DOI: 10.1093/JSCR/RJAD555
Colonic complications in acute pancreatitis: A retrospective review
Publisher: Elsevier BV
Date: 06-2021
Splenic flexure cancer survival: a 25‐year experience and implications for complete mesocolic excision (CME) and central vascular ligation (CVL)
Publisher: Wiley
Date: 28-03-2023
DOI: 10.1111/ANS.18434
Abstract: The management of splenic flexure cancers (SFCs) in the era of complete mesocolic excision (CME) and central vascular ligation (CVL) is challenging because of its variable lymphatic drainage. This study aimed to compare survival outcomes for SFCs and non‐SFCs, and better understand the clinicopathological characteristics which may define a distinct SFC phenotype. An observational cohort study at Concord Hospital, Sydney was conducted with patients who underwent resection for colon adenocarcinoma (1995–2019). Clinicopathological data were extracted from a prospective database. Overall survival (OS) and disease‐free survival (DFS) estimates and their associations to clinicopathological variables were investigated with Kaplan–Meier and Cox regression analyses. Of 2149 patients with colon cancer, 129 (6%) had an SFC. The overall 5‐year OS and DFS rates were 63.6% (95% CI 62.5–64.7) and 59.4% (95% CI 58.3–60.5), respectively. SFCs were not associated with OS ( P = 0.6) or DFS ( P = 0.5). SFCs were more likely to present urgently ( P 0.001) with obstruction ( P 0.001) or perforation ( P = 0.03), and more likely to require an open operation ( P 0.001). These characteristics were associated with poorer survival outcomes. No differences were noted between SFCs and non‐SFCs with respect to tumour stage ( P = 0.3). SFCs have a distinct phenotype, the in idual characteristics of which are associated with poorer survival. However, the survivals of SFCs and non‐SFCs are similar, possibly because the most important determinant of outcome, tumour stage, is no different between the groups. This may have implications for the surgical approach to SFCs with respect to standardization of CME and CVL surgery for these cancers.
Bouveret syndrome-a rare form of gastric outlet obstruction.
Publisher: Oxford University Press (OUP)
Date: 05-2021
DOI: 10.1093/JSCR/RJAB183
Abstract: Bouveret syndrome is a rare form of gastric outlet obstruction. It is typically diagnosed in frail elderly patients with protracted biliary disease. Thus, it has disproportionally high rates of morbidity and mortality. A 90-year-old man presented to our tertiary hospital with acute abdominal pain and symptoms of bowel obstruction. He was diagnosed with Bouveret syndrome on abdominal computed tomography and required judicious resuscitation and an emergency laparotomy. This article highlights the key features of Bouveret syndrome, and reviews the current diagnostic modalities as well as the contemporary treatment paradigm.
Right hemicolectomy anastomotic leak study: a review of right hemicolectomy in the binational clinical outcomes registry (BCOR )
Publisher: Wiley
Date: 24-02-2023
DOI: 10.1111/ANS.18337
Abstract: Surgery remains mainstay management for colon cancer. Post‐operative anastomotic leak (AL) carries significant morbidity and mortality. Rates of, and risk factors associated with AL following right hemicolectomy remain poorly documented across Australia and New Zealand. This study examines the Bowel Cancer Outcomes Registry (BCOR) to address this. A retrospective cohort study was undertaken of consecutive BCOR‐registered right hemicolectomy patients undergoing resection for colon cancer (2007–2021). The primary outcome measure was AL incidence. Clinicopathological data were extracted from the BCOR. Factors associated with AL and primary anastomosis were identified using logistic regression. AL‐rate trends were assessed by linear regression. Of 13 512 patients who had a right hemicolectomy (45.2% male, mean age 72.5 years, SD 12.1), 258 (2.0%) had an AL. On multivariate analysis, male sex (OR 1.33 95% CI 1.03–1.71) and emergency surgery (OR 1.41 95% CI 1.04–1.92) were associated with AL. Private health insurance status (OR 0.66 95% CI 0.50–0.88) and minimally‐invasive surgery (OR 0.61 95% CI 0.47–0.79) were protective for AL. Anastomotic technique (handsewn versus stapled) was not associated with AL ( P = 0.84). Patients with higher ASA status (OR 0.47 95% CI 0.39–0.58), advanced tumour stage (OR 0.56 95% CI 0.50–0.63), and emergency surgery (OR 0.16 95% CI 0.13–0.20) were less likely to have a primary anastomosis. AL‐rate and year of surgery showed no association ( P = 0.521). The AL rate in Australia and New Zealand following right hemicolectomy is consistent with the published literature and was stable throughout the study period. Sex, emergency surgery, insurance status, and minimally invasive surgery are associated with AL incidence.
An uncommon presentation of a sinister entity.
Publisher: Oxford University Press (OUP)
Date: 02-2020
DOI: 10.1093/JSCR/RJZ357
Abstract: A case of a female patient presenting with clinical findings ominous for a neoplastic bowel obstruction is reported. Abdominal computed tomography demonstrated a bowel obstruction with evidence of intussusception. Laparotomy revealed an irreducible ileoileal intussusception and segments of the jejunum infiltrated with pigmented deposits. There was no perforation and no evidence of an ulcerating or fungating mass. Intestinal melanoma is not an uncommon sequela of cutaneous melanoma, yet the disease can occur as a primary intestinal process, albeit this is a rarity. Surgical resection is the primary treatment modality and may offer the hope of increased symptom-free survival and overall survival for those patients suffering from metastatic or primary melanoma of the small intestine.
An unusual urethral foreign body
Publisher: Elsevier BV
Date: 2013
Inferior mesenteric vein pylethrombophlebitis as the predominant presentation of diverticulitis
Publisher: Wiley
Date: 06-2023
DOI: 10.1111/ANS.17824
Colonic adenocarcinoma following total colectomy and abdomino‐perineal resection for ulcerative colitis
Publisher: Wiley
Date: 24-10-2020
DOI: 10.1111/ANS.16405
Related Organisations
Related Funding Activities
No related grants have been discovered for Krishanth Naidu.