Valentino appendix: a report of 3 cases.

We present three cases of young male patients with perforated duodenal ulcer that were diagnosed and treated as appendicitis with appendectomy. They presented with peritonitis and were treated accordingly. Because of the misdiagnosis, their hospital course was significantly prolonged. This morbidity could have been avoided by careful history-taking, examination and per-operative findings.

Morbidity meetings: what makes it to; what stays out of the forum.

OBJECTIVES: To review the utility of morbidity and mortality forum in General Surgery at a tertiary care hospital in Karachi, Pakistan. METHODS: The retrospective study was conducted at the Aga Khan University Hospital and reviewed morbidity data from March to May 2009. Case notes of all patients admitted to the General Surgical service during the study period were reviewed to identify in-hospital morbidities. RESULTS: There were a total of 340 inpatients during this period. Case notes identified 61 (17.94%) patients with morbidities; 35 (57.37%) males and 26 (42.62%) females. The morbidity record for the same period identified 32 (52.5%) patients, while 29 (47.5%) morbidities were missed. Of the total morbidities, 32 (52.5%) patients were admitted to the general ward, and 29 (47.5%) to high dependency areas. Nine (28%) morbidities identified in the general ward, and 23 (79%) in high dependency areas were formally presented. Morbidities related to the abdominal cavity were the commonest (n = 22; 36%). Wound-related (n = 17; 28%) and cardio-pulmonary (n = 8; 13%) complication were the next most frequent. CONCLUSIONS: Abdominal cavity morbidities were the most common in this review followed by wound related and cardiopulmonary complications. The morbidity and mortality forum is an educational activity that has stood the test of time and continues to be the cornerstone of post-graduate education. It should be considered a mandatory activity in all postgraduate training programmes.