1.Split-Thickness Decompression in the Management of Intracranial Pressure
Andrew K. WONG ; Ricky H. WONG
Korean Journal of Neurotrauma 2021;17(1):48-53
Surgical management of elevated intracranial pressures due to stroke or traumatic brain injury has classically been through decompressive craniectomy (DC). There is significant morbidity associated with DC including subdural hygromas, syndrome of the trephined, and the need for subsequent cranioplasty. Alternative techniques including the hinged and floating craniotomy have shown promise though can still suffer from complications associated with an unsecured bone flap. We report a case in which a patient who presented with an acute subdural hematoma and associated midline shift that was successfully treated with decompression via thinning and re-securing of the bone flap in a “split-thickness decompression.”
2.Guidance on performance and reporting of high-resolution oesophageal manometry and ambulatory pH monitoring in Singapore.
Andrew Ming Liang ONG ; Alex Yu Sen SOH ; Yu Tien WANG ; Reuben K WONG ; Christopher Tze Wei CHIA ; Kewin SIAH ; Daphne ANG
Annals of the Academy of Medicine, Singapore 2021;50(8):629-637
INTRODUCTION:
We aimed to provide a practical and evidence-based guide on the indications, performance and reporting of high-resolution oesophageal manometry (HRM) and ambulatory pH monitoring (PHM) in adult patients in Singapore.
METHODS:
The guideline committee comprised local gastroenterologists from public and private sectors with particular expertise in aspects of HRM and PHM, and it was tasked to produce evidence-based statements on the indications, performance and reporting of these tests. Each committee member performed literature searches to retrieve relevant articles within the context of domains to which they were assigned.
RESULTS:
Twelve recommendation statements were created and summarised.
CONCLUSION
Standardising key aspects of HRM and PHM is imperative to ensure the delivery of high-quality care. We reported the development of recommendations for the performance and interpretation of HRM and ambulatory reflux monitoring in Singapore.
Adult
;
Esophageal pH Monitoring
;
Esophagus
;
Humans
;
Hydrogen-Ion Concentration
;
Manometry
;
Singapore