The DORA digital repository system captures, stores, indexes, preserves, and distributes digital research material. http://dora.health.qld.gov.au:80/qldresearchjspui 2026-04-13T05:12:17Z 2026-04-13T05:12:17Z Saunders, Samantha L Malhotra, Ganeev Gardiner, Kelsey Tierney, Michael Perkovic, Adam Chuah, Eunice Redwood, Eleanor Meere, William Cooper, Dominic Higgins, Angus Sutton, Patrick Bland, Adam Mikhail, Philopatir Starmer, Gregory Boyle, Andrew Lee, Astin Fernandez, Ritin Stewart, Peter Spina, Roberto Ford, Thomas J https://dora.health.qld.gov.au/qldresearchjspui/handle/1/10860 2026-04-01T06:26:09Z 2026-01-01T00:00:00Z

Title: Safety and Workflow Using Rotational Atherectomy in Non-Surgical Centres-The SWAN Study Authors: Saunders, Samantha L; Malhotra, Ganeev; Gardiner, Kelsey; Tierney, Michael; Perkovic, Adam; Chuah, Eunice; Redwood, Eleanor; Meere, William; Cooper, Dominic; Higgins, Angus; Sutton, Patrick; Bland, Adam; Mikhail, Philopatir; Starmer, Gregory; Boyle, Andrew; Lee, Astin; Fernandez, Ritin; Stewart, Peter; Spina, Roberto; Ford, Thomas J Abstract: Historically, high-risk percutaneous coronary intervention (PCI) procedures such as rotational atherectomy (RA) required on-site surgical backup. However, advancements in PCI techniques, coupled with the geographic realities of Australia's dispersed population, warrant a reassessment of RA in the context of contemporary clinical practice. We aimed to establish the safety and outcomes after RA at non-surgical centres. Consecutive RA PCI cases from September 2012 to February 2024 at seven Australian hospitals without on-site cardiac surgery were analysed. Primary outcomes were referrals for emergency cardiac surgery (bailout) and 30-day mortality. A total of 943 patients (1,010 lesions) were included, with a mean age of 74.4±9.6 years. A total of 72.6% were male and the average body mass index was 28.7±7.1 kg/m2. Common comorbidities included diabetes (35.1%), a history of smoking (48.7%), and acute coronary syndrome or emergency presentation (32.9%). Off-site surgical bailout was necessary for four patients (0.4%) (temporary pacing wire-related right ventricular perforation with tamponade [n=2]; burr entrapment not retrievable percutaneously [n=2]). Major coronary perforations occurred in 0.8% (n=8; Ellis III). Minor perforations occurred in 2.3% (n=22). Tamponade occurred in eight (0.8%) patients. Burr entrapment occurred in six (0.6%) patients. A total of 32 patients (3.4%) died within 30 days of the procedure; 13 cases (1.4%) were PCI-related, but only eight of these (0.8%) were directly attributable to RA (significant ischaemia, e.g., no/slow reflow [n=4]; perforation with tamponade unable to be temporised percutaneously [n=2]; burr entrapment [n=1]; extensive coronary dissection [n=1]). Female sex and acute coronary syndrome presentation were predictors of poorer outcome. RA can be safely conducted without on-site surgical backup, including in regional Australian areas. In geographically dispersed populations, regional access to RA-assisted PCI is critical. Immediate percutaneous management remains the mainstay of management of rare but potentially severe complications such as tamponade, perforations, and burr entrapment. Description: Cairns & Hinterland Hospital and Health Service (CHHHS) affiliated author: Gregory Starmer

2026-01-01T00:00:00Z McConnell, Amanda McNeil, Heather Singh, Jasraaj Kitchen, William Johnson, Mark Atkinson, Lucy https://dora.health.qld.gov.au/qldresearchjspui/handle/1/10859 2026-04-01T06:12:12Z 2026-01-01T00:00:00Z

Title: A Retrospective Evaluation of Emergency Department Electric Scooter Impact Before and After the Introduction of a Hire Electric Scooter Service Authors: McConnell, Amanda; McNeil, Heather; Singh, Jasraaj; Kitchen, William; Johnson, Mark; Atkinson, Lucy Abstract: To assess the impact of hire e-scooters on injury presentations at Cairns emergency department (ED). A retrospective cohort study comparing e-scooter injuries before and after the introduction of hire e-scooters. A total of 323 patients presented with e-scooter injuries. There were 133 'before' and 190 'after' cases. The majority were males aged 10-20. Hospital admissions and length of stay increased in the 'after' group (32% vs. 9%, 27 vs. 9 staying > 24 h). Hire e-scooters are associated with a higher trauma burden. These findings support targeted safety interventions and collaborative injury prevention strategies. Description: Cairns & Hinterland Hospital and Health Service (CHHHS) affiliated authors: Amanda McConnell, Heather McNeil, Jasraaj Singh, William Kitchen, Mark Johnson, Lucy Atkinson

2026-01-01T00:00:00Z Kelly, Andrew Pilat, Elena Augustson, Connor Horstman, Zac https://dora.health.qld.gov.au/qldresearchjspui/handle/1/10858 2026-04-01T05:19:06Z 2026-01-01T00:00:00Z

Title: Internal Herniation Through the Falciform Ligament of the Liver: A Systematic Review of Diagnosis and Operative Strategies Authors: Kelly, Andrew; Pilat, Elena; Augustson, Connor; Horstman, Zac Abstract: Internal herniation through a defect in the falciform ligament of the liver is an exceptionally rare occurrence with a risk of small-bowel obstruction that can result in strangulation and bowel necrosis if diagnosis is delayed. Because of its infrequency, available evidence is limited to isolated case reports and small descriptive studies, and optimal diagnostic and operative strategies remain poorly defined. A systematic search of PubMed/MEDLINE, Embase and Cochrane Library was performed to identify English-language articles published over the past 10 years reporting cases of internal herniation through the falciform ligament. Titles and abstracts were screened using predefined inclusion and exclusion criteria, followed by full-text review. Data were extracted regarding patient demographics, presentation, imaging findings, operative management and outcomes. A qualitative synthesis was undertaken in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Seven studies met the inclusion criteria, all of which were single-patient case reports or imaging-focused descriptions. Patients typically presentations varied but included acute abdominal pain and symptoms of small-bowel obstruction, and both congenital and iatrogenic falciform ligament defects were implicated. Computed tomography frequently demonstrated closed-loop bowel positioned anterior to the liver, beak-like tapering at the site of constriction and abnormal displacement of the round ligament. All patients underwent urgent surgical intervention. Management consisted of reduction of the herniated viscus with division or closure of the falciform ligament defect, with bowel resection required when ischemia was present. Both open and laparoscopic approaches were reported, and short-term postoperative outcomes were generally favourable. Internal herniation through the falciform ligament is a rare but potentially serious surgical emergency that should be considered in cases of unexplained proximal small-bowel obstruction. Recognition of characteristic computed tomography findings may facilitate earlier diagnosis and intervention. Prompt operative exploration remains the cornerstone of management, with ligament division or closure and selective bowel resection based on intraoperative viability. Description: Cairns & Hinterland Hospital and Health Service (CHHHS) affiliated authors: Andrew Kelly, Elena Pilat, Connor Augustson, Zac Horstman

2026-01-01T00:00:00Z Sorour, Caitlin Jeyarajan, Eshwarshanker https://dora.health.qld.gov.au/qldresearchjspui/handle/1/10857 2026-04-01T05:01:22Z 2026-01-01T00:00:00Z

Title: Inflammatory pseudotumour of the spleen complicated by a cholesterol granuloma: a diagnostic dilemma Authors: Sorour, Caitlin; Jeyarajan, Eshwarshanker Abstract: Inflammatory pseudotumours (IPTs) and cholesterol granulomas (CG) are rare benign lesions that often mimic malignancy on imaging, creating significant diagnostic uncertainty. We report the case of a 67-year-old man with a long-standing calcified splenic cyst who developed new abdominal symptoms secondary to extrinsic compression of the stomach by the lesion and subsequently underwent a laparoscopic splenectomy. Histopathology confirmed an IPT with xanthogranulomatous inflammation. Six months later, a surveillance positron emission tomography scan revealed a solitary fluorodeoxyglucose-positron (FDG) avid left upper quadrant lesion concerning for malignancy in the context of newly diagnosed cutaneous squamous cell carcinoma. Laparoscopic resection and subsequent histopathology demonstrated a CG at the splenectomy site. This case highlights the diagnostic challenges posed by IPT and CG, emphasizes their potential to mimic malignant disease radiologically, and reinforces the importance of histopathological confirmation to guide appropriate management. Description: Cairns & Hinterland Hospital and Health Service (CHHHS) affiliated authors: Caitlin Sorour, Eshwarshanker Jeyarajan

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