https://www.um.edu.mt/library/oar/handle/123456789/38140 Thu, 11 Jun 2026 08:20:27 GMT 2026-06-11T08:20:27Z https://www.um.edu.mt/library/oar/handle/123456789/10449 Title: Hip arthroplasty Authors: Vella, Christine; Vella Baldacchino, Andrea Abstract: A 68- year old gentleman presented to outpatients clinic complaining of pain in his right hip, 10 years after undergoing a total hip replacement. Following a thorough history, physical, lab and radiographic investigations, aseptic loosening of the hip prosthesis was diagnosed. One-stage revision surgery was carried out and the patient is currently undergoing rehabilitation and being followed up. Aim: This report will review the history, examination, investigations and management of a case of aseptic loosening of a total hip arthroplasty (both acetabular and femoral components). It will also serve as an excellent illustration of the various examination techniques and other investigations which are made use of for the diagnosis of hip (and other orthopaedic) conditions. Apart from describing the main surgical therapy required in this case i.e. revision arthroplasty, the case report will also deal with the complex yet equally essential perioperative drug management which complements the surgical treatment. Moreover, this case highlights the holistic approach to patient care, requiring a multidisciplinary team (including proper nursing, physiotherapy etc.). Sun, 01 Jan 2012 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/10449 2012-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/10448 Title: Persistent vegetative state secondary to a motor vehicle accident Authors: Abela, Franklin; Dimech, Anthony Abstract: The case presents a young girl who was involved in a road traffic accident. Despite being alive at present, her body cannot perform any basic functions since she is in a persistent vegetative state. Numerous examinations and investigations showed several lesions in the head, neck and thorax, the most striking of which being an avulsion injury at the junction of the spinal cord with the medulla. Aim: The purpose of this writing is to shed light on a rare condition brought about by one of the most common mechanisms of injury. Considering the extent of the injury that this girl presented with, her survival rate was low, yet somehow she managed to cheat death. The frequency of such cases taking place in Malta is exceptionally rare, making this episode worth publishing. Sun, 01 Jan 2012 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/10448 2012-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/10447 Title: Metastatic pancreatic cancer Authors: Micallef, Simon; Vella, Sarah Abstract: A 69-year-old Caucasian woman who had recently been diagnosed with pancreatic cancer presented with severe low back pain associated with weakness and paresthesiae in her lower extremities. She had also developed urinary retention. She was diagnosed with spinal cord compression at T10-11 secondary to vertebral and epidural metastasis. In view of the poor prognosis, the patient was referred for palliative care. This case documents spinal cord compression secondary to bone metastasis, a rare complication of pancreatic cancer. Sun, 01 Jan 2012 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/10447 2012-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/10441 Title: Colovesicular Fistula Authors: Lauretta Agius, Daniele; Attard, Caroline Abstract: A fistula is an atypical connection between two epithelial surfaces, in the case of an enterovesical fistula between the urinary and gastrointestinal systems. These may be the result of a number of causes including: 1. Congenital abnormalities 2. Inflammatory diseases of the bowel (such as diverticulitis and Crohn’s Disease) 3. Cancer 4. Infection 5. Trauma 6. Iatrogenic (such as a post-operative complication) [3] A colovesical fistula (colovesicular fistula), an abnormal connection between the bladder and colon, is a known complication of diverticular disease, occurring in around 2%-22% of patients suffering from diverticulosis. These fistulae tend to occur three times more often in males than in females. The difference in occurrence is thought to be related to the fact that in females there is the uterus which may prevent the colon and bladder from coming into contact with each other. In fact in females other types of fistulae, such as vesicovaginal and enterovaginal, occur more frequently than colovesical fistulae. [2] Aim: This article highlights the importance of the early identification and management of colovesical fistulae, which although uncommon complications of diverticulitis, can be very uncomfortable for the patient and if not treated early, can lead to high morbidity. Sun, 01 Jan 2012 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/10441 2012-01-01T00:00:00Z