title: Acute nontraumatic general surgical conditions on a combat deployment.
abstract: Literature is lacking on acute surgical problems that may be encountered on military deployment; even less has been written on whether or not any of these surgical problems could have been avoided with more focused predeployment screening. We sought to determine the burden of illness attributable to acute nontraumatic general surgical problems while on deployment and to identify areas where more rigorous predeployment screening could be implemented to decrease surgical resource use for nontraumatic problems.
  
  
  
  We studied all Canadian Armed Forces (CAF) members deployed to Afghanistan between Feb. 7, 2006, and June 30, 2011, who required treatment for a nontraumatic general surgical condition.
  
  
  
  During the study period 28 990 CAF personnel deployed to Afghanistan; 373 (1.28%) were repatriated because of disease and 100 (0.34%) developed an acute general surgical condition. Among those who developed an acute surgical illness, 42 were combat personnel (42%) and 58 were support personnel (58%). Urologic diagnoses (n = 34) were the most frequent acute surgical conditions, followed by acute appendicitis (n = 18) and hernias (n = 12). We identified 5 areas where intensified predeployment screening could have potentially decreased the incidence of in-theatre acute surgical illness.
  
  
  
  Our findings suggest that there is a significant acute care surgery element encountered on combat deployment, and surgeons tasked with caring for this population should be prepared to treat these patients.
authors.affiliation: The Royal Canadian Medical Service, Department of National Defence, Ottawa, Ont. and the Department of Surgery, Division of General Surgery, University of Toronto, Toronto, Ont.
authors.forename: Dylan
authors.initials: D
authors.lastname: Pannell
authors.affiliation: The Royal Canadian Medical Service, Department of National Defence, Ottawa, Ont., the Division of General Surgery, Sunnybrook Health Sciences Centre, and the Department of Surgery, Division of General Surgery, University of Toronto, Toronto, Ont.
authors.forename: Avery B
authors.initials: AB
authors.lastname: Nathens
authors.affiliation: The Royal Canadian Medical Service, Department of National Defence, Ottawa, Ont.
authors.forename: Jacques
authors.initials: J
authors.lastname: Ricard
authors.affiliation: The Royal Canadian Medical Service, Department of National Defence, Ottawa, Ont.
authors.forename: Erin
authors.initials: E
authors.lastname: Savage
authors.affiliation: The Royal Canadian Medical Service, Department of National Defence, Ottawa, Ont., the Division of General Surgery, Sunnybrook Health Sciences Centre, and the Department of Surgery, Division of General Surgery, University of Toronto, Toronto, Ont.
authors.forename: Homer
authors.initials: H
authors.lastname: Tien
mesh_terms: D000208:Acute Disease; D000328:Adult; D055826:Afghan Campaign 2001-; D001064:Appendicitis / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control / Q000601:surgery; D002170:Canada / Q000453:epidemiology; D017281:Cost of Illness; D005260:Female; D006547:Hernia / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D059685:Herniorrhaphy; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D008889:Military Personnel; D012189:Retrospective Studies; D014570:Urologic Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control / Q000601:surgery