The United Kingdom National Health Service through the lens of an overseas clinical observer: A reflective account based on personal experience.

This article provides insight into an aspect of the National Health Service (NHS) of the United Kingdom (UK) through the perspective of an overseas clinical observer. The NHS is a government-funded medical and health care service in the UK and has developed over the years providing a high standard of medical care and professionalism. The Clinical Observership Programme has been designed primarily for International Medical Graduates to experience how the NHS functions and the kind of services it offers.

The Incidence, Distribution and Clinicopathology of Missed Colorectal Cancer After Diagnostic Colonoscopy.

Background: Colonoscopy does miss some lesions that may be later diagnosed as post-colonoscopy colorectal cancers (PCCRCs). We evaluated the rate of PCCRCs in a cohort of our patients.

Methods: The data of patients diagnosed with first primary colorectal cancers (CRCs) between July 2014 and June 2017 were analyzed.

Increasing trend in retained rectal foreign bodies.

Aim: To highlight the rising trend in hospital presentation of foreign bodies retained in the rectum over a 5-year period.

Methods: Retrospective review of the cases of retained rectal foreign bodies between 2008 and 2012 was performed. Patients' clinical data and yearly case presentation with data relating to hospital episodes were collected.

Colitis cystica profunda of the rectum: An unexpected operative finding.

Colitis cystic profunda is a rare entity benign condition of the colon and rectum that can mimic suspicious polyps or malignancy. The commonest sites of affectation are the rectum and the sigmoid colon but it can be unusually widely distributed in the colon. The aetiology of this condition is not fully elucidated and confident diagnosis can only be made on histological features.

Recurrent and troublesome variceal bleeding from parastomal caput medusae.

Variceal bleeding is common in chronic liver disease and is a frequent cause of acute upper gastrointestinal bleeding. The most common site of varices is the lower oesophagus but they may occur at any location where there are portosystemic anastomoses and collateral vascular formation. Location of ectopic varices at the site of enterocutaneous stomas is rare.

Recurrent intestinal volvulus in midgut malrotation causing acute bowel obstruction: A case report.

Intestinal malrotation occurs when there is a disruption in the normal embryological development of the bowel. The majority of patients present with clinical features in childhood, though rarely a first presentation can take place in adulthood. Recurrent bowel obstruction in patients with previous abdominal operation for midgut malrotation is mostly due to adhesions but very few reported cases have been due to recurrent volvulus.

Midgut malrotation first presenting as acute bowel obstruction in adulthood: a case report and literature review.

Malrotation of the midgut is generally regarded as paediatric pathology with the majority of patients presenting in childhood. The diagnosis is rare in adults, which sometimes leads to delay in diagnosis and treatment. A high index of suspicion is therefore required when dealing with patients of any age group with abdominal symptoms.

Caecal diverticulitis presenting as acute appendicitis: a case report.

Solitary caecal diverticulum is an uncommon entity and therefore difficult to diagnose except at surgery. Caecal diverticulitis is an infrequent cause of acute abdomen and usually presents in a manner similar to acute appendicitis. It is extremely difficult to differentiate it preoperative from acute appendicitis and such distinction is usually made in the operating room.

Acute gallbladder torsion: an unexpected intraoperative finding.

Gallbladder torsion is an uncommon clinical entity and a difficult condition to diagnose preoperatively. Since its first description in 1898 by Wendel there have been over 500 documented cases in the literature. It is known to occur when there is rotation of the gallbladder along the axis of the cystic duct and vascular pedicle.

Tumour Lysis Syndrome Occurring in a Patient with Metastatic Gastrointestinal Stromal Tumour Treated with Glivec (Imatinib Mesylate, Gleevec, STI571).

Tumour lysis syndrome (TLS) is a rare side effect of chemotherapy for solid tumours. It describes the metabolic derangements following rapid and extensive tumour cell death following a good response to chemotherapy. Symptoms are those of metabolic derangement and renal failure.

Analysis of blood transfusion predictors in patients undergoing elective oesophagectomy for cancer.

Background: Oesophagectomy for cancers is a major operation with significant blood loss and usage. Concerns exist about the side effects of blood transfusion, cost and availability of donated blood. We are not aware of any previous study that has evaluated predictive factors for perioperative blood transfusion in patients undergoing elective oesophagectomy for cancer.

Concepts of seroma formation and prevention in breast cancer surgery.

Background: Seroma formation is the commonest early sequel to breast cancer surgery especially when axillary dissection is undertaken. It is associated with significant morbidity and financial burden. The main pathophysiology of seroma is still poorly understood and remains controversial.

Current concepts in anal fissures.

Introduction: Anal fissure is a common and distressing problem the true incidence of which is probably higher than recorded. There is a progressive understanding of the etiopathogenesis of this entity and the changing trend in its management approach. This is a systematic review of available published literature looking at current management options in anal fissures.

Symptomatic pyloric pancreatic heterotopia: report of three cases and review of the literature.

Background: Pancreatic heterotopia is a relatively common congenital anomaly which sometimes becomes symptomatic and mimics other upper gastrointestinal tract (GIT) pathologies. It is the presence of abnormally located pancreatic glandular tissue at sites with no structural or vascular contact with the main pancreas. It most often occurs in the proximal gastrointestinal tract.