Loop ileostomy: modification of technique.

Introduction: A loop ileostomy is a suitable procedure for faecal diversion. A number of technical improvements and advancement in stoma management have made its creation a suitable alternative to a loop colostomy. We describe an alternative technique for securing a loop ileostomy and perform a retrospective review of this technique.

Prospective evaluation of ultrasound in distal ileal and colonic obstruction.

Aim: To evaluate prospectively the usefulness of ultrasound in determining the site and cause of distal small bowel and colonic obstruction.

Materials And Methods: Ultrasound findings in 60 consecutive patients with suspected distal ileal or colonic obstruction were correlated with final surgical and radiological diagnoses. The diagnostic value of ultrasound was compared with plain abdominal radiography (AXR) for the presence and level of obstruction.

Colonic involvement in Fabry's disease.

The case of a 54 year old man with Fabry's disease and extensive jejunal and colonic diverticulosis causing colonic stricture is presented. Histological examination of the resected colon revealed evidence of ceramide trihexose deposition in the myenteric nerve plexus. Colonic involvement in Fabry's disease has not been reported before.

Reducing hours of work of preregistration house officers: report on a shift system.

Objective: To determine the advantages and disadvantages of a shift system of working compared with the conventional on call system for preregistration house officers.

Design: A shift system of working was employed in the unit from 1 August 1989 to 31 July 1990. During attachments of three or six months four house officers rotated at intervals of one month among three daytime shifts and one night shift (Mondays to Fridays only).