Giant duodenal diverticulum masquerading as a sealed perforation.

Giant duodenal diverticula are large outpouchings involving all layers of the duodenal wall. Whilst often an incidental finding, giant duodenal diverticula can present with diverticulitis or biliary obstruction. We report a case of a giant duodenal diverticulum that was initially misdiagnosed as a localised duodenal perforation on CT.

Radiation dose in barium swallow examinations: an Oxford tertiary care centre experience.

Aim: To assess the radiation dose in standard barium swallow studies (BaSS) performed at a large tertiary referral centre, benchmarked against the national diagnostic reference level (NDRL), and to provide evidence to support reducing radiation dose through improving operator's training.

Materials And Methods: In this retrospective observational study, 1,004 adult BaSS (M:F = 411:593) were assessed. The radiation dose was first compared with NDRL, and then stratified by the operator's training level and compared using analysis of variance (ANOVA).

Proteus Mediastinitis Causing Fatal Pseudoaneurysm following Aortic Valve Replacement.

We report an unusual case of Gram-negative mediastinitis following aortic valve replacement via median sternotomy. The patient presented two months after surgery following a urinary tract infection in septic shock with a discharging sternal wound and blood cultures positive for Proteus mirabilis. Imaging revealed a large anterior mediastinal abscess and aortic pseudoaneurysm which subsequently ruptured resulting in fatality.

Appropriate patient selection in the management of common bile duct stones: when not to do ERCP.

Background. Magnetic resonance cholangiopancreatography (MRCP) is noninvasive and accurate for diagnosing intra common bile duct stones (ICSs). However, given limited access, routine utilisation for investigating all patients with gallstone disease is neither practical nor cost-effective.

Laxative-free CT colonography.

Objectives: The aim of this study was to determine if the introduction of faecal tagging to CT colonography (CTC) made the examination easier to tolerate or reduced the number of false-positives.

Methods: Our department changed bowel preparation for CT colonography from Picolax (Ferring Pharmaceuticals Ltd, London, UK) to Gastrografin (Bracco Diagnostics Inc, Princeton, NJ) only with a modified diet. Questionnaires were given to a subgroup of patients within these cohorts.