A new protocolised treatment strategy optimising medical and surgical care leads to improved healing of Crohn's perianal fistulas.

Background & Aims: Crohn's perianal fistula healing rates remain low. We evaluated the efficacy of a protocolised multidisciplinary treatment strategy optimising care in adults with Crohn's perianal fistulas.

Methods: A new treatment strategy was established at a single tertiary centre.

Improving Hepatocellular Carcinoma Surveillance Outcomes in Patients with Cirrhosis after Hepatitis C Cure: A Modelling Study.

Background & Aims: Hepatocellular carcinoma (HCC) presents a significant global health challenge, particularly among individuals with liver cirrhosis, with hepatitis C (HCV) a major cause. In people with HCV-related cirrhosis, an increased risk of HCC remains after cure. HCC surveillance with six monthly ultrasounds has been shown to improve survival.

Perianal Fistulizing Crohn's Disease-Associated Anorectal and Fistula Cancers: Systematic Review and Expert Consensus.

Background & Aims: Perianal fistulizing Crohn's disease (PFCD)-associated anorectal and fistula cancers are rare but often devastating diagnoses. However, given the low incidence and consequent lack of data and clinical trials in the field, there is little to no guidance on screening and management of these cancers. To inform clinical practice, we developed consensus guidelines on PFCD-associated anorectal and fistula cancers by multidisciplinary experts from the international TOpClass consortium.

Elimination of oral contrast leads to faster scans in the workup of abdominal pain in the emergency setting without compromising diagnostic accuracy.

Introduction: The aim of this study was to study how the effect of eliminating oral contrast for computed tomography of the abdomen and pelvis (CTAP) in the workup of abdominal pain in the emergency department (ED) would affect the time from patient review to scan and time from review to discharge.

Methods: In this retrospective study, we analysed all ED presentations with abdominal pain to our university affiliated tertiary hospital before and after a protocol that eliminated oral contrast-enhanced CTAPs were implemented in September 2018. Two equivalent periods between September and November of 2017 and 2018 were analysed.

A case of a bleeding benign gastrocolic fistula in 2014.

Introduction: In the era of proton pump inhibitors in the treatment of peptic ulcer disease, the incidence of a gastrocolic fistula arising from unoperated gastric ulcers is extremely low.

Presentation Of Case: We present the case of a 68-year old farmer who presented with melaena and was found to have a benign gastrocolic fistula in the setting of untreated peptic ulcer disease, chronic NSAID ingestion and heavy alcohol intake. The diagnosis was made by gastroscopy.

Large jugular bulb abnormalities involving the middle ear.

Objective: Jugular bulb abnormalities (JBA), such as jugular bulb diverticula (JBD) or large jugular bulbs, rarely present in the middle ear. We review a large series of temporal bone histopathologic specimens to determine their prevalence and present a series of cases of JB abnormalities involving the middle ear (JBME) that shed light on the probable mechanism for their development.

Patients: 1,579 unique temporal bone specimens and individuals with radiographically-diagnosed JBME.

Prevalence of jugular bulb abnormalities and resultant inner ear dehiscence: a histopathologic and radiologic study.

Objective: Jugular bulb abnormalities (JBA), including high-riding jugular bulb (HRJB) and jugular bulb diverticulum (JBD), can erode into the inner ear. In this study, the authors investigate the prevalence and consequences of JBA and their erosion into inner ear structures using temporal bone histopathology and computed tomography (CT).

Study Design: Cross-sectional study of temporal bone histopathology and radiology.

A clinical and histopathologic study of jugular bulb abnormalities.

Objective: To further define the spectrum of clinical presentation and explore the histologic sequelae of jugular bulb abnormalities (JBAs).

Design: Retrospective review.

Setting: Academic medical center.