Faecal haemoglobin concentration and colorectal cancer site, stage and grade in a symptomatic cohort.

Aim: Minimal evidence exists regarding faecal immunochemical tests (FITs) for colorectal cancer (CRC) site, stage and grade in symptomatic patients. The primary aim is to determine any association between faecal haemoglobin concentration (f-Hb) (analysed with OC-Sensor™ Pledia) and these prognostic factors. The secondary aim is to determine the association between f-Hb and anaemia, microcytosis and iron deficiency (Hb, mean corpuscular volume [MCV] and ferritin).

The repeat FIT (RFIT) study: Does repeating faecal immunochemical tests provide reassurance and improve colorectal cancer detection?

Aim: Faecal immunochemical tests (FIT) are highly sensitive for colorectal cancer (CRC) detection. Little evidence exists regarding repeat FIT. The repeat FIT (RFIT) study aimed to determine whether second and third FIT provide reassurance and improve CRC or significant bowel disease (SBD) identification.

An observational study of replicate faecal immunochemical tests in the urgently referred symptomatic cohort.

Introduction: Triage of patients with suspected colorectal cancer (CRC) utilises a single faecal immunochemical test (FIT) at a defined threshold. Limited evidence exists regarding whether replicate FIT improves the positive and negative predictive value in symptomatic patients. This study examines urgently referred symptomatic patients undergoing replicate FIT.

A single centre 20-year retrospective cohort study: Percutaneous endoscopic colostomy.

Aim: Percutaneous endoscopic colostomy (PEC) represents an important intervention in specific patients. Limited data currently exist. We present the largest recorded study of patients undergoing PEC.

Replicate and repeat faecal immunochemical tests in symptomatic patients: A systematic review.

Background: Faecal Immunochemical tests (FITs) in the assessment of patients presenting with symptoms have generally used a single sample. Little evidence pertains to the use of replicate, where a number of tests are done prior to decision-making or repeat FIT, where additional FIT are performed following clinical decision-making. Overwhelmingly, research has focussed on FIT to help identify colorectal cancer (CRC).

Ovarian torsion: diagnosis, surgery, and fertility preservation in the pediatric population.

Ovarian torsion is rare in the pediatric population. Delayed diagnosis can significantly impact fertility. The aim of this review is to highlight current knowledge regarding clinical presentation, diagnosis, surgical management, and follow-up in the pediatric population.

Risk prediction score and appendicectomy in the elderly: a single centre 5-year retrospective cohort study.

Background: Appendicitis is a common surgical emergency that can be a challenging entity to manage. In the elderly, it is associated with significant morbidity and mortality. Risk prediction is not routinely performed prior to surgery.

Systematic review of Meckel's diverticulum in pregnancy.

Introduction: Meckel's diverticulum (MD) is the most common congenital malformation in the gastrointestinal tract. Limited up-to-date evidence is available regarding MD in pregnancy. We aim to review the available pertinent literature to help support clinical decision making and patient management in the future.

Bilateral pelvic kidneys with upper pole fusion and malrotation: a case report and review of the literature.

Background: The incidence of ectopic kidneys is 1:12,000 clinically and 1:900 postmortem. Patients with pelvic mal-rotated kidneys are more susceptible to recurrent urinary tract infections, recurrent renal stones, and renal injury. Fusion of the kidney lower poles is relatively common compared to other types of renal anomalies.

A Prospective Observational Study Assessing the Relationship Between Solitary Thyroid Nodule Size and Incidence of Malignancy.

Background Solitary thyroid nodule (STN) is a well-documented entity. Autopsy data indicate a 50% prevalence of thyroid nodules >10 mm in patients without clinical evidence of thyroid disease. Prevalence of palpable nodules is 4-7%.

Challenging removal of a knotted nasogastric tube following insertion under general anaesthetic.

A 74-year-old man presented with acute small bowel obstruction secondary to recurrence of a caecal tumour. The patient underwent laparotomy and formation of loop ileostomy and had a nasogastric tube (NGT) inserted in the theatre. A decision was made to remove the patient's NGT postoperatively, which was found to be stuck.

A systematic review of symptomatic small bowel lipomas of the jejunum and ileum.

Introduction: Small bowel lipomas are rarely encountered benign adipose growths found within the small intestine wall or mesentery. Limited up-to-date evidence exists regarding such lipomas. We aim to aid clinical decision-making and improve patient outcomes through this comprehensive review.

A challenging case of a chyle leak following axillary lymph node clearance.

Chyle leak following axillary lymph node clearance is a rarely reported complication. We present a case of chylous leakage following axillary lymph node clearance, which was diagnosed on clinical grounds. Surgical re-exploration was undertaken due to ongoing high output.

A systematic review of gallstone sigmoid ileus management.

Introduction: Gallstone sigmoid ileus is a rare although serious complication of cholelithiasis resulting in large bowel obstruction. The condition accounts for 4% of all gallstone ileus patients. There are no recognized management guidelines currently.

A single centre case series of gallstone sigmoid ileus management.

Aims/introduction: Gallstone sigmoid ileus is a rare condition that presents with symptoms of large bowel obstruction secondary to a gallstone impacted within the sigmoid colon. This arises because of three primary factors: cholelithiasis causing a cholecystoenteric fistula; a gallstone large enough to obstruct the bowel lumen; and narrowing of the bowel. We describe 3 patients treated in a district general hospital over a 3-year period, and discuss their management.

Does music reduce anxiety and discomfort during flexible sigmoidoscopy? A systematic review and meta-analysis.

Aim: To investigate the role of music in reducing anxiety and discomfort during flexible sigmoidoscopy.

Methods: A systematic review of all comparative studies up to November 2016, without language restriction that were identified from MEDLINE and the Cochrane Controlled Trials Register (1960-2016), and EMBASE (1991-2016). Further searches were performed using the bibliographies of articles and abstracts from major conferences such as the ESCP, NCRI, ASGBI and ASCRS.

Urinary retention secondary to acute vasculitic penile swelling in a pediatric patient.

Acute urinary retention secondary to vasculitic penile swelling in children is extremely rare. Henoch-Schönlein purpura is a self-limiting IgA-mediated cutaneous vasculitis, which can cause soft tissue edema. Acute urinary retention requires urgent intervention to prevent obstructive uropathy.

Are we following an algorithm for managing chronic anal fissure? A completed audit cycle.

Background: Anal fissure is one of the commonest proctological diseases with considerable national variation in sequential treatment. We aimed to audit our compliance of chronic anal fissure (CAF) management with national guidance provided by the Association of Coloproctology of Great Britain and Ireland (ACPGBI).

Methods: We retrospectively audited patients presenting to outpatient clinics with CAF over a 6-month period.

A novel surgical approach for treatment of sigmoid gallstone ileus.

We report a rare case of large bowel obstruction secondary to a gallstone impacted within the sigmoid colon, in the presence of sigmoid diverticular disease. An 89-year-old woman presented with an 8-day history of increasing abdominal distension, pain and associated nausea. Abdominal X-ray demonstrated large bowel dilation.