Removing hospital-based triage from suspected colorectal cancer pathways: the impact and learning from a primary care-led electronic straight-to-test pathway.

Background: The 2-week wait referral pathway for suspected colorectal cancer was introduced in England to improve time from referral from a general practitioner (GP) to diagnosis and treatment. Patients are required to be seen by a hospital clinician within 2 weeks if their symptoms meet the criteria set by the National Institute for Health and Care Excellence (NICE) and to start cancer treatment within 62 days. To achieve this, many hospitals have introduced a straight-to-test (STT) strategy requiring hospital-based triage of referrals.

Fixation of the access-port is not required in gastric banding.

Background: Laparoscopic adjustable gastric banding (LAGB) is increasingly performed in patients with morbid obesity. Suturing of the access-port in LAGB can be difficult and time consuming but is felt necessary by many surgeons to prevent migration and facilitate band adjustments.

Methods: Between 2003 and 2006, 226 patients underwent LAGB with the MIDband.

Hepatic adenomatosis--a rare double complication of multiple adenoma rupture and malignant transformation.

Hepatic adenomatosis (HA) is a rare disorder that is susceptible to hemorrhagic complications and, rarely, to malignant transformation. We report a 24-year-old woman who was found to have HA with > 10 tumors; she presented with simultaneous rupture of two of the adenomas, along with malignant change in one. Hematoma evacuation and caudate lobe resection were done and she has been doing well 6 months later.