The mule who took us for a ride.

Foreign body ingestion is not uncommon in patients with mental disorders, alcohol intoxication and for purposes of drug trafficking. Small objects pass spontaneously; however, larger ones may get stuck in the oesophagus, stomach or at narrow areas of the bowel. 'Body packers' is a term used to describe persons who swallow or insert drug-filled packets into a body cavity.

Microsatellite instability in young patients with mucinous colorectal cancers - characterization using molecular testing, immunohistochemistry, and histological features.

Context: The incidence of colorectal cancers (CRCs) in young Indian patients is higher than the international average. CRCs in young patients are commonly of mucinous type and show microsatellite instability (MSI).

Aims: To ascertain the MSI status of mucinous CRCs in patients ≤40 years of age by molecular testing and to correlate this with immunohistochemical (IHC) analysis and tumor histology.

A prospective randomized controlled trial comparing early postoperative complications in patients undergoing loop colostomy with and without a stoma rod.

Aim: A stoma rod or bridge has been traditionally placed under the bowel loop while constructing a loop colostomy. This is believed to prevent stomal retraction and provide better faecal diversion. However, the rod can cause complications such as mucosal congestion, oedema and necrosis.

Demographics and outcomes of surgically treated right sided colon cancer in India: a 9-year single institution experience.

Background: There is sparse Indian data on right colon cancer. Available literature suggests that it affects the young and survival is poor.

Aim: This article reviews demographics and outcomes of surgically treated right sided colon cancer over a nine year period in a single colorectal unit in a tertiary care teaching hospital.

Surgical manifestations of scrub typhus: A diagnostic dilemma.

Scrub typhus, a zoonosis caused by Orientia tsutsugamushi, is a systemic febrile illness. The disease presents with diverse clinical manifestations, ranging from subclinical disease to multiorgan failure and fatal disease. It may rarely present as an acute abdomen which may lead to a diagnostic dilemma.

Factors influencing forces during laparoscopic pinching: Towards the design of virtual simulator.

Background: The design of good virtual simulators for laparoscopic training requires realistic visual and tactile perception. This is a study to characterize the factors that contribute to forces during laparoscopic pinching.

Methods: Surgeons were divided into four groups according to years of experience in laparoscopic surgery.

Indian Society of Gastroenterology consensus statements on Crohn's disease in India.

In 2012, the Indian Society of Gastroenterology's Task Force on Inflammatory Bowel Diseases undertook an exercise to produce consensus statements on Crohn's disease (CD). This consensus, produced through a modified Delphi process, reflects our current recommendations for the diagnosis and management of CD in India. The consensus statements are intended to serve as a reference point for teaching, clinical practice, and research in India.

The effect of autologous bone marrow-derived cells on healing chronic lower extremity wounds: results of a randomized controlled study.

Case studies suggest that bone marrow-derived stem cells may improve chronic wound healing. A prospective, randomized, clinical study was conducted to compare the rate of healing chronic lower limb wounds in patients with diabetes mellitus whose wounds were treated with topically applied and locally injected bone marrow-derived cells or whole blood (control). Of the 48 patients participating in the study, 25 were randomized to study treatment and 23 to control treatment.

Evidence-based surgery: knowledge, attitudes, and perceived barriers among surgical trainees.

Objectives: This study was conducted to assess the knowledge and attitude of surgical trainees toward evidence-based medicine (EBM) and their perceived barriers to its practice.

Design: The McColl questionnaire and the BARRIERS scale were modified and incorporated into a single questionnaire, which was administered to all surgical trainees attending a Continuing Surgical Education meeting.

Setting: Department of Surgery, Christian Medical College, Vellore, India.

Control of presacral venous bleeding with helical tacks on PTFE pledgets combined with pelvic packing.

Persistent and torrential bleeding from presacral veins is an uncommon complication during rectal resection. Control of bleeding is often difficult. We report an effective technique for controlling sacral bleeding using endoscopic helical tackers applied over pledgets of expanded polytetrafluoroethylene.

Transanal excision of anorectal lesions--a single centre experience.

Background: Transanal excision is commonly used to treat lesions of the anorectum. It avoids the morbidity of radical pelvic surgery, while allowing for complete histopathological examination of the lesion.

Aim: The aim of this study was to look at the spectrum of disease treated by transanal excision, and their outcomes, in a tertiary care institute.

Anal sphincter repair for fecal incontinence: experience from a tertiary care centre.

Aim: Structural anal sphincter damage may be secondary to obstetric anal sphincter injury, perineal trauma or anorectal surgery. We reviewed the spectrum of anal sphincter injuries and their outcomes in a tertiary care colorectal unit.

Methods: Data of patients who underwent anal sphincter repair between 2004 and 2008 were analyzed retrospectively.

Radiologic and pathological correlation of staging of rectal cancer with 3 Tesla magnetic resonance imaging.

Purpose: To assess the sensitivity and specificity of 3 Tesla magnetic resonance imaging (MRI) in the prediction of extramural spread and metastatic adenopathy in rectal carcinoma.

Materials And Methods: This was a prospective cohort study that included forty consecutive patients with rectal carcinoma from the Department of Colorectal Surgery. Three Tesla (3T) MRI was performed on these patients after a 4-hour fast and cleansing water enema.

Surgical intervention for anorectal fistula.

Background: Surgery for anorectal fistula may result in recurrence, or impairment of continence. The ideal treatment for anorectal fistulae should be associated with low recurrence rates, minimal incontinence and good quality of life.

Objectives: To assess the efficacy and morbidity of operative procedures for chronic anal fistula, primary outcomes being recurrence and incontinence.

Peritonitis following stapling of a flush ileostomy.

Peritonitis following staple stabilization of a flush ileostomy has not yet been reported in the literature. We report a case of iatrogenic injury to a loop of the ileum in an unrecognized parastomal hernia which caused peritonitis after stapling of a flush ileostomy.

A blinded, prospective, randomized controlled trial of topical negative pressure wound closure in India.

Wound closure using topical negative pressure (TNP) has been reported to be effective, but equipment costs can be prohibitive in resource-challenged countries. Because nonhealing wounds are exceedingly common in developing countries such as India, the ability to optimize wound care with limited resources is very important. To investigate the feasibility and efficacy of providing TNP in an Indian medical referral center, a randomized controlled trial comparing a locally constructed TNP device (treatment) to wet-to-dry gauze dressings (control) was conducted.

A tale behind the rectum.

Tailgut cysts, also called benign retrorectal hamartomas, are uncommon developmental cysts found behind the rectum. Here, we present a rare case of a tailgut cyst associated with uterine anomaly, sacral and vertebral anomalies and vascular duplication, in a young lady who presented with constipation and infertility.

Rectal cancer in young adults: a series of 102 patients at a tertiary care centre in India.

Objective: Rectal cancer in young patients is uncommon. There is little information on rectal cancer in young adults in India. The aim of this study was to determine the relative incidence of rectal cancer in young patients in India and identify any differences in histological grade and pathological stage between younger and older cohorts.

Early activation of mucosal dendritic cells and macrophages in acute Campylobacter colitis and cholera: An in vivo study.

Background And Aim: Macrophages and dendritic cells are closely related mononuclear phagocytic cells. Little is known about their in vivo role in acute intestinal bacterial infections in humans. We undertook to evaluate these cells in rectal mucosal biopsies of patients with acute colitis.