Single-session catheter-directed lysis using adjunctive clot fragmentation with power pulse spray only is a fast, safe, and effective option for acute pulmonary embolism.

Objective: Single-session, catheter-directed thrombolysis (CDT) with adjunctive power pulse spray (PPS) only, without thrombectomy, was evaluated for its safety and effectiveness. We performed a single-center, retrospective analysis of prospectively collected data.

Methods: Patients with high-risk or intermediate-risk pulmonary embolism (PE) who met the inclusion criteria and underwent a single session of CDT-PPS were included in the study.

Pharmacomechanical thrombectomy of iliofemoral deep vein thrombosis is associated with a low incidence of post-thrombotic syndrome and perioperative complications.

Background: Iliofemoral deep venous thrombosis (IFDVT) is associated with an incidence of post-thrombotic syndrome (PTS) of up to 50%. PTS is associated with high morbidity, impaired quality of life and a significant economic burden. The aim of the current study was to assess the impact of a single session pharmacomechanical thrombectomy (PMT), dedicated venous stents and a risk mitigation protocol on the rate of PTS.

Neoadjuvant Chemoradiation for Rectal Cancer Achieves Satisfactory Tumour Regression and Local Recurrence - Result of a Dedicated Multi-disciplinary Approach from a South Asian Centre.

Background: Pre-operative long-course chemoradiotherapy (CRT) for rectal cancer has resulted in improvement in rates of restorative rectal resection and local recurrence by inducing tumour downstaging and downsizing. Total mesorectal excision (TME) is a standardised surgical technique of low anterior resection aimed at the prevention of local tumour recurrence. The purpose of this study was to evaluate tumour response following CRT in a standardised group of patients with rectal cancer.

Review article: Non-penetrating neck artery dissection in young adults: Not to be missed!

Young adults who present to the ED with neck pain following non-penetrating, seemingly trivial trauma to the neck, are at risk of neck artery dissection and subsequent stroke. Sport-related neck injury is the chief cause. Physical examination may often be unremarkable, and although there may be reluctance to expose young patients to radiation, radiological imaging is central to making a diagnosis of arterial wall disruption.

Review article: Acute superior mesenteric vessel ischaemia: A review of clinical practice and biomarkers.

A patient with acute occlusion of the superior mesenteric vessels resulting in superior mesenteric vessel ischaemia (SMVI) who presents to the ED with abdominal pain and unremarkable abdominal examination risks delay in diagnosis and treatment with adverse outcome. A comprehensive literature search was performed, and the evidence was reviewed. To-date, there are no accurate biomarkers of SMVI and so, heightened awareness among ED staff and rapidly actioning diagnostic imaging and surgical referral will help fast-track the patient with SMVI to surgical management.

Rare presentation of Waldenström's macroglobulinaemia requiring bilateral above-knee amputations: a case report.

Background: Waldenström's macroglobulinaemia is a rarely encountered B-lymphocytic malignancy. Waldenström's macroglobulinaemia-associated paraproteinaemia is linked to an increase in serum viscosity, which results in a hypercoagulable state. Burning bilateral foot pain in a man with alcohol dependence and controlled atrial fibrillation presenting to the emergency department was attributed to peripheral neuropathy, given satisfactory angiographic evidence of bilateral foot arterial blood supply.

Colorectal cancer in the young, many questions, few answers.

At a time where the incidence of colorectal cancer, a disease predominantly of developed nations, is showing a decline in those 50 years of age and older, data from the West is showing a rising incidence of this cancer in young individuals. Central to this has been the 75% increase in rectal cancer incidence in the last four decades. Furthermore, predictive data based on mathematical modelling indicates a 124 percent rise in the incidence of rectal cancer by the year 2030 - a statistic that calls for collective global thought and action.

Twisted benign ovarian teratoma presenting with pain and generalized pruritus: a case report.

Introduction: Cystic ovarian teratomas comprise 20% of all ovarian neoplasms, and are commonly encountered in patients between 20 and 40 years of age. Although these cysts are usually asymptomatic, we present the case of a patient whose cyst resulted in pruritus and abdominal pain. Based on a MEDLINE search of the literature, we believe this is the first case report of a twisted ovarian cyst presenting with generalized pruritus.

Proximal and distal rectal cancers differ in curative resectability and local recurrence.

Aim: To evaluate patients with proximal rectal cancer (PRC) (> 6 cm up to 12 cm) and distal rectal cancer (DRC) (0 to 6 cm from the anal verge).

Methods: Two hundred and eighteen patients (120 male, 98 female, median age 58 years, range 19-88 years) comprised 100 with PRC and 118 with DRC. The proportion of T1, T2 vs T3, T4 stage cancers was similar in both groups (PRC: T1+T2 = 29%; T3+T4 = 71% and DRC: T1+T2 = -31%; T3+T4 = 69%).

Prevalence of left-sided colorectal cancer and benefit of flexible sigmoidoscopy: a county hospital experience.

The best way to evaluate the colon for both diagnosis of symptoms and surveillance is colonoscopy. However, access to colonoscopy is often restricted. Our objective was to assess the anatomic distribution and stage at presentation of colorectal cancer (CRC) in a county hospital population, the prevalence and distribution of CRC in younger patients, and the utility of flexible sigmoidoscopy for early diagnosis of left-sided cancers in this population.