Migrated Laparoscopic Surgical Clips Causing Acute Cholangitis 32 Years After Laparoscopic Cholecystectomy.

Surgical clip migration post-laparoscopic cholecystectomy is a rare but important complication to consider in patients presenting with biliary obstruction. Titanium surgical clips are widely used in laparoscopic surgery to ligate vessels and ducts and are particularly important in laparoscopic cholecystectomy to ligate the cystic duct. More common complications associated with clips involve dislodgement, however, there are reported cases of migration into visceral structures causing an obstruction.

Inhibited postprandial retrograde cyclic motor pattern in the distal colon of patients with diarrhea-predominant irritable bowel syndrome.

Patients with irritable bowel syndrome (IBS) have recurrent lower abdominal pain, associated with altered bowel habit (diarrhea and/or constipation). As bowel habit is altered, abnormalities in colonic motility are likely to contribute; however, characterization of colonic motor patterns in patients with IBS remains poor. Utilizing fiber-optic manometry, we aimed to characterize distal colonic postprandial colon motility in diarrhea-predominant IBS.

High-resolution impedance manometry characterizes the functional role of distal colonic motility in gas transit.

Background: The colonic motor patterns associated with gas transit are poorly understood. This study describes the application of high-resolution impedance manometry (HRiM) in the human colon in vivo to characterize distal colonic motility and gas transit; (a) after a meal and (b) after intraluminal gas insufflation into the sigmoid colon.

Methods: HRiM recordings were performed in 19 healthy volunteers, with sensors positioned from the distal descending colon to the proximal rectum.

Gas in gallbladder-gallstone ileus?

Gallstone ileus is an uncommon presentation among acute surgical patients. Its diagnosis is often delayed due to its non-specific clinical presentation. We report the case of an 81-year-old gentleman with a 2-day history of small bowel obstruction (SBO).

Effect of electrode separation on high-resolution impedance manometry catheters for ex vivo animal experiments.

Background: High-resolution impedance manometry (HRIM) catheters are used for esophageal reflux and bolus transit studies. Usually, these catheters have electrodes spaced at 20 mm intervals that are used for measuring electrical impedance between the consecutive electrodes and pressure sensors with 10 mm separation. Electrical impedance is a distributed measurement between the electrodes, unlike the point measurement of pressure sensors.

Health smart cards: differing perceptions of emergency department patients and staff.

An analytical, cross-sectional survey of 270 emergency department patients and 92 staff undertaken in three tertiary referral hospital emergency departments was completed to compare the perceptions of patients and staff regarding the use of health smart cards containing patient medical records. The study recorded data on a range of health smart card issues including awareness, privacy, confidentiality, security, advantages and disadvantages, and willingness to use. A significantly higher proportion of staff had heard of the card.

Handheld mobile telephone use among Melbourne drivers.

Objective: To evaluate change in handheld mobile telephone (mobile) use among motor vehicle drivers between 2002 and 2006.

Design And Setting: Observational study of motor vehicle drivers at three times (10:00-11:00; 14:00-15:00; 17:00-18:00) on three consecutive Tuesdays in October 2006 at 12 highway sites in metropolitan Melbourne.

Main Outcome Measures: Rates of handheld mobile use overall and by the sex and age of drivers, highway site (major metropolitan road, central business district, freeway exit ramp) and time of day.