Oligometastatic colorectal adenocarcinoma to the spleen and ovaries.

In the context of colorectal cancer, splenic and ovarian metastases are rare outside of widely disseminated disease. Growing evidence suggests that 'oligometastatic' or limited metastatic disease can be treated surgically with good oncological outcomes. Splenic and ovarian metastases are not well represented in studies of oligometastatic colorectal cancer, resulting in uncertainty in the best management for these patients.

Effectiveness of an Oral Gastrografin Regimen for Complete Distal Intestinal Obstruction Syndrome.

Objectives: To assess the effectiveness of oral Gastrografin treatment and outcomes in adult patients with complete distal intestinal obstruction syndrome (cDIOS).

Background: DIOS is an important gastrointestinal complication of cystic fibrosis (CF). Conservative treatment options for cDIOS are largely empirical, and the optimal management remains unclear.

Anal cancer: a 20-year retrospective study from Australia.

Backgrounds: Anal cancer is an uncommon condition, occurring at higher rates in specific subpopulations. Clinical experience is limited and substantial changes have recently occurred in our understanding of this condition. We, therefore, set out to characterize patients presenting with anal cancer and investigate whether there have been any changes over the past 20 years.

Acute Cytomegalovirus Infection Associated With Splenic Infarction: A Case Report and Review of the Literature.

Splenic infarction associated with acute cytomegalovirus infection (CMV) in immunocompetent patients was initially described as a very rare occurrence but has been reported in recent years with increasing frequency. Many cases undergo multiple investigations only to leave acute CMV as the likely cause. There is a risk of splenic rupture and, although this complication is rare, fatalities have occurred.

Circumferentially oversewn inverted stapled anastomosis.

Background: Leak rates of over 5% following anastomoses between the ileum and colon continue to be reported in large series and are associated with substantial morbidity and with mortality rates of 10-20%. In 1994, we began performing circumferentially oversewn inverted stapled anastomoses in patients undergoing ileo-colic anastomoses or ileostomy closure. It has become increasingly apparent that this method is associated with a low risk of leakage, which we should report.

Neuromuscular and vascular hamartoma as an unusual cause of small bowel obstruction.

Introduction: Neuromuscular and vascular hamartoma (NMVH) is a rare, controversial lesion of the intestine, with only 23 cases reported in the English literature since its initial description in 1982.

Presentation Of Case: A 59year old female suffering from longstanding Crohn's disease with chronic stricture presented with symptoms of small bowel obstruction. Contrast studies demonstrated massive dilatation of the proximal small bowel.

Is low serum albumin associated with postoperative complications in patients undergoing oesophagectomy for oesophageal malignancies?

A best evidence topic was written according to a structured protocol. The question addressed was: in patients undergoing oesophagectomy for oesophageal malignancy, is low serum albumin associated with postoperative complications? Altogether, 87 papers were found using the reported search, of which 16 demonstrated the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated.

Evaluating informed consent for colonoscopy.

Background: This study aimed to collect and analyze data on patient knowledge of colonoscopy and their preferences regarding the provision of information about the procedure. Specifically, how much detail patients know about different aspects of the procedure and through which methods they best understand risk are evaluated and demographic correlations identified.

Materials And Methods: The study sample consisted of colonoscopy patients from 2 colorectal surgeons and a gastroenterologist at St Vincent's Public Hospital, Sydney for the period August 1 to November 1, 2010.

Referral pathways in colorectal cancer: an audit of surgeons's records.

Purpose: To explore the referral pathways of patients with newly diagnosed colorectal cancer to surgeons.

Method: Australian surgeons from three states completed a questionnaire and their records were audited.

Results: Thirty-three surgeons provided data on 530 patients seen in the preceding 12 months.

Multimedia article. An improved technique for end stoma creation in obese patients.

Purpose: The formation of an end colostomy in obese patients can be technically demanding and often requires the creation of a particularly large defect in the abdominal wall. This is because of the thickness of the subcutaneous fat and mesenteric fat, and increased resistance or friction while negotiating the bowel and mesentry through the abdominal wall.

Methods: The use of an Alexis Wound Protector to circumferentially retract the abdominal wall defect and, thus decrease resistance or friction during stoma formation, is described (see Video, Supplemental Digital Content 1 and 2, which demonstrates the technique, http://links.

A safe technique for the insertion of the Hasson cannula.

Background: Most techniques of Hasson cannula insertion still involve a significant risk of visceral or vascular damage. This is true even for the modified open techniques of cannulation.

Methods: A technique of sequential clipping and elevation of abdominal wall layers is described, which permits safer Hasson cannulation at the umbilicus or at other sites on the abdomen even in the presence of underlying adhesions.