An unusual cause of small bowel obstruction caused by a Richter's-type hernia into the urinary bladder.

Introduction: The authors present an unusual case of small bowel obstruction in a 62-year-old man.

Presentation Of Case: A 62-year-old man with a background of transitional cell carcinoma (TCC) of the bladder presented to the emergency department with abdominal pain, distension, vomiting and had not opened his bowels for three days. 3 weeks previously he had a repeat Transurtheral resection of bladder tumour (TURBT), during which there was an iatrogenic perforation of the bladder.

Persistent umbilical discharge from an omphalomesenteric duct cyst containing gastric mucosa.

Umbilical discharge in infancy is often attributed to infection or an umbilical granuloma. It is important to investigate if such a discharge is due to an underlying congenital abnormality because corrective surgical intervention may then be required. We present the first case of an infant with a persistent umbilical discharge from an omphalomesenteric duct cyst.

Acute pancreatitis.

Acute pancreatitis (AP) is an important cause of morbidity and mortality worldwide and the annual incidence appears to be increasing. It presents as a mild self-limiting illness in 80% of patients. However, one-fifth of these develop a severe complicated life-threatening disease requiring intensive and prolonged therapeutic intervention.

General paediatric surgical provision of percutaneous endoscopic gastrostomy in a district general hospital--a 12-year experience.

Introduction: A small, but significant, number of children require long-term nutritional support. The aim of this study was to demonstrate the safety and efficacy of providing a percutaneous endoscopic gastrostomy (PEG) service for children in a district general hospital and to raise awareness of the suitability of the procedure to be performed on paediatric surgery lists in similar hospitals across the UK.

Patients And Methods: A multidisciplinary paediatric nutrition team was established and all children accepted for PEG insertion between 1995 and 2007 were entered onto a database prospectively and are included in this study.

Selective cholangiography in 600 patients undergoing cholecystectomy with 5-year follow-up for residual bile duct stones.

Background: The need for cholangiography to identify possible bile duct stones in all patients undergoing cholecystectomy is controversial.

Aims: To assess the results of a policy for selective pre-operative endoscopic retrograde cholangiography (ERC) in patients undergoing laparoscopic cholecystectomy and to determine the incidence of postoperative symptomatic bile duct stones.

Patients And Methods: Between 1993 and 1998, 600 patients underwent laparoscopic cholecystectomy under one consultant surgeon.