Click here to listen to Mr Earnshaw discuss the highlights of the July issue, which is now available online.

A leading article by G. Stansby & D. Berridge and an original article by Saunders et al. on the subject of venous thromboembolism are published in the July 2013 issue of BJS (100:8).  In this podcast, G. Stansby and B. Braithwaite (a co-author on the original article) discuss how vascular units would need to work differently to follow recent treatment guidelines from NICE (National Institute for Health and Care Excellence).

A 75-year-old woman presented with a 2-week history of upper abdominal pain. Her haemoglobin level was 4.7 g/dl.
She underwent upper gastrointestinal endoscopy. The finding was a large duodenal bulb ulcer with complete erosion
into the periduodenal tissue revealing the cystic duct clips from her previous laparoscopic cholecystectomy 5 years
before.

Carotid interventions: past, present and future

Click here to listen to Mr Earnshaw discuss the highlights of the June 2013 issue, which is now available online.

Click here to listen to Jonothan Earnshaw give a brief overview of the contents of the May 2013 issue.

This 59-year-old patient presented with a 2-week history of increasing right upper abdominal pain, swelling and pyrexia. He had a cholecystectomy 4 years previously. Computed tomography identified a large complex abdominal fluid collection. The perihepatic and intra-abdominal abscesses were drained surgically. A gallstone fragment seen in the abscess cavity was the focus of infection. Although a perihepatic collection of this nature is relatively uncommon, it should be noted as a possible outcome of cholecystectomy even years after the original surgery. It highlights the importance of documentation of spilled stones during surgery and their extraction.

This patient required a laparotomy for symptoms of small bowel obstruction. The patient presented with colicky abdominal pain, and was found to have an iron deficiency anaemia. He had a history of previous cutaneous melanoma excision. The diagnosis is metastatic small bowel melanoma, with pigmented lesions in the small bowel, and melanin deposits in the mesentery.

Click here to listen to Mr Earnshaw discuss the highlights of the April issue.  These include the Leading Article by P.E. Watkins on using animals in research and the three articles on liver resection.

This is an incidental intraoperative finding of an appendiceal mucocele. Mucocele of the appendix is an uncommon tumour and is characterized by obstructive dilatation of the appendiceal lumen by intraluminal accumulation of mucinous secretions. Mucocele may be associated with a malignant process; therefore, complete resection without rupturing the mucocele is essential to prevent pseudomyxoma peritonei, a spread of the malignant cells into the peritoneal cavity with mucinous deposits. This patient underwent an open appendicectomy to ensure complete resection and has recovered well from the
surgery. Histology confirmed mucocele of the appendix with clear margins.