With the advent of modern techniques including the widespread use of gastric endoscopy, benign gastric lesions are diagnosed more frequently and can be characterized by means of biopsy. Of all gastric tumours, less than 5% are benign and 90% of these are polyps. The treatment options for benign gastric tumours vary from mucosal resection to limited gastric...
(Vol 13 p 17-22, Emergency medicine and surgery; Gastroenterology; General surgery: 26 April 2013)
Ectopic pancreatic tissue is most often an incidental finding of imaging, surgery, or autopsy. Image-guided diagnosis is difficult, and definitive diagnosis usually relies on histological analysis. A case of ectopic pancreatic tissue located near the lesser curvature of the stomach is presented followed by a brief discussion of the clinical management of heterotopic...
(Vol 13 p 30-35, Endocrinology; Gastroenterology; General surgery: 2 April 2013)
A patient was admitted and diagnosed as acute pancreatitis of obscure aetiology. Laboratory investigations and radiological studies failed to reveal the underlying cause. A worm was pulled out of the nasogastric tube by the patient. In a modern society and in developed hospital settings, is it possible that we are missing, or underdiagnosing what we once regarded as...
(Vol 12 p 49-55, Emergency Medicine and Surgery; Gastroenterology; General Surgery: 23 October 2012)
We describe a case of very late stent thrombosis (ST) in a patient presenting with hematemesis while taking aspirin and oral anticoagulation therapy (OAC). This case shows that the management of patients with an indication for OAC who undergo percutaneous coronary intervention with drug-eluting stent (DES) implantation is challenging because of the need to balance the...
(Vol 11 p 48-52, Cardiology; Emergency Medicine; Gastroenterology; Haematology; Histopathology; Pathology: 18 July 2011)
Infliximab is one of the most widely used tumour necrosis factor-alpha (TNF-α) inhibitors for control of Crohn disease. We report the case of a patient with ileocolonic Crohn disease developing major arterial thrombosis after treatment with infliximab. After conservative management and infliximab withdrawal, thrombus dissolution and vessel recannalisation were observed....
(Vol 10 p 78-81, Gastroenterology: 22 October 2010)
A case describing a curious MRCP appearance is presented, which, placed in the clinical context, suggested an unusual tropical cause for the patient’s presentation and generated great debate between physicians, surgeons and radiologists.
(Vol 10 p 25-27, Gastroenterology; Radiology: 6 April 2010)
Thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS) is a rare but known complication of chronic viral hepatitis C (HCV). Even less frequently treatment of HCV with interferon-alpha (INFα) may become complicated with TTP/HUS, although only a few such reports have been published. We report a 43-year-old woman who developed TTP on two separate occasions...
(Vol 10 p 1-7, Gastroenterology; Hepatology: 16 February 2010)
Total parenteral nutrition (TPN) is an essential means of maintaining nutrition in those who are unable to do so via an enteral route. However, long term TPN can pose potentially serious complications, in particular liver related damage. This article describes a case of abnormal liver function following total parenteral nutrition and discusses the methods of potentially...
(Vol 8 p 46-48, Gastroenterology: 26 November 2008)
We report the case of a 91-year-old lady who presented with a gastrocutaneous fistula in the absence of any recent surgery. We review the literature and discuss this uncommon surgical problem.
(Vol 8 p 10-13, Breast Surgery, gastroenterology; General Surgery: 28 February 2008)
Abnormalities in midgut rotation occur during the physiological herniation of the midgut between the 5th and 10th week of gestation. The most significant abnormality is a narrow small bowel mesentery which is prone to volvulus. This occurs most frequently in the neonatal period. Less commonly, midgut malrotation presents in adulthood with either acute volvulus or chronic...
(Vol 7 p 67-69, General surgery; Laparoscopic surgery: 16 November 2007)
We report a case of Boerhaave’s syndrome in a previously fit 57-year-old lady with an aetiological association with a co-existing duodenal ulcer. We discuss the diagnostic difficulties presented by this case, the importance of prompt diagnosis and intervention, and the problems involved in the management that are highlighted in this case. This is an extremely rare but...
(Vol 5 p 42-45, Gastroenterology: 21 September 2005)
Isolated Bauhinitis is a rare cause of non-specific abdominal symptoms in adults. Modern descriptions of the disease are lacking. We report two current cases with an overview of the literature and a discussion of the aetiology, clinical signs, diagnostic findings, and treatment guidelines. Colonoscopic and histological findings are used to diagnose the condition....
(Vol 5 p 15-18, Gastroenterology: March 2005)
We report a case of sigmoid perforation caused by Meckel’s diverticulitis. The ætiology, clinical findings and guidelines for therapy are described. Complications of Meckel’s diverticulum should be considered in the differential diagnosis of young patients with recurrent non-specific abdominal pain. If in doubt, operative exploration should be performed.
(Vol 4 p 16-18, Gastroenterology; General Surgery: October 2004)
Two patients with biliary peritonitis without demonstrable perforation are described. Despite biliary peritonitis almost invariably following biliary tract perforation, none could be identified with contemporary imaging. This condition is extremely rare, difficult to diagnose pre-operatively and has high mortality.
(Vol 4 p 13-15, General Surgery; Hepatology; Gastroenterology: August 2004)
We report a case of pulmonary Mycobacterium avium-intracellulare (MAI) in a previously fit 48-year-old man who subsequently developed Crohn's disease. We discuss the potential predisposing factors for pulmonary MAI; the diagnostic uncertainties in this particular case; the relationship between pulmonary MAI and Crohn's disease; and the difficulties in management that are...
(Vol 2 p 24-28, Respiratory Medicine; Gastroenterology; Infection: May 2002)


Frank Cross
Consultant Vascular and General Surgeon
The London Clinic, UK


Neil Barnes
Consultant Physician
Barts Health NHS Trust, London, UK
Ali Jawad
Professor of Rheumatology
Barts Health NHS Trust, London, UK

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