We describe what we believe to be the first reported case of intragastric erosion and migration to the jejenum of a laparoscopically inserted gastric band, 3 months after the original bariatric surgery was performed. This had caused ulceration and necrosis of the small bowel as the tension in the port tubing had caused the bowel to become concertinaed over it and resulted in a cheese-wire effect through the jejunal convolutions. As bariatric surgery becomes more common, patients with complications of their procedure may present to the general surgeon as an emergency. We recommend early intervention in patients with gastric erosion.

SummarySeventy-four cases of haemorrhagic proctitis have been observed during a 10-year period. Inheritance, psychological stress and constipation may be of aetiological significance. A graded therapeutic effect using roughage, salazopyrin and local steroids emphasized the necessity of using all those forms of therapy, both to obtain and maintain remission. Peripheral complications and persisting abnormal serum protein patterns were associated with a high incidence of progression of the disease beyond the confines of the rectum.

Aim Synthetic rectal mesh erosion is a challenging complication following urogynaecological surgery. The aim of this study was to determine the optimal management of rectal mesh erosion following urogynaecological surgery. Method A systematic review was undertaken following a pre‐defined protocol registered with PROSPERO (CRD42018112425) in accordance with PRISMA guidelines. Searches of MEDLINE online database, Cochrane Library and clinical trial registries (ClinicalTrials.gov, EU Clinical Trials, ISRCTN registry) were performed. The included articles were heterogeneous – therefore a narrative synthesis was performed. Results Fourteen studies were included in the review: 11 case reports, one case series, one retrospective cohort and one prospective multicentre trial. Fourteen rectal mesh erosions were identified. Eight (57%) of the rectal erosions underwent major abdominal surgery. In two of these cases, the abdominal approach was used only after failure of the transanal route. Five (36%) of the mesh erosions were managed using a transanal approach. In one case, the mesh passed without intervention. Conclusion Synthetic rectal mesh erosion can be managed successfully via either a transanal or a transabdominal approach with a partial or complete excision of the mesh. An examination under anaesthetic with an attempted transanal removal of mesh should be considered the first step in the management of this condition before consideration of more invasive surgery.

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