RAL bladder augmentation can be safely and efficiently performed. There is a rapid learning curve. We identified minor technical modifications in techniques to help reduce operative time and potential complications. We recommend performing the bowel-bowel anastomosis outside the peritoneum to avoid the risk of leakage. Leakage at the bowel-bladder anastomosis may occur but can be managed with simple catheter drainage.
Epistaxis is a common complaint and is most often a benign selflimited condition. Therefore primary care providers might deem it unnecessary to evaluate a patient with epistaxis closely if they are not alert to more ominous etiologies. In this case report of an elderly patient with epistaxis, we illustrate this point by describing the presentation of adenoid cystic carcinoma of the sinonasal tract. We further elucidate the natural history of this malignancy as well as the recommended methods of its diagnosis and treatment.
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