We report the case of 65-year-old man who developed massive rectal bleeding associated with the use of a fecal collecting device: the Flexi-Seal Fecal Management System. A colonoscopy showed an acute laceration of the anterior rectal wall mucosa, 6 cm from the anal verge, with active bleeding. The tear was most likely the result of an acute event, such as sudden movement of the device within the rectum or trauma sustained during insertion. Massive transfusion was required, and surgical endoscopic treatment was necessary to ensure hemostasis. This is, to our knowledge, the first such case to be reported.

Purpose of the review To review the relevant literature surrounding acromioclavicular (AC) joint injuries particularly pertaining to overhead athletes. Recent findings The AC joint is a unique anatomic and biomechanical portion of the shoulder that can be problematic for athletes, particularly throwers, when injured. Treatment of these injuries remains a topic in evolution. Low-grade injuries (Rockwood types I & II) are typically treated non-operatively while high-grade injuries (types IV, V, and VI) are considered unstable and often require operative intervention. Type III AC separations remain the most controversial and challenging as no clear treatment algorithm has been established. A wide variety of surgical techniques exist. Unfortunately, relatively little literature exists with regard to overhead athletes specifically. Summary Treatment of AC joint injuries remains challenging, at times, particularly for overhead athletes. Operative indications and techniques are still evolving, and more research is needed specifically surrounding overhead athletes.

Case: We present a 51-year-old woman with Aitken A proximal femoral focal deficiency (PFFD) managed with total hip arthroplasty (THA). This patient presented with a history of disabling hip arthritis and multiple operations to improve her proximal femoral deformity and maintain a reduced hip. The hip was dysplastic with persistent femoral deformity, erosive acetabular changes, and abductor weakness. The surgical treatment was a THA. Conclusion: In the setting of hip arthritis, despite abductor weakness and deformity of the proximal femur, hip arthroplasty is a viable option for management of the patient with Aitken A PFFD.