One in four loop ileostomies performed to defunction an elective anterior resection is not reversed, and in the presence of significant comorbidity one in three is not reversed. Only 12% is reversed within 12 weeks.

Complications following ileal pouch-anal anastomosis (IPAA) have been well-described in the literature. While rare, small bowel volvulus following IPAA has been described. We describe the successful use of the modified Noble plication in such a patient with small bowel volvulus about an elongated mesentery. This largely 'historical' technique is well-suited to manage small bowel volvulus, especially when non-resectional management is preferred.

Acute appendicitis is an extremely rare complication of colonoscopy, with no reports in the British literature. Here we discuss a case report of a patient who developed acute appendicitis 24 hours following a normal diagnostic colonoscopy. This case report highlights the rarity of this life threatening complication and discusses its aetiology.

The diagnosis of polymyositis in the elderly population should raise suspicion of an underlying malignancy.

Ovarian cystic teratomas constitute 10-15% of all ovarian tumours and are the most common ovarian neoplasms found in adolescence and during pregnancy. Nevertheless, ovarian cystic teratomas have also been described in patients aged 1-91 years. We report an unusual case of a benign ovarian cystic teratoma presenting as a rectal mass that was managed surgically using radical resection by a multidisciplinary team. This case report highlights the importance of preoperative investigations including colonoscopy and radiological investigations. A dedicated pelvic radiologist/pathologist and the involvement of a multidisciplinary team at the time of initial diagnosis and a gynaecologist and colorectal surgeon at the time of surgery will lead to an accurate diagnosis and the most appropriate treatment. Although rare, erosion of an ovarian dermoid into the rectum should be considered in young women who have an atypical presentation and are found to have a lesion in the rectum with biopsies indicating benign pathology. 2011; 93: e46-e48 Ann R Coll Surg Engl

COVID-19 pandemic has affected more than 215 countries worldwide. Patient management has seen a tremendous change in the current pandemic with many specialities adopting measures to contain human to human transmission of the virus and to make judicious use of resources available. Surgical practices have changed globally with the use of virtual consultation, prioritisation of all elective and non-emergency services, COVID swab testing, chest imaging for all patients undergoing surgery and use of PPE to ensure staff safety. A major impact of COVID-19 has been on emergency surgery services and on surgical training. This article highlights the impact of COVID-19 on the safe delivery of surgical services and emphasizes on the use of webinars, online teaching and simulation as a meaningful tool to deliver surgical training in COVID era.

No abstract

No abstract