Many patients with large thyroid nodules undergo thyroidectomy for symptom relief alone, regardless of their FNAC results. In such patients where other clinical indicators for thyroidectomy are not present, a benign FNAC result can reassure both patient and surgeon that mandatory surgical excision is not needed to exclude malignancy.

Preoperative synoptically reported FNAC is effective when used in diagnosing and planning surgery for thyroid cancer.

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Introduction Acute severe pancreatitis has a high mortality rate (10 to 30 %) and the aetiology of the pancreatitis itself influences the severity assessment and ultimately the treatment.1 Up to 20% of cases of acute pancreatitis are said to be due to unusual causes such as viral infection, trauma and drugs. However to date, there have been no reports in the literature of ureteric obstruction and infection causing acute pancreatitis. Methods We report on a case of a 77-year-old male who presented to the Emergency Department with acute pancreatitis occurring in the setting of an obstructed and infected right urinary system. Results We outline the pathway to diagnosis and management in this patient and highlight the difficulties associated with reaching an accurate diagnosis in the acute setting. Conclusion We report on this unusual case of acute pancreatitis in the emergency setting. By illustrating this case we aim to promote awareness of and encourage clinicians to consider ureteric obstruction as a possible cause of acute pancreatitis, in their workup of patients in the emergency department.

titles marked with an asterisk were judged for the Tom Reeve Research Prize.

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