Objective: To determine the incidence and presenting features of adult coeliac disease in a single university hospital in South Yorkshire. Design: A retrospective case finding study. Data were obtained from pathology and immunology databases, clinical notes, dietetic records, and patient questionnaires. Setting: Royal Hallamshire Hospital in South Yorkshire, England. Participants: All recorded cases of coeliac disease. Main outcome measures: Crude annual incidence rates for coeliac disease was obtained. The numbers of coeliac antibody profiles requested per year from the Royal Hallamshire Hospital were ascertained. Age at diagnosis, sex, year of diagnosis, presenting symptoms, associated conditions, and delay in diagnosis was documented. In addition the specialty of the clinician who made the diagnosis was noted.Results: There were 264 cases in total (male n=86, ratio 1:2). Mean age at diagnosis was 44.9 years (range 1-82, median 44.5). A trend was observed from 1990 to 2000 inclusive, of an annual increase in the incidence of coeliac disease. There has been a coincidental increase in the measurement of associated antibodies. Although 28.4% of patients presented with gastrointestinal symptoms, 20.1% had iron deficiency anaemia. The ratio of typical to atypical symptoms was 1:2.5. (single sample test of proportions p<0.001). The diagnosis was made by a gastroenterologist in only 52.7% of cases. The median duration of symptoms before the diagnosis of coeliac disease was 4.9 years (range 0.25-16 years). Conclusion: Coeliac disease is now presenting more commonly without gastrointestinal symptoms and often to specialties other than gastroenterology. Although more cases are diagnosed, this may be a reflection of increasing recognition rather than a true increase in incidence.

No abstract

No abstract

No abstract

No abstract

No abstract

BackgroundSpecific Image Defined Risk Factors (IDRF) may be of more relevance to the pediatric surgical oncologist than simply the presence of any IDRF. The aim of this study was to correlate IDRF with surgical complications with reference to vascular encasement IDRF and the grade of complication.MethodsWe searched the New Zealand Children’s Cancer Registry for all cases of neuroblastoma treated at a single pediatric oncology center between January 2007 – February 2021 and reviewed the pre-treatment axial imaging for IDRF status. Surgical complications were scored by Clavien-Dindo grade and correlated with the number of IDRF and with the subset of vascular encasement IDRF.ResultsOf 101 patients, 77 were IDRF positive. In total, 74 underwent surgical resection and 32 (43.2%) had a surgical complication. Complications were related to the number of IDRF (OR 1.33, 95% CI 1.05 – 1.73, p = 0.02) and the subgroup of vascular encasement IDRF (OR 1.78, 95% CI 1.12 – 3.04, p = 0.01) but were not significantly correlated with the subgroup of non-vascular encasement IDRF. We report three cases of chyle leak associated with tumor encasing the origin of the celiac axis and/or the superior mesenteric artery.ConclusionsThe vascular encasement IDRF subgroup is potentially a more useful prognostic indicator of surgical complications than non-vascular IDRF. More studies are needed to correlate specific IDRF with specific surgical complications to aid operative decision making.Level of evidenceLevel IIIHighlightsImage Defined Risk Factors (IDRF) in neuroblastoma correlate with survival, completeness of resection, and surgical complications.Complications correlate specifically with the subset of vascular encasement IDRF. Chylous ascites was a specific complication associated with encasement of the celiac and superior mesenteric vessels.

No abstract