The 2007 United Kingdom National Institute for Health and Clinical Excellence (NICE) thromboprophylaxis guidelines concerning hip arthroplasty remain contentious in spite of significant evidence. A survey among British Hip Society members was performed to investigate the impact of these guidelines. Information on thromboprophylactic measures before and after guideline publication was gathered for three categories; Total Hip Replacement (THR), hip fracture and high-risk patients (as defined by NICE). The response rate was 185/250 (74%). All responders used thromboprophylaxis, but only 44%, 22% and 7% indicated they were currently acting in accordance with guidance for THR, high risk and hip fracture groups respectively. Only 19%, 14% and 14% had changed their practice since publication of the guidance in THR, high risk and hip fracture groups respectively. The effects of national guidance in influencing thromboprophylactic protocols have therefore been limited. The reasons were not investigated in this survey.
We report an unusual case of a giant colonic mucocele following ileo-sigmoid bypass surgery in a patient with advanced adenocarcinoma of the splenic flexure. The formation of a giant colonic mucocele resulted from distal splenic flexure obstruction due to tumour relapse and proximal caecal obstruction due to peritoneal disease with subsequent accumulation of mucus in the closed loop.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.