Auscultation of bowel sounds is non-specific for diagnosing bowel obstruction. Differences in sound characteristics between large bowel and small bowel obstruction may help determine the likely site of obstruction.

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No significant difference in the incidence of perioperative complications or recurrence after LVHR was observed between the morbidly obese patients and the non-morbidly obese patients.

The subintimal arterial flossing with antegrade-retrograde intervention technique is safe with high technical success rates and acceptable outcomes in Asian CLI patients with CTOs.

Both torsional and linear mode ultrasonic shears achieved secure hemostasis on vessels up to 5.2 mm. The torsional mode shears had the extended ability to coagulate larger-sized vessels up to 7.4 mm with the same degree of confidence.

AIM:To compare a lansoprazole-based triple versus quadruple therapy for Helicobacter pylori (H pylori) eradication with emphasis on side effect profile, patient compliance and eradication rate at a rural district general hospital in Wales, United Kingdom. C urea breath test 2 mo after treatment. RESULTS: Seven patients were withdrawn after randomisation. Fifty patients were assigned to LAC group and 44 to LMBT group. The intention-to-treat cure rates were 92% and 91%, whereas the perprotocol cure rates were 92% and 97%, respectively. Side effects were common, with 56% experiencing moderate to severe symptoms in the LAC group and 59% in the LMBT group. Symptoms of vomiting, diarrhoea and black stools were significantly more common in the LMBT group. Patient compliance was 100% for triple therapy and 86% for quadruple therapy (P < 0.01). One-third of patients in both groups were still taking acid-reducing medications at six-month follow-up. CONCLUSION: One-week triple and quadruple therapies have similar intention-to-treat eradication rates. Certain side effects are more common with quadruple therapy, which can compromise patient compliance. Patient education or modifications to the regimen are alternative options to improve compliance of the quadruple regimen. METHODS:

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Pancreaticopericardial fistula is an extremely rare complication of chronic pancreatitis with few reported cases. A 45-year-old man with a history of chronic pancreatitis presented with dyspnoea and chest pain. On examination, there were signs of pyrexia, tachycardia, tachypnoea and hypotension. Computed tomography and magnetic resonance imaging demonstrated a fistulous tract arising from the tail of the pancreas and extending through the diaphragmatic hiatus into the posterior mediastinum and the pericardial sac. Initial conservative treatment with antibiotics, octreotide (a somatostatin analogue), and nasojejunal feeding led to resolution of the fistula. The patient subsequently underwent an elective Roux-en-Y pancreaticojejunostomy 1 month later. The operation was performed without complication and he has remained symptom free during follow-up. We present this rare complication of chronic pancreatitis and review the relevant literature.