Despite its limitation as a retrospective review, this study found that reintervention for stent obstruction is necessary in almost one in five cases, and increasing severity of stent angulation is the most important risk factor.

MPS in association with other endoscopic therapies imparts a significant clinical benefit to patients with ARP and PD. Complete clinical resolution occurs in the majority. Treatment is safe, and the response is durable.

Further studies, including patients with a broader range of resilience scores, particularly at the lower end of the spectrum, are required to explore the relationship between resilience and rehabilitation outcomes in greater depth.

Intussusception is the telescoping of proximal bowel wall into the lumen of a distal segment. Whilst it is common in children, intussusception in adults is rare, and predominantly occurs secondary to an underlying malignant neoplasm. Abdominal and pelvic computed tomography (CT) is preferred for detection of lead points and lesion localisation.We present the case of a 79-year-old female with a four-day history of colicky abdominal pain followed by obstipation and distension. CT demonstrated a rounded heterogeneous density protruding into the upper rectal lumen, and also left-sided colonic obstruction. Emergency laparotomy revealed a mid-sigmoid colonic mass intussuscepting into the rectum. Histopathology confirmed a T3N1 moderately differentiated colonic adenocarcinoma.Given the high likelihood of underlying malignancy, surgical reduction of the intussusceptum may be complicated by perforation and tumour spillage. En bloc resection using oncologic surgical principles remains the first line treatment.

When it is not practical to use the algorithm for regular monitoring of HFs, using PD by admission to estimate total HFs and PD by episode in combination with a procedure code to estimate HFs with surgery can produce robust estimations.