A rare case of intestinal internal hernia beneath the external iliac artery following radical cystectomy.

Gastrointestinal complications following radical cystectomy (RC) are a common occurrence, with small bowel obstruction (SBO) a known complication. Limited cases have been reported of SBO following RC due to internal herniation of the small intestine around the ureter, ileal conduit, obturator nerve and, as a consequence of retroperitoneal lymphadenectomy, even the abdominal vasculature. We present a rare case in which intestinal herniation beneath the external iliac artery (EIA) resulted in a closed-loop SBO with ischaemia and necrosis. Intra-operative transection of the unrecognised EIA occurred, necessitating primary arterial repair. This case highlights the importance of maintaining a high index of suspicion for complex pathology and anatomical variations in patients following RC and other operations involving retroperitoneal lymphadenectomy.

Acute obstructive pancreatitis secondary to migration of a gastrostomy tube into duodenum.

Percutaneous endoscopic gastrostomy (PEG) tube is a common procedure. This discusses the rare complication of acute pancreatitis, due to tube migration, causing obstruction of the ampulla of Vater. Radiological confirmation of tubes prior to the usage may aid in preventing this reversible complication.

Imaging of the adnexal mass.

Imaging plays a central role in the diagnosis of adnexal masses, from the initial detection to characterization. Although ultrasound is often the first-line imaging modality in patients with adnexal masses, magnetic resonance imaging, computed tomography, and sometimes positron emission tomography-computed tomography are used for further evaluation. This chapter discusses the role of different imaging modalities in the evaluation of adnexal lesions as well as provides a summary of key imaging findings of common adnexal lesions.

Pancreatic adenocarcinoma presenting as acute pancreatitis during pregnancy: clinical and radiologic manifestations.

Only seven cases of pancreatic adenocarcinoma diagnosed during pregnancy have been reported. In this article, we describe a case of pancreatic adenocarcinoma presenting clinically as acute pancreatitis in a pregnant patient. Magnetic resonance imaging (MRI) and magnetic resonance cholangiopancreatography (MRCP) revealed a pancreatic mass with an inflammatory component and multiple hyperintense metastatic lesions in the liver. The patient was initially treated for biliary pancreatitis, and pancreatic cancer was not suspected given her young age and absence of risk factors. A diagnosis of pancreatic cancer in a pregnant patient requires a high index of suspicion, and pancreatitis can be a mode of presentation.

Neonatal co-infection with helicobacter species markedly accelerates the development of inflammation-associated colonic neoplasia in IL-10(-/-) mice.

BACKGROUND: Inflammatory bowel disease (IBD) is hypothesized to represent an aberrant immune response against enteric bacteria that occurs in a genetically susceptible host. Humans and mice with IBD are at markedly increased risk for colonic neoplasia. However, the long lead time required before development of inflammation-associated colon neoplasia in commonly used murine models of IBD slows the development of effective chemopreventative therapies. MATERIALS AND METHODS: Neonatal coinfection with Helicobacter typhlonius and Helicobacter rodentium was used to trigger the onset of IBD in mice deficient in the immunoregulatory cytokine interleukin (IL)-10. The severity of colon inflammation and incidence of neoplasia was determined histologically. RESULTS: IL-10(-/-) mice demonstrated early onset, severe colon inflammation following neonatal infection with H. typhlonius and H. rodentium. The incidence of inflammation-associated colon neoplasia was approximately 95% at a mean age of 21 +/- 2 weeks. Mutation of endoglin, an accessory receptor for TGF-beta, did not affect the severity of IBD or the incidence of neoplasia in this model. CONCLUSIONS: The rapid onset of severe colon inflammation and multiple neoplastic lesions in the colons of IL-10(-/-) mice neonatally coinfected with H. typhlonius and H. rodentium makes this model well-suited for investigating the mechanisms involved in inflammation-associated colon cancer as well as its chemoprevention.

Memory for timing visual and auditory signals in albino and pigmented rats.

The authors hypothesized that during a gap in a timed signal, the time accumulated during the pregap interval decays at a rate proportional to the perceived salience of the gap, influenced by sensory acuity and signal intensity. When timing visual signals, albino (Sprague-Dawley) rats, which have poor visual acuity, stopped timing irrespective of gap duration, whereas pigmented (Long-Evans) rats, which have good visual acuity, stopped timing for short gaps but reset timing for long gaps. Pigmented rats stopped timing during a gap in a low-intensity visual signal and reset after a gap in a high-intensity visual signal, suggesting that memory for time in the gap procedure varies with the perceived salience of the gap, possibly through an attentional mechanism.