ABSTRACT
The COVID-19 pandemic has caused considerable disruption in healthcare services and has had a substantial impact on the care of patients with chronic diseases, such as inflammatory bowel disease. Endoscopy services were significantly restricted, resulting in long waiting lists. There has been a growing interest in the use of capsule endoscopy in the diagnostic pathway and management of these patients. This review explores the published literature on the role of colon capsule endoscopy in ulcerative colitis and Crohn's disease as a method for mucosal assessment of extent, severity, and response to treatment. Colon capsule preparation regimens and scoring systems are reported. The studies indicate that, despite inherent limitations of minimally invasive capsule endoscopy, there is increasing evidence to support the use of the second-generation colon capsule in inflammatory bowel disease evaluation, providing an additional pathway to expedite investigation of appropriate patients especially during and after the pandemic.
ABSTRACT
The inverted appendix or appendiceal stump is a rare finding that may be identified at colonoscopy. This may cause diagnostic confusion and be misinterpreted as a polyp with a risk of peritonitis if excised endoscopically.
ABSTRACT
Gastric diverticula are rare and may sometimes cause diagnostic confusion. Most cases are asymptomatic and diagnosed incidentally. However, sometimes they can cause a variety of clinical manifestations and may be complicated by bleeding, perforation, or malignancy. Therefore, clinicians should be aware of this unusual finding and the available management options.
ABSTRACT
BACKGROUND: The educational value of post-take ward rounds (PTWRs) is an under-researched area of postgraduate medical education. OBJECTIVE: We investigated perceptions of this activity amongst higher specialty trainees. METHODS: The project was conducted in a large district general hospital in London, UK. Quantitative and qualitative data were collected to establish opinions of the PTWR amongst higher specialty trainees in medicine. Eighteen senior trainees were eligible to participate. Of these, 14 (78%) responded to our questionnaire and 4 were selected by purposive sampling to participate in semi-structured interviews. RESULTS: Most trainees felt that the focus of PTWRs was service provision with little time devoted to teaching (79% of respondents) and that feedback was rarely provided (71% of respondents). Trainees commented on learning opportunities available on PTWRs, as well as consultant behaviour they considered valuable. The main barriers to teaching and learning were time pressures, workload, interruptions, management (rather than patient assessment) focus, lack of follow-up of cases and feedback. The data included useful suggestions for improving the educational value of PTWRs. CONCLUSIONS: PTWRs are currently a wasted educational opportunity. Radical change to organisation and practice will be necessary to address this. There will be resource implications.