"Mirror" ureteric colic caused by proximal ureteric calculus in massively hydronephrotic kidney.

Patients with ureteric calculi usually present with ipsilateral "loin to groin" pain. Rarely ureteric colic may present with contralateral pain, which is referred to as "mirror pain". We report the case notes of a rare presentation of contralateral ureteric colic or "mirror pain" secondary to a ureteric calculus. A comprehensive literature review was also conducted. "Mirror pain" or contralateral ureteric colic is rare. Urologists should be aware of this unusual clinical presentation and appreciate that upper urinary tract calculi can cause pain on the contralateral side.

A Fine Needle Recanalization Technique for Iliac Artery Occlusions in Endovascular Surgery.

BACKGROUND: Endovascular intervention for chronic total occlusions (CTOs) in aortoiliac occlusive disease (AIOD) poses technical challenges. In this manuscript, our experience of fine needle recanalization for the treatment of iliac artery CTO is described. METHOD: A prospective database recorded treatment of 11 limbs in 11 patients since 2011 using this technique. The majority of these CTO were of the common iliac artery (n = 9). RESULTS: Technical success rate was 91% (n = 10). One failed case was due to tortuous iliac anatomy. There was no restenosis of the treated segments at 8 weeks and no major complications, perforations, major limb loss, or periprocedural mortality. CONCLUSIONS: This technique is a safe and viable adjunct for difficult CTO in AIOD with suitable anatomy. It benefits from being a simple, low-profile, low-cost coaxial system and should be part of the armamentarium with other advanced endovascular techniques.

An unusual cause for small bowel obstruction as a complication of an ileostomy formation.

Ileostomy formation is a fundamental component in the surgical management of many gastrointestinal diseases and like all intra-abdominal surgeries, small bowel obstruction is a recognized complication. In this paper we discuss a case of a 44-year-old female who previously had a loop ileostomy for slow bowel transit in the presence of spinal bifida. She presented for subsequent total colectomy because of ongoing pain due to chronic colonic dilation. At surgery, the stoma was not revised and the efferent loop was divided at the peritoneal level of the anterior abdominal wall. Six days postoperatively, the patient developed a small bowel obstruction as a result of the remnant efferent loop within the anterior abdominal wall, forming a cystic mass compressing the ileostomy, requiring surgical intervention. As far as we are aware, this is the first case of small bowel obstruction described due to this unusual etiology.