The Tricky Trachea: Tracheitis and Mediastinitis Treated With Infliximab and Steroids in a Patient With Ulcerative Colitis.

Pulmonary extra-intestinal manifestations of inflammatory bowel disease are rare, comprising 0.21% to 0.4% of the inflammatory bowel disease population. Common symptoms include cough, chest pain, and dyspnea. Abnormal pulmonary function tests are common in these patients, with restrictive, obstructive, and diffusion capacity defects. CT scanning remains the most sensitive imaging technique to detect abnormalities. Pulmonary manifestations are diverse and include airway, parenchymal, and pleural disease. Large airway disease predominates, particularly bronchiectasis. Upper airway disease is rare but concerning for the development of acute airway compromise. To our knowledge, there are no reports of concurrent mediastinitis with tracheitis in the setting of inflammatory bowel disease. We present a case of a patient with ulcerative proctitis who experienced the development of inflammatory tracheitis and mediastinitis. Her disease responded to systemic steroids and biologic therapy. In addition to our case, we reviewed the literature and provide an approach to pulmonary complications as extra-intestinal manifestation of inflammatory bowel disease.

Invasion, isolation and evolution shape population genetic structure in Campanula rotundifolia.

The distribution and genetic structure of most plant species in Britain and Ireland bear the imprint of the last ice age. These patterns were largely shaped by random processes during recolonization but, in angiosperms, whole-genome duplication may also have been important. We investigate the distribution of cytotypes of Campanula rotundifolia, considering DNA variation, postglacial colonization, environmental partitioning and reproductive barriers. Cytotypes and genome size variation from across the species' range were determined by flow cytometry and genetic variation was assessed using cpDNA markers. A common garden study examined growth and flowering phenology of tetraploid, pentaploid and hexaploid cytotypes and simulated a contact zone for investigation of reproductive barriers. Irish populations were entirely hexaploid. In Britain, hexaploids occurred mostly in western coastal populations which were allopatric with tetraploids, and in occasional sympatric inland populations. Chloroplast markers resolved distinct genetic groups, related to cytotype and geographically segregated; allopatric hexaploids were distinct from tetraploids, whereas sympatric hexaploids were not. Genome downsizing occurred between cytotypes. Progeny of open-pollinated clones from the contact zone showed that maternal tetraploids rarely produced progeny of other cytotypes, whereas the progeny of maternal hexaploids varied, with frequent pentaploids and aneuploids. The presence of distinctive hexaploid chloroplast types in Ireland, Scottish islands and western mainland Britain indicates that its establishment preceded separation of these land masses by sea-level rise c. 16 000 years BP. This group did not originate from British tetraploids and probably diverged before postglacial invasion from mainland Europe. The combination of cytotype, molecular, contact zone and common garden data shows an overall pattern reflecting postglacial colonization events, now maintained by geographic separation, together with more recent occasional local in situ polyploidisation. Reproductive barriers favour the persistence of the tetraploid to the detriment of the hexaploid.

Splenic Angiosarcoma with Bone Marrow Involvement Initially Diagnosed as Systemic Mastocytosis: A Case Report.

We describe the case of a 67-year-old female patient presenting with constitutional symptoms and rapid decline. Two bone marrow core biopsies were performed, with spindled cells identified and thought to represent marrow involvement by systemic mastocytosis on the first biopsy. A diagnosis of metastatic vascular malignancy with sarcomatoid features was favored on the second core biopsy. The patient rapidly deteriorated and passed away. The post-mortem examination revealed a splenic angiosarcoma with metastasis to the liver and bone marrow. Splenic angiosarcoma is a rare, aggressive entity, with bone marrow metastasis even more uncommon. This report perceives this as a diagnostic consideration on bone marrow biopsies with spindled cells and explores the diagnostic dilemma and overlapping features of systemic mastocytosis and angiosarcoma.

Biochar Phosphorus Release Is Limited by High pH and Excess Calcium.

Aside from its use for improving soil properties, biochar is increasingly promoted as a direct nutrient provider for sustainable recycling of waste materials. However, incomplete understanding of the interacting factors that determine P release from biochar may limit the efficiency of P recycling from biochar to soil. In particular, the contrasting pH of biochar and soil need to be considered. In this study, soil-free biochar (rice [ L.] husk, 700°C) extractions were performed under different pH (4.6-9.9) and extractant conditions to test how solution composition affects biochar P release. When solution pH was in the range of 7.6 to 8.6 and excess Ca was present in the solution or in biochar, P release was low-only 1 to 7% of the total P was released compared with ∼20% under most other conditions. Importantly, we demonstrate that biochar total Ca concentration is closely related to P availability ( = 0.76) and could be used to predict biochar P release. The results suggest that for maximum P release, low Ca concentrations in biochar and (soil) solution are needed and/or a pH <7.5 at the soil-biochar interface. This novel understanding will help engineer sustainable biochar fertilizers optimized for P provision.

Synchronous bilateral lipoma arborescens of bicipitoradial bursa-a rare entity.

Lipoma arborescens is a rare non-neoplastic condition that affects the synovial lining of joints and bursae accounting for less than 1% of all lipomatous lesions. Characterized by villous proliferation of the synovium, it is an uncommon cause of intra/periarticular mass presenting as a painless, slowly progressive longstanding swelling, and is sometimes accompanied by intermittent monoarticular effusions. We describe a rare case of bilateral lipoma arborescens in the bicipitoradial bursae in a young male referred for MRI evaluation of spontaneous bilateral elbow swelling. We chose to bring this case to light because of the rare simultaneous involvement of the bicipitoradial bursae bilaterally and the role of MR in providing a definite diagnosis, hence obviating the need for biopsy and avoiding consideration of other complex intra/periarticular masses.

Intrarater and interrater reliability of a hand-held dynamometric technique to quantify palmar thumb abduction strength in individuals with and without carpal tunnel syndrome.

STUDY DESIGN: Clinical measurement. INTRODUCTION: Individuals with carpal tunnel syndrome (CTS) sometimes exhibit weakness of palmar abduction strength (TAS). Reliable assessment of this strength in both subjects with and without CTS with the commonly available Microfet 2 is not known. PURPOSE OF THE STUDY: The purpose of this study was to determine the intrarater and interrater reliabilities of a handheld dynamometric (HHD) method to assess TAS in individuals with and without CTS using the commercially available MicroFET2 and to examine the association between TAS in individuals with CTS and the Carpal Tunnel Symptom Questionnaire (CTSQ) scores. METHODS: In 2 different study phases, individuals with and without CTS were assessed for TAS by 2 different examiners. The CTSQ was administered to the individuals with CTS. RESULTS: Intrarater and interrater reliability coefficients (0.89-0.93 and 0.82-0.90, respectively) were excellent in individuals with and without CTS. Weak negative correlations were found between TAS and overall CTSQ and symptom severity subscale scores, and a moderate negative correlation was found between TAS and functional Status Subscale score. DISCUSSION: This HHD method of reliably assessing TAS better quantifies deficits and progress than traditional manual muscle testing for muscle grades greater than 3/5. CONCLUSION: This method of HHD reliably quantifies TAS but is more reliable with the same than different raters.

Microstructural and associated chemical changes during the composting of a high temperature biochar: Mechanisms for nitrate, phosphate and other nutrient retention and release.

Recent studies have demonstrated the importance of the nutrient status of biochar and soils prior to its inclusion in particular agricultural systems. Pre-treatment of nutrient-reactive biochar, where nutrients are loaded into pores and onto surfaces, gives improved yield outcomes compared to untreated biochar. In this study we have used a wide selection of spectroscopic and microscopic techniques to investigate the mechanisms of nutrient retention in a high temperature wood biochar, which had negative effects on Chenopodium quinoa above ground biomass yield when applied to the system without prior nutrient loading, but positive effects when applied after composting. We have compared non-composted biochar (BC) with composted biochar (BCC) to elucidate the differences which may have led to these results. The results of our investigation provide evidence for a complex series of reactions during composting, where dissolved nutrients are first taken up into biochar pores along a concentration gradient and through capillary action, followed by surface sorption and retention processes which block biochar pores and result in deposition of a nutrient-rich organomineral (plaque) layer. The lack of such pretreatment in the BC samples would render it reactive towards nutrients in a soil-fertilizer system, making it a competitor for, rather than provider of, nutrients for plant growth.

A Case of Localized Pulmonary Calcification Presenting as a Persistent Mass Lesion in an Immunosuppressed Patient Following Treatment of a Pseudomonas Pneumonia.

We report a case of a persistent right upper lobe opacity following treatment for a Pseudomonas infection in an immunosuppressed patient with a recent renal transplantation. The patient underwent a surgical lung biopsy for definitive diagnosis of the mass. The lesion was composed of extensive calcifications deposited throughout the lung with associated fibrosis. The patient had a history of a remote parathyroidectomy for hyperparathyroidism; however, the parathyroid hormone (PTH) and the calcium levels were still mildly elevated. No other calcified lung lesions had developed in a follow-up after the initial resection. Pulmonary calcification has been classically associated with varicella pneumonia; no viral cytopathic changes were identified for varicella or other viruses in this case. The calcification appears to be secondary to the recent Pseudomonas pneumonia. To our knowledge, this is the first report of a Pseudomonas pneumonia resulting in extensive localized pulmonary calcification. This is an important diagnostic consideration as this benign entity should be considered in patients with persistent opacities following treatment for pneumonia.

Biochar and enhanced phosphate capture: Mapping mechanisms to functional properties.

A multi-technique analysis was performed on a range of biochar materials derived from secondary organic resources and aimed at sustainable recovery and re-use of wastewater phosphorus (P). Our purpose was to identify mechanisms of P capture in biochar and thereby inform its future optimisation as a sustainable P fertiliser. The biochar feedstock comprised pellets of anaerobically digested sewage sludge (PAD) or pellets of the same blended in the ratio 9:1 with ochre sourced from minewater treatment (POCAD), components which have limited alternative economic value. In the present study the feedstocks were pyrolysed at two highest treatment temperatures of 450 and 550 °C. Each of the resulting biochars were repeatedly exposed to a 20 mg l-1 PO4-P solution, to produce a parallel set of P-exposed biochars. Biochar exterior and/or interior surfaces were quantitatively characterised using laser-ablation (LA)-ICP-MS, X-ray diffraction, X-ray photo-electron spectroscopy (XPS) and scanning electron microscopy coupled with energy dispersive X-ray. The results highlighted the general importance of Fe minerals in P capture. XPS analysis of POCAD550 indicated lower oxidation state Fe2p3 bonding compared to POCAD450, and LA-ICP-MS indicated stronger covariation of Fe and S, even after P exposure. This suggests that low-solubility Fe/S compounds are formed during pyrolysis, are affected by process parameters and impact on P capture. Other data suggested capture roles for aluminium, calcium and silicon. Overall, our analyses suggest that a range of mechanisms for P capture are concurrently active in biochar. We highlighted the potential to manipulate these through choice of form and composition of feedstock as well as pyrolysis processing, so that biochar may be increasingly tailored towards specific functionality.

Bioavailability of phosphorus, other nutrients and potentially toxic elements from marginal biomass-derived biochar assessed in barley (Hordeum vulgare) growth experiments.

Biochars produced from marginal biomass feedstocks are a potential source of recycled nutrients for agriculture, but may also contain potentially toxic elements (PTEs) which can cause phytotoxicity. We assessed the potential for nutrient recycling from such materials against potential environmental risks in 17 biochars containing high concentrations of various PTEs and nutrients. Methods for investigating the risk of biochar-derived PTEs were developed and assessed. Short-term (21days) growth experiments with barley (Hordeum vulgare) in 5% biochar/sand mixtures were used to present the 'worst-case scenario' of high dose and low pH buffering. We compared plant nutrient and PTE concentrations with amounts extracted from the same biochars using 1M NH4NO3 or 0.01M CaCl2 (buffered and unbuffered, respectively) and Mehlich 3 to analyse whether such extractions could be used to predict bioavailability. The yields of barley grown with biochars "EPOCAD550", and "WLB550" were significantly higher than the control (p<0.05). Total phosphorus (P) concentration in above-ground biomass was higher than the control for the EPOCAD550 treatment (p<0.01). Both buffered and unbuffered 0.01M CaCl2 biochar extractions were significantly positively correlated with plant leaf concentration for six of the 18 elements investigated, more than any of the other extractions. CaCl2 extractions provided the most representative assessment of element bioavailability from marginal biochars compared to more resource-intensive growth experiments. Our results provide new insights into the bioavailability of elements in biochar and the standardisation of methods which accurately assess this attribute, which is necessary for promoting use of biochars from marginal biomass for recycling nutrients from wastewater and to agricultural production.

The Impact of College Student Financial Health on Other Dimensions of Health.

PURPOSE: Researchers examined college students' financial health and other health indicators to determine whether the integration of financial health into undergraduate health courses is justified and justify financial health as the newest dimension of health within the field of health promotion. DESIGN: The study utilized a cross-sectional design. SETTING: The study was conducted at a large public university located in the western region of the United States. Participants completed the survey from any computer with Internet access. SUBJECTS: A sample of 3000 undergraduate students was selected. A total of 686 surveys were completed (22.9% response rate). Data were collected from college students ages 18 to 30 during the first 2 weeks of June 2013. MEASURES: Participants completed an online survey regarding their financial health and other dimensions of health. ANALYSIS: SPSS version 19.0 was used to examine the relationships between financial health and individual health variables using χ(2), independent t-test, analysis of variance, Pearson R, point-biserial correlation, and nonparametric analyses. RESULTS: Every dimension of health was impacted significantly by lower levels of financial health. Participants' emotional health was impacted far more than any other dimension, with significant impacts on concentration (p = .005), usefulness (p = .006), decision making (p = .014), and happiness (p < .001) by the mere presence of a budget. CONCLUSION: Findings indicate an apparent relationship between financial health and other health indicators and support the need for financial education by parents and middle/high schools and the incorporation of financial health into undergraduate health courses.

Risks and benefits of marginal biomass-derived biochars for plant growth.

In this study, 19 biochars from marginal biomass, representing all major biomass groups (woody materials, grass, an aquatic plant, anthropogenic wastes) were investigated regarding their content of available potentially toxic elements (PTEs) and nutrients (determined by NH4NO3-extractions) and their effects on cress (Lepidium sativum) seedling growth. The objective was to assess the potential and actual effects of biochar with increased PTE content on plant growth in the context of use in soil amendments and growing media. It showed that the percentage of available PTEs was highest for biochars produced at the highest treatment temperature (HTT) of 750°C. On average, however, for all 19 biochars, the percentage availability of Cu, Cr, Ni and Zn (<1.5% for all) was similar to the percentage availability reported in the literature for the same elements in soils at similar pH values which is a highly important finding. Most biochars exceeded German soil threshold values for NH4NO3-extractable PTEs, such as Zn (by up to 25-fold), As and Cd. Despite this, cress seedling growth tests with 5% biochar in sand did not show any correlations between inhibitory effects (observed in 5 of the 19 biochars) and the available PTE concentrations. Instead, the available K concentration and biochar pH were highly significantly, negatively correlated with seedling growth (K: p<0.001, pH: p=0.004). K had the highest available concentration of all elements and the highest percentage availability (47.7±19.7% of the total K was available). Consequently, available K contributed most to the osmotic pressure and high pH which negatively affected the seedlings. Although a potential risk if some of these marginal biomass-derived biochar were applied at high concentrations, e.g. 5% (>100tha(-1)), when applied at agriculturally realistic application rates (1-10tha(-1)), the resulting smaller increases in pH and available K concentration may actually be beneficial for plant growth.

Current trends in minilaparoscopy.

PURPOSE OF REVIEW: The purpose of this review is to understand the current use of minilaparoscopy in the field and how minilaparoscopy compares with traditional laparoscopy in terms of operative times, complications, pain, and cosmesis. RECENT FINDINGS: Although there are few randomized controlled trials comparing minilaparoscopy with traditional laparoscopy in gynecologic procedures, the results suggest that minilaparoscopy can be performed safely with improved cosmetic outcomes and similar complication rates and operating times. Postoperative pain may be decreased with minimizing incisions sizes. Recently, case reports and case series have been published demonstrating the use of minilaparoscopy across many subtypes of gynecologic surgery. SUMMARY: Traditional laparoscopic surgery has become common practice in gynecology as it has been found to be a well tolerated procedure with improved outcomes and decreased morbidity when compared with laparotomy. Although minilaparoscopy has been used for over 2 decades, its role in gynecology is continuing to evolve. Minilaparoscopy is a growing surgical option in gynecology as we try to minimize the impact of surgery. Results of minilaparoscopy in gynecology mirror those found in urology and general surgery. Although research is limited, minilaparoscopy has proven to be a well tolerated alternative for gynecology.

Optimising the recovery and re-use of phosphorus from wastewater effluent for sustainable fertiliser development.

Recovery and re-use of phosphorus (P) from wastewater treatment systems as agricultural fertiliser presents an important and viable target for P waste reduction and recycling. In this study novel biochar materials for P filtration of wastewater were designed and produced using waste feedstocks, with consideration of the plant accessibility of the P captured by the biochars. The biochars were produced using batch slow pyrolysis at 450 °C and 550 °C from a) AD: anaerobically digested sewage sludge and b) OCAD: a 1:1 mixture of anaerobically digested sewage sludge and ochre, a mineral product from mine drainage treatment. A set of experiments was designed using pH buffering to provide a robust framework for assessing the P recovery capacity and affinity of the biochars compared to other potential P recovery materials (unprocessed ochre, activated carbon and zeolite). After 5 days of repeated exposure to a P solution at a wastewater-relevant concentration (0.02 g P l(-1)) replenished each 24 h, relatively high masses of P were recovered by ochre (1.73 ± 8.93×10(-3) mg P g(-1)) and the biochars OCAD550 (1.26 ± 4.66×10(-3) mg P g(-1)), OCAD450 (1.24 ± 2.10×10(-3) mg P g(-1)), AD450 (1.06 ± 3.84×10(-3) mg P g(-1)), and AD550 (0.986 ± 9.31×10(-3) mg P g(-1)). The biochar materials had higher removal rates than both activated carbon (0.884 ± 1.69×10(-2) mg P g(-1)) and zeolite (0.130 ± 1.05×10(-2) mg P g(-1)). To assess the extractability of recovered P, P exposure was followed by repeated extraction for 4 days with pH 7-buffered deionised water. The AD biochars retained 55% of the P recovered, OCAD biochars 78% and ochre 100%. Assessment of potentially toxic element concentrations in the biochars against guideline values indicated low risk associated with their use in the environment. Our successful demonstration of biochar materials highlights the potential for further development of P filters for wastewater treatment systems from anaerobic digestate produced and pyrolysed on-site with energy recovery.

Amyloid deposition in extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue: A clinicopathologic study of 5 cases.

Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) is the most common subtype of marginal zone lymphoma (MZL), with stomach being the most frequent primary site, followed by salivary gland, lung and ocular adnexa. Although clinically indolent, MALT lymphoma has the potential of local recurrence and systemic spread. Amyloid deposition is a very unusual complication of MALT lymphoma. In this study, we report clinicopathologic features of 5 cases of MALT lymphomas with associated amyloid deposits. One case showed amyloid deposits in the primary lesion; the other four cases showed amyloid deposits only in recurrences. Previous studies suggest that the amyloid deposits do not implicate worse prognosis. In our study, although amyloid deposits were focal and organ confined, one patient had extensive deposits of amyloid in the large bowel wall leading to bowel perforation and another patient developed significant peripheral neuropathy due to amyloid deposits in the brachial plexus. In conclusion, amyloid deposits in MALT lymphomas are rare and organ/tumour confined. However, complications can be critical and cause considerable morbidity. Therefore, pathologists should be aware of the association between MALT lymphoma and amyloid deposition, and clinical follow up is warranted.

Suitability of marginal biomass-derived biochars for soil amendment.

The term "marginal biomass" is used here to describe materials of little or no economic value, e.g. plants grown on contaminated land, food waste or demolition wood. In this study 10 marginal biomass-derived feedstocks were converted into 19 biochars at different highest treatment temperatures (HTT) using a continuous screw-pyrolysis unit. The aim was to investigate suitability of the resulting biochars for land application, judged on the basis of potentially toxic element (PTE) concentration, nutrient content and basic biochar properties (pH, EC, ash, fixed carbon). It was shown that under typical biochar production conditions the percentage content of several PTEs (As, Al, Zn) and nutrients (Ca, Mg) were reduced to some extent, but also that biochar can be contaminated by Cr and Ni during the pyrolysis process due to erosion of stainless steel reactor parts (average+82.8% Cr, +226.0% Ni). This can occur to such an extent that the resulting biochar is rendered unsuitable for soil application (maximum addition +22.5 mg Cr kg(-1) biochar and +44.4 mg Ni kg(-1) biochar). Biomass grown on land heavily contaminated with PTEs yielded biochars with PTE concentrations above recommended threshold values for soil amendments. Cd and Zn were of particular concern, exceeding the lowest threshold values by 31-fold and 7-fold respectively, despite some losses into the gas phase. However, thermal conversion of plants from less severely contaminated soils, demolition wood and food waste anaerobic digestate (AD) into biochar proved to be promising for land application. In particular, food waste AD biochar contained very high nutrient concentrations, making it interesting for use as fertiliser.

Alterations in platelet-derived growth factor expression in the pathophysiology of necrotizing enterocolitis.

BACKGROUND: Necrotizing enterocolitis (NEC) involves impaired ileal blood flow due to alterations in vascular tone control and intestinal angiogenesis. Platelet-derived growth factor (PDGF) is a mediator of normal angiogenesis in intestinal epithelium. We hypothesized that gene dysregulation during experimental NEC results in altered PDGF expression. METHODS: Sprague-Dawley rats were randomized to groups by litter. Controls were delivered vaginally and dam-fed. NEC groups were delivered prematurely by cesarean section and subjected to an established NEC protocol. Ileum was obtained at 0, 12, 24, 48, 72, and 96 h of life from all animals (N = 108 animals). Western blot analysis was carried out for every time point, and samples were evaluated by immunohistochemistry. Antibodies against PDGF-A, PDGF-B, and their receptors, PDGFR-α and PDGFR-ß, were used. Statistical analysis was performed using two-way analysis of variance with a priori P < 0.05. RESULTS: Ileal PDGF-A concentration was higher in controls versus NEC from 24-96 h of life. Its receptor, PDGFR-α, was low in concentration in both groups at all time points. PDGF-B concentration was increased in controls at 24 and 72 h of life but decreased at the 48-h mark. Its receptor, PDGFR-ß, was also low in both groups at 12 and 24 h but increased in controls at 48 and 72 h. CONCLUSIONS: These data support our hypothesis that PDGF and PDGF receptor expression are altered in experimental NEC. Dysregulation of PDGF during intestinal maturation could contribute to the development of NEC. Further investigation into this pathway could yield new therapeutic targets for this devastating disease.

Three-dimensional modeling of the human fallopian tube fimbriae.

OBJECTIVE: Ovarian cancer is the most lethal gynecological malignancy that affects women. Recent data suggests that the disease may originate in the fallopian fimbriae; however, the anatomical origin of ovarian carcinogenesis remains unclear. This is largely driven by our lack of knowledge regarding the structure and function of normal fimbriae and the relative paucity of models that accurately recapitulate the in vivo fallopian tube. Therefore, a human three-dimensional (3D) culture system was developed to examine the role of the fallopian fimbriae in serous tumorigenesis. METHODS: Alginate matrix was utilized to support human fallopian fimbriae ex vivo. Fimbriae were cultured with factors hypothesized to contribute to carcinogenesis, namely; H2O2 (1mM) a mimetic of oxidative stress, insulin (5µg/ml) to stimulate glycolysis, and estradiol (E2, 10nM) which peaks before ovulation. Cultures were evaluated for changes in proliferation and p53 expression, criteria utilized to identify potential precursor lesions. Further, secretory factors were assessed after treatment with E2 to identify if steroid signaling induces a pro-tumorigenic microenvironment. RESULTS: 3D fimbriae cultures maintained normal tissue architecture up to 7days, retaining both epithelial subtypes. Treatment of cultures with H2O2 or insulin significantly induced proliferation. However, p53 stabilization was unaffected by any particular treatment, although it was induced by ex vivo culturing. Moreover, E2-alone treatment significantly induced its canonical target PR and expression of IL8, a factor linked to poor outcome. CONCLUSIONS: 3D alginate cultures of human fallopian fimbriae provide an important microphysiological model, which can be further utilized to investigate serous tumorigenesis originating from the fallopian tube.

Carcinoma of the larynx, metastatic to illeum, presents as ruptured appendicitis: case report and literature review.

OBJECTIVES: Metastasis of laryngeal squamous cell carcinoma (SCC) to the intra-abdominal gastrointestinal tract is exceedingly rare. The objectives of this case report are to describe a case involving a perforated metastasis of a laryngeal SCC to the ileum and to review the literature pertaining to other similar cases. METHODS: A review of patient's chart and a review of the English literature involving malignant SCC of the larynx with metastasis to the small bowel. RESULTS: We describe the case of a 58-year-old man who had failed induction chemotherapy and underwent a laryngopharyngectomy with bilateral neck dissection and pectoralis major flap for a T4N2c laryngeal SCC. Subsequently, the patient was treated with postoperative radiation and cituximab.The patient went on to present with symptoms consistent with a ruptured appendix, supported by ultrasound imaging. The patient was taken to the operating room where a right hemicolectomy was performed. Pathological gross examination confirmed a 4 cm transmural perforation in the terminal ileum. Microscopy demonstrated deposits of metastatic squamous cell carcinoma in the surrounding smooth muscle. Metastatic carcinoma was also found in a separate nodule from the abdominal wall. The patient had an uncomplicated post-operative period, and survived several months thereafter. CONCLUSIONS: Metastasis of laryngeal SCC to the small bowel with perforation is exceedingly rare, but possible. These patients may be successfully managed with resection.