High-stoma output is a common problem that can lead to dehydration and electrolyte disturbance. The following report describes three patients with end ileostomy who had high-stoma outputs where conventional medical management was unsuccessful in controlling stoma output. All three patients responded to high-dose loperamide, resulting in significant clinical improvement. High-dose loperamide therapy should be considered in patients with high-stoma output who have failed conventional medical management.

The house advancement flap achieves primary wound closure in almost 90% of cases with few acute post-operative complications. However delayed wound healing and sinus recurrence remain issues with this technique and it appears to have little advantage over other primary closure techniques.

CRT is a proven and reasonable effective approach in managing anal cancer. Observed recurrence and overall survival rates in this study resemble the published data. Despite newer methods of treatment being investigated, the treatment for anal SCC has not significantly changed in the past four decades and novel approaches are needed to further improve outcomes.

International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations.

A 68-year-old man presented with acute urinary retention. An indwelling catheter was inserted by a junior doctor, which immediately caused perineal pain to the patient. When asked about the catheterisation technique, the junior doctor admitted that he did not insert the catheter to the hilt prior to inflating the balloon. The patient was investigated with a pelvic CT scan and a senior doctor in the emergency department interpreted that the catheter was inserted extravesically with possible haemorrhage. However, subsequent cystoscopy revealed no urethral trauma but a small bladder and a diverticulum. It became clear that the suspected haemorrhage was actually the bladder with markedly thickened wall. What was thought to be the bladder turned out to be the diverticulum. Both pathologies were attributable to chronic bladder outlet obstruction from the occlusive prostate. The patient was discharged with a catheter in situ and planned for transurethral resection of prostate in a week's time.