No abstract

Two groups of women with a diagnosis of breast cancer were interviewed by a consultant surgeon. The consultation was recorded and one group of women were allowed to take the tape away and make reference to it during the preoperative period. Provision of tapes was found to enhance patients' understanding of their treatment and resulted in fewer visits to their general practitioners. Use of tapes did not, however, reduce psychological morbidity. The study also indicated that partners experience comparable degrees of psychological morbidity and that women who undergo wide local excisions remain significantly more anxious postoperatively than women who have mastectomies.

Summary: Drug smuggling by internal bodily concealment is a growing international problem. The management of a patient who swallowed packages containing heroin is described. The medical management, indications for surgery and the ethical dilemmas of treating patients with drugs concealed within the gastrointestinal tract are discussed.

Summary Cutaneous ulceration has only recently been recognized as a complication of Crohn's disease. It usually occurs in the perineum in continuity with Crohn's disease of the anus. A case is presented of metastatic ulceration of the anterior vulva in a patient with Crohn's disease.