Colorectal cancer is the second most common cause of death from cancer in the UK. It is estimated that between 2 to 3 per cent of colorectal cancer occurs in patients younger than the age of 40 years. It remains unclear from the literature whether this group of patients has a worse prognosis from colorectal cancer than the population as a whole. There are no large series that report a 10-year survival in young patients diagnosed with colorectal cancer. The authors’ objective was to assess patients diagnosed with colorectal cancer younger than the age of 40 years to determine whether the 5- and 10-year survival rates in a tertiary referral center compares favorably with survival rates obtained at other centers and the population as a whole. A retrospective observational study was conducted and an analysis of the patient's notes was made, specifically looking at age at diagnosis, nature and duration of symptoms, predisposing risk factors for colorectal cancer, the site within the bowel of the colorectal cancer, the type of curative resection performed, Dukes’ stage, and details of 5- and 10-year follow-up to assess survival. Forty-nine patients age 40 years or younger received treatment for colorectal cancer at St. Mark's Hospital from 1982 to 1992. The overall 5- and 10-year survival was 58 per cent and 46 per cent respectively. The study provides more evidence to support the fact that young patients with colorectal cancer seem to present with more advanced disease. Despite this, the overall 5-year relative survival rate is comparable if not better than other studies, supporting recent evidence that the prognosis in this group of patients is no worse than for colorectal cancer in the population as a whole.

We report a 14-year-old girl who presented with epigastric pain, vomiting, and an upper abdominal mass. A diagnosis of trichobezoar was made on ultrasound and she went on to have a laparotomy, where a large trichobezoar was extracted with a tail that extended into the small intestine.

HighlightsVaricosity treatment (related to arteriovenous malformation) results in skin ulceration.Skin necrosis is a serious but rare complication of sclerotherapy and healing period is usually prolonged.Wound care management vary from a non-adhesive dressing to LFUD/Surgical debridement.Awareness of this complication is essential since atrophic/hypertrophic scars are usually unavoidable and induce psychological trauma.

Under half the deaths in our comorbid cohort were due to rupture. However, decision to palliate may be revisited as risk-benefit ratio changes with aneurysm expansion.

18patients underwent laparoscopic thoracoscopic cardio-oesophagectomy. All 18 patients (12 male, 6 female) had laparoscopic insertion of Freka feeding jejunostomy are included in the study. The feeding jejunostomy was used for feeding from first postoperative day. The standard regime was water at 20 mls/h on day 1 followed by feed (jevity/osmolyte) at 30 mls/h on day 2. The rate of feed was increased at daily increments of 10 mls/h/day to achieve target rate to meet patient's nutritional requirements. Patients were discharged with feeding jejunostomy in situ, removed at follow-up if nutritionally stable. Results The average procedure time was 20 min. Median duration of feeding jejunostomy in situ was 3 weeks (range 8 dayse6 weeks). Tube related complications, n¼3 patients (tube fallout-1, leak-2). Only one of these three patients needed additional parenteral nutrition. There were no procedure or feed related complications. The overall length of stay was not affected by this procedure. The availability of enteral route was useful in n¼2 patients (chest infection-1, gastric stasis-1) for nutrition longer than the anticipated period. Conclusion Laparoscopic insertion of feeding jejunostomy is safe, aids early establishment of enteral route for nutrition in patients undergoing cardio-oesophagectomy and useful in providing prolonged nutritional support in patients who develop complications were oral route is not possible.