Prophylactic fundoplication may not be necessary in neurologically impaired children undergoing gastrostomy for feeding purposes. It increases the postoperative morbidity compared to gastrostomy alone in this group of children. It should be offered selectively to children continuing to have reflux-related complications after gastrostomy. The technical difficulties with a pre-existing gastrostomy can be overcome in the hands of experienced laparoscopic surgeons.

Ann R Coll Surg Engl 2008; 90: 336-337 336An 18-year-old male presented with a day history of gradually worsening painful right scrotal swelling. He denied any urinary complaints, i.e. dysuria, urethral discharge, etc. There was no history to suggest a sexually transmitted infection. This young man was a premature baby born at 28 weeks and had succumbed to ARDS/patent ductus arteriosus which was accordingly treated. He had had a right-sided inguinal hernia and hydrocoele which were repaired, the first at age 1 year and the other at the age of 14 years, respectively. Interestingly, when he presented to the urology department he had received his late school MMR vaccine 12 days previously. Three days following We report the case of an 18-year-old male patient with epididymo-orchitis following MMR vaccine. Salivary gland involvement, meningitis/encephalitis are well-known complications of the MMR vaccine, but involvement and infection of the testis is a rarity. A search for this complication on the medical databases showed no reported cases in the UK. CASE REPORT