Inguinal hernias are a common presentation to surgical admission units throughout the world. The majority of presentations are due to hernias containing either fat or small bowel. However, a wide range of intra-abdominal viscera have been demonstrated in inguinal hernias. We report a case of an 87-year-old man who presented with gastric outlet obstruction secondary to an incarcerated inguinal hernia containing the gastric pylorus.

Only 32.1% were treated as per BSG guidelines. About 19.8% (n = 21) of the patients suffered further morbidity as a result of a delayed operation and there is a clear difference between admitting speciality and the median time to operation.

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Gallstone ileus is an uncommon cause of bowel obstruction that involves cholecystoenteric fistulation and resultant passage of gallstones into the bowel. In the vast majority of cases, the fistula forms between the gallbladder and duodenum leading to small bowel obstruction. We report a case of cholecystocolic fistulation and subsequent large-bowel obstruction in a 75-year-old woman who presented acutely after taking a bowel preparation for an outpatient colonoscopy during the course of an investigation of anaemia and nonspecific abdominal pain. Preintervention imaging revealed a giant gallstone at the rectosigmoid junction, in the presence of a cholecystocolic fistula, and subsequent large bowel obstruction. After a failed period of expectant management, laparotomy and Hartmann's procedure were performed and the patient made an uneventful recovery.

Aims Multiple studies have concluded that the “Weekend effect” results in worser outcomes for patients admitted during the weekend, when compared to weekday admissions. Patient presenting that require emergency laparotomy are, by default, high risk. It may be assumed that their risk of death is higher should they present during the weekend. The aim of this study was to identify if this cohort of admissions is at an increased risk of death should they present at the weekend. Methods All patients entered into the National Emergency Laparotomy Audit database from December 2013 up to and including November 2017 from two independent acute hospitals were included. Adjusted regression analysis (NELA risk score, grade of surgeon and anaesthetist, post-operative admission to critical care and procedure performed) was performed investigating the association between day of admission to hospital and 60-day post-operative mortality. Sunday was used as comparator variable. Results Study cohort included 1346 patients, overall 60-day inpatient mortality was 9.63% (134 patients). Following risk adjustment there was no increased risk of mortality when investigating day of admission to hospital; Monday Odds Ratio (OR 1.60, 95% Confidence Intervals (CI) 0.69-3.71), Friday (OR 2.01, 95% CI 0.85-4.7). Conclusion Risk of death in those that require emergency laparotomy is not affected by day of presentation to hospital.