LDMF reconstruction extends the role of breast-conserving surgery without cosmetic penalties, and may reduce the need for mastectomy.

LDMF reconstruction extends the role of breast-conserving surgery without cosmetic penalties, and may reduce the need for mastectomy.

A case of translocated intrauterine contraceptive device (IUCD) lying partly in the bowel wall at the rectosigmoid junction and its removal by colonoscope is described. This case highlights the possibility of safe retrieval of an IUCD by colonoscopy when it is partly embedded in the bowel wall. Routine sigmoidoscopy alongside other investigations is recommended for translocated IUCDs. Its use can select those patients for whom rectal recovery of the IUCD is feasible, thus avoiding unnecessary surgical intervention.

We report on a case of primary peritoneal adenocarcinoma diagnosed after histological examination of a femoral hernia sac. To the best of our knowledge, this is the first reported case of primary peritoneal adenocarcinoma detected incidentally during repair of a femoral hernia.

Background Caesarean section at full dilatation can be a technically demanding procedure and has a consistent association with laceration injuries to uterus, cervix and vagina. Recent Scottish Morbidity data showed 25% of women delivered by emergency caesarean section and experiencing massive obstetric haemorrhage (MOH) were delivered in the 2nd stage of labour. 16.3% of all the MOH cases were caused by extensions of the uterine incisions and/or broad ligament haematomas. It is therefore surprising that to date a universally accepted formal classification system for maternal injuries (similar to that of obstetric anal sphincter injuries) relating to this scenario, is yet to emerge. Aim To design a simple classification system and to apply this in a review of second stage deliveries at a UK University hospital Method A retrospective analysis of the labour and operation notes of 60 patients delivered by caesarean section at full dilatation during a 9 month period in 2010. Uterine extensions were graded as: Grade 1 [easy to suture, no increase in operating time], Grade 2 [increased operating time and total blood loss] or Grade 3 [involvement of uterine artery, cervix, vagina, or bladder]. Results 25% [15/60] had uterine extensions of which 53% were Grade1, 27% were grade 2 and 20% were grade 3. It was easy to grade the extensions retrospectively. Grade 3 extensions resulted in longer operating times and higher blood transfusion rates. Conclusion A simple classification of uterine extensions can improve the consistency of contemporaneous documentation and has potential as a research tool.