Reactions to urographic contrast media occurring after the patient had left the department were studied by giving patients a questionnaire to complete. 841 questionnaires were returned (about 80% of those issued). 70% of patients had no delayed reactions and 7% expressed a positive response to urography i.e., found the procedure interesting and not unpleasant; 13% had arm pain, 5% a rash and 14% had a variety of reactions, many of which were the same as those described in iodism. Women had significantly more rashes (7%) than men (4%) and those media containing the meglumine or iodamide ions caused more rashes than other media. Conray 420 caused more arm pain than Conray 280 or the non-ionic media, which would be expected from the known effects on vascular endothelium. Symptoms of iodism were equally common from the various contrast media.

Minimal preparation computed tomography is an effective and reliable investigation for the exclusion of clinically relevant CRC in this population. It provides clinicians with a valuable and pragmatic alternative to colonoscopy and CT colonography when invasive examination or cathartic bowel preparation will be poorly tolerated and small polyps are of limited significance. MPCT has an advantage over purely luminal imaging in the detection of extra-colonic pathology and appears to have an equally important role in the detection of CRC.

Complications following foreign body (FB) ingestion are an uncommon clinical problem. A 59-year-old man presented with a 4-week history of left iliac fossa pain and 1 episode of dark red blood mixed with stools. Inflammatory markers were elevated, and computed tomography (CT) of the abdomen and pelvis showed an ill defined abdominal wall inflammatory collection in close contact with the small bowel loops. He was treated with antibiotics, and follow-up CT, colonoscopy and small bowel enema were mostly unremarkable. The patient presented again ten months later with left iliac fossa cellulitis and fever. Multiplanar CT (the patient's fourth scan) demonstrated a 10cm abdominal wall collection with a linear hyperdense structure in the collection. The radiologists suspected a FB and on close scrutiny of the previous scans, they noted it to have been present on all of them. A targeted incision led to the removal of a 3cm fishbone from the collection. This case highlights the need to consider the possibility of a FB being the underlying cause in any unexplained intra-abdominal or abdominal wall inflammatory process so that the diagnosis is made in a timely manner.

We report a case of delayed perforation of normal colonic wall by the wire tips of an enteral Wallstent, which had successfully been used to treat a malignant obstruction of the sigmoid colon. Perforation occurred 5 days following insertion and despite surgery, resulted in fatality. Though perforation at the tumor site is a recognized complication during or following colonic stent placement, it is rare for the ends of the stent to perforate through nondiseased bowel wall. The site of the obstructing lesion and thus the position of the stent on a bend in the colon may be a contributory factor.

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