
Case of coconutention (January 2023 [2])
A 56-year-old man presented with a 2-day history of severe abdominal pain, anuria, and absolute constipation. Abdominal CT showed a large foreign body in the rectum, which compressed the prostatic urethra, causing urinary retention. A coconut was removed from the rectum via exploratory laparotomy.
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Colonic lipoma (January 2023 [1])
A 46-year-old woman presented with abdominal pain. A computed tomography scan found colonic intussusception. She underwent a laparoscopic colectomy at which a giant lipoma was found.
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Taenia saginata: unexpected finding during laparoscopic Roux-en-Y gastric bypass (October 2022 [1])
While performing the jejuno-jejunal anastomosis during a laparoscopic Roux-en-Y gastric bypass to treat morbid obesity, a yellowish filamentous structure appeared from the bowel lumen. It was removed, and subsequent microbiological analysis reported it to be a Taenia saginata (a tapeworm).
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Colostomy granulomas, not always what they seem (July 2022)
A 53-year-old patient with a history of Crohn’s disease had experienced painful bleeding from colostomy granulomas for 7 years. Repeat biopsies diagnosed a stomal adenocarcinoma; multiple previous biopsies had been negative for malignancy. A left colectomy was performed. Definitive histopathology showed a mucinous pT2N0 adenocarcinoma with a complete resection.
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Snapshot quiz (March 2022)
A 60-year-old man presented with acute epigastric pain and diarrhoea. His medical history included chronic obstructive pulmonary disease with recent exacerbation for which he was taking glucocorticoid therapy. What is the name of the clinical sign found on CT scan and correlated intraoperatively?
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Snapshot quiz (September 2021 [1])
A middle-aged man presents with a long history of rectal bleeding and intermittent constipation. What is shown in this intraoperative image?
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Snapshot quiz (July 2021)
What has caused the stricture in the small bowel and what has developed in the lumen of the bowel as a result?
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Snapshot quiz (March 2021 [1])
A 30-year-old woman presented with a history of abdominal pain for 8 days. The pain was initially in the right lower abdomen, but had become generalized 2 days before admission. On examination, she had generalized peritonitis. She had no co-morbidity and came from a North Indian village. At emergency surgery, there was a giant perforation in the caecum with most of the caecum thickened and gangrenous. What caused this presentation?
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Snapshot quiz (February 2021)
A 31-year-old woman with a long history of bowel symptoms presented with a tender abdominal mass. After CT she underwent an urgent colectomy. What is the likely diagnosis?
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Snapshot quiz 20/10
An 81-year-old man with Parkinson's disease presented with diffuse abdominal pain and distension. The patient underwent an exploratory laparotomy. What is the diagnosis?
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Snapshot quiz 18/10
While performing a laparoscopic colonic resection for cancer, the structure shown was found in the lesser pelvis of a male patient (a as encountered, b after transection by the pathologist). What is it?
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Snapshot quiz 18/2
This 63-year-old man with chronic back pain also had long-standing intestinal obstruction. He had intraoperative endoscopy after appendicectomy (a, b). What was the cause of the small bowel and colonic strictures in the ileocaecal resection specimen (c)?
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Snapshot quiz 17/5
What is the cause of this leg ulcer in a 37-year-old woman with ulcerative colitis?
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Snapshot quiz 15/11
What is this condition, and which procedure has the lowest recurrence rate after reduction and repair?
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Snapshot quiz 14/11
This 75-year-old man complained of severe anal pain. He had undergone resection of this rectum for cancer 9 years previously. What does the proctoscopic image show?
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Snapshot quiz 14/8
An 8-year-old boy presented with a 3-day history of left buttock and perianal pain; there was no pruritus ani. On clinical examination, a tender inflammatory swelling, corresponding to an abscess, was found in the left perianal region and extending laterally (a). On clinical examination, the anal crypts were of particular interest (b). What is this condition, and how should it be treated?
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Snapshot quiz 13/32

Snapshot quiz 13/25

Snapshot quiz 12/20

Snapshot quiz 12/08a

Snapshot quiz 12/2

Snapshot quiz 11/12
