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Archive for June, 2012

Unusual causes of bowel obstruction: Large bowel obstruction due to impaction of a gallstone

28 Jun, 12 | by Emma

Gallstone ileus as a cause of small bowel obstruction … is not that rare but large bowel obstruction….?

Seema Biswas
Editor-in-Chief

Large bowel obstruction due to impaction of a gallstone

Unusual causes of bowel obstruction: Fast atrial fibrillation and caecal volvulus – a case report and evidence based management

21 Jun, 12 | by Emma

Elderly patients with bowel obstruction frequently present with cardiovascular complications that introduce an added challenge in their management. Here the authors describe an unusual presentation of a caecal carcinoma in a patient with concomitant atrial fibrillation.

Seema Biswas
Editor-in-Chief

Fast atrial fibrillation and caecal volvulus – a case report and evidence based management

Unusual causes of bowel obstruction: Disseminated histoplasma and CMV infection presenting as subacute intestinal obstruction in an immunocompromised patient

13 Jun, 12 | by Emma

How common is a stricture in the ascending colon? Surely at colonoscopy this is worthy of biopsy? An interesting read…causes of bowel obstruction in immunocompromised patients…

Seema Biswas
Editor-in-Chief

Disseminated histoplasma and CMV infection presenting as subacute intestinal obstruction in an immunocompromised patient

A case of an erroneous preference diagnosis?

6 Jun, 12 | by Dr Dean Jenkins

“Misdiagnosing patients’ preferences may be less obvious than misdiagnosing disease, but the consequences for the patient can be just as severe”, states a new publication from the Kings Fund – Patients’ preferences matter: stop the silent misdiagnosis.

The author, Al Mulley, argues that well informed patients make different choices about their treatment. Also, patients’ may want different things to their doctors and there are big differences across different geographical areas.

How to address these important preferences is challenging in a busy clinical practice. It is easy to make assumptions about what another person would prefer. In medicine we often feel we act in the patient’s best interests but when was the last time we had the opportunity to really explore the implications of a certain decision, or plan ahead with a patient to future events to help shape their care?

This is a useful paper, freely available to download, that offers some suggestions for how health care systems can avoid the erroneous preference diagnosis.

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