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Acute acalculous cholecystitis is a rare condition associated with a high risk of gangrene, empyema and perforation of the gallbladder. In this case report it is described how hepatitis A infection leads to a fulminant perforated acalculous chole-cystitis, which is described sporadically in the literature. The patient presented in this case report had icterus and highly elevated liver enzymes. Magnetic resonance cholangiopan-crea-tography showed an acalculous gallbladder surrounded by free fluid. Laparoscopic cholecystectomy was performed due to sus-picion of perforated acute acalculous cholecystitis.

We report two cases of a benign post-operative stricture of the recto-sigmoid colon managed by insertion of a self-expanding coated plastic stent (SEPS). Both patients presented symptoms of stenosis which dilatation did not relieve. Both patients refused surgical intervention. Instead the strictures were managed by insertion of a SEPS. The clinical symptoms disappeared after SEPS insertion. We conclude that SEPS may represent a possible therapeutic tool in selected cases with benign post-operative stenosis of the recto-sigmoid colon.

The association between cancer and venous thromboembolism is well described. Several studies indicate that elements of the haemostatic system participate in tumour genesis. During the last decade a number of post-hoc analyses of trials not primarily designed to evaluate the effect of low molecular weight heparins (LMWH), on cancer survival, have indicated an increased survival. This has recently been supported by results from several prospective trials with LMWH. The possible anti-cancer effect of LMWH is not known in details. Treatment regimes with LMWH have to be performed.

We report a case of a 74-year-old man with a Clark's level II, 2.5 mm melanoma on his back that was excised. A post-operative PET scan found no lesions. One and a half years later, the patient developed anaemia with blood in his stool. A gastroscopy and colonoscopy found no lesions. Video capsule endoscopy, however, detected a tumour in the small intestine. At laparotomy, the tumour was removed. Histological diagnosis showed metastatic malignant melanoma. We believe that video capsule endoscopy may increase the rate of diagnosis of small-bowel melanoma metastases.

We report on a case of a 69-year-old man with a benign stricture of the sigmoid colon due to diverticulosis, complicated by a colovesicular fistula. Due to severe co-morbidity, surgical excision of the fistula and resection of the sigmoid colon were not indicated. Instead, the stricture and the fistula were managed via the insertion of a self-expanding, uncoated metallic stent (SEMS). The clinical symptoms disappeared after insertion of the SEMS. We conclude that SEMS may be a possible therapeutic tool in selected cases of benign stricture of the colon, with or without fistula.