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Cholecystocutaneous fistulas (CCFs) are rare complications of gallbladder disease, wherein chronic inflammation leads the formation of an anomalous fistulous tract between the gallbladder and skin. Widespread availability of imaging modalities and timely access to surgical expertise has caused a marked decline in their incidence. Consequently, there is notable heterogeneity in management approaches to this disease entity, and guidance regarding the best, evidence-based treatment strategy is lacking. Most patients are definitively managed with cholecystectomy and en bloc excision of the adjoining fistula tract. However, there is no guidance on how to manage patients whose comorbidities preclude them from operative intervention. We provide the first report chronicling the stepwise development of a CCF in a 75-year-old woman, complete with pictorial documentation of its evolution. Furthermore, we present the inaugural account of a practical, safe approach to the long-term conservative management of CCFs in patients in whom surgical or endoscopic intervention is prohibitive., Competing Interests: None declared., (Published by Oxford University Press and JSCR Publishing Ltd. © The Author(s) 2023.)

Although Meckel's diverticulum is the most common congenital anomaly of the small bowel (2% prevalence worldwide), it rarely causes symptoms, with only 4% of those with the anomaly developing any complications, including Meckel's diverticulitis. In contrast to this, appendicitis is the most common general surgical emergency, with a lifetime incidence of 6.7-8.6%. Therefore, the case of a man presenting with right-sided abdominal pain to an Emergency Department with both Meckel's diverticulitis and appendicitis is rare. This case study illustrates the importance of careful assessment of the entire abdomen when operating on patients with right-sided abdominal pain, so as not to miss Meckel's diverticulitis even when appendicitis has already been found., Competing Interests: None declared., (Published by Oxford University Press and JSCR Publishing Ltd. © The Author(s) 2023.)

The SpaceOAR Vue hydrogel system was developed to reduce the toxicity to the rectum following radiation therapy for prostate cancer. Initial trial data reported the product as overall effective and safe. However, a few additional observed complications have likely been brought on by its increased utilization. The case presented herein describes rectal erosion, with abscess and rectal fistula formation, associated with the use of the SpaceOAR Vue hydrogel system. The SpaceOAR Vue hydrogel system was subsequently found to be absent between radiotherapy treatments and was thought to have been passed rectally through the fistula. The benefits and complications of the SpaceOAR Vue hydrogel system are discussed, as well as key factors to consider as the recommendation of routine use increases., Competing Interests: None declared., (Published by Oxford University Press and JSCR Publishing Ltd. © The Author(s) 2023.)

Ectopic splenic tissue can be classified as accessory spleen, polysplenia or a phenomenon termed as splenosis. Once believed a rare occurrence, the incidence of splenosis is now thought to be significantly higher. Generally, splenosis is asymptomatic and discovered incidentally during operation, imaging or at autopsy. The case presented herein describes an incidental finding of an intraabdominal splenosis, which was subsequently biopsied to investigate for peritoneal metastatic disease. The biopsied tissue subsequently caused significant post-operative haemorrhage. Past medical history and specific pre-operative imaging modalities for patients presenting with asymptomatic peritoneal or intra-abdominal nodules are discussed. Splenosis is highlighted as a common condition to consider prior to invasive investigations., (Published by Oxford University Press and JSCR Publishing Ltd. © The Author(s) 2022.)

Stent migration is a well-documented complication following biliary stent insertion. The majority of cases demonstrate passage through the bowel without incident; however, migration may also result in complications, including bowel obstruction or perforation requiring urgent intervention. Risk factors for stent migration comprise of disease pathology as well as stent characteristics including dimension, material and number. Although duodenal diverticulae has been noted as a risk factor for duodenal perforation or obstruction post stent migration, it has yet to be implicated as a contributor to migration itself. Here, we present an unusual case of ileal obstruction secondary to biliary stent impaction, in which the presence of a duodenal diverticulum may be considered a viable risk factor for stent migration., (Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author(s) 2021.)

Sacrococcygeal teratomas are rare congenital tumours that are even more uncommon when present in adulthood. They are derived from residual stem cells in the presacral space that differentiate into clusters of somatic cell. We present the diagnosis, management and post-operative follow-up in a 37-year-old gentleman referred to our department with an incidental finding of a lobulated presacral cystic mass on computed tomography imaging. Magnetic resonance imaging and fluorodeoxyglucose (FDG)-positron emission tomography (PET) scans were performed to further characterize the lesion. The decision was then made for surgical excision and the specimen along with the coccyx was retrieved en-bloc via a trans-sacral surgical approach. Histopathology of the mass uncovered the presence of squamous, respiratory and prostatic epithelium consistent with the diagnosis of a sacrococcygeal teratoma., (Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author(s) 2020.)

Background: Cystic lymphangiomas are rare benign tumours and their actual incidence in the colon is unclear. Within the large bowel, these lesions are often submucosal and are incidental findings on colonoscopy., Case Report: A 43-year-old man with colonic lymphangioma presented with a 7-month history of abdominal pain and altered bowel habits. Computed tomography showed a cystic mass lesion at the distal descending colon. Colonoscopy revealed a smooth, polypoid mass, initially thought as an inverting diverticulum. He underwent laparoscopic high anterior resection. The pathological analysis revealed the descending colon mass to be a lymphangioma with no evidence of diverticulosis., Conclusion: There is increasing incidence in lymphangioma due to the increasing accessibility to colonoscopy, particularly for asymptomatic or subacute disease. Although colonoscopic excision, sclerotherapy and use of steroids or fibrin glue have been advocated as possible modes of treatment, surgical excision is still considered to be the treatment of choice.