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A 36-year-old male presented with dizziness and melena 5 years post laparoscopic Roux-en-Y gastric bypass (LRYGB). Initial treatments with proton pump inhibitors and blood transfusions was followed by esophagogastroduodenoscopy (EGD) and CT angiography, identifying an active arterial bleed at the gastrojejunal anastomosis. Super-selective celiac artery coil embolization successfully controlled the bleeding. This case highlights the importance of considering late-onset gastrointestinal bleeding as a potential complication post-LRYGB. Early diagnosis and intervention, including advanced radiological techniques, are crucial for successful management and optimal patient outcomes., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Purpose: Mitomycin C is a routinely used antimetabolite which effectively limits the scarring process. Conventionally, the intra-operative technique of MMC delivery during trabeculectomy is the direct application of the soaked sponges. The aim of this study is to evaluate the current practice of delivering MMC during trabeculectomy and to see the practices related to a retained MMC swab during trabeculectomy in the UK., Methods: An electronic questionnaire of 8 questions regarding the intraoperative use of MMC during trabeculectomy surgery was emailed to 69 ophthalmologist members of the UK and Eire glaucoma society (UKEGS) through email in July 2019., Results: 97.2% of the surveyed glaucoma surgeons said they use MMC during trabeculectomy routinely, while 2.9% said they never use MMC for trabeculectomy. In reply to a question 'Have you ever had a retained MMC-soaked sponge/fragment of sponge', 11.76% replied 'yes', 88.24% said 'No'. In response to what technique was employed at the time of retained MMC sponges, all the respondents said they had employed the same technique of 'multiple individual sponges'. 47.1% surgeons said they use multiple individual sponges on being asked what technique they currently employ for delivering MMC during trabeculectomy surgery, while 14.7% surgeons use multiple sponges linked with a 'necklace suture' and 5.9% inject MMC., Conclusion: Our survey suggests the intra-operative MMC use in the UK is high and that unintentional MMC-soaked swab retention does occur, albeit rarely. A preference of using the MMC-soaked swabs as a delivery method of MMC is seen in our survey.

This retrospective study was done to evaluate the visual and anatomic outcomes of scleral buckling for the repair of rhegmatogenous retinal detachment (RRD). All scleral buckle procedures performed at the Aga Khan University Hospital, Karachi, from May 1999 to April 2012 were included. A total of 75 eyes of 72 patients were studied. The mean age of patients at surgery was 33.0±17.2 years. The mean logarithm of the minimum angle of resolution (logMAR) visual acuity (VA) was 0.9±0.8 pre-operatively and 0.5±0.6 at 1 year (p=0.018). At baseline, 27(36%) eyes had a best corrected visual acuity (BCVA) of 20/50 or better, while at 1 year after surgery 47(63.5%) eyes had BCVA of 20/50 or better. Retina had successfully attached after first attempt in 70(93.3%) cases. Scleral buckling for the repair of RRD resulted in a high anatomical success rate as well as significant improvement in visual acuity.