Bladder injury in a child during laparoscopic surgery.

Injury to intra-abdominal organs occurs in approximately 0.2% of adult laparoscopic general surgery cases. This risk is increased in the paediatric population due to the comparatively smaller operative field. Laparoscopic appendicectomy is the most common laparoscopic procedure performed in children. Placement of a suprapubic working port is common; this is associated with a risk of bladder injury. We present our experience of managing a 6-year-old boy who sustained an extra-peritoneal bladder injury during port placement for a laparoscopic appendicectomy. We will also review the relevant current literature.

Common femoral artery aneurysm repair using bifurcated graft.

Common femoral artery aneurysms are rare, and surgical repair is indicated if they are significantly large, or if they are symptomatic (thrombosis causing limb ischaemia and compression of surrounding structures). Synthetic grafts are preferred, especially in cases involving large aneurysms, or the bifurcation of the common femoral artery. We present a case of bilateral common femoral artery aneurysms extending into the bifurcation repaired using a synthetic graft which is traditionally used for an axillobifemoral bypass. This technique was employed due to the specific anatomical relationship between the profunda femoris and the superficial femoral artery in our patient. We will also review the current literature on the operative approaches to repair of common femoral artery aneurysms.

Bilateral shoulder septic arthritis in a fit and well 47-year-old man.

Bilateral septic arthritis of the shoulder is uncommon in the immunocompetent patient with no previous risk factors for joint infection, and is thus easily missed. Septic arthritis is associated with significant rates of morbidity and mortality. Early diagnosis and management is the key to a favourable outcome; septic arthritis should be considered as a differential diagnosis in the unwell patient presenting with shoulder pain and reduced range of joint movement. We present a case of a 47-year-old previously fit and well man with bilateral shoulder septic arthritis. We will also review the current literature on management and long-term outcomes of patients with septic arthritis of the glenohumeral joint.