⭐ An exciting opportunity to join the team! We are now looking to recruit a number of Consultant Honorary Senior Clinical Lecturers, who will work collaboratively with Pears Cumbria School of Medicine. Click here for more information: buff.ly/49RpKFH

This 50M presented with acute severe UC with low albumin (13) and CRP 200 . CT showed colitis with pneumatosis. He improved with steroids and early infliximab, but this AXR was requested after I incidentally noticed him with a distended abdomen despite improving symptoms and CRP. Repeat CT confirmed toxic megacolon. Surgery were reluctant to operate as he looked well, but he eventually went for colectomy. The surgeon said it was one of the worst colon specimens he had seen, with adhesions, microperforations and risk of imminent peritoneal contamination. Thankfully he had surgery in time. Lessons: 1) A very low albumin is a very poor prognostic marker in acute severe UC. 2) The Travis criteria (CRP >45) after 3 days of IV steroid is predictive of colectomy in 85%. This is based on old data but be used as a prompt for surgical referral. 3) IV steroids can mask symptoms and make the patient look deceiving well. 4) I have yet to medically salvage a patient with toxic megacolon - they almost always need colectomy, but happy to hear other’s experiences. Any other pearls? Image: pt.m.wikipedia.org/wiki/Fich…

The safety and efficacy of total mesorectal excision (TME) surgery following dose‐escalation: Surgical outcomes from the organ preservation in early rectal adenocarcinoma (OPERA) trial, a European multicentre phase 3 randomised trial (NCT02505750) onlinelibrary.wiley.com/doi/…

EXCLUSIVE: The doctor who helped catch Britain’s worst baby killer. Dr Ravi Jayaram spent two years pleading with hospital managers to investigate Lucy Letby. Instead, they made him apologise and attend mediation with her.

📣Hot off the press- our analysis of @NHSResolution data regarding 'Fail to Warn' over the last decade, published in @BJSurgery academic.oup.com/bjs/advance… @moiqbalhussain @AntonyHEcon @RachEHou10 @simontoh14 @MedicaQc @PHUresearch @Concentric_Hlth @sbrihealthcare @RCSnews @RCSEd

RT @vanashpatel: Measuring outcomes that matter most to patients has the potential to deliver high-quality patient-centred care. 'PROMs and…

Here’s ⁦@helenlewis⁩ being very very good on RD. theatlantic.com/ideas/archiv…

If you're a BMA consultant member in England and think consultants shouldn't take action to fix pay, fix pensions & fix the pay review process, then stop us, vote no! But not until you've watched this short youtube youtube.com/watch?v=9hu-g1tc… or read this bma.org.uk/our-campaigns/con…

Absolutely right for Tayo Oke to be celebrated in this week's @bmj_latest ❤️❤️. An inspiration, silver scalpel nominee and a pioneering educator for women in surgery @WomenSurgeonsUK @GeeMcLachlan

Photos from the ASU UClan Skills Course following previous message

Here I am working in the NHS. I came to this country as a child refugee. I have only ever had a British passport & only ever considered myself a British citizen. The #NationalityandBordersBill means that my citizenship could be revoked without right of appeal. Thanks for that

A number of units are starting to routinely employ ICG fluorescence for perfusion assessment in colorectal surgery - is this study going to influence practice? Perfusion Assessment in Left-Sided/Low Anterior Resection... : Diseases of the Colon & Rectum journals.lww.com/dcrjournal/…

Huge congratulations @philtozer1 general and colorectal surgeon @StMarksHospital for being awarded @ACPGBI @Dukes_Club 2021 Trainer of the Year @StMarksHospital #IBD

After completely removing a polyp, the histology unexpectedly shows cancer. Imaging is normal. What is the risk of residual cancer and how do you manage the patient? Great algorithm for the MDT in @ColorectalDis 📌👇 onlinelibrary.wiley.com/doi/…

Very useful study on a subject that continues to perplex many colorectal cancer MDTs - Primary Tumor Resection Chemo vs Chemo Alone for Colorectal Cancer Patients With Asymptomatic, Synchronous Unresectable Metastases (JCOG10: A Randomized Clinical Trial ascopubs.org/doi/full/10.120…

The Holland sea of flowers in full bloom. Over 30 million tulips.