Editorial Board

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Reviewer thank you list

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Bilateral presence of radix entomolaris in first and second permanent mandibular molars identified in a Caucasian woman

Description

A healthy Caucasian girl aged 12 years was referred to the dental clinic by a general dentist who failed to completely instrument canals in the mesial and distal root of tooth 36 (FDI system). In the first session, supernumerary root radix entomolaris (RE) was identified and cone beam CT (CBCT) scan was taken. Afterwards, several ledges in the root canals were successfully negotiated and treatment was completed in the third session (figure 1). CBCT revealed the presence of RE also on tooth 37 and deep longitudinal grooves and C-shaped canal pattern in roots of both neighbouring premolars (figure 2). Additionally, panoramic radiograph indicated the presence of RE on the contralateral first and second molars (figure 3). Roots of mandibular third molars have not yet been developed. Clinically, the crowns of both mandibular second premolars were mesiodistally enlarged; the right one exhibiting...

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Unexpected complication of colonoscopy

The authors present a rare case of a 71-year-old man presenting with large bowel obstruction after attempted colonoscopy. The procedure was impossible to complete due to a tight sigmoid stricture and the patient presented with an acute abdomen the following day. He was managed conservatively and discharged before returning for an elective laparoscopic sigmoid colectomy. The potential differentials of an acute abdomen post-colonoscopy are discussed and the literature reviewed on this rare complication. Finally, the authors review whether there is pressure on endoscopists to 'complete' colonoscopies (by achieving caecal intubation) based on regulatory indices in quality, and how this might have to be disregarded in unfavourable circumstances.

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Strongyloides hyperinfection syndrome and VRE pneumonia

Immunocompromised patients have high risk of infections from bacteria, viruses, fungi and parasites. One of these infections is those caused by Strongyloides stercoralis. Immunocompromised patients are at risk of hyperinfection syndrome which is characterised with more systemic manifestation and a higher risk of morbidity and mortality. This can be complicated by coinfection with enteric organisms, specifically Gram-negative. Enterococci are Gram-positive cocci which are inhabitants of the human gastrointestinal tract. Even though enterococci can cause serious infections in multiple sites, they are a rare cause of pneumonia. We present a case of disseminated strongyloides with vancomycin-resistant enterococcus causing pneumonia. The patient had a complicated course with respiratory failure and septic shock. He died eventually due to his severe infections. After a literature review, we could not find a similar case of coinfection of disseminated strongyloides with vancomycin-resistant enterococcus pneumonia in immune-compromised patients.

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Oesophageal presentation of Crohn's disease

Crohn's disease (CD) is characterised by a transmural inflammatory process, which can affect any part of the digestive tract; however, CD with oesophageal presentation is rare. We report a case of a previously healthy young woman with symptoms of dysphagia, odynophagia, chest pain and weight loss, who presented oesophageal ulcers at upper endoscopy and whose histology revealed granulomatous oesophagitis. After complementary study, a mild ileocaecal involvement of CD was demonstrated. The patient became asymptomatic with proton pump inhibitor and a course of prednisolone. Mucosal healing was obtained after maintenance therapy with azathioprine. In the absence of extraoesophageal symptoms, oesophageal CD may be overlooked. CD must always be considered as differential diagnosis in the presence of oesophageal ulcers.

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