A case is described of the appearance of a pancreatic or peripancreatic lesion after left renal calculus fragmentation by extracorporeal shock wave lithotripsy (ESWL). Its anatomical location and subsequent disappearance suggest it was related to trauma caused by the shock waves. The brief literature on pancreatic injury after ESWL is ...

The authors report six cases of acute urethritis and three cases of acute cervicitis caused in all instances by Neisseria meningitidis group B. The patients, five heterosexual men, one homosexual man, and three female prostitutes were seen at a venereal clinic in Mexico City. All of them were initially diagnosed ...

Pancreatic encephalopathy is an uncommon condition found in patients with acute pancreatitis. The present report shows the interest of MRI in the diagnosis of this disorder. Patchy white matter signal abnormalities, resembling plaques seen in multiple sclerosis, may reflect the lesions that are found in the cerebral white matter of ...

We report four cases of fatal mercury vapor inhalation, a rare occurrence. The mercury vapor was released at a private home, where one of the occupants was smelting silver from dental amalgam containing an unknown amount of mercury. Within 24 hours of the incident, all occupants began having shortness of ...

This case report features the unusual presentation of a blind-ending ureteric duplication (BEUD) as acute abdomen. The partially obstructed BEUD had mimicked acute appendicitis, leading to previous errors in the diagnosis and management of the case. A high index of suspicion is necessary to diagnose such a rare congenital anomaly ...

Four cases of acute angle closure glaucoma in eyes with a small but patent Nd-YAG laser iridotomy are presented, and similar cases in the literature are reviewed. Theoretically a 15 microns diameter iridotomy should be large enough to prevent angle closure glaucoma due to pupil block. Mechanisms by which larger ...

A case of a patient with pancreatitis and familial hypocalciuric hypercalcaemia is presented and the literature linking FHH and pancreatitis is reviewed. The case for a causal link between the two conditions is not proven and seems unlikely. In view of this we strongly challenge the recommendation of total parathyroidectomy ...

The average general orthopaedic surgeon examines and treats a considerable number of acute lateral ankle ligament sprains in a busy office practice. A cursory review of recent articles published on this subject will present a confusing picture regarding diagnosis and treatment of Grade III injuries. An air of controversy surrounds ...

A case of acute ileotyphlitis is reported in a man treated with cytotoxic drugs for metastatic non-seminomatous germ cell tumor of the testis. This case illustrates the variable features of acute ileotyphlitis and highlights the importance of clinical awareness in order to establish the diagnosis and commence treatment immediately.

Although several cases of reactions to bee venom including acute renal failure have been reported, the literature from Africa is scanty and that concerning children virtually non-existent. We report a child who was stung by over 1,000 bees and developed acute renal failure and extensive scalp necrosis. The pathogenesis of ...

We observed 797 consecutive cases of chronic pancreatitis from 1963 to 1987 in the cities of Belo Horizonte and São Paulo. Alcoholism was the main etiological agent, responsible for 714 cases (89.6%). Chronic calcifying pancreatitis from different etiologies, alcohol, idiopathic, nutritional, and familial, was the most important form of chronic ...

Praziquantel is recommended as the drug of choice for all forms of schistosomiasis. We report the first case (to our knowledge) of exudative effusive polyserositis following treatment of schistosomiasis with this drug. This involved pleura, pericardium, and peritoneum and was associated with acute respiratory failure. The latter preceded the appearance ...

We report a unique case of recurrent gross enlargement of the tongue associated with lymphangiectasia and tongue protrusion in an adult male with Down's syndrome. There were three episodes of acute macroglossia with no clinically identifiable cause. Spontaneous resolution always occurred after five to six days. Histological examination of the ...

Although the acute ingestion of iron-containing preparations can produce very serious consequences, the majority of reported exposures are not associated with significant morbidity or mortality. We present 3 cases of acute iron ingestion and review the aspects of general management, with an emphasis on the appropriate choice of a gastrointestinal ...

Acute angle closure glaucoma generally occurs in older hypermetropic individuals, precipitated by pupillary dilation. However it is often forgotten that it can occur in younger people and that it does not occur solely as a result of the use of mydriatics or normal pupillary dilation in response to darkness. It ...

Acute appendicitis is an uncommon complication of infectious mononucleosis (IM) and can readily be misdiagnosed because of the acute abdominal pain with which patients with IM occasionally present. A case report is presented of a patient with IM who developed acute appendicitis during the acute phase of the illness. The ...

We report a case of malakoplakia arising in the pancreas of a 45-year-old woman. Clinical and histological features are described. Malakoplakia was present with chronic pancreatitis and adenocarcinoma. The aetiology of malakoplakia at this site may be due to a stromal response to carcinoma or an abnormal localised histiocytic response ...

The association between acute pancreatitis and organophosphate (OP) poisoning may still not be widely recognised. A case of organophosphate (diazinon) poisoning presenting as acute pancreatitis is described. The diagnosis of OP was not made during admission to hospital as the history of exposure to OP was not obtained then. Obtaining ...

The simultaneous expression of both lymphoid and myeloid phenotypic features in acute leukaemia is rare. We report 3 cases of biphenotypic hybrid acute leukaemia seen in our institution. All 3 patients achieved remission with treatment for acute lymphoblastic leukaemia but two subsequently relapsed while on treatment. The hybrid acute leukaemias ...

Two cases of acute non-haemorrhagic conjunctivitis due to coxsackievirus A24 (CA24) are described. These are the first Australian isolates. The presentation was as a severe conjunctivitis in otherwise healthy adults who had not travelled outside Australia. The course was of short duration and self-limiting with no long-term sequelae. The isolates ...

Chlamydia has been found to be the cause of a high percentage of cases of neonatal and chronic conjunctivitis in an inner-city population. To assess the etiology and epidemiology of acute conjunctivitis in this population, conjunctival scrapings were sampled from 45 patients presenting to an ocular emergency room; and replicate ...

Annular pancreas, an uncommon condition, is often hard to diagnose before operation. We report a case of annular pancreas with pancreatitis of the annulus that was diagnosed by the use of computed tomography followed by endoscopic retrograde cholangiopancreatography. An upper gastrointestinal series and duodenoscopy revealed stenosis of the second portion ...

Thirty seven cases of pancreatic ascites in the Japanese literature were reviewed. The ratio of males to females was high, and the incidence of associated pancreatic pleural effusion was higher than in the English literature. Other aspects of pancreatic ascites in Japan were similar to those reported in the English ...

Twenty years ago, we reviewed the pediatric surgical experience with traumatic pancreatitis and pseudocysts at a large children's hospital. That series encompassed 13 years, during which time 23 cases were found. Six of these had pseudocysts, five of which were managed by external catheter drainage and one by excision. The ...

Thirty children presenting with acute encephalopathic illness within a month of measles were studied. A male preponderance was found and 83.3% of cases were below 5 years of age. The interval between onset of measles rash and that of encephalopathy ranged from 0 to 20 days. Fever (96.6%), convulsions (70%), ...

Extramedullary hematopoiesis associated with fibrosis is found frequently in the liver and spleen, but seldom in other organs. Acute abdomen due to extramedullary hematopoiesis has been reported in two patients with intestinal obstruction because of heavy infiltration of the terminal ileum. This report describes the case of a 71-year-old woman ...

Toxic nephropathies manifest morphologically as glomerulonephritides, vasculitides, tubular necrosis, and acute or chronic tubulointerstitial disease. The most common toxicity is acute interstitial nephritis owing to hypersensitivity. However, focal segmental glomerulosclerosis and necrotizing angiitis secondary to heroin abuse, membranous glomerulopathy owing to gold, penicillamine and captopril, thrombotic microangiopathy associated with mitomycin ...

A preliminary report of 50 cases of acute pelvic inflammatory disease (PID) studied at the Kenyatta National Hospital to find out the role of chlamydia trachomatis in its aetiology is presented. Endocervical swab cultures were done. There were 2/50 (4.0%) cases positive for chlamydia trachomatis. The role of this pathogen ...

A case is reported of a patient without previous gastrointestinal symptoms, who presented with polymicrobial septicemia caused by Escherichia coli, Enterococcus faecalis, Clostridium difficile and Bacteroides vulgatus. Septicemia occurred during acute diverticulitis. A strain of Clostridium difficile, which was of the same serogroup C as the blood culture isolate and ...

Cystadenocarcinoma of the pancreas is uncommon, but should be positively identified and distinguished from other cystic lesions of the pancreas because of its good surgical prognosis in comparison with pancreatic adenocarcinoma. I report two cases of cystadenocarcinoma of the head of the pancreas, in which a previously undescribed abnormal appearance ...

A 34-year-old woman with a recent history of a influenza-like illness and signs of bronchopneumonia presented with many of the features of acute epiglottitis, a condition which still carries a high mortality in adults. Urgent laryngoscopy and bronchoscopy under inhalational anaesthesia were negative. The results of arterial blood gases, taken ...

Acute calcific tendinitis is a frequently unrecognized cause of hand and wrist tenderness and swelling. We report 12 cases seen over an 8-year period. Roentgenograms showed deposits in various peritendinous sites especially near the pisiform. Special views may be required for visualization. A correct diagnosis was made in 5/12 cases; ...

We present 2 cases of psoas muscle pancreatic pseudocysts. In both cases there was no clinical or laboratory evidence of recent acute pancreatitis. The route of extension for the pseudocyst from the pancreas to the psoas was the perirenal space. In both cases the diagnosis was made on the basis ...

A focal dilatation of a loop of small bowel has been identified in the left upper quadrant in a series of individuals with suspected appendicitis. Retrospective review of 100 cases of surgically proven appendicitis demonstrated this sign in 51. No previous description of this sign has been found. This finding ...

A 15-year-old boy ingested 19.6 g (15 g verifiable) phenytoin sodium approximately four hours before emergency department presentation. The patient survived the suicide attempt with only supportive care, despite the ingestion of 392 mg/kg and a peak serum level of 100.8 micrograms/mL. A wide spectrum of physical findings consistent with ...

A case of right pyelonephritis with hydronephrosis complicating relapsing acute pancreatitis and right pararenal phlegmon formation is presented. Hydronephrosis is a reportedly rare complication of extrapancreatic inflammation; the only 6 previous cases involving the right side are reviewed. The present case report, to our knowledge, is the first to describe ...

Acute terminal pancreatitis (ATP) was defined as a postmortem entity of localized acute pancreatitis without any clinical evidence of pancreatic disease. Based on the deliberate examinations of pancreatic tissue from 76 autopsies, we found 10 cases (13%) that met the criteria of ATP. Shock as an immediate cause of death ...

Pancreatitis secondary to organophosphate insecticide toxicity is extremely rare. The few previously reported cases have resulted from oral ingestion of these agents. We present the first reported case of acute pancreatitis occurring after cutaneous exposure to an organophosphate insecticide. Symptoms of pancreatitis persisted for 6 months, followed by total resolution. ...

A case report is presented of a young man admitted to a general hospital with leukocytosis, elevated temperature, right lower lobe infiltrate, and confusion. A diagnosis of rhabdomyolysis, acute renal failure, and Legionnaire's disease was made. The patient subsequently had a respiratory arrest and died on the 29th hospital day. ...

We report two cases of hypokalemic periodic paralysis in children presenting to the emergency department with diffuse weakness and no antecedent history of neurologic disease. The literature is briefly reviewed. Any child with acute weakness and normal mental status should undergo serum potassium determination to allow prompt diagnosis and therapy.

There is fairly widespread belief that suppuration superimposed upon acute cholecystitis is a rather uncommon condition. Scanty information on this subject is found in the published literature. No doubt, the scarcity of data further reinforces this clinical impression. Yet, from the few studies available, a surprisingly high incidence (7-11%) is ...

Iliofemoral thrombophlebitis characteristically presents as acute inflammation and swelling of the affected extremity. We report a patient in whom the presenting complaints of high fever, nausea and left lower quadrant pain mimicked an acute abdomen. The diagnosis was confirmed by venogram after gallium scan and computer tomographic scan revealed abnormalities ...

The incidence of chronic pancreatitis has been increasing in the western world. Although chronic alcohol abuse accounts for 90% of adult cases, the physician must be aware of the multiplicity of causes for chronic pancreatitis. We present a case of obstruction of the pancreatic duct and chronic pancreatitis caused by ...

Tricresylphosphates (TCP) have been responsible for a large number of epidemic and individual intoxications since the recognition, in 1899, that phospho-creosote was the cause of paralysis in patients being treated for tuberculosis. Although children are mentioned as being among the victims of epidemic intoxication, no well documented reports of acute ...

Acute cytomegalovirus mononucleosis has been associated with maculopapular rashes, petechiae, purpura, urticaria, ulcerative lesions, and vesicular eruptions. Although erythema nodosum has been reported in association with a number of infectious and noninfectious diseases, to our knowledge it has not been associated with cytomegalovirus infections. We report the first case of ...

Subcutaneous fat necrosis is a rare and often overlooked sign of pancreatic disease. It is manifested in painful subcutaneous erythematous nodules, often found on the legs. The histopathological finding is pathognomic. Therefore, correlation of clinical manifestations with histopathological and laboratory findings may be helpful in recognizing some disorders of subcutaneous ...

The history of a girl is described who experienced two separate episodes of acute confusion with agitation. The first occurred at the age of four after a mild head injury, the second recently at the age of thirteen after prolonged physical effort. EEG's performed during both episodes showed marked diffuse ...

The role of the common parameters of inflammation in the diagnosis of acute appendicitis was studied by measuring axillary temperature (Tax), blood leukocyte (Leuk) and lymphocyte fraction (Lymph), serum C-reactive protein (CRP) and ESR in 354 patients with clinical diagnosis of acute appendicitis. Laparotomy showed normal appendix in 97 cases, ...

Four cases of acute gangrenous inflammation of the male genitals are discussed, after a brief review of the literature, with reference to the authors' own experience. In addition to dermal and fascial necrosis the disease causes severe sepsis and shock. Characteristics include rapid progression, occasionally in a matter of hours, ...

When acute cholecystitis follows orthopaedic operations, the disease is frequently obscure and fulminating, with rapid progress to gangrene and perforation of the gallbladder, which may be fatal. Three cases are reported and the literature is reviewed. Various aspects of the disorder are discussed. It is important that orthopaedic surgeons should ...