Three patients with Leriche syndrome in whom a conventional low puncture lumbar aortogram failed to demonstrate the causative lesions are described. The aortic obstruction in Leriche syndrome is not always at the lower end of the aorta and may be high in the lumbar aorta. The importance of a high ...

Three dogs were serially studied with sonography after cholecystectomy and total acute biliary obstruction. Peripheral biliary dilatation could be diagnosed as early as 4 hr after biliary obstruction and before significant elevation of serum bilirubin. These experimental results support the thesis that total biliary obstruction may be diagnosed before the ...

We discuss 7 cases of the primary megacystis syndrome to demonstrate that the syndrome is non-obstructive and non-neurogenic, and probably of psychogenic origin owing to learned dysfunctional voiding. The major complication is vesicoureteral reflux and initial therapy is aimed at its correction. Prolonged followup and retraining of voiding habits are ...

The radiographic pattern of chronic idiopathic intestinal pseudoobstruction syndrome (CIIPS) in children includes: (a) manifestation of motility disorder, and (b) signs of bowel occlusion. The findings on plain films are identical to those of mechanical obstruction. However, when there is a clinical history of chronic symptoms of a disparity between ...

The nature and cause of psychiatric symptoms associated with the posthyroidectomy bilateral abductor vocal cord paralysis (BAVCP) syndrome are analyzed. The postthyroidectomy BAVCP syndrome is characterized by normal voice, airway obstruction, hypothyroidism, hypoparathyroidism, and psychiatric manifestations. Forty-five (35.2%) of 128 patients with postthyroidectomy BAVCP syndrome had psychiatric manifestations of some ...

Common hepatic duct obstruction that results from a gallstone impacted in the cystic duct or fundus of the gallbladder is an uncommon cause of obstructive jaundice and cholangitis. In the literature, the Mirizzi syndrome frequently is used to describe a rare entity consisting of an anatomic variation of the cystic ...

Silicone tube intubations were performed on 36 cases of congenital nasolacrimal obstruction and on three children with traumatic canalicular lacerations. The success rates of 84% in congenital nasolacrimal duct obstructions, 54% in congenital punctal-canalicular obstructions, and 100% in canalicular lacerations and the minimal complications encountered suggest that silicone intubations in ...

The sleep apnea syndrome is a relatively unappreciated but by no means rare cause of nocturnal hypercapnia and hypoxemia that sometimes persist into the waking hours. The authors describe their experience in diagnosing and treating this disease in seven patients who were characteristically overweight, tended to snore, and had daytime ...

Four children with Down syndrome (trisomy 21) came to medical attention in late childhood with symptoms of obstruction of the upper gastrointestinal tract. Each patient had radiographic evaluation. The combination of Down syndrome, retained foreign material in the stomach or proximal duodenum, and obstruction resulted in the diagnosis of congenital ...

Rhinitis medicamentosa, the syndrome of rebound nasal congestion secondary to prolonged topical intranasal use of vasoconstrictors, is reviewed. In this condition, the nasal airway is very obstructed; atrophic rhinitis is the most serious complication. Management consists of withdrawing the offending nasal spray and alleviating the nasal obstruction by means of ...

Eleven cases of neonatal intestinal obstruction associated with a white ileal meconium plug are described; 6 of these presented with complications--such as, giant meconium pseudocyst, perforation, volvulus, or atresia. Most of these complications are presumed to have arisen during the intrauterine period. Only one patient could be relieved of the ...

Pseudo-obstruction of the colon is an acute abdominal problem that can occur from a variety of causes and multiple organ failures. It is characterized by massive colonic dilatation and a clinical picture suggestive of mechanical large-intestinal obstruction, without any organic obstruction. Decompression should be cautiously attempted with proctoscopy and, possibly, ...

Our patient demonstrated two unusual features: (1) severe upper airway obstruction due to bilateral vocal cord paralysis at first manifestation of a myasthenic syndrome; and (2) precipitation of this syndrome following surgery and anesthesia with succinylcholine. In addition, this case illustrates use of ventilatory measurements through an endotracheal tube for ...

One hundred and forty-two biopsies were reviewed to reappraise the value and indications for testicular biopsy in the investigation of infertility. These biopsies were categorized within the following morphologic patterns: normal, hypospermatogenesis, maturation arrest, Sertoli cell-only syndrome, and Klinefelter's syndrome. The morphology of the biopsies was correlated with the available ...

Three patients with Down's syndrome demonstrated severe sleep-induced ventilatory failure characterized by Cheyne-Stokes respiration with superimposed obstruction of the upper airway. Anatomic otolaryngologic factors were present in two of the three patients, implicating both mechanical and CNS factors in the pathogenesis of this phenomenon. Administration of protriptyline hydrochloride elicited considerable ...

The diagnosis of intestinal obstruction is readily made when a patient presents with typical history and signs, and when plain films of the abdomen display characteristic findings. Some patients, however, constitute diagnostic problems because abdominal roentgenograms are still equivocal, even after repetition in four hours. In the unclear case, use ...

Pulmonary function in Behçet's syndrome has not received much attention, although sporadic cases of airways obstruction have been described. In this series of five cases one had abnormal results with reversible airways obstruction and emphysema. These findings were likely to have been associated with asthma, previous smoking habits and pulmonary ...

The clinical features of the multiple mucosal neuromas (MMN) syndrome permit the recognition of these patients and their potential development of the associated medullary thyroid carcinoma (MTC). The distinctive physical appearance caused by the mucosal neuromas, the Marfanoid habitus and, occasionally, the positive family history aid in establishing the diagnosis. ...

Anticoagulated patients may have a characteristic syndrome of femoral neuropathy from an iliacus muscle hematoma. They may present with urologic signs and symptoms, including groin, flank and thigh pain, groin tenderness, an iliac fossa mass and hematuria. Urography may reveal an enlarged psoas shadow and hydronephrosis from ureteral obstruction. Prompt ...

Portal vein obstruction in childhood produces portal hypertension and hepatopetal collaterals surrounding the obstructed portal vein; this is the "cavernomatous transformation of the portal vein" which is a well defined angiographic entity. Clinically findings are the various manifestations of Banti's syndrome, especially splenomegaly and gastrointestinal bleeding. Ultrasonic diagnosis is possible ...

Verner and Morrison, in 1958, reported non-insulin-secreting tumours of the pancreas that were associated with a syndrome of refractory diarrhea, achlorhydria and hypokalemia. Surgical resection of such tumours results in rebound acid hypersecretion and cessation of the watery diarrhea. The authors report the case of an 84-year-old man who had ...

Abdominal muscle deficiency with a "prune belly" abdomen as been a major feature of the so-called prune belly syndrome, which has been regarded as a specific entity, although the etiology and developmental pathology are not understood. We present evidence that abdominal muscle deficiency is an etiologically nonspecific anatomic defect which ...

In a retrospective study of selected cases, abdominal colic in 30 horses was attributed to enterolith obstructions of the large intestine. Obstructions caused by "true" enteroliths were confined to horses more than four years old. Prominent clinical features were recurrent mild abdominal pain, inappetance, gaseous distension and minimal intestinal motility. ...

Mucocutaneous lymph-node syndrome (MCLS) is an acute exanthem with specific clinical features, sometimes complicated by involvement of internal organs. Two patients with MCLS had clinical and radiographic evidence of mechanical small-bowel obstruction, probably on the basis of focal vascular insufficiency, as anatomic obstruction was not documented in either instance. The ...

A patient with multiple basal cell carcinoma syndrome, a symptom complex characteristized by nevoid basal cell carcinomas of the skin, jaw cysts, skeletal abnormalities, and hyporesponsiveness to parathormone is presented. In addition, the patient had a retroperitoneal lymphagiomyoma, a hamartomatous lesion, causing ureteral obstruction. The association of neuroectodermic syndromes and ...

We have encountered two patients with volvulus of the small intestine at the ileocolic anastomosis, occurring after jejunoileal bypass. This uncommon complication is generally seen many months after bypass and may be difficult to diagnose. Barium enema examination was helpful in one patient. If there are acute, severe abdominal symptoms, ...

A previously healthy, non-smoking young man is presented who was briefly exposed to a high concentration of sulfur dioxide. An immediate episode of pulmonary edema was followed by a silent interval with subsequent development of a severe, irreversible obstructive syndrome. This history, together with radiographs showing hyperinflation and sequential physiologic ...

The clinical triad of gait disturbances, memory impairment and urinary incontinence is associated with a communicating hydrocephalus in the 'normal pressure hydrocephalus'-syndrome. The authors present a case of H.D.C. (hydrocephalus-dementia-complex) in Paget's disease with an identical syndrome, but with obstructive hydrocephalus, causing a triventricular dilatation. Today, each case of mental ...

In a series of 19 patients with Budd-Chiari syndrome, transhepatic venography and inferior vena cavography were used to localize the site of hepatic outflow obstruction. Classification into two types was made on the basis of the site of obstruction. Four cases were grouped as type I, in which obstruction was ...

A 5-year-old boy with Cockayne's syndrome is described. In addition to the recognised clinical features, he presented with severe fixed airways obstruction, and investigations confirmed clinical and physiological emphysema. In a disorder associated with many of the features of aging, it is probably that the presence of relative alpha-1-antitrypsin deficiency ...

Pharyngeal airway during sleep was observed with help of Fibro-optic flexible bronchoscope and cineradiography in 10 adult patients with Hypersomnia Sleep-Apnea (HSA) syndrome. The results of the study suggest that the structures involved in production of airway obstruction in the patients with HSA syndrome are the muscles of velopharyngeal sphincter ...

Hyperbilirubinemia may be of several etiologies in the individual patient. An 18-year-old man presented with extreme hyperbilirubinemia (direct bilirubin 23.0 mg/dl, total bilirubin 60.0 mg/dl), hepatosplenomegaly, and anemia. Hematologic studies prelaparotomy documented the presence of hereditary spherocytosis. Intraoperative liver biopsy revealed moderately reduced levels of glucuronyl transferase activity (Gilbert's syndrome). ...

Three cases of Mirizzi syndrome (partial mechanical obstruction of the common hepatic duct owing to compression by a stone impacted in the cystic duct or gallbladder neck, or due to the inflammatory reaction resulting from compression) are reported. The roentgen features at endoscopic retrograde cholangiography (ERC) are discussed. As there ...

The role of mucociliary transport in man can be evaluated by studying persons with the recently recognised "immotile-cilia syndrome". Such persons have chronic or recurrent infections of the upper and lower airways and have ultrastructural defects of cilia and sperm tails. Men suffering from the syndrome usually are sterile and ...

The second documented case of obstructing polyp of the gallbladder-an extremely rare lesion-is presented. Symptoms were indistinguishable from those of acute obstructive cholecystitis. The mechanism of obstruction is hypothesized.

The use of jejunum in conduit urinary diversion may lead to electrolyte disturbances, characterized by hyponatremia, hypochloremia, hyperkalemia, acidosis, and azotemia, and a clinical picture of nausea, vomiting, dehydration, anorexia, and lethargy. Four out of six patients deviated with a jejunal loop developed this syndrome, the cause of which is ...

Pneumothorax, pneumomediastinum and subcutaneous emphysema are potential complications of a variety of pediatric illnesses. A review by the authors confirms the reports of others that asthma is the primary medical cause of pneumothorax and subcutaneous emphysema and that a variety of inflammatory and obstructive lesions can be associated with extra-vasation ...

A patient with hypersomnia and periodic breathing has been studied. Both airflow obstruction and an abnormally of the respiratory control mechanism were implicated in the pathogenesis of the ventilatory arrhythmia. It is suggested that the older terms "Pickwick" syndrome and primary alveolar hypoventilation are abandoned for more descriptive terms, e.g. ...

Forty-eight patients with Raynaud's syndrome and seven volunteers without it were studied by magnification hand angiography which included studies of the effects of cold exposure before and after the selective intraarterial administration of reserpine. Most of the patients with Raynaud's syndrome, in addition to organic obstructive disease, exhibited both basal ...

Total obstruction of the airways caused all respiratory efforts to stop on 15 occasions in 10 preterm babies. This was not seen in 60 studies on 38 term babies. These findings suggest that failure to achieve an oral airway may not be the only mechanism by which upper airway obstruction ...

Pseudo left axis deviation (not true left axis deviation and the S1S2S3 syndrome are infrequently reported electrocardiographic findings in chronic airway obstruction. One hundred fifty-eight patients with severe chronic airway obstruction documented by pulmonary function testing were evaluated for these electrocardiographic findings. Pseudo left axis deviation was found in 23 ...

Symptomatic disease from Strongyloides stercoralis has been recognized for the first time in Trinidad. Five cases are reported, all showing clinical features suggestive of a sprue-like syndrome. Subtotal jejunal villous atrophy was seen in one case and partial villous atrophy in two. Three patients had laparotomies because of suspected partial ...

The physiologic importance of 12 integral storage and voiding reflexes has not been generally recognized and appreciated by clinicians. Pathologic overactivity of reflexes No. 9 and No. 10, the urethrodetrusor facilitatory reflexes, appears to be a very common factor in the etiology of the juvenile incontinence syndrome. Mild but urodynamically ...

Eleven neonates with bladder obstruction, causing retention of urine, and a large, palpable lower abdominal mass were treated at the Yale-New Haven Hospital during a five year period. Intrinsic and extrinsic lesions, including urethral atresia, posterior urethral valves, ectopic ureteroceles, hydrocolpos and a neuroblastoma of the pelvis, were diagnosed by ...

Dilation of the penile urethra is described in a male infant with the classic triad of the prune belly syndrome. This dilated penile urethra was not accompanied by obstruction of the urethra proximal or distal to the dilation. Dilation of the penile urethra is a rare feature of the prune ...

A large number of diseases may present with respiratory distress. In adults, upper airway obstruction (UAO) is relatively rare. Consequently, UAO may initially be overlooked in the differential diagnosis of the dyspneic patient. Because it may progress rapidly, delays or errors in diagnosis can be critical. During an eight-month period ...

A series of 137 patients with amoebic liver abscess has been studied. Recognition of clearly defined but diverse clinical syndromes was found to be necessary not only in diagnosis but also in planned surgical management. The majority of patients had the classic syndrome of fever, right abdominal or chest pain, ...

The afferent loop syndromes result from obstruction to the afferent jejunal loop. Acute ALS results from complete obstruction, usually occurs early after surgery and runs a devastatingly lethal course unless promptly treated by reoperation. In chronic ALS the obstruction is intermittent and produces a clinical syndrome from which a diagnostic ...

We have described a characteristic syndrome of intestinal dysfunction in infants of diabetic mothers. This finding appears to result from a transient intramural dysfunction. Many respond to rectal irrigations alone. However, a significant number will require close observation and possible diversion for persistent partial intestinal obstruction. Failure to recognize persistent ...

Weak solutions of CHOH alter tissue properties, probably by forming intermolecular cross-linkages. The maximum length (Lmax) to which alveolar wall can be extended is reduced. If exposed to CHOH while extended, the resting length (LO) of alveolar wall increases. Maximum extensibility (Lambdamax equal to Lmax/LO) decreases. Similar changes are found ...