A case is presented of acute cholecystitis that produced extensive ascending, intrahepatic acute cholangitis (sufficient to produce obstructive jaundice of significant degree) without evidence of choledocholithiasis or ductal dilatation.Questions are raised concerning the present accepted clinical classification of both cholangitis and obstructive jaundice.

In the past 31 years, 47 cases of duodenal obstruction were admitted to the Royal Belfast Hospital for Sick Children. Thirty-six per cent of these had Down's syndrome. The crude mortality was 48% but this figure was reduced to 33% in the last five years of the study. The combination ...

A 75-year-old man had multiple findings that indicated thromboembolic disease. A radiocolloid study showed splenic defects. The remainder of the spleen was hot on radiogallium imaging. The patient had Trousseau's syndrome (tumor-associated thromboembolism) due to carcinoma of the pancreas. The splenic vein was obstructed. Vascular compromise should be considered in ...

Common hepatic duct obstruction from an impacted calculus in the cystic duct is an uncommon cause of jaundice. The complimentary role of both transhepatic cholangiography and sonography can facilitate and assist the physician in making a preoperative diagnosis of Mirizzi syndrome and prevent an unnecessary choledochotomy and exploration of the ...

A patient with acquired immune deficiency syndrome who developed symptoms of partial gastric outlet obstruction during the course of a severe diarrheal illness due to cryptosporidiosis is presented. Endoscopic evaluation of the stomach revealed an inflamed pyloric ring and channel with clinical evidence suggestive of partial outlet obstruction. The finding ...

The mechanisms of hypercapnia in eight patients with the "Pickwickian" syndrome and obstructive sleep apnea (OSAS) were evaluated pretherapy and posttherapy (tracheostomy in seven patients and chronic nocturnal use of nasal CPAP in one). Four patients (correctors) became eucapnic within two weeks of therapy. Four others (noncorrectors) remained hypercapnic. Neither ...

A 62-year-old man with pseudotumor cerebri (PTC) syndrome was discovered to have a cholesteatoma of the left mastoid. The mass indented the sigmoid sinus without occluding it. The PTC resolved postoperatively. To our knowledge, PTC has not been previously reported in association with a cholesteatoma. Additionally, this case demonstrated that ...

Gastric volvulus is an uncommon condition in which an acquired torsion of the stomach results in acute or chronic gastrointestinal symptoms. We report a case of an intrathoracic organoaxial gastric volvulus presenting as a cholestatic syndrome, secondary to partial obstruction of the common bile duct by the diaphragm at the ...

Ninety consecutive patients with atrioventricular canal were studied to identify the association between left-sided obstructive lesions and Down's syndrome. Three groups were recognized: Group I, 76 patients with atrioventricular canal and no left-sided obstructions; Group II, nine patients with atrioventricular canal and left-sided inlet obstructions; Group III, five patients with ...

The combination of the empty sella syndrome (ESS) and benign intracranial hypertension (BIH) is illustrated by two case histories. The causal relationship between the ESS and the BIH can be explained by two mechanisms. Raised intracranial pressure could produce a herniation of the subarachnoid cistern into the sella turcica, if ...

To determine whether a persistent contraction of the pelvic floor muscle during straining, as observed in constipated patients during defaecography, was due to a conscious action of the patients or really represented a functional disorder, segmental colonic transit studies were performed in 24 patients in whom the diagnosis spastic pelvic ...

Detailed studies on the distribution of the muscle coat at the omasoabomasal junction in cattle, especially in the pila omasi, were carried out in order to clarify the mechanism of closing of the ostium omasoabomasicum. Anatomical and histological observations revealed that the muscle coat forming the circumference of the ostium ...

The report includes a description of the prevalence of chronic bronchitis and asthma-like symptoms in the industrial population in an attempt to study the relationship between these two syndromes and airflow obstruction. The data were derived from the cross-sectional study performed in 4,717 male workers employed in the chemical industrial ...

The aqueduct (A) is the most common site of intraventricular blockade of CSF flow. There are multiple causes of its obstruction which can be classified as congenital or acquired, but their morphological differentiation is often impossible, since in both human and experimentally induced obstructions of the A. various histological changes ...

The bobble-head doll syndrome is a rare movement disorder; fewer than 40 cases have been reported. It is usually associated with cystic abnormalities in the region of the anterior third ventricle. Various physiologic mechanisms have been proposed but none of them has been substantiated. We report a patient with this ...

Hypothenar hammer syndrome is a reversible yet uncommonly encountered cause of Raynaud's phenomenon. Characteristic findings include coldness in the dominant hand of a male, absence of triphasic color change and thumb involvement, and occupational or recreational use of the hand as a hammer. Angiography demonstrates the specific findings of irregularity ...

Episodic apnea leading to asphyxia is a relatively common disorder of young children. Important apnea syndromes include apnea of prematurity, "narrow upper airway syndrome," congenital hypoventilation syndrome, breath-holding spells, and "near-miss" sudden infant death syndrome. More recently described syndromes include apnea associated with feedings, regurgitation or gastroesophageal reflux, and apnea ...

The blind pouch syndrome is associated with a spectrum of diseases affecting the gastrointestinal tract that includes: malabsorption, ulceration, bleeding, and perforation. The clinical signs and symptoms of anemia, weight loss, abdominal pain, vomiting, and intermittent intestinal obstruction can be found. Occasionally, constipation or more often diarrhea is an important ...

Some children who snore heavily, have been shown to have periods of apnoea which, if frequent, are known as the obstructive sleep apnoea syndrome (OSA). Twenty patients with OSA, who presented to the Department of Thoracic Medicine, Royal Children's Hospital, Melbourne, over a three-year period, were reviewed. The findings indicated ...

A 56-year-old woman was admitted to the hospital because of icterus and pruritus of 1 month duration. During her evaluation, endoscopic retrograde cholangiography revealed large cystic duct stones causing partial obstruction of the common hepatic duct. Successful management was accomplished with choledochojejunostomy and T-tube decompression. The case herein reported illustrates ...

Metastatic malignant pheochromocytoma can be a disease of long duration and though poorly responsive to both radiation therapy and chemotherapy, pharmacologic management of its myriad manifestations can be very effective. Hypertension is the most recognized feature of this disease, but gastrointestinal manifestations can, on rare occasions, be just as serious ...

A group of 20 surgical specimens in 18 patients with a previously unappreciated syndrome of unremitting epididymal pain and induration 5 to 7 years after vasectomy was collected during a 2-year interval. These symptoms uniformly were unresponsive to conservative measures, including empiric antibiotics. Total unilateral or bilateral epididymectomy and partial ...

Macroglossia can cause a wide spectrum of problems in the pediatric population. Airway obstruction is the most severe of the sequelae and must be handled promptly. Typically, congenital macroglossia does not present with sudden airway obstruction, however, traumatic or postoperative macroglossia can. Iatrogenic postoperative macroglossia is presented and mechanisms of ...

The clinical and physiologic features of 28 infants with Pierre Robin syndrome and those of 20 infants with various types of nasal obstruction were reviewed to determine whether different causes of upper airway obstructure may lead to a common syndrome. The patients had no significant differences in distribution of main ...

Intestinal obstruction of the duodenum by entrapment between the aorta and the superior mesenteric artery (SMA) is an uncommon cause of megaduodenum. Despite many case reports, acceptance of the SMA syndrome as a clinical entity has been controversial on account of its confusion with other causes of megaduodenum. We therefore ...

A 12-year-old girl with obstructive lung disease was examined with respect to the ultrastructure of her nasal mucociliate epithelium. She had the characteristics of the immotile-cilia syndrome: chronic rhinitis, sinusitis, and bronchitis, a severely decreased mucociliary clearance of the lungs, and nasal polyps. The nasal cilia showed a normal cross-sectional ...

Six small-breed, middle-age dogs with a history of chronic intermittent vomiting had benign pyloric lesions causing gastric outlet obstruction. Marked similarities were found in clinical signs, pathologic changes, and treatment results. The condition was classified as a syndrome and was named chronic hypertrophic pyloric gastropathy. The appearance of the obstructive ...

A case of Bouveret's syndrome which later presented as a jejunal obstruction is reported. Special reference is made to the echographic findings. Bouveret's syndrome has a double-arch-shadow image in the zone of the gallbladder bed on ultrasound examination. So far, this sign has been considered specific for gallstones inside the ...

We treated a patient who had an inferior vena cava (IVC) obstruction associated with Budd-Chiari syndrome. All of the right, middle, and left hepatic veins were completely obstructed. The IVC was obstructed by a membranous substance and thrombus at the hepatic portion and was completely occluded by a fibrous septum ...

A distinctive, mostly proprioceptive polyneuropathy can occur in association with gastric partitioning in morbidly obese subjects. The syndrome occurred also in a nonobese patient receiving parenteral hyperalimentation and involved cranial nerves. The only consistent etiologic feature is surgical obstruction at the level of the gastric fundus. The condition reverses on ...

Abdominal muscle deficiency, urinary tract abnormalities, and cryptorchidism are the three major features of the prune-belly syndrome, also referred to as triad syndrome or Eagle-Barrett syndrome. The etiology is unclear and the pathogenesis a subject of continuing debate. Clinical and pathologic experience with seven cases of prune-belly syndrome is reviewed. ...

A syndrome of abdominal pain, intestinal obstruction, weight loss, and fever can be caused by adhesions from granulomatous peritonitis. Contamination of the abdominal cavity at operation by cotton lint from disposable surgical drapes and laparotomy pads appears to be the etiological factor. Exogenous granulomatous peritonitis has been virtually ignored as ...

We report on 1 family in which 7 male patients had solitary bladder diverticulum. This family represents an autosomal dominant form of this disease by which only men are affected. Diverticula of the bladder can be classified as congenital (primary) or acquired (secondary). Vesical diverticula are uncommon in children and ...

Experience with 16 males with prune belly syndrome reveals that half have done well without any surgical treatment. The authors felt that two patients had unnecessary loop cutaneous ureterostomies--and inappropriate operation for these children. Urethral obstruction was found in two boys. Four neonates died of severe renal dysplasia. Although the ...

In a patient with Ewing's tumor, bilateral papilledema developed along with a left jugular foramen syndrome. Plain tomograms demonstrated a metastasis at the base of the skull. A digital intravenous angiogram showed an occlusion of the left transverse sinus at the level of the jugular foramen. The papilledema was explained ...

Mirizzi's syndrome is a rare entity of common hepatic duct obstruction that results from an inflammatory response secondary to a gallstone impacted in the cystic duct or neck of the gallbladder. It results from an almost parallel course and low insertion of the cystic duct into the common hepatic duct. ...

Intravenous digital subtraction angiography (DSA) was used to evaluate 22 patients with Leriche syndrome. The technique successfully demonstrated both the level of obstruction and the reconstitution of arterial flow to the lower extremities. In view of the relative safety of DSA, compared with the axillary approach in standard angiography, the ...

The yellow nail syndrome is a rare cause of recurrent pleural effusions. We studied a case of this entity, placing special emphasis on the microscopic and ultrastructural aspects of the pleural lymphatics. The patient had the classic symptoms of recurrent bilateral pleural effusions, yellow, dystrophic fingernails and toenails, and lower-limb ...

Three cases of a phytobezoar in B-II-gastrectomy are considered in relation to their development around a suture thread acting as precipitating factor; the bezoar was responsible for the presenting obstructive syndrome. Endoscopic diagnosis and definitive treatment by removal of the bezoar together with the thread after cutting the fixed end ...

The Blue Rubber Bleb Nevus syndrome is a rare disease characterized by a distinctive type of hemangioma which involves the skin and the gastrointestinal tract. In the latter location, these lesions are often responsible for chronic blood loss and secondary anemia, and in rare situations may act as a leading ...

A case of gastric retention caused by gallstones (Bouveret's syndrome) is reported. One of the two causal stones was lodged in the pylorus and the other in the cap of the duodenum. Preoperatively a fistula was demonstrated between the gallbladder and the pylorus. The clinical and roentgenologic findings are described. ...

The sump syndrome has been reported to occur infrequently following a choledochoenterostomy (duodenostomy or jejunostomy) for stone disease. The enterostomy stoma usually decreases in diameter following surgery allowing for reflux into the distal, inactive segment of the bile duct without adequate egress of the material. This stagnant portion of the ...

Opitz syndrome, or G syndrome, is a composite of congenital malformations including hypertelorism, hypospadias, and recurrent aspiration secondary to a disordered swallowing mechanism. The mode of inheritance is probably autosomal dominant with male predominance. This paper describes an infant with this syndrome who developed progressive airway obstruction requiring several endotracheal ...

Several pathogenetic mechanisms have been suggested to explain the syndrome of deficiency of anterior abdominal muscles and genitourinary abnormalities which is usually seen in males. We have recently seen four such cases, two males and two females, all of which showed obstruction of the lower urinary tract, with dilatation proximally. ...

Presented here is an unusual case of extrinsic biliary obstruction due to a mass caused by xanthogranulomatous pyelonephritis, in itself a rare disease, of the right kidney. This phenomenon has not been described previously in the literature, and it should be brought to the attention of practitioners as another possible ...

The rare syndrome of idiopathic female pseudohermaphroditism with vaginal urethra, clitoral hypertrophy and accessory phallic urethra is commonly associated with urinary tract obstruction. We report a new case and discuss the characteristic features. The embryogenesis of this condition seems to involve complex interactions between the müllerian duct and urogenital sinus ...

Delineation of lymphatic vessels is a frequent finding in arthrograms of rheumatoid joints. Arthrography of the rheumatoid wrist when associated with oedema of the upper limb reveals a characteristic pattern consistent with lymphatic obstruction. In our opinion, these findings may be regarded as further evidence in favour of lymphatic obstruction ...

The term "CB syndrome" comprises the presence of umbilical vein collateral circulation due to portal hypertension associated with cirrhosis or other recognizable structural anomalies of the liver. Usually the dilated remnant of the umbilical vein is the main collateral pathway. Demonstration of this structure not only indicates the presence of ...

Two infants with asplenia and complex cyanotic congenital heart disease showed unusual findings at cardiac catheterization. Each had a patent pulmonary outflow tract and a severe obstructive lesion of the aortic arch. These cases emphasize the heterogeneity of the asplenia-polysplenia syndromes. Pulmonary atresia or critical pulmonic stenosis is not an ...

Patients with adenocarcinoma of the ceruminous gland arising in the middle ear have a typical syndrome consisting of unilateral hearing loss, otalgia, facial paresis, and a middle-ear mass. Adjacent cranial nerves also may be affected. Some patients may have an ipsilateral cerebellar ataxia if the lesion extends into the cerebellopontine ...