CONGENITAL PATENT URACHUS IN AN ADULT: A CASE REPORT

A rare case of the congenital patent urachus in an adult is reported. The patient, a 42-year-old man, was admitted with the chief complaint of macroscopic hematuria. During the cystoscopy perfusion water discharged from the umbilicus. Diagnostic imaging revealed a tubular fistula between the bladder and umbilicus and the patient underwent -urachal resection and partial cystectomy. Microscopically the lumen was lined by transitional, columnar and squamous epithelium and there was no evidence of malignancy. To date 11 cases of congenital patent urachus in an adult have been reported in Japan. From a review of the Japanese literature, the common chief complaint is urine discharge from the umbilicus accompanying cystitis and/or urachal inflammation. Urachal resection is performed in all cases. We also clarified the epithelial histology of the patent urachus in this patient.     

ADENOCARCINOMA ARISING IN A DUODENAL DUPLICATION CYST A CASE REPORT

A case of adenocarcinoma complicating a pyloroduodenal duplication cyst is reported. The diagnosis and therapy are discussed.     

DUPLICATION OF THE PROXIMAL COLON MIMICKING VOLVULUS: A CASE REPORT

The case of a 56 year old female with intermittent pain, weight loss, anaemia, and a palpable tympanic abdominal mass is reported. Barium enema showed a very redundant loop of proximal colon, which was thought to have undergone recurrent volvulus. At colonoscopy, the findings seemed normal, but a much shorter length of colon was intubated to the caecum than expected from the barium findings. The duplicated colon was discovered only intra-operatively. This unusual diagnosis should be considered when a barium enema shows a long redundant colon which is not confirmed on colonoscopy.     

MUCINOUS CYSTADENOMA OF THE APPENDIX AN UNUSUAL CAUSE OF RECURRENT INTUSSUSCEPTION IN AN ADULT

The case of a 35 year old woman who presented with mucoceles that resulted in recurrent intussusception is reported.     

CONGENITAL DUODENAL DIAPHRAGM IN AN ADULT: AN UNUSUAL CASE ASSOCIATED WITH COELIAC DISEASE AND RECURRENT PEPTIC ULCERATION

A case of congenital duodenal diaphragm In an adult is reported. A correct preoperative diagnosis of this rare condition was made. The duodenal diaphragm was associated with both coellac disease and recurrent peptic ulceration, resulting In a complicated clinical course.     

BENIGN GASTRIC ULCER IN PERNICIOUS ANAEMIA: A CASE REPORT

This is the report of a benign gastric ulcer in a patient with achlorhydria on pentagastrin stimulation and suffering from documented pernicious anaemia.     

CONGENITAL DUODENAL DIAPHRAGM IN AN ADULT

A case of congenital duodenal diaphragm has been presented. The clinical features of protracted vomiting, epigastric pain and discomfort after meals with a gastric splash occurring at any age, the biochemical features of profound hypokalaemia and hypochloraemic alkalosis, and the radiological demonstration of a diaphragm have been shown to be of diagnostic significance. The operation of vagotomy and gastroenterostomy was unsuccessful in this case, and a literature review suggests that duodenotomy with excision of the diaphragm is the preferred method of treatment.     

RESPIRATORY OBSTRUCTION DUE TO IMPACTION OF THE EPIGLOTTIS IN AN ADULT: A Case Report

A case is presented of respiratory obstruction caused by impactionof the epiglottis, which occurred in an adult patient underanaesthesia. The history of excision of a thyroglossal cystwas noted pre-operatively, but its significance was missed.The respiratory obstruction was managed by re-intubation andposturing before final extubation. Subsequent recovery was uneventful.     

PERFORATION OF A GASTRIC ULCER INTO THE PERICARDIUM: A CASE REPORT

This report describes a patient in whom a gastric ulcer arising in a surgically transposed thoracic stomach perforated into the pericardial aac.     

MALIGNANT SACROCOCCYGEAL GERM CELL TUMOUR IN AN ADULT

In adults, malignant sacrococcygeal germ cell tumour is a rare cause for a presacral tumour, with only 17 cases having been reported in the literature since 1907. We report the case of a 34 year old male who presented with a 6 month history of symptoms relating to a malignant presacral tumour which required en bloc excision including the lower sacrum and rectum. He died with lung and mediastinal metastasis 7 months following surgical excision and adjuvant chemotherapy using Cisplatin, Bleomycin and Etoposide. Prior to his death, he had a severe polyarthritis of his peripheral joints and evidence of hypertrophic osteo-arthropathy. The literature indicates that adults with these tumours have a poor prognosis, with only one reported long-term survivor. Surgical excision offers the only chance of cure, with the role of adjuvant therapy not having been defined because of the small numbers.     

ACUTE GASTRIC DILATATION IN AN INCARCERATED HIATUS HERNIA

A case is reported of an unusual complication in which acutegastric dilatation occurred in an incarcerated hiatus hernia,resulting in left ventricular failure in the postoperative period.Failure to recognize this gave rise to concern when the patientre-presented for further surgery. ^*Department of Anaesthesia, Royal Liverpool Hospital, PrescotStreet, Liverpool L7 8XP. Walton Hospital, Rice Lane, Liverpool L9 1AE.     

ADULT HEPATOBLASTOMA: CASE REPORT AND REVIEW OF THE LITERATURE

We report a case of hepatoblastoma in a 24 year old woman. The tumour was removed by an extended right lobectomy after transcatheter hepatic arterial embolization. A survey of the literature revealed 31 cases of adult hepatoblastoma. According to these reports there are no characteristic clinical features of the tumour, making a correct diagnosis before surgery or autopsy extremely difficult. Complete removal of the tumour is the only treatment which is potentially curative provided that lesion is confined within the liver capsule.