Melanoblastoma: With special reference to metastatic dissemination

Two cases of melanoblastomatosis with widespread and unusual sites of metastasis are described. The frequency and sites of metastases in melanoblastomatosis are discussed. In the case in which no melanin occurred in the urine, there was no involvement of the liver.     

Failure of epidural anesthesia to prevent postoperative paralytic ileus

This study used radiopaque markers and serial abdominal radiographs to assess the effect of epidural anesthesia on postoperative colonic ileus. Epidural anesthesia did not result in significantly faster return of propulsive motility in the colon after surgery as compared with control (P greater than 0.05). In addition, no significant difference was seen between the groups in colonic transit time and time for the first passage of gas and feces. The level of inhibition of sympathetic efferent nerves to the abdominal cavity was assessed by repeated measurements of blood glucose levels during the first postoperative day. Blood glucose levels were found to be significantly lower in the epidural group, demonstrating an inhibition of efferent sympathetic nerves below the level of T-5. Results show lack of effect of continuous epidural anesthesia in the prevention of postoperative paralytic ileus and suggest that mechanisms other than spinal reflexes play a major part in the development and maintenance of intestinal paralysis.     

Herpes zoster and paralytic ileus: a case report

A case of herpes zoster presenting as intestinal obstruction is described. Clinical and radiological evidence of intestinal obstruction was obtained. The mechanisms by which herpes zoster may cause an ileus are discussed.