HELLP syndrome. A case report

A black patient with the HELLP syndrome is presented. This syndrome is apparently rare in black patients in South African hospitals. In patients with gestational proteinuric hypertension, the importance of recognising epigastric pain is emphasised. The management of maternal thrombocytopenia and the possible consequences for the fetus are described.     

Kallmann's syndrome. A case report

A patient with hypogonadotrophic hypogonadism and anosmia (Kallmann's syndrome) presenting as delayed puberty is described. The clinical, hormonal and testicular histological features are noted. The basic principles of treatment are discussed.     

Meigs' syndrome. A case report.

A case of Meig's syndrome is reported and the rarity of this condition is emphasised. The need for exploratory laparotomy in patients with solid ovarian tumours associated with ascites and pleural effusion, and free of malignant cells, is stressed.     

Wermer's syndrome. A case report

Wermer's syndrome (or multiple endocrine adenomatosis type I) is a hereditary condition characterized by tumours or hyperplasia involving multiple endocrine organs. Most commonly the pituitary and parathyroid glands and the pancreas are involved. We record a further case, the patient presenting with acromegaly due to a pituitary adenoma, hypercalcaemia due to a parathyroid adenoma and peptic ulceration.     

Hair-thread tourniquet syndrome. A case report

The authors report the case of a 3-month-old boy with hair-thread tourniquet syndrome, seen just distal to the MP joint on the right fourth toe. The patient was brought to the hospital with a history of irritability and weeping. On examination there was swelling, ecchymosis and a hair fibre was found wrapped around his right fourth toe. After the hair fibre was removed there was a fast healing period and no signs of tissue necrosis were seen.     

Ovarian hyperstimulation syndrome. A case report

An iatrogenic disease resulting from the induction of ovulation is described. It would appear that it is uncommon in southern Africa.     

Acute volar compartment syndrome during skeletal traction in distal radius fracture. A case report

Fractures of the distal end of the radius rarely cause acute compartment syndrome of the forearm. Acute compartment syndrome of the forearm occurred after a fracture of the distal end of the radius in a 17-year-old boy who developed symptoms after application of skeletal traction. Satisfactory recovery was obtained by early decompressive fasciotomy. In this case a combination of traction and elevation of the forearm appeared to have increased the susceptibility of the limb to acute compartment syndrome.     

The Zollinger-Ellison syndrome. A case report

A vagotomy and antrectomy was performed on a 15-year-old boy with a malignant gastrinoma for emergency control of massive upper gastro-intestinal haemorrhage from a large posterior penetrating duodenal ulcer in the presence of jejunal ulceration and liver metastases. Hypergastrinaemia was confirmed by elevated serum gastrin levels. In the short term postoperatively the patient's disease has been controlled with oral cimetidine. Although controversy continues over the efficacy of cimetidine in the management of gastrinomas, medical treatment should be considered as an alternative to total gastrectomy in children with malignant gastrinomas because they are often slow-growing, indolent and compatible with long survival.     

Scapho-capitate fracture syndrome of both hands--first description of a bilateral occurrence of a rare carpal injury

The scapho-capitate fracture syndrome is a rare but severe injury of the carpus. It is characterized by a rotation of the proximal fragment of the capitate bone of 90 or 180 degrees and a fracture of the navicular bone in the intermediate third. This injury is caused by a fall on the outstretched and dorsiflected hand. The scapho-capitate fracture syndrome was firstly described in 1956 by Fenton. There are 31 cases described in literature but none of these involves both hands. Here we describe the first case of scapho-capitate fracture syndrome in both hands, in a 21 year old woman who jumped out of a window with suicidal intentions. She was treated operatively by Herbert-screws and K-wires.