Spondylo - Epiphyseal Dysplasia Ribbing - Fairbank Type Report of Three Cases

Spondyloepiphyseal Dysplasia Ribbing-Fairbank type in three members of a family are described. A fourth member of the family was also probably affected. The importance of the radiographic examination for the recognition of the disease is stressed and the radiographic differential diagnosis is reviewed.     

A DUPLICATION OF THE ALIMENTARY CANAL

A duplication adherent to the lesser curve of the stomach in a child, aged six months, is described. The duplication had a cyst lined with gastric mucosa, and pancreatic tissue was present in the lesser omentum adjacent to the cyst. In common with the other cases of duplications in this region, the main presenting symptom was vomiting. Suggested mechanisms of origin of alimentary canal duplications are discussed. It is concluded that no single hypothesis can explain all types. However, in individual cases there is frequently strong evidence for favouring one or other of the proposed mechanisms of development.     

SMALL BOWEL TUMOURS

Primary tumours of the small bowel have been reviewed over a 16 year period; 58 tumours were found in 55 patients. The sex incidences were equal, and the peak age at presentation was in the seventh decade. Sixteen (28%) of the tumours were benign and 42 (72%) malignant. Carcinoma accounted for 57% of the malignant growths, and carcinoid for 29%. The average duration of symptoms was 21·4 months and 7·8 months for benign and malignant tumours respectively. Forty-nine of the 58 tumours caused symptoms, and 14 of these (29%) presented as surgical emergencies. Benign tumours usually cause obstructive symptoms, whereas malignant tumours frequently present with weight loss, anæmia or changed bowel habit in addition to pain and vomiting. Diagnostic methods and their shortcomings are considered. Clinical suspicion is the most important single factor in making the diagnosis.