Postgraduate medical journal
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Case Reports
Intracranial abscess complicating diverticulitis with CT scan mimicking primary glioma.
The case of a 64 year old woman with diverticulitis complicated by a metastatic cerebral abscess is reported. Presentation was atypical and investigations were misleading; the computed tomographic scan was interpreted as showing a glioma. This case demonstrates that malignancy should never be assumed and the importance of making a histological diagnosis. Once the abscess was drained the patient made a full recovery with resolution of her neurological deficits.
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Herniation of a thoracic disc in an acromegalic giant is reported. Degenerative changes in the spine in association with dorsal kyphosis, and the additional strain, resulted in the disc prolapse.
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Spontaneous aortocaval fistula is an uncommon complication of an abdominal aortic aneurysm. This report details two cases of this condition presenting with symptoms attributable to arteriovenous shunting. Pain was not a prominent feature so that attention was not initially drawn to the abdomen. Diagnosis and management of the condition are discussed.
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A 44 year old man with longstanding diabetes mellitus gave a 6-month history of periodic attacks of flaccid quadriplegia. Following one of these episodes he was admitted for assessment. In view of persistent hyperkalaemia, hypoadrenalism was suspected and Addison's disease was confirmed biochemically. Adrenal replacement therapy restored the potassium levels to normal and resulted in no further attacks of paralysis.
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A case is described of subcutaneous and mediastinal emphysema developing as a complication of lung function tests in an immunocompromised patient with presumed Pneumocystis carinii pneumonia.