Irish journal of medical science
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Pneumobilia is the presence of gas within the biliary tree. It is an important diagnostic sign in spontaneous biliary enteric fistulae, classically in gallstone ileus. There are a number of other causes including surgically created biliary enteric fistula, instrumentation of the bile duct at endoscopic retrograde cholangiopancreatography, emphysematous cholecystitis and pyogenic cholangitis. Pneumobilia has also been reported following blunt abdominal trauma. The significance of isolated pneumobilia following abdominal trauma has not been conclusively established. ⋯ Pneumobilia following blunt abdominal trauma is not an absolute indication for laparotomy.
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Pneumocystis carinii pneumonia (PCP) is a rare form of pneumonia associated with immune-suppression. It is common in patients with AIDS and with a CD4 count of less than 200 cells/mm(3). We report a case of PCP secondary to immune-suppression in a 41-year-old man with psoriatic arthritis being treated with the immune-modulatory agent etanercept. ⋯ This report highlights a recognised but previously unreported complication of etanercept.
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Metastatic oesophageal carcinoma to the brain is an uncommon diagnosis that may cause abnormal neurological findings. ⋯ Oesophageal carcinoma is a recognised cause of intracerebral metastatic tumours, though this is an uncommon occurrence.
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Aseptic meningitis is a frequent diagnostic problem, with little data available regarding its prevalence and the commonly identified causes. ⋯ The median duration of admission to hospital in the undiagnosed group was 12 days, which may be improved with increased accuracy and availability of diagnostic techniques such as polymerase chain reaction.