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Volume 12

A patient was admitted and diagnosed as acute pancreatitis of obscure aetiology. Laboratory investigations and radiological studies failed to reveal the underlying cause. A worm was pulled out of the nasogastric tube by the patient. In a modern society and in developed hospital settings, is it possible that we are missing, or underdiagnosing what we once regarded as...
(p 49-55, Emergency Medicine and Surgery; Gastroenterology; General Surgery: 23 October 2012)
A case of a 27 year-old patient who presented after medical management of a missed miscarriage with an acute abdomen is described. She was found to have a haemorrhagic angiomyolipoma, which was successfully treated radiologically. This case highlights the need to consider this differential in the presentation of acute abdomen in the context of a recent or concurrent...
(p 44-48, General Surgery; Gynaecology; Radiology; Urology: 23 October 2012)
We present a case of an uncommon viral myopericarditis in a 19-year-old man with chest pain. Electrocardiographic abnormalities and elevated cardiac enzymes were present. Myopericarditis of unknown origin was diagnosed following cardiac magnetic resonance imaging. During admission, the patient developed tonsillitis and serology tests confirmed an acute Epstein–Barr viral...
(p 40-43, Cardiology; Emergency Medicine: 10 August 2012)
We report an interesting complex CFTR gene mutation in a patient with cystic fibrosis. It is an insertion combined with a deletion that spans an exonic splice site, causes a frameshift and could affect splicing. This rare mutation poses a challenge to provide correct nomenclature and to interpret its clinical significance.
(p 36-39, Pathology; Paediatrics; Respiratory Medicine: 10 August 2012)
We report a case of an 85-year-old lady with repeated hospital admissions secondary to presumed urosepsis with blood cultures positive for Escherichia coli. Chest radiographs during the final admission had changed dramatically and computed tomography scan of the aorta confirmed mycotic thoracic aortic aneurysm.
(p 27-31, Emergency Medicine; Infection and immunity; Vascular surgery: 6 August 2012)
Objectives: We report the first case of writing apraxia as the main presenting feature of a posterior communicating artery aneurysm. Cerebral aneurysm usually presents with visual impairment, nausea and vomiting, severe headache and loss of consciousness. Case report: A 58-year-old man presented to the neurological department because of writing difficulty, which affected...
(p 32-35, Neurosurgery: 30 July 2012)
Metastatic involvement of the thyroid is extremely rare and can present many years after the primary. Rarely, they cause critical airway obstruction and death as a result. This article describes the case of previously well 68-year-old man, who on presentation with left shoulder pain and mild shortness of breath, was found to have extensive and longstanding left cervical...
(p 23-26, Head and neck surgery; Medical ethics: 3 July 2012)
We present a case of a 58-year-old woman with a posterior neck mass who underwent fine-needle aspiration of the lesion, with initial cytopathologic evaluation being consistent with metastatic squamous cell carcinoma. However, following excisional biopsy of the tumor, histopathologic evaluation revealed a pilomatricoma. Appreciation of the difficulty in cytologic...
(p 17-22, Head and neck surgery; General surgery; Paediatric surgery; Pathology: 27 April 2012)
We report an unusual case of partial thickness contact burns to a neonate after he accidentally urinated on an electrical lamp causing the bulb to explode. We recommend that lamps should be covered and located away from children. Providing parental education on burn injury prevention and improving clinician awareness is vital.
(p 14-16, Paediatrics, Plastic surgery, Primary care: 17 April 2012)
A 76-year-old man presented with a mass on his right leg. He had sustained an open fracture of the right tibia 58 years ago. Imaging showed a well-circumscribed fusiform calcified mass and atrophy of the right calf muscles. The findings and the history led to the diagnosis of calcific myonecrosis.
(p 10-13, Pathology; Radiology; Trauma: 5 March 2012)
This is a rare case of freezing of the corneas in extremely cold conditions. A large proportion of the worlds’ population inhabits areas where frequent exposure to subzero temperatures is common. Early recognition, appropriate referral and treatment of frozen corneas may help to minimize any potential complications that can develop later on, as well as reduce pain and...
(p 6-9, Emergency Medicine and Surgery; Occupational Health; Ophthalmology: 19 January 2012)
Oromandibular dystonia is thought to originate from a dysregulation of centrally mediated movement, whereby repetitive or sustained spasms of the masticatory, facial, or lingual muscles result in involuntary, and possibly painful jaw movement. Here we present 2 unique cases of oromandibular dystonia referred as temporomandibular joint disorders.
(p 1-5, Dentistry: 19 January 2012)


Frank Cross
Consultant Vascular and General Surgeon
The London Clinic, UK


Neil Barnes
Consultant Physician
Barts Health NHS Trust, London, UK
Ali Jawad
Professor of Rheumatology
Barts Health NHS Trust, London, UK

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