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Volume 13

Background: Chagas disease is endemic in the southern cone of Latin America and is becoming more prevalent in the United States with more than 300,000 people infected. It is an important cause of heart block worldwide, but is thought to be rare in the United States, and therefore easily overlooked. Heart block from Chagas disease often occurs in the young, and is...
(p 27-29, Cardiology; Electrophysiology: 8 January 2014)
We report the case of a 65-year-old man who we thought was an atypical presentation or a variant of the Klippel-Trenaunay-Weber syndrome. Although it is primarily a disorder of infancy and childhood, it has been reported to present in adulthood also[1,2]. Our case report highlights the need to consider the differential diagnosis of Klippel-Trenaunay-Weber syndrome in...
(p 74-78, General medicine; Vascular medicine; Vascular surgery: 17 December 2013)
Necrotizing fasciitis of the abdominal wall is associated with high morbidity and mortality. Early recognition and aggressive debridement of necrotic tissue are essential to achieve good outcomes. We describe an unusual presentation of a woman who was diagnosed with infected wound on the abdomen and was initially treated with traditional therapies.
(p 69-73, General Surgery: 17 December 2013)
Multiple pathologic fractures in a patient with sickle cell disease is rare; bone involvement is well documented in this disease, however multiple pathologic fractures as a complication are uncommon. We present a case involving a 19-month-old boy known to have sickle cell disease who developed multiple pathologic fractures as a complication of his disease. The patient was...
(p 63-68, Haematology; Orthopaedics; Paediatrics; Pathology; Radiology: 22 July 2013)
Inflammatory oncotaxis is the term used to describe the phenomenon whereby mechanically injured tissues are predisposed to the development of metastases. Normal tissue injury elicits an inflammatory response, and it has been found that the microenvironment created is similar to that of the tumour microenvironment. Subsequently tumours have often been described as “wounds...
(p 57-62, HPB Surgery; Oncology: 22 July 2013)
A 79-year-old woman was admitted to the emergency room with an ulcerated large wound in the lateral region of her neck. Computed tomography (CT) of the thorax revealed air bronchograms, nodular infiltration and areas of consolidation areas in both lungs. Multiple conglomerated lymph nodes, tending to coalesce with each other with areas of necrosis, were observed on the...
(p 52-56, Respiratory Medicine: 18 June 2013)
A 60-year-old woman transferred with suspected cauda equina syndrome lacked lower extremity pulses on arrival. She rapidly developed visceral malperfusion due to underlying type B aortic dissection, necessitating aortic fenestration with thrombectomy. Despite misdiagnosis and delayed treatment, she could ambulate 1 year postoperatively. Aortic dissection remains integral...
(p 47-51, Vascular Surgery: 18 June 2013)
We present the case of a 32-year-old woman who presented at 37 weeks’ gestation with foetal bradycardia. At caesarean delivery, an intra-abdominal haemorrhage was noted before the uterine incision was made. A subsequent exploratory laparotomy revealed the source of the bleeding to be an extensive ruptured haematoma involving both lobes of the liver. Radiologic...
(p 42-46, General Surgery; Obstetrics: 18 June 2013)
We present a case of primary recurrent hydatid cyst of the tibialis posterior in a 55-year-old woman with complaints of leg pain. Hydatid cyst was diagnosed by ultrasonography and serological tests. The patient underwent surgical excision of the lesion with perioperative prophylaxis with albendazole.
(p 23-26, General surgery: 18 June 2013)
We present a case of an 11-year-old boy who had an abdominal pain for 4 days, which was found to be caused by an acute appendicitis that ruptured. The second day after an open appendectomy, he was found to have a small bowel obstruction that was not found during the procedure. The reasons for this misdiagnosis are discussed in this article to help other health care...
(p 36-41, Paediatric Surgery: 29 May 2013)
With the advent of modern techniques including the widespread use of gastric endoscopy, benign gastric lesions are diagnosed more frequently and can be characterized by means of biopsy. Of all gastric tumours, less than 5% are benign and 90% of these are polyps. The treatment options for benign gastric tumours vary from mucosal resection to limited gastric...
(p 17-22, Emergency medicine and surgery; Gastroenterology; General surgery: 26 April 2013)
Ectopic pancreatic tissue is most often an incidental finding of imaging, surgery, or autopsy. Image-guided diagnosis is difficult, and definitive diagnosis usually relies on histological analysis. A case of ectopic pancreatic tissue located near the lesser curvature of the stomach is presented followed by a brief discussion of the clinical management of heterotopic...
(p 30-35, Endocrinology; Gastroenterology; General surgery: 2 April 2013)
This report documents a case of embolia cutis medicamentosa after therapeutic injection of neovessels associated with Achilles tendinosis with polidocanol. This condition has not previously been reported as a complication of this procedure.
(p 12-16, Rheumatology; Sports medicine: 6 March 2013)
We report a rare case of leiomyosarcoma arising in the nasal cavity. A 45-year-old woman visited our hospital because of recurrent epistaxis in 1998. A biopsy was performed on a mass in the posterior area of the left nasal cavity, and a histological diagnosis of leiomyosarcoma was made. Although the nasal tumor was resected via left lateral rhinotomy, tumor recurrence was...
(p 4-11, ENT; Head and neck surgery: 6 March 2013)
Nodular sclerosing Hodgkin disease stage IV according to the Ann Arbor classification was diagnosed in a 30-year-old nulliparous woman. Because management required the use of a chemotherapy regimen with a high risk of secondary infertility, ovarian cryopreservation was realized by single-site laparoscopic unilateral oophorectomy. The single-site approach can limit...
(p 1-3, Gynaecology; Oncology: 6 March 2013)


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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