Spinal stroke as a presentation of dissecting aneurysm of the aorta

A case of ischaemic spinal cord injury in a 70-year old patient is presented. Autopsy showed a DeBakey type 1 dissecting aneurysm of the thoraco-abdominal aorta with involvement of the intercostal and lumbar arteries on the left side. The zone of spinal cord infarction was extensive. The vascular anatomy of the spinal cord is reviewed, and its vulnerability to ischaemia is emphazied (AU)

Segmental infarction of the omentum: diagnosis by ultrasound - case report

Pre-operative diagnosis of segmental infarction of the omentum is difficult because of its rarity and non-specific clinical features. We present a case of omental infarction and suggest that ultrasound scan may be helpful in the diagnosis of this entity (Summary)

Infarction of fibroadenoma of the breast

Although infarction is an infrequent complication of a fibroadenoma, its recognition is important since it has been mistaken for carcinoma. Awareness of the lesion as well as careful evaluation of gross and microscopic findings will help to differentiate it from carcinoma. The pathogenesis of this complication is unclear.(AU)

Retinal and choroidal neovascularization in sickle cell disease.

Small vessel obstruction characterizes sickle cell disease and when occurring in the peripheral retinal vessels, initiates a sequence of vascular events which may culminate in the development of proliferative sickle retinopathy (PSR). Repeated examinations of the retinal vasculature of patients with different genotypes of sickle cell disease over the last 10 years (Condon and Serjeant,1972a,b,c; 1975; 1980a) have allowed observations on the natural history of PSR and on factors related to its development. Choroidal neovascularization has been a common complication of a trial of xenon arc photo-coagulation in PSR. Observations on the aetiology and natural history of both retinal and choroidal neovascularization are presented in this report. (AU)

Leg ulceration in sickle cell anaemia

In Jamaica, leg ulcers are a major manifestation of sickle cell disease. The chronicity of the lesions is such that education and consequent work potential are seriously affected. Although these lesions rarely cause mortality, they are a major determinant of the morbidity of the disease. (AU)

Haemoglobin SC disease in Jamaica

A skeletal survey was carried out on 84 cases of haemoglobin SC disease. The radiological features noted were increased translucency of bone, abnormal trabecular pattern, medullary expansion, wide vascular channels in phalanges, and radiological evidence of infarction, both medullary and cortical. The frequency of bone lesions thus demonstrated increased with age. The most characteristic lesions in this region were those of vascular necrosis; contributing factors such as the high haemoglobin level characteristic of the condition are discussed. An interesting feature was the lack of correlation betweeen clinical severity and degree of radiological change. (AU)

Sickle cell beta thalassaemia in Jamaica

An analysis of the radiological appearances in a skeletal survey of 48 patients in Jamaica with sickle cell beta thalassaemia is presented. The appearances are similar to those in homozygous sickle cell disease and SC disease and a confident distinction between the conditions on radiological grounds alone is likely. (AU)

Conditions of the hip associated with hemoglobinopathies

In the Western hemisphere where malaria and parasitic infection is rare, the complications of the abnormal hemoglobins are those essentially of infarction. Hyperplastic changes never reach the extent seen in West Africa, infection is a less serious problem, patients survive into adult life and the hip joint produces a large proportion of the orthopedically crippled. Treatment follows the same lines which would be adopted in a patient with avascular necrosis of the femoral head with normal hemoglobin. The prognosis is worse because the age of onset is usually later resulting in slower and less complete restoration to normalcy. Special care in the general management of patients during operations is essential, particularly the avoidance of excessive blood loss or anoxia which may precipitate a crisis (summary)

Central rupture of the liver with massive liver-cell necrosis: A case report and review of the literature

A case of massive central rupture of the liver in which the patient became jaundiced is described. Autopsy revealed, in addition to the intrahepatic haematoma, large areas of infarction in the liver, some of which had become infected and had given rise to septic embolization to various organs. There was deranged liver function which is ascribed to the structural changes found in the liver. The occurrence of hepatocellular jaundice with this type of liver injury has not, to our knowledge, been previously recorded. It is suggested that immediate investigation and treatment are essential if the patient is to survive.(AU)

Clinical features of pulmonary lesions in sickle cell anaemia

Acute pulmonary diseases in patients with sickle cell anaemia are usually diagnosed as pneumonia, but in our experience their rate of resolution and clinical course is different from pneumonia occuring in patients with normal haemoglobins. To confirm this we analysed the clinical course of these clinical episodes in a group of patients with sickle cell anaemia and compared them with a control group of patients with acute lobar pneumonia (AU)