Splenoportal occlusion associated with a deficiency of factors 5 and 7 presenting with massive oesophageal variceal bleeding in a 40 year old African

Splenoportal occlusion presenting with massive haematemesis is reported in a 40-year old African with no previous history of liver disease. Physical examination was within normal limits except for a splenomegaly. There were no spider naevi. Endoscopy revealed large oesophageal varices extending from the middle third distally. Colour doppler ultra-sound showed the portal vein to be occluded. There was no history of umbilical sepsis or intra-abdominal septicaemia. Haematological investigation revealed a deficiency of factors 5 et 7 but no other congenital defect was present. Oesophageal transection was performed to control rebleeding after a transient relief with propranol. He has continued to do well two-yaers after the acute incident

AIDS: from rumour to reality: observations at the Connaught Hospital; Freetown

In the past three years; starting September 1987; we have evaluated 5 patients (2 females; 3 males) with clinical AIDS. Criteria for the diagnosis were the presence of two major and one minor sign. Mean age was 37.6 years. None of them gave a history of drug abuse; both females were married heterosexuals; one of them (MJ) had given birth to three children; one of whom died about three months before she presented at our clinic. The other female patient had six children; all of them were reportedly alive at time of her illness. Two male patients were seafarers; married and to our knowledge heterosexuals. The other male patient was unmarried; had no offspring and denied homosexual contacts