Chronic relapsing pancreatitis in a child: use of the puestow procedure to achieve ductal drainage

A case of chronic relapsing pancreatitis presenting in an 8-year old African Jamaican girl is outlined. Aggressive supportive management failed to control pain and vomitting. The Puestow Procedure effectively aborted these symptoms. The use of the Puestow procedure should not be inordinately delayed in chronic relapsing pancreatitis if symptoms persist, since it may not only control pain but also halt declining pancreatic function.

Plexiform neurofibroma: a rare cause of obstructive jaundice

A case of obstructive jaundice secondary to a neurofibroma in the common hepatic duct is presented. The histological appearance was that of a plexiform neurofibroma. The clinicopathological features are discussed

Admissions for trauma at the University Hospital of the West Indies

Trauma accounted for 20 per cent of all admissions to the general surgery wards of this University Hospital in a developing country. It was the most common reason for admission. This condition affects the young, males more commonly than females, and results in the need for operation in almost 40 per cent of admitted trauma patients. Trauma surgery accounts for 17 per cent of all operations done. Hospital stay and age are significantly greater in those requiring operation. The head, chest and abdomen are, in order of frequency, the most commonly affected areas of the body, and injury is mainly the result of interpersonal violence (52 per cent ), accidental injuries including burns (20 per cent ), and road traffic accidents (20 per cent ). In-patient mortality was 4.5 per cent , significantly higher in older patients and mainly in those with head injuries and burns. Scarce resources and resource allocation mandate preventive measures to minimize the human and economic waste

Hydrops of the gallbladder

Hydrops of the gallbladder is an uncommon condition of infants and children. There is acute distension of the gallbladder in the absence of calculi without evidence of inflammation in the early stages of the disease. A case of hydrops of the gallbladder in a 4-year-old male child is presented. The literature is reviewed and the diagnosis and treatment of the condition discussed.

Thoracic outlet syndrome

A case of thoracic outlet syndrome (TOS) treated at the University Hospital of the West Indies, Jamaica is presented. The diagnosis, investigation and management of TOS are discussed.

Cavernous haemangioma of the duodenum: a rare case of gastrointestinal bleeding

Vascular malformations (VMs), including haemangioma, of the upper gastrointestinal tract, are rare causes of bleeding. Bleeding from these lesions is often recurrent and diagnosis is often delayed for months to years. A patient with severe, recurrent upper gastrointestinal bleeding requiring repeated hospitalization and blood transfusions is presented. Upper endoscopy, barium meal and small bowel enteroclysis were negative. Selective mesenteric angiography revealed a VM in the second part of the duodenum. Segmental resection of the duodenum was performed and microscopial examination showed cavernous haemangioma. VM should be considered in patients with recurrent gastrointestinal bleeding and negative conventional investigations. Mesenteric angiography may be the only investigation which will identify these leisons. Results after excision are excellent.