Massive diffuse intraperitoneal multicystic mass in an infant

An 18-month-old boy was referred for painless progressively increasing abdominal distension, poor oral intake, and lethargy since 1 year. There was no history of fever, hematurea, or intestinal obstruction. The child was pale and had a pulse rate of 150 beats/min. The child had mild respiratory distress due to huge abdominal distension. The abdomen was tense and nontender. There was no evidence of intraperitoneal free fluid or any definitive lump. The hemogram showed anemia, other blood biochemistry test results were normal. Ultrasonography of the abdomen suggested the possibility of encysted ascites. A 64-slice contrast-enhanced computed tomography of abdomen showed diffuse intraperitoneal multicystic mass, composed of variable sizes and wall thickness cysts [Figure 1]. The definitive organ of origin could not be identified. Bowel loops were displaced upward by the mass. Diagnostic laparoscopy showed a pale, soft, extremely friable mass composed of cysts of variable sizes arising from the dome of the bladder. The cysts were noncommunicating and had no fluid. The mass was loosely adhered to the bowel, liver, and peritoneum. The rest of the abdominal organs were normal. Complementary cystoscopy was performed to rule out intraluminal extension of tumor, which was normal

study of biogenic amines in central aortic and coronary sinus blood in ischemic heart disease

We studied aortic and coronary sinus epinephrine [E], nor-epinephrine [NE], dopamine [DA] and serotonin [5-HT] in fourteen patients with stable angina [SA], six patients with vasospastic angina [VA] and six control subjects [C]. SA patients were studied at rest and during incremental atrial pacing. VA patients were studied at rest and during various stages of vasospasm. E and DA were same in SA, VA and C subjects and did not rise with pacing or during vasospasm. NE was also same in all three subgroups but increased during vasospasm [p<0.01] but not with atrial pacing. 5-HT was, however, higher in SA and VA patients as compared to C subjects [p<0.05] and increased further during vasospasm [p<0.01] but not with atrial pacing. This increase in NE and 5-lIT during vasospasm was seen before EKG changes manifested or angina occurred. Thus NE and 5-HT play an important causative role in vasospasm, and are not released as a secondary phenomenon in angina. Serotonin is elevated even during resting state in SA and VA. The role of E and DA could not be established

Double outlet right ventricle with laevomal position of aorta

A rare congenital anomaly - Double Outlet Right Ventricle DORV [SDL] with laevomalposition of aorta, is reported with its clinical, echocardiographic and angiocardiographic characteristics