Unusual Presentation of Primary Hypothyroidism.

Primary hypothyroidism may present with myriad of unusual presentation apart from typically described signs and symptoms. We report an unusual case of primary hypothyroidism clinically presenting as acute psychosis and radiologically mimicking as pituitary macroadenoma. A 19-year-old female presented with h/o abnormal behaviour in the form of auditory hallucination, fearfulness, loss of memory and inability to recognise family members six months back. She also gave h/o multiple joint pain, easy fatigability, facial puffiness, somnolence, progressive weight gain, constipation and cold intolerance for similar duration. MRI brain revealed enlarged pituitary, while the thyroid function analysis pointed towards primary hypothyroidism. Patient improved with LT4.

Side-to-side aorto-mesenteric anastomosis for management of abdominal angina.

Abdominal angina and fear of eating are manifestations of mesenteric ischemia. This infrequent cause of abdominal pain was diagnosed in a 60-year-old female smoker. We performed a novel side-to-side aorto-mesenteric anastomosis for mesenteric revascularization, with good short-term (6 months) result.