Bronchogenic cyst presenting as dysphagia.

We report an adult patient who masqueraded as a case of gastroesophageal reflux disease for over 6 years. On close questioning he was found to have severe constricting pain in the retrosternal region and non progressive dysphagia for 6 years. Cineradiography of the oesophagus and CT scan chest revealed a large bronchogenic cyst compressing the oesophagus and the trachea. Excision of the cyst relieved the symptoms.

Pre-operative and post-operative ultrasound evaluation of Budd Chiari syndrome due to coarctation of the inferior vena cava.

Coarctation of the inferior vena cava (IVC) is being increasingly recognised as a congenital and operable cause for chronic Budd Chiari syndrome. It is necessary to distinguish this entity from other causes of Budd Chiari syndrome because of a more favourable outcome after surgery. Early diagnosis would result in surgical intervention before irreversible liver damage and also possibly avoid the onset of hepatocellular carcinoma. Real time ultrasound has proved valuable in pre-operative diagnosis in nine patients with coarctation of the IVC. It has also been found useful to confirm patency of dorsal cavo-atrial bypass using polytetrafluoroethylene grafts in five patients and isthmusplasty of the IVC in one patient. Ultrasound is recommended for routine screening of high risk population.

Giant cervical herniation of an apical pulmonary bulla.

A 60-year-old woman had a giant air cyst in the right side of the neck, which arose from the apex of the right lung. We are unable to find a similar case report in literature.

Tuberculous aortoarteritis.

Tuberculous aortoarteritis is a distinct entity. Despite the still wide prevalence of active tuberculosis in developing countries, tuberculous aortoarteritis appears to be rare. The vessel is often involved by a direct extension of the disease from adjacent tuberculous tissue. Occasionally it may result from blood-borne seedlings from an active distant focus. True and false aneurysms are the common manifestations. Stenosing and/or constricting types of lesions and perivascular fibrosis have been encountered by us. The probable pathogenesis is discussed with illustrative cases.

Extra- and intrasplenic artery aneurysms in portal hypertension.

Extra- and intrasplenic arterial aneurysms have occasionally been encountered in cases of portal hypertension both with and without cirrhosis. The exact pathogenesis is speculative; however, it is postulated that hyperkinetic splenic circulation, probably related to hepatic arterial insufficiency or hypoplasia, constitutes the primary pathogenic mechanism. Other factors such as splenomegaly and hormonal influence may be contributory.

Obscure stenosing aortitis and arteritis associated with perivascular lymphadenitis--combined angiographic and lymphographic evaluation.

A series of eleven cases of an obscure occlusive type of aortitis and arteritis is reported. These are characterised by chronic nonspecific perivascular lymphadenitis and fibrosis, constricting the lumen of the vessels. Subsequent spread of the inflammatory process produces irreversible changes in the vessel wall. Timely excision of the nodes, release of fibrous strands and decompression of the vessels may result in a permanent cure; The inflammatory process is nonspecific in nature. The etiology is obscure and is subject to speculation. Tuberculous inflammation of the lymph nodes appears to be unlikely while filarial lymphadenitis is probable. The disease is not a primary panarteritis as observed in Takayusu's disease or allergic vasculitis. Males are predominantly affected and present invariably with clinical signs and symptoms of peripheral vascular obliterative disease of the lower extremities.