Care by parents in hospital.

admitted to the paediatric ward, representing 3-8% (17/439) of the infants under 1 year but 12% of the bed occupancy. Infants who had previously been in the neonatal intensive care unit accounted for a large proportion of the bed occupancy partly because they stayed in the ward longer for general problems (such as upper respiratory infections and social and feeding difficulties) than the other infants (table) and partly because a small number needed prolonged admissions for intensive treatment of chronic conditions-for example, one infant with chronic lung disease needed ventilation for five months and another required many months of intravenous feeding after extensive bowel resection in the neonatal period. Comment Although only a small number of infants who had previously received intensive care required admission to the paediatric ward, they represented about half the bed occupancy of infants under 1 year. Interestingly, although the paediatric ward served only the Cambridge Area Health Authority, babies admitted to the neonatal intensive care unit from the region accounted for about one third of the bed occupancy of those aged under 1 year. This study highlights the need for continued intensive nursing care for a few infants under 1 year after their discharge from a neonatal intensive care unit. This represents a considerable workload for a general ward, and as the survival rates of such infants continue to improve4 it is vital that these wards should be appropriately staffed and equipped. Spontaneous urinoma due to retroperitoneal fibrosis and aortic aneurysm Rupture of the ureter or renal pelvis leading to a mass of encapsulated extravasated urine usually occurs after surgery or trauma. When it occurs spontaneously it is usually a result of ureteric obstruction due to calculus. We report a case of urinoma caused by retroperitoneal fibrosis in association with an aortic aneurysm. Case report A 72 year old man with a history of right ureterolithotomy was admitted for investigation of uraemia. He was found to have a large, firm, ballotable abdominal mass on the left side. Blood urea concentration was 20-2 mmol/l (121 mg/100 ml) and creatinine concentration 428 ,mol/l (4-8 mg/100 ml). Intravenous urography showed a small right kidney and a hydronephrotic left kidney displaced upwards by a mass. The left ureter was not identified. Ultrasonography showed an abdominal aortic aneurysm with a large cystic mass adjacent. After needle aspiration had confirmed that this mass contained urine, contrast was injected (figure) and 600 …