Addison's disease and diabetes mellitus.
نویسنده
چکیده
of a vein. It is a rare condition and was first described in 1928 by Harris of Toronto. It may be seen in either the internal or external jugular vein (more commonly the latter), and appears as an abnormal spindle shaped swelling which is due to a developmental abnormality of the vein wall itself. Such dilatations have been referred to as 'venomas ', thereby likening the process to cystic hygromaarising in the lymphatic system in the neck. It was possible in this case to establish a diagnosis of venous cyst by physical signs in the first place, later confirmed by X-rays. The swelling was of soft consistency and cystic, but cystic hygroma or lymph cyst could be excluded however, as it did not transilluminate. Any arterial connection was excluded by the absence of pulsation and bruit. Pataro, Crosbie and Martinez Conde (I96I) state that the one characteristic present in their series of four cases, was the increase in size of the tumour when the patient made an effort (e.g. performing the Valsalva rrmanoeuvre) or to a lesser degree on lying down. They mention three types of swellings in the neck which show these features rs follows: (I) A tumour of the superior mediastinum. This can be demonstrated by a chest X-ray. (2) A laryngeal diverticulum. This can be excluded by laryngoscopy and by normal X-ray appearances of the larynx and trachea. (3) The neck venous tumour. The diagnostic feature in the present case was the remarkable way in which a swelling could be made to appear, by pressure on the neck in the supraclavicular fossa, with the patient erect, and the slow subsidence of the swelling on withdrawing the hand. This manceuvre could be constantly repeated and proved the swelling to be a cyst communicating freely with the venous system in the neck. If this sign occurs, it would seem to establish the diagnosis of phlebectasia.
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SELBY, J.B. (1962) Addison's disease associated with diabetes mellitus. Amer. Practit. 13, 347. SOLOMON, N., CARPENTER, C.C.J., BENNETT, I.L. & HARVEY, A.McG. (1965) Schmidt's syndrome and coexistent diabetes mellitus. Diabetes, 14, 300. THORN, G.W., FARSHAM, P.H., PRUNTY, F.T.G., BERGNER, G.E. & HILLs, A.G. (1949) Clinical studies in Addison's disease. Ann. N. Y. Acad. Sci. 50, 646. TZAGOURINS...
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ورودعنوان ژورنال:
- Proceedings of the Royal Society of Medicine
دوره 59 6 شماره
صفحات -
تاریخ انتشار 1950