majority of instances. The first attack always proves continued or remittent, and is "looked upon as dangerous. After the prodromata of general languor, lassitude, costiveness, want of appetite, &c., the fever is ushered in by a chill followed by the hot stage of several hours' duration. Generally, there is complete intermission in the first day, but next morning the attack recurs. The symptoms...

A14-year-old female presented to the emergency department (ED) for the evaluation of difficulty swallowing. She experienced no headache, visual changes, respiratory abnormalities, unusual ingestions, hematemesis, or bilious vomiting. The rest of her review of symptoms was negative except for dizziness upon standing. Her medical history was significant for seeking medical care at another facilit...

a 47 years old lady presented with repeated intermittent, colicky, left upper, and periumblical abdominal pain associated with nausea and vomiting since two years prior to admission. each episode of the pain spontaneously subsided after bilious vomiting. the patient had no history of surgery, abdominal trauma or intra-abdominal infection, weight loss or previous history for small bowel obstruct...

Background: Cholecystocutaneous fistula is a rare complication of chronic gallstone disease. We present a case of cholecystocutaneous fistula successfully managed with day-case laparoscopic cholecystectomy. Case Outline: An 80-year-old man initially presented with acute biliary sepsis, was treated conservatively, and later developed a right upper quadrant swelling in keeping with an abscess. He...

Vomiting accounts for up to 36% of neonatal visits to the emergency department. The causes of vomiting can range from benign to life-threatening. Evidence to guide the diagnosis and management of neonatal vomiting in the emergency department is limited. History and physical examination are extremely important in these cases, especially in identifying red flags such as bilious or projectile emes...

The results of elective truncal vagotomy and drainage in 547 duodenal ulcer patients are reported. Altogether, 204 patients were randomly allocated to pyloroplasty and 200 to gastrojejunostomy. In 101 patients gastrojejunostomy was electively chosen and in 42 patients the duodenum was opened to confirm the diagnosis. Operative mortality was 0.5%, the incidence of proved recurrent ulceration 3.3...

In a patient with duodenal atresia, a "double bubble" is classically present on plain radiographs. When bowel gas exists distal to the duodenum, duodenal atresia often is excluded from the differential diagnosis. The authors present a case in which contrast can be seen in the small bowel and biliary system on upper gastrointestinal series in a patient with duodenal atresia and an anomalous comm...

From the Departments of Pediatric Surgery, S.M.S. Medical College and Allied Sir Padampat Mother and Child Health Institute Jaipur, Rajasthan. Reprint requests: Prof. A.K. Sharma, B-2 Doctor's Bungalows, Gangwal Park, Jaipur, Rajasthan. was relieved by non-bilious vomiting. The baby was dehydrated, the rest of the physical examination and routine investigations were normal. Plain erect skiagram...

much as the active and intelligent treatment adopted proved so utterly unavailing.?Ed.] Mr. V. T. was 42 years of age. On Sunday, 3rd March, he returned to Hazareebaugh from a long tour in the Tributary Mahals, where he had suffered much from " fever and bilious attacks." I learn from his journal that he was often ill for days together, yet he pushed on, determined to perform the duty fully ; a...

Isovaleric acidemia is a rare branched-chain organic acidemia. The authors describe a 3.5-year-old girl with isovaleric acidemia and acute abdominal pain associated with bilious emesis. Elevated serum amylase and abdominal ultrasonography demonstrating an enlarged and edematous pancreas, along with the presence of peripancreatic exudates, confirmed the presence of acute pancreatitis. The patien...