HYSTERICAL ABDOMINAL DISTENTION SIMULATING ACUTE INTESTINAL OBSTRUCTION: WITH REPORT OF A CASE

In hysterical abdominal distention the symptoms may so closely simulate those of obstruction of the bowel that needless laparotomy is carried out.Clues that indicate hysterical distention rather than organic cause are: (1) History of vomiting but without dehydration; (2) complaint of severe pain although temperature, pulse and the number of leukocytes in the blood all are normal; (3) normal tympanic quality of the abdomen; (4) distention out of proportion to the amount of gas observed in x-ray examination; (5) pronounced lordosis caused by thrusting the abdomen forward; and (6) remission of distention when the patient is under general anesthesia.It must be remembered, however, that even when there is strong suspicion of hysterical cause, distention may actually be due to obstruction. In the case herein reported, obstructive adhesion finally did occur after the patient had had numerous exploratory operations in which the viscera were observed to be normal.     

成人肾恶性横纹肌样瘤的研究:1例报告及文献复习

应用组织化学、免疫组织化学及电镜技术对我国首例成人肾恶性横纹肌样瘤（ｍ ａｌｉｎｇａｎｔｒｈａｂｄｏｉｄｔｕｍ ｏｒ, ＭＲＴ） 进行了研究, 与婴幼儿ＭＲＴ相比本例有以下临床病理特点： （１） 以血尿为早期和唯一症状,肿块缺乏特征性ＣＴ 改变; （２） 光镜下大量ＰＡＳ阳性嗜酸性球形小体多位于细胞外, 电镜下细胞外小体由微丝构成并有界膜包绕; （３） 免疫组化显示肿瘤细胞向神经外胚层、横纹肌和组织细胞多向性分化; （４） 肿瘤侵袭力较低, 高度表达ｎｍ ２３－Ｈ１ 蛋白, 随访１８个月术后化疗效果佳, 提示其恶性度较婴幼儿ＭＲＴ 低。     

ISOLATED ANOMALOUS INFERIOR VENA CAVA CONNECTION TO THE LEFT ATRIUM: REPORT OF A SUCCESSFUL SURGICAL CASE AND REVIEW OF THE LITERATURE

This report describes a rare case of isolated anomalous connection of the inferior vena cava to the left atrium. Patching of a surgically-created atrial septal defect and rerouting of caval drainage ino the right atrium effected a successful correction. This case brings to 18 the total number of reported cases in the literature in which the inferior vena cava was connected to the left atrium.