The peritoneo-saphenous shunt for palliation of refractory ascites.

Objective: To describe a safe surgical technique for the management of refractory ascites.

Patients And Method: Two preterminal patients with respiratory compromise caused by refractory ascites had the long saphenous vein transected at mid-thigh and anastomosed to the peritoneum in the region of the internal inguinal ring. This allowed direct drainage of the ascitic fluid into the vascular system (peritoneosaphenous shunt).

Meningitis following fractures of the paranasal sinuses: accurate, non-invasive localization of the dural defect by direct coronal computed tomography.

A consecutive series of 30 patients admitted with non-meningococcal meningitis is presented. In all there was a history of preceding head injury. All 30 patients were investigated by direct coronal computed tomography (CT) scan to determine whether or not a site of fracture into a paranasal air sinus could be demonstrated.

Sacral nerve root entrapment demonstrated on computed tomography--'the winking ogre'.

Pictorial analogies are a descriptive modality often employed to convey radiological (as well as clinical and pathological) appearances. Examples of this useful descriptive device abound and many anatomical terms take their origin from such analogies. The cauda equina (horse's tail) and the uvula (grape) are but two classic examples.

Hepatotoxicity of paracetamol enhanced by ingestion of alcohol: report of two cases.

Two fatal cases of poisoning by paracetamol are described. Both patients were heavy imbibers of alcohol and both had swallowed less paracetamol that that generally regarded as a lethal dose. The biochemistry of paracetamol hepatotoxicity is outlined and the increased susceptibility of alcoholic patients to the hepatotoxic effects of paracetamol is remarked upon.