Caroli's disease associated with a gastric diverticulum.

Caroli's disease or communicating ectasia of the intrahepatic biliary tree is a rare disease with unknown aetiology. The coexistence of this along with the uncommon condition of a gastric diverticulum has never been reported before. A deficiency in the fibromuscular matrix of both the bile ducts and the gastric wall may explain why these two pathologies may coexist in a single patient.

Dengue haemorrhagic fever/dengue shock syndrome. An unwelcome arrival in Trinidad.

This is the first report of dengue haemorrhagic fever and dengue shock syndrome in Trinidad. Dengue infection was confirmed serologically or by viral isolation in five patients, aged 15 to 53 years, who presented with fever, thrombocytopenia and haemoconcentration. Three patients developed dengue shock syndrome, which was fatal; although there was no haemorrhagic tendency among these patients, bleeding occurred shortly before death in one of them.

Thyroid surgery without drainage: 15 years of clinical experience.

Drainage in thyroid surgery has been a routine but empirical practice with no scientific evidence to support its benefit. The largest series to date of non-drainage in thyroid surgery is presented, comprising 260 patients over a 15-year period. No case selection for non-drainage was employed.

Cutaneous histoplasmosis in the acquired immune deficiency syndrome--a report of three cases from Trinidad.

Three cases are reported of patients with the Acquired Immune Deficiency Syndrome (AIDS) and cutaneous histoplasmosis. Their initial presentation was that of a generalised maculopapular rash. Two patients were bisexual males and the third was an unmarried female.

Adenomyosis uteri: a study of 416 cases.

Adenomyosis was noted in 16% of 2,616 consecutive hysterectomy specimens examined during a 7-year period. Multiparas between the ages of 30 and 50 years were most commonly affected. Abnormal uterine bleeding was the common symptom.

Kaposi sarcoma in the acquired immune deficiency syndrome (AIDS), presenting as lymphogranuloma venereum (LGV) in a promiscuous trinidadian male.

A 27-year-old promiscuous male who denied homosexuality, intravenous drug abuse or having received blood transfusions, had disseminated Kaposi sarcoma. The aggressive nature of the tumor in a young man with the Acquired Immune Deficiency Syndrome (AIDS) presenting as lymphogranuloma venereum (LGV) is highlighted. The relation of the HTLV III virus to a diffuse membranoproliferative glomerulonephritis with sclerosis and associated hyaline degenerative changes in the juxtaglomerular apparatus are discussed.

Paracoccidioidomycosis in Trinidad.

Paracoccidioidomycosis is a systemic disease endemic to South America, but rarely recognised in other parts of the world. The patient we describe represents the first case of paracoccidioidomycosis observed in Trinidad.

Post-menopausal breast abscess.

Thirty post-menopausal women with breast abscess were treated at Port of Spain General Hospital, Trinidad, between 1976 and 1980. In this age group, breast abscess can be confused with cancer due to a lack of inflammatory features. History and physical examination are often not helpful in differentiating an abscess from carcinoma.

Breast disease in young West Indian women: an analysis of 1051 consecutive cases.

Our analysis of 1051 breast biopsies in West Indian women under the age of 30 y revealed that 99% of the breast lumps were benign. Fibroadenoma was the commonest (67%) lesion and there was a steady increase in the frequency of fibrocystic disease with age. Carcinoma in this group is therefore rare.

Actinomycosis of the liver.

We present our first case of actinomycosis in Trinidad and we believe this is also the first reported case of hepatic actinomycosis in the West Indies.

Dirofilariasis of the breast.

Sections of an adult filarial worm, probably Dirofilaria tenuis or related species were found within the breast tissue. This is the first human dirofilarial infection reported from Trinidad.

Massive proteinuria in light chain disease.

A 33-year-old man with overall renal function in the lower normal range had daily excretion in the urine of between 31 and 70 gm of protein composed entirely of free monoclonal K light chains. K light chains were also present in the serum. Serum protein electrophoresis and findings on bone marrow and lymph node biopsy were diagnostic of light chain disease.