Spontaneous vaginal drainage of a pelvic abscess: an unusual presentation of perforated appendicitis.

We report a child with the unusual presentation of spontaneous vaginal drainage of a pelvic abscess after nonoperative management of perforated appendicitis. Although drainage through the rectum has been previously described, this is the first report of spontaneous transvaginal drainage of a pelvic abscess from appendicitis in a child.

Ovarian Sertoli-Leydig cell tumor with retiform pattern.

Sertoli-Leydig cell tumors (SLCT) are sex cord-stromal tumors which exhibit testicular differentiation.1 They account for less than 0.2% of ovarian neoplasms in total but comprise 4% of ovarian tumors in females under 20 yrs of age.

Chronic lithium neurotoxicity presenting as Parkinson's disease.

A 71 year old man who had been on lithium for 9 years for mania presented with an encephalopathic illness which was almost certainly due to lithium intoxication. Having recovered from this acute episode (although he was left with some sequelae) he was recommenced on lithium for his manic symptoms with a careful control of his blood levels. After remaining fairly stable for 8 years he presented with features suggestive of Parkinsonism and was admitted to hospital for investigation.

Hypergastrinemia, gastric endocrine cell hyperplasia, and intractable diarrhea.

A patient with pernicious anemia developed severe intractable diarrhea night and day. Investigation revealed chronic atrophic gastritis and a markedly elevated level of serum gastrin. No obvious explantation for the diarrhea was found, but after antrectomy, the gastrin level returned to normal and the diarrhea subsided.