Hepatoma in pregnancy.

We present the third case of hepatoma in pregnancy to be reported in an African. Despite the high incidence of hepatoma in the male population, hepatoma complicating pregnancy is very rare in this environment. Death usually occurs within one year of onset of symptoms.

Pulmonary radiological findings in hepatoma.

Pulmonary radiological features of 27 patients with a diagnosis of hepatoma were reviewed and compared with 64 controls. Coin shadows, nodular, lymphangitic or hilar node metastases were observed in 50% of the hepatoma cases. Other radiological pulmonary findings in hepatoma included statistically significant elevation of the right hemidiaphragm, double contour of the diaphragmatic silhouette and discoid atelectasis.

Unfolding of the aorta (aortitis) associated with pulmonary tuberculosis.

Dilatation of the thoracic aorta was observed in a significant number of normotensive tuberculous patients below the age of 40 years. Histological examination in a selected number of patients showed a non-specific aortitis. It is suggested that aortitis is probably due to an auto-immune response related to pulmonary tuberculosis and that tuberculosis should be recognized as a common cause of unfolding of the aorta in the African.

Cervical spondylosis and dysphagia.

Spondylosis can lead to dysphagia in the elderly. In these patients pressure of solid food on the osteophytes very probably induces pain and cricopharyngeal spasm, and a transient sharp cut-off is seen in the barium column at fluoroscopy. Three cases are presented and it is suggested that this triad should be looked for in all elderly patients with cervical spondylosis.

Atypical radiological presentations of pulmonary tuberculosis.

Unfamiliar manifestation of pulmonary tuberculosis found in Central and West Africa are presented. These include egg shell calcification in parenchyma and glands, calcification of the diaphragmatic pleura resembling asbestosis, honeycombing and B Kerley's lines with or without complicating bronchiectasis. There should be an index of suspicion of pulmonary tuberculosis even when other typical tuberculous lesions are not associated with these lesions not normally attributed to the disease.

Bilharzial hydronephrosis: a clinicoradiological study.

I have studied 68 patients with hydronephrosis. Except when complicated by infection, calculosis, cancer and severe strictures, function at excretory urography was relatively good even in advanced cases of hydronephrosis. In Zambia, Central Africa the intensity of infection and the disordered ureteral motility are the most important factors in the pathogenesis of bilharzial hydronephrosis.

Cerebral angiography in Central Africa.

Based on the findings from angiograms done over a 4-year period in Zambia, the most common indications were cerebrovascular disorders, head injuries, infective lesions, epilepsy and intracranial tumours. A few patients were also investigated for headache and vomiting, visual symptoms and papilloedoma. The overall positive yield at 23% was high.

Traumatic aneurysms and arteriovenous fistulas in Nigeria.

Traumatic aneurysms and arteriovenous fistulas may be as common in the developing and less industrialized countries as they are in the developed countries. In a 4 year period 12 cases of traumatic aneurysms and arteriovenous fistulas were seen at the University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria. Nine of these resulted from civilian injuries while 3 were due to military activities.

Angiography of stroke in Central Africa.

Stroke is prevalent in Africa, hypertension being the most common underlying cause. Yet in 113 patients suffering from this condition who were investigated with cerebral angiography in Zambia, abnormalities were found in 46 patients of whom only six were hypertension. Atherosclerosis was rare, seen only in four patients.

Incidence of peptic ulcer in the Zambian African - a radiological study.

Five hundred and sixty-eight (568) consecutive barium meal examinations have been studied. 152 showed peptic ulcer. There were 146 duodenal and six gastric ulcers.

Tropical vasculitis and tuberculosis.

Attention is drawn to the association of Tropical aortitis, or vasculitis with active or previous tuberculous infection. This suggests that the two diseases may be related. It is recognised that environmental factors may be important since the incidence of this complex appears to be high in the indigenous populations of Southern and Central Africa and uncommon in people of African origin in industrialised nations.

Wilson-Mikity syndrome--a case report.

We present a premature infant given oxygen at birth for transient respiratory distress with persistent radiological findings and no apparent subsequent clinical abnormality. These features are consistent with Wilson-Mikity syndrome which we describe as the first case report from Zambia.

Evaluation of the physiological function of the ureter by fluoroscopy in bilharziasis.

Of 40 cases of bilharziasis of the urinary tract examined by excretory urography, 26 (65%) showed evidence of abnormal ureteral motility. Although the severe ureteral dilatation of bilharziasis is generally believed to be caused by fibrotic strictures, only 2 strictures were seen. Abnormal peristalsis was also found in ureters which were not dilated.

The less familiar manifestations of schistosomiasis of the urinary tract.

One hundred and fifteen patients with schistosomiasis of the urinary tract were studied. Sixty-five percent of the ureters showed striking deformities, including medial deviation, a straight lumbar course, and in the pelvic segment a bowed appearance with medial and cranial displacement at the vesico-ureteric junction. This appearance, which resembles a "cowhorn", is due to fiborsis the bladder trigone.

Assessment of transvenous right atriography in the diagnosis of pericardial effusion.

From our results, we feel that transvenous right atriography is a reliable confirmatory investigation of pericardial effusion. The procedure is simple and can be carried out in any hospital. Spurious positive results may arise from faulty technique or due to marked pericardial thickenning whilst false negatives may be enountered with viscid, inspissated or loculated pericardial effusion.

The layered pyelogram in hydronephrosis.

Fifty patients were studied with erect films at excretory urography. Twenty-eight had hydronephrosis, bilateral in two cases; a total of 30 hydronephrotic kidneys were therefore investigated. Thin layers of contrast medium were shown in the dilated calyces in 29 of the 30 kidneys.