An unusual case of pancreatic cancer with leptomeningeal infiltration.

Introduction: Pancreatic cancer is a common malignancy and often presents at an advanced stage. Metastases are common but neurological involvement is rare. We aim to describe an unusual case of leptomeningeal involvement from pancreatic cancer.

Percutaneous endoscopic gastrostomy in a military hospital.

Percutaneous endoscopic gastrostomy (PEG) is a simple, relatively safe and cost effective means of establishing enteral access for patients requiring long term nutritional support. PEG has several advantages over surgical gastrostomy and should be considered the procedure of choice for long term enteral therapy in appropriate patients. At the Queen Elizabeth Military Hospital (QEMH) between June 1992 and October 1993 thirteen percutaneous endoscopic gastrostomies were successfully performed.

A case of factitious fever and 'epilepsy'.

We describe the case of a 23 year old male who presented with a history of intermittent pyrexia associated with apparent episodic loss of consciousness. During these events, thermometers placed in the rectum and axillae supported the elevated oral temperature readings. After numerous investigations including electroencephalography had excluded organic disease, the patient was observed applying a hot douche to his rectum prior to his temperature being recorded.

Chronic pancreatitis in the British Army 1978-1989.

A retrospective study was made of all 28 soldiers with chronic pancreatitis first diagnosed between 1978 and 1989. All patients were male, alcohol was the aetiological factor in 90%, the mean age at diagnosis was 30 and the commonest mode of presentation was with recurrent painful episodes of pancreatitis. Endocrine and exocrine pancreatic insufficiency occurred in a quarter and a third of patients respectively and one third required surgical intervention.