Acute abdomen and angioedema: a classic presentation
by Mohamad Hachem, Thomas Rix and Salem Shubber
Hereditary angioedema (HAE) is an infrequent disorder characterised by abnormalities in the levels and/or function of complement C1 esterase inhibitor (C1 INH). Clinical manifestations of HAE are due to recurrent episodic swelling of the subcutaneous or submucosal tissue. When swelling involves the gastrointestinal mucosa, patients may present with nausea, vomiting, diarrhoea, and severe abdominal pain. However, HAE is almost never suspected as a potential cause of acute abdomen. We describe a typical case of hereditary C1 esterase inhibitor deficiency in a 37-year-old woman presenting with recurrent acute abdomen and who had undergone negative surgical interventions before diagnosis was eventually established. Both the diagnostic and therapeutic approach to this rare condition is discussed in this report. (Accident and Emergency Medicine, Surgery (including Trauma); 28th March 2007) More...

Severe penetrating neck injury, successfully repaired epiglottis
by V. Savinsky and G. Roshchin
Penetrating traumatic laryngeal--pharyngeal injuries are relatively rare and traumatic injuries to the epiglottis are extremely rare. The incidence varies between countries. Most of these cases are dealt with by ear, nose and throat specialists, and trauma surgeons deal with such trauma when concomitant injury is present. In our institution laryngeal--pharyngeal trauma occurs 3--5 times per year. The literature records one case of penetrating injury to the epiglottis with complete transection but without an attempt at surgical repair [1]. This report describes a traumatic laceration with subtotal trans-section of epiglottis which was successfully repaired.
(May 25th 2006) More...

Bilateral scapular fractures following low voltage electrocution
Musculoskeletal injuries following low voltage electrocution are extremely rare. We present the case of a 54-year-old gentleman who had an accident while working with 240-volt live wires. The absence of any associated trauma should not rule out the presence of scapular fractures in such cases.(May 2004) More...

Blunt abdominal trauma with unexpected anaphylactic shock due to rupture of hepatic cysts A 12-year old girl with abdominal trauma was admitted to an emergency department in Turkey in a state of anaphylactic shock due to a traumatic spillage of hepatic hydatid cyst fluid. (April 2002) More...