2005

HC Chew, SH Lim
Correspondence: Dr Chew Huck Chin, chinnjing@pacific.net.sg

ABSTRACT
A 63-year-old woman presented at the emergency department (ED) with a history of increasing lethargy and drowsiness. The electrocardiogram (ECG) showed tall peaked T waves with broadening of the QRS interval, suggestive of hyperkalaemia. This patient had an elevated serum potassium level due to diabetic ketoacidosis. She was treated with intravenous calcium chloride and insulin with 50% dextrose. The ECG changes associated with hyperkalaemia are discussed, with illustrations from a second 48-year-old male patient with renal failure who presented with malaise, lethargy and generalised weakness.

Keywords: diabetic ketoacidosis, hyperkalaemia, tall T waves, widened QRS complex
Singapore Med J 2005; 46(8): 429-433

ME Aziz, NRN Yusof, MS Abdullah, AH Yusof, MI Yusof
Correspondence: Dr Mohd Imran Yusof, drimran@kb.usm.my; drimran93@yahoo.com

ABSTRACT
Persistent sciatic artery is a very uncommon embryological vascular variant. This case report highlights this rare vascular anomaly, diagnostic difficulty, complication and subsequent treatment in a 43-year-old man who presented with sudden onset of right leg pain for a few hours. He was unable to walk because of pain and numbness. Emergency right lower limb angiogram showed a large aneurysm that was initially thought to arise from the right common femoral artery, associated with thrombus formation within the right popliteal artery. A below knee amputation was performed due to worsening ischaemia of the right leg. The persistent right sciatic artery was later obliterated using percutaneous stenting and endovascular grafting, with deployment of two wallstents.

Keywords: aneurysm, embryological vascular variant, persistent sciatic artery
Singapore Med J 2005; 46(8): 426-428

S Gupta, R Sharma, R Kaushik
Correspondence: Dr Robin Kaushik, robinkaushik@yahoo.com

ABSTRACT
The chance finding of the vermiform appendix lying within an inguinal hernia occurs in approximately one percent of cases of inguinal hernia, and is known as an Amyand's hernia. We report a rare presentation of Amyand's hernia, where the appendix was found within the left hernial sac during surgery for an obstructed inguinal hernia in a nine-month-old male baby.

Keywords: acute abdomen, Amyand’s hernia, appendix, appendicitis, inguinal hernia
Singapore Med J 2005; 46(8): 424-425

YA Meunier
Correspondence: Dr Yann A Meunier, yannmeu@yahoo.com

ABSTRACT
Acute acquired cytomegalovirus (CMV) infection occurring in an 18-year-old Brazilian woman is reported. She presented with high fever, diarrhoea, colicky abdominal pain, vomiting, arthralgia and asthenia. CMV IgG Ab (151) and CMV IgM Ab were positive. ELISA was confirmed by immunofluorescence. The patient received symptomatic treatment and recovered fully. It is unusual to have features of infectious mononucleosis-like syndrome and gastrointestinal disorders in the same patient.

Keywords: cytomegalovirus, gastrointestinal disorders, infectious mononucleosis-like syndrome
Singapore Med J 2005; 46(8): 421-423