VILLOUS ADENOMAS WITH ELECTROLYTE DERANGEMENT.
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Biomedical subjects
Publications and source records attributed to A B WILKINSON.
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Sixteen cases of verified Cushing's syndrome, and twelve cases of probable Cushing's syndrome were reviewed and data on them were compared with various reports on Cushing's syndrome in the literature. The diagnosis hinges upon a high index of suspicion, and one or several of the major criteria may be lacking. Ultimate establishment of correct diagnosis should be based largely on the clinical features, although stimulation and suppression tests may help to confirm a clinical diagnosis. In well-established clinical cases, with borderline laboratory confirmation, exploration may be justified, especially if tests fail to identify a specific cause. In cases of adrenal cortical tumor, all pathological tissue should be removed if possible, with great care to support and stimulate the remaining atrophic adrenal gland during and following operation. In cases of bilateral adrenal cortical hyperplasia, the problem is one of how much to remove. At present most investigators advocate radical subtotal resection, leaving less than 10 per cent of one side.
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Complete obstruction of the circulation to the lower extremities by lodgement of an embolus at the bifurcation of the aorta requires early surgical intervention if life is to be preserved and function retained.A summary of thirteen cases of aortic embolism is presented, including three apparently new etiologic factors. The literature is reviewed, and current cases compared with previously reported cases. A detailed report of aortic saddle embolus arising from auricular fibrillation in the absence of organic heart disease, and with complete return to health and heavy work, is reported.
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