Transient ischaemic attacks and stroke due to extracranial aneurysm of internal carotid artery.

tenderness. The serum amylase was 4,500 Somogyi units and the blood urea was 36 mg/100 ml. She was treated with intravenous fluids and antibiotics. Three days after admission her urine output began to fall. Her serum calcium fell to 7-6 mg/100 ml. After 10 days her blood urea was 346 mg/100 ml, and intermittent haemodialysis was begun. Laparotomy next day confirmed the diagnosis of pancreatitis. Intermittent haemodialysis was maintained for the next two weeks, when a diuresis occurred. She then made a rapid recovery and was discharged from hospital seven weeks after admission. She was readmitted four months later with a mild attack of pancreatitis, and eight months after her first illness she was readmitted for a second time when a laparotomy and cholecystectomy were performed. The gall bladder contained multiple faceted stones. She remained well one year later. A 60-year-old training officer was admitted with central abdominal pain and vomiting. There was abdominal tenderness and guarding. The serum amylase was 7,100 Somogyi units and the blood urea was 45 mg/100 ml. He was treated with analgesics, antispasmodics, antibiotics, and intravenous fluids. He remained well until two days after admission, when he became confused. His blood urea was 101 mg/100 ml, amylase 4,500 Somogyi units, and serum calcium 5-3 mg/100 ml. He was treated with additional intravenous calcium. Four days after admission he was very ill and confused, with bilateral pleural effusions, a-soft silent abdomen, and a strongly positive Grey-Turner's sign in both flanks. The blood urea was 193 mg/100 ml, calcium 6-0 mg/100 ml, amylase 1,300 Somogyi units, and the white cell count was persistently high. Peritoneal dialysis was begun and continued for the next 10 days. He was also treated with intravenous glucagon (Knight et al., 1971). Despite dialysis his blood urea rose to 365 mg/100 ml on the next day, and he was comatose and unrousable. He was passing altered blood per rectum and fresh blood was aspirated from the nasogastric tube. He was treated with blood transfusion. The blood sugar rose to 800 mg/100 ml and small doses of insulin were given. He developed an Escherichia coli bronchopneumonia, and was given ampicillin, kanamycin, and oxygen. He remained in this grave condition for the next three days and then began to show slow improvement. Two weeks later he managed to take a little food. One month after admission he developed a swinging pyrexia, and an abdominal mass …