Hong Kong Journal of Emergency MedicineWith the advance in diagnostic radiology, penetrating atherosclerotic ulcers of the aorta become increasingly recognised in our daily practice. However, their natural history and treatment are not well defined. We report a case of penetrating atherosclerotic ulcer at the aortic arch and review the literature. (Hong Kong j. emerg.med. 2009;16:246-251)

We report three cases of choledochal cyst. The calibre of the common bile duct in each of them was demonstrated by ultrasonogram, CT scan, radiography and laparotomy to be almost normal before recurrent attacks of pancreatitis, following which the common bile duct was shown to become grossly dilated. This observation leads us to surmise that recurrent pancreatitis contributes to the formation of choledochal cysts.

A 70-year-old man developed ventricular tachycardia after consumption of a self-prescribed dose of Chinese herbal medicine containing Chuanwu and Fuzi. He made a good recovery after initial resuscitation in Accident and Emergency department (A&E) as well as supportive treatment in CCU. This case report demonstrates the initial resuscitation of patient with Chuanwu poisoning, discuss its pathophysiology and variety of treatment.

The purple urine bag syndrome, purple discoloration of urine, is an uncommon and alarming condition in patients requiring long-term urinary catheterization but the clinical course is usually benign. We report two cases of the syndrome with a literature review on its aetiology and management.

Sibutramine is a slimming agent and acts on reducing appetite and increasing satiety. It was withdrawn from the market worldwide , including Hong Kong, since November 2010 due to its side effects on the cardiovascular system. However, sibutramine is still commonly found as adulterant in the slimming medications which could be bought from internet or over-the-counter. A Chinese healthy young lady developing sudden cardiac arrest after taking sibutramine for weight reduction is described.