Malignant and benign causes of inferior vena cava (IVC) occlusion and compression are recognized. Cases of benign IVC compression with associated distal thrombus formation have not however been frequently described. We present two cases of benign external IVC compression associated with distal thrombus formation; one resulting from a giant, benign, hepatic cyst, and another due to pelviureteric junction obstruction, resulting in massive hydronephrosis.

INTRODUCTION Inferior epigastric artery (IEA) pseudoaneurysms are recognised complications of abdominal wall procedures, and a variety of approaches including surgical excision and ligation, percutaneous procedures and conservative management have been employed in treating this rare complication. METHODS We describe a case of an IEA pseudoaneurysm diagnosed on computed tomography (CT) angiography, 14 days following a laparoscopic assisted low anterior resection, which was managed successfully with surgical excision and ligation. A review of the literature identified 32 reports of this complication since 1973 with 69% of cases occurring since 2000. FINDINGS The main aetiology of IEA pseudoaneurysm was abdominal surgery (n=20); 65% of cases were attributable to abdominal wound closure or laparoscopic surgery. Two-thirds (66%) of patients presented between 11 and 63 days, and all except 1 case presented with discomfort, abdominal mass or haemodynamic instability. Colour Doppler ultrasonography was the imaging modality of choice (n=18), either alone or in combination with computed tomography and/or angiography. Surgical ligation and excision and percutaneous coil embolisation formed the mainstay of attempted treatments (69%), particularly following treatment failure using an alternative technique. CONCLUSIONS The incidence of iatrogenic IEA pseudoaneurysms appears to be increasing. Awareness of this rare complication is of clinical importance to avoid excessive morbidity for affected individuals.

It is widely recognised that children with Down syndrome have a broad range and a high prevalence of visual deficits and it has been suggested that those with Down syndrome are more likely to exhibit visual perception deficits indicative of cerebral visual impairment. This exploratory study aims to determine the prevalence of behavioural features suggestive of cerebral visual impairment (CVI) occurring with Down syndrome and whether the visual problems can be ascribed to optometric factors. A cohort of 226 families of children with Down syndrome (trisomy 21), aged 4–17, were invited to participate in a validated question inventory, to recognise visual perception issues. The clinical records of the participants were then reviewed retrospectively. A five-question screening instrument was used to indicate suspected CVI. The majority of the 81 families who responded to the questionnaire reported some level of visual perceptual difficulty in their child. Among this cohort, the prevalence of suspected CVI as indicated by the screening questionnaire was 38%. Only ametropia was found to have a significant association with suspected CVI, although this increased the correct prediction of suspected CVI outcome by only a small amount. Results suggest that children with Down syndrome are more likely to experience problems consistent with cerebral visual impairment, and that these may originate from a similar brain dysfunction to that which contributes to high levels of ametropia and failure to emmetropise. It is important that behavioural features of CVI are recognised in children with Down syndrome, further investigations initiated and appropriate management applied.

Gliomatosis peritonei is a rare complication of ovarian teratomas characterized by peritoneal implants of glial tissue. Glial tissue in such cases is usually low grade although there have been cases of malignant evolution described. There is no clear guidance as to how often and for how long these patients should be followed up. There are clear dose implications when performing multiple CT scans. We present a case of immature ovarian teratoma complicated by the development of low grade gliomatosis peritonei. The MRI appearances are presented and described, and we discuss the potential role of MRI in the follow up of such cases.

Deaf and hearing children's picture naming Impact of age of acquisition and language modality on representational gesture. This is the accepted version of the paper.This version of the publication may differ from the final published version.Permanent repository link: http://openaccess.city.ac.uk/21631/ Link to published version: http://dx. AbstractStefanini, Bello, Caselli, Iverson & Volterra (2009) reported that Italian 24-36 month old children use a high proportion of representational gestures to accompany their spoken responses when labelling pictures. The two studies reported here used the same naming task with (1) typically developing 24-46 month old hearing children acquiring English and (2) deaf children of deaf and hearing parents aged 24-63 months acquiring British Sign Language (BSL) and spoken English. In Study 1 children scored within the range of correct spoken responses previously reported, but produced very few representational gestures. However, when they did gesture they expressed the same action meanings as reported in previous research. The action bias was also observed in deaf children of hearing parents in Study 2, who labelled pictures with signs, spoken words and gestures. The deaf group with deaf parents used BSL almost exclusively with few additional gestures. The function of representational gestures in spoken and signed vocabulary development is considered in relation to differences between native and non-native sign language acquisition.