Umbilical anomalies arise from fetal structures such as the omphalomesenteric duct (OMD) or urachus or from failure of closure of the umbilical fascial ring. Persistence of the OMD may lead to several anomalies including umbilical sinus, umbilical cyst, Meckel's diverticulum, or patent OMD (POMD). A POMD is usually associated with the ileum, but rarely may be with the caecum or appendix. We describe a POMD of the vermiform appendix and discuss the possible pathogenesis and management.

Central nervous system involvement in tuberculosis is still common in developing countries and can present in a variety of clinical pictures. We report a patient with tuberculous meningitis combined with intra-cerebral tuberculomas, where the presence of unexplained urinary retention led to the discovery of an additional tuberculoma of the conus medullaris. The patient responded well to conservative treatment.

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DISCUSSIONAcute lymphoblastic leukemia can present with proptosis, secondary glaucoma, hetrochromia iris, hypopyon, hyphema, retinal detachment, microaneuresyms, isolated retinal hemorrhages, tortuous blood vessels, and swollen optic disc [1-5]. The differential diagnosis of the swollen optic disc includes benign intracranial hypertension (pseudotumor cerebri), papilledema due to mass lesion, malignant hypertension, optic neuropathy due to Graves disease, metastatic orbital lesion, optic neuritis, diabetes, meningioma, optic glioma, and infiltration of nerve heads with leukemia and lymphoma.

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