WEMJ Volume 115 No.4 - December 2016



Professor Peter Dunn has excelled himself again with more fascinating information about perinatal medicine. Two articles from his unpublished archive and a new article from Williams, A.N. and O’Dell, F.J., to which Peter has contributed.

Then a fascinating case of Otogenic lateral sinus thrombosis and remarkably good imaging followed by two student reports.

Another bumper issue just in time for Christmas!

Seasons greetings to all!


1) Massive Materno-Fetal Transfusion: an unusual case of neonatal polycythemia.  Peter M. Dunn, WEMJ Volume 115 No.4 Article 1 December 2016
Mrs. W, a gravida 5, aged thirty-three, was delivered at Southmead Hospital, Bristol, in March, 1969.  Pregnancy was uncomplicated.  A normal vertex delivery took place at thirty-nine weeks gestation.  The baby was a normally formed girl weighing 7lb 15oz with a length of 50cm and a head circumference of 35cm.  The placenta weighed 2lb 3oz and appeared normal.  The umbilical cord was clamped and divided at 30 seconds after delivery.  Mrs. W’s blood group was Group A, Rh positive. Baby N did not require resuscitation but was noted to be intensely plethoric and bloated at birth.      


2) Congenital Sternomastoid Torticollis: aetiology, diagnosis and management.Peter M. Dunn, WEMJ Volume 115 No.4 Article 2 December 2016

Congenital sternomastoid torticollis is a congenital postural deformity arising from obstruction to the venous drainage from that muscle by persistent pressure on the shoulder during late fetal life.  It occurs in 1 in 300 births   

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3) The ‘Gosset’ Icterometer: a brief history: Williams, A.N., O’Dell, F.J.,  Dunn, P.M. WEMJ Volume 115 No 4  Article 3 December 2016

Dr Isaac Henry Gosset (1907-1965) was the first consultant paediatrician for Northampton, with responsibilities which included both general and neonatal care. In 1954 for neonatal use he designed the ‘Gosset Icterometer’. Made of Perspex it allowed a rough estimation of serum bilirubin without requiring a blood test. Two successful clinical trials were published in the Lancet, these were amongst the earliest such papers in neonatal care. The ‘Gosset’ icterometer is no longer used in UK neonatal practice, however sixty years after inventing his device it is still in use in various countries around the world.   

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4) Otogenic lateral sinus thrombosis: Alenezi AO, Surana S.K., Walla, Khaled Shawky F.A., Al-Refai D, Mahesh Baj^.  CT and MRI imaging features WEMJ Volume 115 No 4  Article 4 December 2016

In this case report, we present a case of acute otitis media complicated by lateral venous sinus thrombosis and discuss the relative merits of the imaging investigations. 

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5) Service Evaluation: Bronchoscopic lung volume reduction using endobronchial valves for the symptomatic improvement of emphysema: Saveria Di Gerlando,(Medical Student, University of Bristol) WEMJ Volume 115 No 4  Article 5 December 2016

The r e s u l t s demonstrate significant improvement in clinical outcomes at 4 to 6 week follow up in those with total or sub-total target lobe collapse. 

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6) Myasthenia-like paraneoplastic syndrome secondary to suspected ovarian cancer: Ornjira Angkanawatana (Medical Student, Bristol University) WEMJ Volume 115 No 4  Article 6 December 2016

A 67-year-old woman presented with gradual onset non-fatigable slurred speech with dysphagia, diplopia, bilateral ptosis, and a right-sided facial droop and weakness particularly in her right arm.  

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Welcome to the West of England Medical Journal. This is the online journal of the Bristol Medico Chirurgical Society. The journal was formerly known as the Bristol Medico Chirurgical Journal and was first published in 1883.

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