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Cases Approach to the patient Case 1 Postoperative dyspnoea Case 2 Inside out Case 3 A wound leak Case 4 Postoperative infection Case 5 An inflamed neck Case 6 A sore neck Case 7 Hidden infection Case 8 Burnt thorax Case 9 Burn treatment Case 10 Lumps on the scalp Case 11 A lump on the wrist Case 12 Recurrent abscesses over the sacrum Case 13 A septic great toe Case 14 A skin tumour Case 15 Two men with facial ulceration Case 16 A pigmented spot on the face Case 17 A pigmented skin lesion that has got bigger Case 18 A lump on the chest wall Case 19 A patient with a chest drain Case 20 A fatal lung disease Case 21 A pulsating abdominal mass Case 22 Abdominal bruising Case 23 A painful calf Case 24 Black toes Case 25 A useful instrument in vascular surgery Case 26 A young woman with cold hands Case 27 A complication of varicose veins Case 28 A chronic leg ulcer Case 29 Another leg ulcer Case 30 A cerebral mass on magnetic resonance imaging Case 31 A cerebral vascular catastrophe Case 32 A baby with a large head Case 33 A blow to the skull Case 34 A severe head injury Case 35 Another severe head injury Case 36 A spinal abnormality in a newborn child Case 37 Back injury Case 38 A lacerated wrist Case 39 A hand deformity Case 40 A deformed finger Case 41 A boy with a droopy eyelid Case 42 A lump on the lip Case 43 A white plaque on the tongue Case 44 A baby with two gross congenital deformities Case 45 A painful submandibular swelling Case 46 A lump over the angle of the jaw Case 47 A patient with difficulty swallowing Case 48 Another patient with difficulty swallowing Case 49 A third patient with difficulty swallowing Case 50 Heartburn Case 51 A fateful vomit Case 52 Vomiting in a baby Case 53 A gastric ulcer Case 54 A bloody vomit Case 55 An acute abdominal emergency Case 56 A serious gastric lesion Case 57 A surgical specimen of stomach Case 58 An acutely painful, distended abdomen Case 59 Neonatal intestinal obstruction Case 60 A very constipated small boy Case 61 A painful distended abdomen in an old man Case 62 An unusual case of severe rectal bleeding in a child Case 63 An abdominal mass in a young man Case 64 A striking and diagnostic facial appearance Case 65 Acute abdomen in a medical student Case 66 Yet another mass in the right iliac fossa Case 67 A symptomless finding on a barium enema examination Case 68 Ulcerative colitis Case 69 A complication of longstanding ulcerative colitis Case 70 A very old woman with an abdominal mass Case 71 A patient with subacute obstruction Case 72 A pathological anal verge Case 73 A painful mass at the anal verge Case 74 Another painful mass at the anal verge Case 75 An agonizing anal verge Case 76 A very painful buttock Case 77 A patient with recurrent perianal sepsis Case 78 A prolapsing anal mass Case 79 An ulcer in the rectum Case 80 An ulcer at the anal verge Case 81 A large swelling in the groin Case 82 A groin lump in an old woman Case 83 A lump at the umbilicus Case 84 A swelling in the abdominal wall Case 85 A jaundiced and very ill patient Case 86 A postmortem finding Case 87 A man with a grossly swollen abdomen Case 88 A massive haematemesis Case 89 A schoolmistress with attacks of abdominal pain Case 90 A collection of calculi Case 91 A patient with jaundice and interesting physical signs Case 92 The patient in Case 91 has surgery Case 93 A giant abdominal mass Case 94 A severe abdominal injury Case 95 A painless lump in the neck Case 96 Swollen legs in a young woman Case 97 A frightened girl with a breast lump Case 98 Breast screening Case 99 An ulcerating breast lesion Case 100 A sinister break Case 101 A woman with a sore nipple Case 102 A painless lump in the neck Case 103 A young immigrant with a lump in the neck Case 104 A lump in the neck that moves on swallowing Case 105 A woman with an obvious endocrine disease Case 106 A mass of cervical lymph nodes Case 107 A rapidly enlarging mass in the neck Case 108 A patient with colic, and its underlying endocrine cause Case 109 A girl with hirsutes Case 110 Congenital disease of both kidneys Case 111 Haematuria of sinister origin Case 112 A gross congenital abnormality Case 113 A bladder stone found at autopsy Case 114 An insidius cause of lumbago Case 115 A man with difficulty passing urine and with an interesting X-ray Case 116 Sciatica with a sinister cause Case 117 A patient with a very distended bladder Case 118 A foreskin problem in a child Case 119 An ulcerated prepuce Case 120 A missing testis Case 121 A swelling in the scrotum Case 122 Two examples of testicular tumours Case 123 A renal transplant recipient with a gastrointestinal haemorrhage