Primary hyperparathyroidism : a diagnostic and operative problem

Early diagnosis and early surgery for primary hyperparathyroidism are of paramount importance. Various aids are available for both and have been discussed. Clinical features including nephrolithiasis and peptic ulceration are also described. Furthermore, bone pain is a relatively common symptom. Progression of the disease leads to progressive deformity, like kyphosis, bowing of the limbs. Whatever the presenting feature or features of primary hyperparathyroidism, the adenoma or adenomata must be removed. Parathyroid adenoma will eventually cripple the patient and kill him. An endeavour has been made to show pitfalls and disagreements in the laborious progression from clinical suspicion, biochemical confirmation of the diagnosis to surgical extirpation.peer-reviewe