Chronic nausea as the leading symptom: an indication for double-contrast examination of the upper intestinal tract following normal gastroscopy.

We report a patient with chronic nausea as the leading symptom of a primary carcinoma of the duodenum located at the flexura duodeno-jejunalis. The tumour was not reached at gastroscopy, which was performed twice. Since this area usually cannot be seen upon gastroscopy or upon small bowel enteroclysma according to Sellink, a double-contrast investigation of the upper gastrointestinal tract using a hypotonic agent should be performed when nausea persists although gastroscopy is normal.

[Surgical treatment of sigmoid diverticulitis].

Unlabelled: From 1972 to 1982 113 patients suffering from diverticulitis of the sigmoid colon were admitted to our hospital. 63 patients underwent conservative-, 50 patients surgical therapy (23 emergency procedures, 27 elective operations).

Complications: 8 times free perforation, 15 times retroperitoneal abscess formation, 6 times haemorrhage, 3 times fistulae to the urinary bladder, 9 patients suffered from acute obstruction of the bowel.

[Immediate or interval operation of acute cholecystitis in patients over 70].

Among 1372 cholecystectomies there were 152 patients suffering from acute cholecystitis. 54 patients were over 70 years of age. On suspecting a free or covered perforation surgery took place immediately (11 patients).

[Primary fibrotic bile duct stenosis].

The author reports about five patients suffering from a primary fibrotic stenosis of the biliary system. All patients were assigned into hospital with a painless jaundice. In all cases a diagnosis was secured histologically.