Gunshot liver trauma with disruption of the right hepatic duct managed by surgery, radiology, and endoscopy: a case report.

During the process of treating a complicated gunshot wound of an upper limb, chest, abdomen, and spine, there appeared--sometime after the initial treatment--a necrosis of the right hepatic duct in the bullet path within the liver. Although laparotomy was the life-saving operation during the first and second period, the final diagnosis and solution were based on bypassing the defect, i.e.

[Adenocarcinoma of the small intestine: a rare diagnosis--4 case reports].

The authors submit four case-histories of rare primary adenocarcinoma of the small intestine. The poor symptomatology and equivocal results of examinations caused a long delay of the final solution. As compared with data in the literature the submitted cases can be considered typical.

[Primary adenocarcinoma of the duodenum].

The authors describe a case of 60-year-old man with primary adenocarcinoma of the distal duodenum. The first, ex post assumed symptom, was haemorrhage into the gastrointestinal tract almost two years before the final diagnostic conclusion. The diagnosis was not correctly established even during subsequent examinations during progression of the disease and not even during the first surgical revision.

In vitro autoreactivity against skin and synovial cells in patients with juvenile idiopathic and rheumatoid arthritis.

In the present study we compared specific lysis of various autologous target cells in patients with juvenile idiopathic arthritis JIA; n = 8) or rheumatoid arthritis RA; n = 17) with those of healthy controls (n = 15). (51)Cr-release cytotoxic assay with autologous peripheral blood mononuclear cells as effector cells was used. When compared with controls, effector cells of patients with JIA or RA were found to lyse significantly autologous synovial cells (p < 0.

[Mini-invasive procedures in the treatment of complicated retroperitoneal hemorrhage in a patient with multiple injuries].

The authors present the case-history of a patient with multiple injuries where the dominating injury was haemorrhage into the retroperitoneum and subsequently into the abdominal cavity. The solution after CT and sonographic diagnosis was laparoscopy and subsequent arteriography with embolization. The authors consider the described procedures as the most suitable one in the given case.

[Our experience with a conservative treatment of the blunt injuries of the liver and the spleen.].

Indication for conservative treatment in the blunt injuries of the liver and the spleen have been recently significantly extended. On the example of the case histories and discussion in the literature the authors specify the necessary conditions, difficulties and results of this procedure. Key words: conservative treatment, injury of the liver, injury of the spleen.

[Blunt injury of abdomen as a part of polytrauma.].

In the period from 1 July till 31 August 1998 Central Military Hospital Praha treated 28 multiply injured patients (with polytrauma including blunt injury of abdomen, of which 27 were operated on and 1 patient was treated conservatively. The mean injury severity score was 39.3.