Metastasis to the pancreas--an indication for pancreatic resection?

Background And Aims: Isolated metastatic involvement of the pancreas is very rare. To evaluate the possible benefit of surgery, we retrospectively analyzed patients that underwent pancreatic resection for metastases into the pancreas.

Patients/methods: In 12 patients (8 men and 4 women), metastatic disease was treated by pancreatic resection (two total pancreatectomies, nine pylorus-sparing duodenopancreatectomies, and one left-side pancreatic resection) between 1993 and 2005 at our institution.

Treatment of bilateral elbow dislocation using external fixation with motion capacity: a report of 2 cases.

Bilateral elbow dislocation is a rare injury and only 11 cases are described in the literature, including 8 patients with isolated ligamentous and 3 patients with an additional osseous injury. We present 2 cases of bilateral posterior elbow dislocations treated with a bilateral hinged elbow fixator with motion capacity to allow for early physiotherapy. Both patients had a high-energy trauma with one who fell off a ladder from a 5 m height and the second from a mountain bike injury during off-road biking.

Duodenal somatostatinoma: clinical and immunohistochemical patterns--difficult differential diagnosis in regard to gangliocytic paraganglioma: report of a case.

The authors report a large duodenal somatostatinoma, a very rare tumor entity. A 8.5 cm globular mass in the area of the unicate process of the pancreas was detected in a 45 year old caucasian female by computerized tomography.

[Neoadjuvant chemotherapy of primary hepatic non-Hodgkin's lymphoma].

Background: Since primary malignant lymphomas of the liver represent a rare entity, no commonly accepted therapeutic strategy has been developed so far.

Case Study: We report the case of a diffuse large-cell B-cell lymphoma of the liver in a 48-year-old female patient. The tumor presented as a solitary mass measuring 12.

Immunomagnetic enrichment and detection of micrometastases in colorectal cancer: correlation with established clinical parameters.

Purpose: Micrometastatic disease in bone marrow is of prognostic significance in colorectal cancer patients. However, detection rates of standard immunocytology are relatively low. We used magnetic activated cell sorting (MACS), a highly sensitive method, to increase detection rates and correlated the presence of cytokeratin (CK)-expressing cells with clinical parameters.

[Surgical palliation of pancreatic carcinoma. Results of a 7 year period].

Introduction: High perioperative complication rates in the 1980s led to preferred use of endoscopic therapy for surgical palliation of pancreatic cancer. This encouraged us to analyse our own patients retrospectively.

Material And Methods: In the period from 1 January 1992 to 31 December 1998, 253 patients with an exocrine carcinoma of the pancreas were operated on at the St.

Two cases of colorectal cancer complicating Crohn's disease and review of the literature.

Two cases of colorectal carcinoma complicating Crohn's disease are reported and the relevant literature is reviewed. It is important to be aware of this increasing complication and the specific group of patients at risk. Special attention to possible malignant transformation could lead to earlier diagnosis and treatment.

[Possibilities of surgical and drug therapy of parasitic cholestasis].

Out of 123 patients with hydatid-disease of the liver in 15 patients biliary engorgement by compression from cysts or parasites in the biliary system were observed. Diagnosis can be established by serology, sonography, scintigraphy, ERCP and CT. Invasive diagnostic procedures are not indicated.

[B II-Y-Roux anastomosis--resection procedure of choice in complicated ulcer?].

43 patients with complicated gastric, duodenal or anastomotic ulcers resected according to Billroth II-Roux were controlled clinically, by endoscopy and X-ray. Little amounts of bile acid were found in only one case. Two groups with different pH-values were verified: 6 patients with pH from 1.

[Stress-induced haemorrhages in intensive care patients (author's transl)].

An analysis of the case material of the intensive care unit of the Department of Surgery showed haemorrhages from acute gastro-duodenal lesions in 8% of the cases. Control of the bleeding by therapeutic lavage with suspensions of antacids was the more effective the higher the frequency of application. Prophylactic lavage with antiacids in patients liable to develop gastric bleeding succeeded in reducing the incidence of this complication to 1%.

[Binding capacity of sex hormone binding globulin and corticosteroid binding globulin in serum of male patients with liver cirrhosis (author's transl)].

The binding capacities of SHBG and CBG were measured by agar gel electrophoresis in 63 men with cirrhosis of the liver and in 42 healthy male subjects. The normal range (X- +/- 2s) for SHBG was 8.3-17.

[Endoscopic transpapillary splitting of a choledochocele (author's transl)].

A choledochocele with obstruction to outflow from the biliary and pancreatic duct systems was diagnosed by endoscopic retrograde cholangio-pancreatography in a 67-year-old man with radiating upper-abdominal pain and constantly elevated gamma-glutamyl transferase. After distension of the choledochocele with contrast medium a papillotome was introduced across the papilla and the choledochocele was split open. There were no complications and flow from both systems became normal.

[Lens induced myopia in steroid cataracts (author's transl)].

Longterm investigations of patients on immun-suppressive corticosteroid therapy showed that the development of advanced corticosteroid cataracts is accompanied by a marked increase of lens myopia up to 7.5 dpt. It can be assumed that this phenomenon is due to the optical effect of the discoid posterior subcapsular opacities.

[Surgical management of liver trauma (author's transl)].

Surgical management and follow up of 85 patients with liver trauma are reported. 20 patients had only liver trauma, all others were polytraumatised. Letality was 20% in patients with sole liver trauma, the overall letality was 43%.

[Radiological lung changes after thoracoabdominal surgery in the lateral decubitus position (author's transl)].

Radiological changes that may occur in the depenent lung when surgery is performed in the lateral position are generally of a transient nature; they disappear when the position of the patient is changed after the operation, but may, in some cases, be demonstrable post-operatively as atelectatic areas. From the second post-operative day onwards, and reaching a peak on the 5th post-operative day, there is an increased incidence of ventilatory disturbances and infiltrations. The course and distribution of these pulmonary disturbances point to post-operative immobilization in the recumbent position as the main causal factor.

[Cataract during intermittent hemodialysis. The influence of hypocalcemia on the development of opacities (author's transl)].

Twenty uremic patients on intermittent hemodialysis were followed up for lens changes over 4-53 months. Only one patient of 22 years with megaureters and megacystis developed bilateral anterior and posterior subcapsular cataracts during dialysis treatment. The morphology of these cataracts was similar to that of fresh hypocalcemic opacities.

[Psychopathological findings and social psychiatry problems in patients with transplanted kidneys].

Chronic haemodialysis and kidney transplantation reveal a great number of psychological and psychiatrical problems and tasks. As there are special psychological problems and many psychoreactive symptoms and the fact that haemodialysis and kidney transplantation are strain situation in themselves, one should examine the question of capability, and often a psychiatric or psychotherapeutic treatment is necessary. Authors examined twelve patients who had undergone kidney transplantation, regarding their psychopathological and social-psychiatrical status.

[Corticosteroid cataracts following kidney transplantation. Investigations on the influence of additional factors upon the development of opacities (author's transl)].

15 patients with kidney transplants were followed up for a period of 3 to 45 months. All but one developed lenticular opacities in the posterior subsapsular region. The opacities were classified according to their severity.