The free jejunal graft in head and neck reconstruction.

Reconstruction of the pharynx and cervical esophagus presents a tremendous surgical challenge to the Head and Neck Surgeon. Over the past 2 years the free jejunal graft with microvascular anastomosis has been used in 12 consecutive cases. Careful follow-up included not only clinical assessment, but regular radiographic evaluation, as well as fiberoptic esophagoscopy and biopsy of the jejunum.

Hepatorenal syndrome: reversal by peritoneovenous shunt.

Two patients with hepatorenal syndrome were treated by insertion of a peritoneovenous shunt. The renal deficit was corrected rapidly in both cases. A 62-year-old woman with a slow onset syndrome with urine output of 100 to 150 ml/day and urinary sodium excretion of 1 mEq/day responded with large volume urinary output and sodium excretion.