Marked individual variations in normal pancreas volume were observed. Pancreatic volume could be computed using the diameters measurable by the cross-sectional imaging employing the formula: V = (AP(tail) + AP(body))/2 × L(body&tail) × CC(body) + (AP(head)/2)2 × 3.14 × CC(head).

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The aim of this retrospective study was to present and compare the results of using two different types of esophageal self-expanding stents (uncovered and covered) for palliative treatment of patients with inoperable malignant stenosis of the esophagus and cardia. Over a period of 8 years, 152 patients underwent fluoroscopically guided insertion of metal esophageal stents. We inserted uncovered esophageal nitinol Strecker stents in 54 patients (group I) and covered esophageal Ultraflex stents in the remaining 98 patients (group II). The stent insertion procedure was successively performed in all patients. Closure of esophageal fistula by covered stents was achieved in 8/8 patients. Mean dysphagia score was significantly decreased in both patient groups at 4 weeks follow-up: from 2.73 before stent insertion to 0.15 in group I, and from 2.67 to 0.05 in group II (on 0-4 scale). Eighty-eight per cent of patients with covered stents and 54% with uncovered type were free of symptoms during follow-up. Complications occurring during follow-up and their comparative frequency in the two groups of patients were as follows (group I: group II%): stent migration (0 : 10%); tumor or granulation tissue ingrowth (100 : 53%); overgrowth at the ends of stents (17 : 30%); restenosis causing recurrent dysphagia (37 : 8%); and appearance of esophageal fistulas (8 : 6%). In conclusion, fluoroscopically guided insertion of self-expandable esophageal stents is a safe and comfortable method of palliation for patients suffering with malignant dysphagia. In selection of a stent, covered types should be given priority for prevention of restenosis.

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A recurrent incisional hernia resulting from the rupture of low-weight polypropylene mesh is rarely reported in the literature. Three patients with recurrent incisional hernia due to low-weight polypropylene mesh central rupture were operated 5, 7 and 13 months after initial sublay hernioplasty. The posterior myofascial layer was fully reconstructed in all patients during the hernioplasty, whereas the anterior myofascial layer was only partially reconstructed. The recurrent hernia was managed using heavy-weight polypropylene mesh; in two patients, a new sublay hernioplasty was performed and in one patient an "open preperitoneal flat mesh technique" was performed under local anaesthesia as a day case procedure. If closing of the anterior myofascial layer cannot be ensured during the incisional hernioplasty, the use of low-weight polypropylene meshes should be avoided; preference should be given to the heavy-weight polypropylene meshes.

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The elective spigelian hernia can be successfully repaired under local anesthesia as a day-case procedure. The "open preperitoneal flat mesh technique" provides excellent results under these conditions.

No abstract