No abstract

Case reports renal cell carcinoma and a subsequent lobectomy for pulmonary metastases. Endoscopy and biopsy showed invasion of the gastric mucosa by metastatic neoplasm.Coeliac angiography showed a widespread hypervascular tumour in the gastric and duodenal area with multiple feeding vessels from branches of the splenic artery (Fig 1). Following subtotal occlusion of the splenic artery with gel-foam embolisation (Fig 2) bleeding stopped for three months. Further gel-foam embolisation of the splenic artery was then successfully carried out on recurrent tumour vessels in the gastric area (Fig 3). No complications occurred during either procedure and at five month follow up no pancreatic ill effects were noted and no further episodes of upper gastrointestinal haemorrhage had occurred.

Ultrasonography was used to diagnose, localize and direct the percutaneous transabdominal needle aspiration of 10 pancreatic pseudocysts in 9 patients. Thirty-four aspirations were performed without complication. In 9 pseudocysts no other treatment was necessary, and in all patients relief of pain or obstructive symptoms when present was obtained. None of the cysts have recurred with a mean follow-up of 26 months.

Primary lesions of bowel wall were biopsied transabdominally in 7 patients. Adequate material for histological diagnosis was obtained in all. In 3 patients previous biopsy performed at endoscopy had failed to establish a diagnosis. In 2 others the area biopsied, i.e., gallbladder, was inaccessible to endoscopy and confirmation would have otherwise required laparotomy. No complications occurred.