Eighteen patients with metastatic carcinoid were treated by hepatic artery embolization with Gelfoam or polyvinyl alcohol foam for control of the carcinoid syndrome. Seventeen showed subjective or objective clinical improvement, including less skin flushing, diarrhea, and bronchospasm. Fourteen showed improvement in biochemical indices, including decreased urinary 5-hydroxyindoleacetic acid levels. The mean life span of the treated patients from the first episode of flushing to the time of this report was 5.4 years, and half of the patients are still alive. This survival time compares favorably with previous reports of survival of 3.2 years from the onset of flushing.
Postoperative jejunojejunal intussusception occurred in normal bowel of 3 patients operated on for small bowel obstruction due to Crohn's disease. Various radiologic patterns and a number of etiologic factors are described. It is concluded that this complication is prone to occur in patients having chronically dilated small bowel preoperatively and should be managed by as conservative a surgical procedure as possible.
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