We suggest that ELUS and MRI must be evaluated within the framework of established parameters when treatment modalities such as preoperative radiation therapy and local or radical surgical approach must be decided.

This experimental study compared the effects of laparoscopic (n = 31) and open (n = 32) cholecystectomy on gastric intramucosal pH (pHi). For this purpose, pHi was measured tonometrically before induction of anaesthesia, at 30-min intervals during surgery, and 1, 2 and 4 h after operation in otherwise healthy patients undergoing elective cholecystectomy. Additionally, perioperative arterial pH (pHa), arterial carbon dioxide tension (PaCO2), intramucosal carbon dioxide tension, arterial bicarbonate concentration, end-tidal carbon dioxide pressure (PECO2), levels of serum lactate, lactate dehydrogenase (LDH) and gamma-glutamyl transferase (GGT), haematocrit and arterial blood pressure were recorded. In the two groups no significantly different changes occurred in pHi, pHa, serum lactate concentration or haematocrit at any of the observation times. PECO2 and PaCO2 were significantly raised during the laparoscopic procedure, whereas levels of LDH and GGT and arterial blood pressure rose during and after open cholecystectomy. In spite of the increased intra-abdominal pressure and the peritoneal carbon dioxide absorption related to the creation of a pneumoperitoneum, no decrease in pHi was detectable during laparoscopic cholecystectomy.

We describe a patient with recurrent intestinal bleeding and sigmoid perforation due to amyloidosis. Hartmann's procedure was carried out with resection of the diseased sigmoid colon and by performing a terminal colostomy. The postoperative course was uneventful, but the patient died 3 months later of lobar pneumonia and multiple organ system failure.

Background: Cecal perforation due to neutropenic colitis is a known and described side effect of many chemother-apy regimens. We present a case of a patient with gastric adenocarcinoma who developed spontaneous cecal per-foration during chemotherapy without the classic pattern of typhlitis. Case Report: A 58-year-old woman was on chemotherapy for an adenocarcinoma of the gastric junction, when she developed a cecal perforation. There was neither evidence for leucopenia nor for typhlitis. La-parotomy was performed and cecostomy was estab-lished using the perforated bowel. Postoperative course was uneventful. The patient died from tumor progres-sion 8 months after the diagnosis was made. Conclusion: There is no evidence for a connection between this event and chemotherapy treatment but neither can it be ex-cluded. Even if unusual, colon toxicity could be a poten-tial life-threatening complication associated with more drugs than usually thought.

This study investigates the use of EuroCollins (EC) and University of Wisconsin (UW) solution, two major preservation fluids, for small bowel preservation. After in situ flushing, grafts were cold-stored at 4°C with either EC for 30 min (group 1a), 6 h (group 1b) and 12 h (group 1c) or with UW for 30 min (group 2a), 6 h (group 2b) and 12 h (group 2c). Using UW, cold ischemia was extended to up to 18 h (group 2d). As a control, small intestines were flushed and stored for the same time periods in cold saline (group 3a–c). Survival in group 1b was 66 % versus 100% in group 2b. After 12 h 80% survived in group 2c, but there were no survivors in group 1 c. After 18 h of cold storage, survival was only observed in group 2d (25%). Saline was ineffective after 6 h of preservation. Histology at the end of preservation revealed characteristic changes for EC (intracellular vacuoles) and UW (amorphic granules). We conclude that with UW small bowel can be preserved for up to 12 h.