Management options for pancreatic pseudocysts.

Between July 1987 and February 1990, 42 patients with pancreatic pseudocysts were treated. In 83% the pseudocyst was related to alcohol. Patients were managed by observation (7), surgical external drainage (7), and internal drainage (12). Fifteen patients were treated by ultrasound guided percutaneous catheter drainage (UGPCD) with apparent success in 67%. In 5 of these UGPCD was abandoned because of either prolonged drainage or infection of the pseudocyst. In patients with recurrent pseudocysts or in those with failed UGPCD, the cystic collections were successfully drained internally in 16 out of 17 patients (94%). Internal drainage appears to be acceptable treatment for mature pseudocysts, recurrent pseudocysts or for failed UGPCD, provided there is no downstream pancreatic duct obstruction or duct dilatation. If either exist, resection or direct ductal drainage will be required.

Risk factors and survival from colorectal cancer in black patients in Soweto, South Africa.

In Africa, while colorectal cancer is very uncommon in the black population, it is rising in urban dwellers. A series of 42 patients treated at Baragwanath Hospital, Soweto, were compared with 92 controls. Average age of patients was relatively low 55 years. 73 per cent presented late with far advanced disease at Stages C and D. No familial component was apparent. Patient's years of schooling and social class were non-revealing compared with data on controls. Dietarily, the same applied to fat intake (relatively low) and fibre intake (considerably decreased). Median survival time was short, 7.5 months.

Survival of black patients with gastric cancer in Soweto, Johannesburg, South Africa.

In a series of 39 black gastric cancer patients, treated at Baragwanath Hospital, Soweto, Johannesburg, the time of 50 per cent mortality was 3.5 months, half that of white patients. Patients' median age was lower than that of white patients, 58 versus 70 yr. Male/female ratio was 1.3:1. Black patients presented late; no patients' lesions were at clinical stages I and II, compared with 5-15 per cent reported for white patients. Weight loss, abdominal pain and vomiting were predominant features. Frequencies of smoking and of alcohol consumption in male and female patients appeared much the same as those prevailing in the general population. No marked differences between patients and controls were apparent in socioeconomic state, educational level, general dietary intake, nor in ownership of a refrigerator.