Pancreatic tumor resectability: spiral CT, surgical and pathological assessment

Resectability of pancreatic tumors can be difficult to assess. The initial investigations [abdominal ultrasonography and; conventional C.T.scans] may fail to assess the resectability of pancreatic tumors in up to 30% of cases. The aim of this retrospective study was to evaluate the accuracy of spiral computed tomography [C.T.] in assessing the resectability of small pancreatic ductal adenocarcinoma and; to correlate the C.T findings with histopathologic and surgical findings. Spiral C.T. scans were obtained in fifteen patients who underwent surgery for potentially resectable pancreatic adenocarcinoma. C.T. findings were correlated with surgically assessed extent of tumor and pathological findings. Twelve patients had resection of the tumor with pancreaticoduodenectomy operation Three patients proved during operation inoperable due to the presence of small [< 1 cm] hepatic metastatic deposits [2 patients] and peritoneal and omental seedling in one patient. We concluded that thin-section helical CT is a useful application in the diagnostic imaging of pancreatic tumor and in determining tumor resectability

Endosonographic criteria for perianal fistula

The aim of this work is to define the endosonographic criteria of fistula in ano as a trial to avoid recurrent perianal fistula. 42 patients underwent endosonography preoperatively in an outpatient setting. Analysis of endosonographic findings revealed the presence of positive results in 38 cases for positive location of an internal opening. The following endosonographic criteria were demonstrated: [1] root like budding formed by the intersphincteric tract that contracts the internal sphincter [3 cases], the appearance of root like budding with internal sphincter defect [6 cases] and subepithelial breach connecting to intersphincteric tract through an internal sphincteric defect [29 cases]. False negative results were recorded in four cases. It is concluded from these findings that endosonography is of particular importance in locating the internal opening of the perianal fistula and hence helping in the prevention of recurrence