[Gastric and duodenal intramural hematoma: report of two cases]. / A gyomor és duodenum intramuralis haematomája: két eset ismertetése.

Two cases of intramural hematoma arising in the duodenum and the stomach are reported. Both patients were male, aged 40 and 58 years, and suffered from chronic pancreatitis. Hematoma of the duodenal wall may have resulted from the acute exacerbation of the chronic pancreatitis in the first patient. As to the second case, continuous administration of Colfarit following myocardial infarction may have been causal to the gastric lesion. The initially suspected diagnosis in the first case, was pancreatic pseudocyst with obstruction of the duodenum while in the second case the gastric hematoma imitated a submucosus neoplastic process. The authors review clinical symptoms and therapeutic approaches of intramural hematomas of the proximal gastrointestinal tract. Literature data regarding etiology and therapy are presented.

[Evaluation of 3757 cases of open biliary tract surgery before the introduction of the laparoscopic method (basis for comparison)]. / A laparoscopos módszer elötti 3757 nyitott epemütét értékelése (Alap az összehasonlításra).

3757 elective nonmalignant biliary tract operations are evaluated retrospectively in the 17-year period from January 1, 1974 to December 31, 1990. The operations were divided into four periods according to development and frequency of intraoperative diagnostics: I. period without examinations of common bile duct (511 operations), II. selective period (848 operations), III. routine period (906 operations), IV. restricted routine period (1492 operations). The authors experienced improvement in their results if they carried out intravenous cholangiography routinely. Comparing eight characteristic factors they believe that their results are favourable if they performed intraoperative common bile duct examinations (manometry, cholangiography, flow rate measurement) in 39.6% rate and if they employed praeoperatively EST if necessary. They propose the selective intraoperative cholangiography. In the period of 39.6% intraoperative cholangiography (restricted routine period) they found common bile duct stones in 10.7%, unsuspected stones in 0.4%, retained stones in 1.6%, unnecessary choledochotomies in 2.7% and intraoperative common bile duct injuries in 0.2%. The overall mortality rate was 0.4%. They deal with the intraoperative differential diagnostics of Vater papilla stenosis and spasm.

Interposition of the gall bladder: a rare congenital malformation of the extrahepatic bile ducts.

A rare congenital malformation of the extrahepatic bile duct is presented: in an elderly female patient the cystic duct was missing and intra-operative cholangiography revealed a gall bladder wedged between the common duct and the hepatic duct. The situation was solved by syphonoplasty and T-tube drainage. Five similar cases have only been published in the literature. The importance of intra-operative radiomanometry during of the bile duct is stressed.