Gastric hyalinization as a possible consequence of corrosive injury.

We report a case of gastric obstruction due to hyalinization of the antrum. The endoscopic appearance of the lesion was suggestive of Crohn's disease or gastric neoplasm. Biopsy showed pseudopolypous gastritis with ulceration and fibroid granulation. Surgery was carried out to relieve the obstruction. Examination of the resected specimen showed massive hyalinization of all layers of the antral wall with circular collagenous infiltration and a normal duodenal bulb. The question of hyaloid gastritis as a unique entity is raised. Subsequently, information from the patient revealed the cause: voluntary acid ingestion causing corrosive injury.

[Genetic counseling in a case of Takayasu arteritis]. / Genetikai tanácsadás Takayashu arteritis esetén.

Two cases affected with Takayashu arteritis are presented. The adult probanda born in 1960 after genetic counselling and appropriate prenatal care had a healthy liveborn boy. Her previous six pregnancies were terminated on the basis of forced medical reason. The infant probanda died at the age of 4 months with the features of sudden infant death syndrome (SIDS). Pathohistological examination detected her Takayashu arteritis. It seems to be the youngest published case in the international literature and Takayashu arteritis may be the rare cause of SIDS.

[The role of conservative surgery in Crohn disease: practical results obtained from a case]. / A konzervatív sebészet helye Crohn-betegségben: egy eset gyakorlati tanulsága.

The 42 years old male patient in a 12 year period got over seven laparotomies and repeated bowel resections, due to which there was left only about 50 cm long jejunum, grossly dilatated and connected side to side to the transverse colon after a right hemicolectomy. The patients was admitted in a serious state of malnutrition due to a Y-shaped fistula formation between the too long blind end of the jejunotransversostomy and the first part of the jejunum. The blind end was resected and the 2 holes on the jejunum was closed by one layer wire stitches. The histology demonstrated a typical granulomatosis process. In summary: the Crohn's disease cannot be cured by surgical means. In this panalimentary process the repeated small bowel resections imply a later short bowel syndrome. On the base of the literature and of their modest experience the authors emphasize the need of conservative surgery and for the so called skip-lesions only stricture plasties to be performed instead of resections.

[Pancreatic cystic tumor misdiagnosed as pseudocyst: lessons from an intraoperative error]. / Altömlönek vélt cysticus daganat a hasnyálmirigyben: egy intraoperatív tévedés tanulságai.

A 62-year old woman presented a fistula due to a previously made cystojejunostomy performed because of a small pancreatic lesion considered as a pseudocyst. This intervention was performed in another institute. In the course of the exploration the authors resected the whole mass with the Roux-en-Y loop, and with the spleen. The histological examination proved a cystadenocarcinoma of the pancreas. There are discussed the problems of the intraoperative diagnosis of pancreatic lesions, and the possibilities of the reduction of mistakes. The authors emphasize the experience of the surgeon--which is the most important factor of the cure--and the importance of the fine needle biopsy.

[Primary adenocarcinoma at a colostomy site]. / Anus praeternaturalisban kialakult primer adenocarcinoma.

The colostomy opening is a very rare site of the large bowel cancer. There is only one case report in the world literature and none in the Hungarian one. The authors report a case of a 51 year old man, who presented a typical malignant growth in his colostomy opening, created 24 years before due to a rectal lesion considered as an inoperable cancer, though not proved histologically. Later the patient was treated by telecobalt irradiation, and the growth perfectly disappeared. Now the second, metachron malignancy arising from the colostomy has been removed and the patient is symptom free four years after the operation. Emphasizing the importance of postoperative follow-up in cases of gastrointestinal malignancies the authors considered this case as an unique but instructive one.