Colonoscopy in patients with a primary family history of colon cancer.

Patients with a primary family history of colon cancer were recommended to have full colonoscopy for screening. The results of 125 such patients who also were asymptomatic, had no prior history of neoplasms, and had negative fecal occult blood, showed 15 patients (12 percent) with neoplasms. Only 6 (5.2 percent) had neoplasms that were detectable only by colonoscopy (i.e., above 55 cm). These results suggest that colonoscopy may not be necessary to screen patients with a primary history of colon cancer.

Hemorrhagic pancreatitis: a complication of transcatheter embolization treated successfully by total pancreatectomy.

Since pancreatitis can be produced experimentally in dogs by embolization of microspheres into the pancreatic arterial circulation, there has been speculation that intentional or inadvertent embolization of the pancreas in human subjects could also produce pancreatitis. Although such therapeutic embolization has increased, no pathologically documented case of this complication has been recorded. We have reported the first such case occurring in a patient with a large, highly vascular, nonfunctioning islet cell carcinoma of the tail of the pancreas preoperatively embolized with Gianturco coils and Gelfoam particles suspended in sodium tetradecylsulfate solution to facilitate distal pancreatectomy. The resultant hemorrhagic pancreatitis and duodenal necrosis required a total pancreatectomy. We conclude that, by itself, occlusion of the origin of the splenic and gastroduodenal arteries with coils would have been effective and without complication; however, the addition of Gelfoam particles in a sclerosing solution reduced the microscopic pancreatic circulation to a critical point and resulted in hemorrhagic pancreatitis.