[Pancreatitis-induced pseudocysts of the spleen: a rare complication]. / Pankreatitisinduzierte Pseudozysten der Milz: Eine seltene Komplikation.

Secondary splenic cysts usually occur following blunt abdominal trauma. In rare cases, the spleen can be affected in pancreatitis. Since the clinical findings are fairly uncharacteristic, this was a difficult diagnosis to make before imaging examination techniques became available. These cysts only became apparent as a result of their complications. Today, thanks to sonography and abdominal CT-scan, these cysts can be detected in their asymptomatic stage. Furthermore, interventional sonography allows the puncture and drainage of these cysts, and this technique is thus an alternative to surgery. Two cases of pancreatitis with splenic involvement are presented.

Through-the-scope balloon dilatation of benign pyloric stenoses.

In 9 patients with benign pyloric stenosis, the stenosis was dilated using through-the-scope (TTS) balloon catheters (diameter 1.5 to 1.8 cm), which can be passed through the biopsy channel of a standard fiberscope under direct vision. In all cases, the stenosis was secondary to fibrous changes in peptic ulcer disease. In addition, all patients had active ulcers. All dilatation treatments were primarily successful: the stenoses were opened for the passage of the fiberscope. There were no complications; even with active ulcers there were no side effects. The treatment was followed by immediate symptomatic relief. On prospective evaluation over a period of 7 months (mean), 6 patients remained asymptomatic, 2 patients had to be dilated again for restenosis and have since been asymptomatic for 1 and 12 months, respectively. One patient had to undergo surgery after 7 months for ulcer perforation into the common bile duct. The TTS technique has considerable advantages over the methods requiring a guide wire. This technique with its easy practicability and low incidence of complications may become a valid alternative to surgical procedures if the good initial results can be confirmed in further studies.

[Streptococcal abscesses of the liver: diagnosis and therapy using ultrasound controlled puncture]. / Streptokokkenabszesse der Leber: Diagnostik und Therapie mittels ultraschallgezielter Punktion.

Three male patients without accompanying diseases, 27, 47, and 52 years of age, were admitted with fever of unknown origin. Focal liver disease was seen on ultrasound and the diagnosis of an abscess was confirmed by sonographically-guided fine-needle puncture. Microaerophilic streptococci were found in two cases, streptococcus viridans once. Two patients had cryptogenic abscesses; one had previously undergone surgery for a rectal abscess. All three patients were cured of their condition by appropriate antibiotic coverage and evacuation of the abscess by needle aspiration.