[A unusual cause of acute pancreatitis: obstruction of the afferent loop after gastrectomy according to Bilroth II. Apropos of a case and review of the literature]. / Une cause rare de pancréatite aiguë: l'occlusion de l'anse afférente après gastrectomie de type Bilroth II. A propos d'un cas et revue de la littérature.

We report a case of afferent loop obstruction after Bilroth II gastrojejunostomy presenting as acute pancreatitis. This form of presentation is extremely rare; to our knowledge, only 19 cases of acute pancreatitis secondary to afferent loop occlusion in patients with prior Bilroth II gastrojejunostomy have been previously reported in the literature. Obstruction can be caused by kinking, internal herniation, adhesive bands or recurrence of gastric ulcer or cancer. Because conservative management is invariably fatal, diagnosis and surgical treatment must be performed as soon as possible. CT Scan is now considered to be the imaging method of choice for the diagnosis. A case report and review of the literature are presented.

Tomoscintigraphy of the lumbar spine: prospects and clinical application.

In an in vivo prospective study, we examined the lumbar spine of 18 patients presenting with a first episode of acute low-back pain with single photon emission computed tomography (SPECT) and magnetic resonance imaging (MRI). Scintigraphic activity at L2 was considered 100%, and the other levels were quantified in relation to L2. MRI scans were rated for disc signal intensity on T2-weighted images. The results show that an abnormal intervertebral MRI signal corresponds with an abnormal image on tomoscintigraphy. On tomoscintographic profiles, the disappearance of the 'discal dip' corresponds well with degeneration on MRI. Furthermore, a positive MRI at one level appears to influence other levels at which a significantly higher scintigraphic activity was observed. Of patients with acute LBP 50% had a normal disc SPECT; it is concluded that in these cases a non-discal origin for the pain must be sought.