Successful treatment of a morbidly obese and growth-retarded adolescent with Williams-Beuren Syndrome by combining the medication of growth hormone and sibutramine.

A 16-year-old male adolescent diagnosed to have the Williams-Beuren syndrome was referred to our obesity outpatient clinic, due to his morbid obesity (body mass index 39.2 kilograms per square metre) and gluttony. After several unsuccessful dietary treatments, we started therapy with sibutramine. As growth hormone (GH) deficiency was diagnosed by an additional GH-stimulation test, we commenced with a GH-treatment. This well-tolerated combination therapy led to a remarkable weight loss of 10 kg and a growth-rate acceleration of 3.7 cm/year. Nine months after stopping the treatment with sibutramine, a partial weight gain was noticed. This case report justifies further research work on a combination therapy with sibutramine and GH for similar cases.

Congenital "transhaesio intestini tenuis supragastrica" in a 14-year-old girl - a rare case of internal hernia.

Intestinal obstruction caused by internal hernia is a rare condition. A 14-year-old girl who suffered from acute abdominal pain two days after appendectomy is presented. Abdominal sonography and plain abdominal x-ray showed dilated small bowel loops and air-fluid levels indicating mechanical intestinal obstruction. Exploratory laparotomy revealed small intestine loops herniated through the lesser omentum. The anatomical aspects are reviewed and discussed.

Laparoscopic partial splenic resection.

Twenty domestic pigs with an average weight of 30 kg were subjected to laparoscopic partial splenic resection with the aim of determining the feasibility, reliability, and safety of this procedure. Unlike the human spleen, the pig spleen is perpendicular to the body's long axis, and it is long and slender. The parenchyma was severed through the middle third, where the organ is thickest. An 18-mm trocar with a 60-mm Endopath linear cutter was used for the resection. The tissue was removed with a 33-mm trocar. The operation was successfully concluded in all animals. No capsule tears occurred as a result of applying the stapler. Optimal hemostasis was achieved on the resected edges in all animals. Although these findings cannot be extended to human surgery without reservations, we suggest that diagnostic partial resection and minor cyst resections are ideal initial indications for this minimally invasive approach.