Hepaticoportal fistula and portal hypertension.

A large intrahepatic fistula between the hepatic artery and portal vein was detected at angiography in a patient with portal hypertension and bleeding esophageal varices. Hemodynamic studies demonstrated that increased vascular resistance in the liver rather than increased flow through the fistula was responsible for the portal hypertension and a portocaval shunt was performed. A repeat angiogram two months after the operation showed that the fistula had closed spontaneously.

Carcinoma of the pancreas presenting as relapsing pancreatitis.

A case is reported of a 32-year old man, in which relapsing pancreatitis was the presenting symptom of an underlying carcinoma of the body of the pancreas. The rare association of clinically manifest pancreatitis and pancreatic carcinoma is reviewed and a possible pathogenetic mechanism is proposed in this case. It is suggested that pancreatic carcinoma should be suspected in patients with relapsing so-called idiopathic pancreatitis.

Treatment of alkaline reflux gastritis. A report of twenty cases.

The surgical treatment of twenty patients operated for postoperative alkaline reflux gastritis is discussed together with the pathogenesis of this syndrome as a late postoperative surgery syndrome. Diagnostic procedures and results of investigations and treatment were compared with data of the literature. Surgical treatment is of great benefit. The different surgical technics should be used according their own indication.