[ A case of successfully treated duodenal hemangioma]. / Duodenum haemangioma gyógyult esete.

In some cases the radical removal of gastrointestinal hemangiomas involves an excessive risk or too extensive operation. Consequently some other solution has to be applied. At our patient with duodenum haemangioma the combination of angiographic embolism and endoscopic sclerotization was successfully employed.

[Barrett esophagus in children]. / Barret-oesophagus gyermekekben.

The case of a 6.5 years old boy, hospitalised because of recurrent vomiting, epigastrial, periumbilical abdominal pain, is reported. The contrast--medium swallow--x-ray examination showed no alteration, while during repeated continuous 24 hours pH monitoring of the distal esophagus, the pH values permanently were wound to remain under 4. By esophagoscopy, only moderate inflammatory signs could be detected. The long-lasting complaints and the results of pH monitoring indicated serial biopsy from the esophagus-wall. The histological finding showed gastric mucosa 2 cm above the lower esophageal sphincter, i.e. a Barrett syndrome. Upon the treatment administered according to the diagnosis, the complaints of the child considerably improved.

[Fluid and electrolyte balance in the postoperative period]. / Folyadék és elektrolit háztartás a posztoperatív idöszakban.

Authors investigated the concentration changes of arginine vasopressin (AVP) and of atrial natriuretic peptide (ANP) in plasma. The renal characteristics of water- and sodium metabolism in the first 24 hours of the postoperative period in 11 children operated with acute appendicitis have been studied. Crystalloid infusion was applied in 60 ml/kg/24 h dose, in 5 cases however, 1 g/kg albumin vas also administered during the operation. In children getting crystalloid infusion (group "A") the initial AVP value was 29.9 +/- 8.8 pg/ml, which further increased to 58.2 +/- 15.2 pg/ml (p 0.05) by the 6. postoperative hour and even in the 24. hour it remained above the physiological value (19.9 +/- 5.3 pg/ml). During the observation time significant Na- and water retention developed. The albumin administration (group "B") stopped the further increase of AVP values, the Na-household remained in equilibrium and the water retention developed only in smaller degree. The ANP plasma concentration of both groups was in the normal range and did not change during observation time. Our data show that for the postoperative water retention first of all the increased AVP activity is responsible. The more intensive AVP secretion may be induced by the relative intravascular hypovolemia since by enhancing the plasma volume the further increase of postoperative hormone activity could be prevented.

Vasoactive hormones in familial pheochromocytoma with predominant norepinephrine secretion.

A family was investigated with an increased occurrence of pheochromocytoma. Three males out of 7 family members showed biochemical and morphological evidence of catecholamine-secreting tumor. Plasma concentrations of norepinephrine, aldosterone, arginine vasopressin and renin activity, as well as urinary excretion of norepinephrine, were enhanced in all the 3 patients. The plasma level of atrial natriuretic peptide decreased. After surgical removal of the tumor the hormonal alterations tended to be normalized; however, plasma concentration of norepinephrine remained above normal. The elevated plasma norepinephrine was postoperatively accompanied by slightly increased urinary norepinephrine excretion in 1 patient without any detectable tumor. The severity of the disease was most pronounced in the youngest patient, while in the oldest one a 'silent' pheochromocytoma was found. The occurrence of familial pheochromocytoma in successive generations may suggest an autosomal-dominant inheritance.