Use of an intravenous port catheter for the delivery of intrathecal morphine in a terminally ill cancer patient with pain.

We present a case of a terminally ill cancer patient with metastasis who was suffering from inadequate pain control despite high doses of systemic opioid administration. In addition, her quality of life was significantly impaired due to opioid-induced troublesome side effects. In the situation as above, intrathecal opioid administration has established as a safe and effective therapeutic option with a positive benefit-risk ratio. This case reports a novel technique, where an intravenous port catheter was used to administer intrathecal opioid.

Ultrasound-guided pulsed radiofrequency ablation of the genital branch of the genitofemoral nerve for treatment of intractable orchalgia.

Chronic orchalgia is a frustrating clinical problem for both the patient and the physician. We present a 17-year-old boy with a bilateral idiopathic chronic intractable orchalgia with failed conservative treatment. For 2 years, he suffered from severe attacks of scrotal pain that affected his daily activities and caused frequent absence from school. Ultrasound-guided pulsed radiofrequency ablation (PRF) of the genital branches of the genitofemoral nerve performed after local anesthetic nerve block confirmed the diagnosis and yielded 6 weeks of symptom relief. Seven-month follow-up revealed complete satisfactory analgesia. The use of PRF is an effective and non-invasive approach to treat intractable chronic orchalgia.

[Case report of isolated Crohn's disease of the stomach presenting as plastica linitis]. / Maladie de Crohn gastrique isolee simulant une linite plastique. A propos d'un cas.

INTRODUCTION: Crohn's disease of the stomach is rare. There is nearly always concomitant disease in the small bowel or colon. Gastric involvement occurs rarely as an isolated entity. Upper endoscopy is sensitive for detecting subtle disease but more extended lesions can mimic neoplasms such us linitis. Exégèse: A 74-year old female was admitted to hospital with abdominal pain, vomiting and weight loss. Upper endoscopy and radiology aspects was suspicious of gastric linitis. Multiple endoscopic biopsies of the stomach showed one granuloma, chronic inflammation and Helicobacter Pylori. Because of the importance of obstructive syndrome, the patient underwent surgery. The resected stomach concluded to a Crohn's disease. CONCLUSION: Through this observation, we review clinical characteristics, diagnostic difficulties and treatment options of Crohn's disease of the stomach.