Surface-coil MR imaging of orbital neoplasms

Fifteen patients with orbital neoplasms demonstrated by CT were studied with magnetic resonance (MR) using a 13 cm surface coil and a 0.6 T superconducting magnet. The use of a surface coil allowed for a reduction in slice thickness and a significant improvement in spatial resolution resulting in better demonstration and improved characterization of orbital lesions. All neoplasms (15/15) were demonstrated by MR. The lesions were grouped into four main categories on the basis of signal intensities on T1- and T2-weighted images. CT was superior to MR in displaying densely calcified or bony lesions (two of 15 cases). MR was at least equal or superior to CT in demonstrating the other lesions (13 of 15 cases) and had the added advantage of improved tissue characterization in some cases. With the use of surface coils, MR could become the primary imaging technique for evaluation of orbital neoplasms.     

Sentinel Bleeding After Pancreaticoduodenectomy: A Disregarded Sign

Introduction Delayed massive hemorrhage induced by pancreatic fistula after pancreaticoduodenectomy is a rare but life-threatening complication. The purpose of this study was to analyze the clinical course of patients with late hemorrhage, with or without sentinel bleeding, to better define treatment options in the future. Material and Methods From April 1998 to December 2006, 189 pancreaticoduodenectomies were performed. Eleven patients, including two patients referred from other hospitals, were treated with delayed massive hemorrhage occurring 5 days or more after pancreaticoduodenectomy. Sentinel bleeding was defined as minor blood loss via surgical drains or the gastrointestinal tract with an asymptomatic interval until development of hemorrhagic shock. The clinical data of patients with bleeding episodes were analyzed retrospectively. Results Eight of the 11 patients had sentinel bleeding, and seven of them had it at least 6 h before acute deterioration. Seven out of 11 patients died, five out of eight with sentinel bleeding. No differences could be detected between patients with or without sentinel bleeding before delayed massive hemorrhage. The only difference found was that non-surviving patients were significantly older than surviving patients. Delayed massive hemorrhage is a common cause of death after pancreaticoduodenostomy complicated by pancreatic fistula formation. The observation of sentinel bleeding should lead to emergency angiography and dependent from the result to emergency relaparotomy to increase the likelihood of survival.     

Seltene Hintergrundsbefunde bei Jugendlichen

Ohne ZusammenfassungArbeiten aus dem Gebiete der Pathologie des Zentralgefässsystems der Netzhaut. (Gefässsystem und Auge.) VI. Mittheilung.IV. u. V. Mitteilung siehe dieses Archiv. Bd. LXXXVII, 2. S. 334 u. 354.