Results of surgical treatment for vascular injuries

Management of synchronous tumours of the oesophagus and pancreatic head: a novel approach

Synchronous tumours of the oesophagus and pancreatic head are very rare. This report describes a unique case of an adenocarcinoma of the distal oesophagus and a neuroendocrine tumour of the pancreatic head diagnosed synchronously but successfully managed metachronously. Initially, the patient underwent an oesophagectomy, with a colonic reconstruction following some months later by pylorus-preserving pancreaticoduodenectomy. A staged resection was performed after a review of the literature suggested increased morbidity with synchronous major abdominal operations.

Pyoderma gangrenosum: a new complication after groin exposure for attempted endovascular aortic stent-graft placement

Pyoderma gangrenosum (PG) is an uncommon and frequently misdiagnosed inflammatory dermatosis. This neutrophilic inflammation of the dermis has been well described in relation to other inflammatory illnesses (i.e. inflammatory bowel disease). Although rare, PG is increasingly described in relation to trauma or surgical interventions. It is important for vascular surgeons to be aware of the potential development of PG at vascular access sites. Although endovascular surgery is a minimally invasive form of vascular surgery, it does require cutaneous manipulation, which can incite PG. The purpose of this report is to describe a case of PG that developed after an attempted endovascular surgery and to elucidate this rare dermatologic disorder's diagnosis and treatment.

DIGEST: digest

Professor Seiki Matsuno, Chief Editor oy Surgery Today (The Japanese Journal of Surgery), has selected from the January to March 2000 issues of the journal for this quarter's digest. A digest of BJS for the same period written by Professor Pierre Guillou, Associate Editor, appears in the Japanese journal.