[Acute pancreatitis: case reports from 1992-1997. Analysis of the costs of DRG, role of ERCP in the reduction of hospitalization time]

In the period 1992-1997, 211 cases of acute pancreatitis were observed: 81 grave cases; 130 slight cases. The ERCP and endoscopic sphincterotomy were performed in 84 cases. From the critical revision 2 groups of patients emerged, homogeneous for etiology and clinical classification, the first submitted to ERCP within 72 hours from the entry in hospital; the other after 72 from the hospitalisation. The "t" Students test for small numbers was significant (p < 001) showing a decrease of hospitalisation in the submitted group to ERCP within 3 days. In 42 cases of acute pancreatitis observed in 1997 a study was made about the hospitalised patients' costs. Two homogeneous groups of acute and slight pancreatitis have been considered. The parameters analysed were about the costs of: a) days hospitalisations; b) pharmaceutical expenses; c) hematological examination; d) surgical operation, laparothomic and laparoscopic surgery; e) instrumental examination. The results of the expense have been compared with the obtained DRG, both for each single case and also for homogeneous group of grave and slight pancreatitis. This comparison showed that the obtained gain through DRG is: a) insufficient to cover the expenses of the grave pancreatitis cases; b) clearly positive in the slight cases. This last result has been very important in the final balance; in fact is only for this positive result that final balance was economically favourable.

[Syndactyly: an angiographic study]

Systematic angiographic examination (87 angiographies) done in all the congenital malformations of the hand and in particular in cases of syndactyly in patients 6-11 years of age, has given the authors the opportunity to observe anomalies of the vascular topography of the hand (distal displacement of the bifurcation of the common digital arteries, anomalies of excess or lack of arteries of the palm: common digital arteries, proper digital arteries, etc.) and of performing surgery carefully according to the angiographic appearance of the malformation.

[Digital videoangiography of the hand]

We have been using digital subtraction angiography for a year. The advantages as compared with customary angiography are pointed out. Some examples are used to illustrate its use.

Arteriographic findings in congenital malformations of the hand

The authors show their routine technique for arteriographic examination in patients with congenital malformations. They demonstrate angiograms taken in the more common congenital deformities of the hand. Vascular anomalies are nearly always found. Most commonly the progressively more distal artery is seen with the development of a single arterial system in the more advanced deformities. The authors suggest that anomalies in the development of the vascular tree may in fact prove to be the determining factor in congenital anomalies, since the differentiation of the vascular tree appears very early in embryonic life.