Orhan Demircan

Diffuse Cavernous Hemangioma of the Rectum and Sigmoid Colon

We present an 18-year-old man with painless rectal bleeding, hematuria and diffuse cavernous hemangioma of the rectum and sigmoid colon. Thirty units of blood were transfused during the interval preceding definitive surgery. Low anterior resection and partial cystectomy were performed. During the postoperative period no rectal bleeding occurred, but he died of massive intracerebral bleeding 10 months after the operation.

Re: Technique of Lateral Pancreaticojejunostomy

Accessible online at: http://BioMedNet.com/karger Dear Sir, I read with interest the beautifully written ‘How I Do It’ article by Dr. Richard Prinz entitled ‘Technique of Lateral Pancreaticojejunostomy’ in the June 1997 issue. While I agree with most all of his technical points, I notice in figure 3 that the Roux limb is brought through the right transverse mesocolon and oriented with the blind end towards the patient’s left (tail of pancreas). I orient my Roux limb differently, bringing it through the left mesocolon with the blind end of the Roux limb towards the head of the gland. While this is neither technically easier nor technically more difficult than the technique outlined by Dr. Prinz, it makes any type of reoperative surgery that might be necessary on the pancreas much easier. Usually when further surgery is needed in patients after a pancreaticojejunostomy, it is to remove or deal with the head of the pancreas. If the Roux limb is oriented as described by Dr. Prinz, the mesentery of the Roux limb will cover the superior mesenteric vessels, making it difficult to gain appropriate and safe exposure of the pancreas. If the Roux limb is oriented as I have described, exposure of the superior mesenteric vein is much easier. Michael G. Sarr, MD Professor of Surgery, Mayo Medical School Chair, Division of Gastroenterologic and General Surgery Mayo Clinic and Mayo Foundation Rochester, MN 55905 (USA)

Cardiac Tamponade due to Rupture of a Hepatic Hydatid Cyst into the Pericardium

We describe a patient with a hydatid cyst in the left liver lobe that ruptured into the pericardial sac, resulting in cardiac tamponade. The chest x-ray showed prominent enlargement of the cardiac sha