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A scrotal mass as initial manifestation of necrotising pancreatitis is very rare. In addition, the diagnosis is very difficult because diseases that occur more frequently produce similar symptoms. Therefore, it is very important to think about rare entities in the differential diagnosis for testicular pain., (© Georg Thieme Verlag KG Stuttgart · New York.)

Duplications of the gastrointestinal tract are congenital anomalies seen in about 0.2% of all children. These include the rare gastric duplications. Latter diagnosis is usually made in the first months after birth on recurrent vomiting by detection of an abdominal tumor. The most important imaging modality is ultrasonography. The case of a prematurely born child weighing 1900 g is presented in whom at the age of three weeks a gastric duplication of the greater curvature was diagnosed and who was successfully treated by resection. The postoperative follow-up for 24 months was uncomplicated.

Purpose: To clarify whether in nonocclusive mesenterial disease the extent of damage to the intestinal wall can be limited by local intraarterial application of Captopril., Method: Producing shock by means of pericardial tamponade in 18 piglets. Examination of three groups: Intraarterial application of Captopril at the beginning of the shock phase (n = 6) or administration one hour after the beginning of the shock phase (n = 6), as well as a control group (n = 6). Analysis of clinical pathology (laboratory chemistry) and haemodynamic parameters over a test period of 4 hours and histological preparation of resected segments of the small intestine., Results: The initiation of therapy at the beginning of the shock improved the blood supply of the intestinal wall (measured by means of laser sonography in relative flow units RFU) from 226 RFU to 303 RFU; the rise in lactate from 2.7 to 3.6 mmol/l was significantly less (p = 0.05) than for the control group (from 3.1 to 11.5 mmol/l). The frequency and severity of the histological changes that are typical for ischaemia were less pronounced. If therapy was started only after a one-hour shock phase, this effect was no longer noticeable (rise in lactate from 5 to 9.5 mmol/l, intestinal wall blood flow from 168 to 170 RFU)., Conclusion: Intraarterial administration of Captopril can reduce the extent of damage in nonocclusive mesenterial ischaemia (nonocclusive disease) if therapy is initiated early enough.

The emergency treatment of the enterothorax is problematic due to weak lung functions and unstable hemodynamics, and because it does not influence the stage of maturity of the lungs. By delayed operation children with a critical starting position have a greater chance to survive, after their condition has been stabilised by intensive care treatment. During the stabilising period we managed to decrease the FiO2 level below 50% and to decrease the pCO2 level to 43 +/- 13 mm Hg in our patients (n = 10). Furthermore we succeeded to raise the O2 degree of saturation from 72 +/- 13 to 89 +/- 9%. The pH level went up from 7,238 +/- 0,181 to 7,394 +/- 0,060. If the condition of the patients worsens during the stabilising period--in our patients the stabilising period was between 12 and 24 hours--immediate operation is indicated. We have no experience so far in using ECMO in such situations.

Visceral aneurysms are very rare (0.1% in autopsy-statistics). In our own review of literature we have found only 9 described cases of an aneurysm of the gastroepiploic artery. In the presented case an aneurysm was found when the patient developed an acute upper gastrointestinal bleeding. Due to the high risk of rupture (20% of all visceral aneurysms), which can be either intraperitoneally, intraluminally or into the satellite vein, the treatment should be surgically on finding.

The qualitative and quantitative MRI findings in 16 patients with focal nodular hyperplasia (FNH) of the liver are described; nine of these were confirmed histologically. A central scar is typical of FNH and provides a reliable diagnosis. This finding was seen in half the cases. If the scar is not demonstrable, the following features suggest the diagnosis: smooth margins, homogeneous signal distribution, increased signal intensity in T2-weighted spin-echo images and reduced signal intensity in inversion-recovery sequences. The T1 and T2 relaxation times in FNH are increased by about 30% compared with normal liver tissue.

A prototype of a measuring device is described, which reads the tube peak voltage and the switch-on time of x-ray units by means of two radiation detectors with different energy dependences due to detector materials (Caesium Iodine and Silicon). With a storage oscilloscope the curves of the tube voltage and the relative absorbed dose rate of intensifying screens can be displayed. The measuring range of the tube peak voltage is 60 kV to 150 kV. It is possible to measure exposure times of radiography equipment above 2 ms wit sufficiently low uncertainty. The tube peak voltage has been read with a relative uncertainty below 5% for almost all dose rates, which arise in practical application of medical x-ray units, and its calibration is made by means of x-ray apparatus with tube voltage reading, which has been compared to a Ge(Li) spectrometer. The stability of tube voltage reading of the measuring device is only effected by radiation damage of the detectors after a long time of utilization. The small diameter of the probe permits the accommodation of other probes, ionization chambers, phantoms, etc. in the radiation field at the same time.