[Rare late complication of transcystic drainage]

The authors performed 3539 successful endoscopic retrograde cholangio-panreatographies between 1982 and 1992. In 1160 (32.7%) of the cases was revealed some kind of pathological condition. In connection with one case, following conventional cholecystectomy, a very rare complication was diagnosed by endoscopic means. There was a stent-like object, hanging into the duodenal lumen, through a parapapillar fistula. This was surgically removed. It turned retrospectively out that the removal of K-32 feeding tube used as a transcystic drain 18 years earlier had managed only partially. After this period of time did it cause a biliary flow obstruction and a choledocho-duodenal fistula. The endoscopic diagnostic possibilities, course of disease and treatment is presented hereby.

[Massive colorectal hemorrhage in adult Schönlein-Henoch purpura]

Schönlein-Henoch purpura is a well known syndrome, rare in adults, and is seldom accompanied with extensive colorectal haemorrhage. In abdominal purpura, the small bowel is more frequently involved, but cases of oesophageal, gastroduodenal and colorectal localisation also have been reported. The cases with colorectal bleeding, appearing in adulthood and elderly patients, could cause differential diagnostic problems. Described endoscopic features of one patient, who was referred to our department, because of colorectal bleeding. The treatment, course of disease and endoscopic follow-up is presented. No previous endoscopic documentation of this type of localisation has been reported in Hungarian literature, so far.

Screening for colorectal cancer in a Hungarian county

An initial screening for colorectal cancer in asymptomatic adults was performed with Haemoccult in 26,357 persons, rigid rectoscopy in 10,673 and flexible sigmoidoscopy in 3,963 persons. The rate of cancer detection was 4.4% in screenees with a positive Haemoccult test, 0.08% using rigid rectoscopy and 0.28% using flexible sigmoidoscopy. The respective frequency of patients discovered to have polyps was 16.2%, 1.32% and 8.49%. 77% of the 36 colorectal cancers detected due to the Haemoccult test program were either Dukes A or B. A comparison of these screening results indicates that Haemoccult screening markedly increases the yield of colorectal neoplasms when asymptomatic persons are examined. This screening should be repeated annually to reduce the morbidity and mortality of colorectal cancer.

[ECG studies during esophagogastroduodenoscopy]

Esophago-gastro-duodenoscopy combined with ECG-monitoring was carried out on a total of 300 patients. In the group of patients with pulmonary, cardiac and vascular damage (102 patients) there was a high incidence of irregularities in the rhythm and repolarization (21.2% and 36.2% resp.) The deviations observed were of a transitory nature and no permanent damage or deaths occurred.