Idiopathic acute pancreatitis and sarcoidosis.

Pancreatic involvement is rare in sarcoidosis. We describe a 30-year-old man who had two episodes of acute pancreatitis within one month with no current aetiology. Diagnosis of sarcoidosis was based on the presence of bilateral mediastinal adenopathies, alveolar lymphocytosis on bronchoalveolar lavage and biopsy of an enlarged lymph node showing multiple granulomas. This case and five others previously reported in the literature suggest the diagnosis of sarcoidosis should be considered in apparently acute idiopathic pancreatitis.

Hyperbaric oxygenation in severe perineal Crohn's disease.

PURPOSE: Perineal involvement in Crohn's disease is a common and distressing condition, often refractory to medical or surgical treatments. Recent reports suggest the efficacy of hyperbaric oxygenation (HBO) in the healing of perineal lesions. We evaluated HBO in severe patients with perineal Crohn's disease. METHODS: Ten consecutive patients (8 women, 2 men; mean age, 30 years) were studied. There were four superficial fissures, four cavitating ulcers, six low or superficial fistulas, two high fistulas, and one irreversible anal stenosis. All patients had received one or more medical treatments without healing the perineal lesions, and all had had previous surgery for perineal lesions. RESULTS: Two patients discontinued HBO after a few sessions and did not complete treatment. Eight patients completed at least 30 HBO sessions and were evaluable. At the end of the procedure, six of eight patients treated were healed, three completely and three partially. All patients who healed completely received HBO as an additional treatment to local perineal surgery. CONCLUSION: HBO might be useful as a last resort treatment of chronic perineal Crohn's disease, resistant to other treatments or as a complement to surgery.