Placement of an implantable percutaneous permanent triple-lumen catheter.

A new technique has been described for the placement of an implantable percutaneous triple-lumen catheter. This procedure eliminates the need for a large bore introducer. It also provides a mechanism to change these catheters over a wire if necessary. This cannot be accomplished with the Hickman or Broviac catheters. The three lumens allow multiple, simultaneous intravenous therapies to be administered in the long-term inpatient, as well as the outpatient.

Sclerosing cholangitis, chronic pancreatitis, and Sjogren's syndrome: a syndrome complex.

The disease complex of chronic pancreatitis, sclerosing cholangitis, and Sjogren's syndrome seems to be a well-defined entity with an autoimmune cause similar to that which occurs in primary biliary cirrhosis. Treatment depends on the component of primary sclerosing cholangitis and, more particularly, on the degree of extrahepatic involvement.

Another facet of Mirizzi's syndrome.

Mirizzi's syndrome is a rare entity of common hepatic duct obstruction that results from an inflammatory response secondary to a gallstone impacted in the cystic duct or neck of the gallbladder. It results from an almost parallel course and low insertion of the cystic duct into the common hepatic duct. In a variant of Mirizzi's syndrome, the cause of the common hepatic duct obstruction was a primary cystic duct carcinoma rather than gallstone disease.