[Gastrointestinal manifestation of malignant systemic diseases]. / Gastrointestinale Manifestation maligner Systemerkrankungen.

Malignant diseases of the lymphoreticular system can become manifest within the gastrointestinal tract, either isolated, involving solitary organs, in generalized form, or as diffuse polyposis. The ratio of primary to secondary lymphomas is quoted as being 1:2 to 1:3. The clinical picture is characterized by their spread. Abdominal pain, loss of weight, anorexia, nausea and vomiting, including even gastrointestinal hemorrhage, are the most frequently observed symptoms. The involvement of the gastrointestinal tract in Hodgkin's and non-Hodgkin lymphomas of, on average, some 10%, is confirmed in our own material over the past 7 years. From a total of 580 malignant lymphomas, 47 cases were confirmed, endoscopically and bioptically, to have gastrointestinal involvement, primary lymphomas accounting for 1/3, secondary for 2/3. Gastric lymphomas accounted for 59.6%, small-bowel lymphomas for 25.5%, a large-bowel involvement was seen in 14.9%. The centrocytic-centroblastic and lymphoblastic lymphomas predominate.

Endoscopic-radiological findings in metastatic obstructive jaundice.

Metastatic obstructive jaundice usually results from an occlusion of the common hepatic or bile duct. More rarely, the underlying cause is a disseminated intrahepatic infiltration that has led to the occlusion of the bile canaliculi. The endoscopic-radiological examination techniques usually permit a reliable differentiation between neoplasms originating primarily in the biliary tract, and ductal occlusions caused by metastatic disease. In addition to this, both ERC and PTC permit the placement of an internal or external biliary drain during one and the same procedure. ERC represents a highly suitable method for the follow-up monitoring or documentation of the therapeutic effect of biliary drainage, radiotherapy and/or polychemotherapy. With the aid of regular follow-up examinations, recurrent disease can be detected early on, and appropriately treated.

[Agranulocytosis and metamizole]. / Agranulozytose und Metamizol.

Among 78 000 patients hospitalized over a period of 11 years there were 12 with agranulocytosis drug- or allergy-induced. It is often difficult to be certain of the aetiology, because drug combinations or several drugs simultaneously are often prescribed. A definite relationship could not be proven, although it seemed possible, between six cases of agranulocytosis and the intake of metamizole. Taking into account two deaths and four relatively mild cases assumed to be the result of metamizole treatment, this incidence is similar to that reported in the literature. Alternative drugs have not been proven to cause fewer side-effects. These results suggest that there is no reason at present to stop the use of metamizole.