Der Internist
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Atraumatic rupture of the spleen is a rare, but life-threatening complication of pancreatitis. We report a case of an atraumatic spleenic rupture in chronic pancreatitis. A 41 year old man presented in the emergency room with abdominal pain and typical signs of acute pancreatitis. ⋯ Hence we assumed a spontaneous rupture. The reported case demonstrates that in acute pancreatitis and signs of shock it is necessary to rule out rupture of the spleen e.g. via ultrasound and abdominal CT scan. If there are signs of spleenic rupture, the only therapy of this life-threatening complication is instant operation to save patient's life.
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Review
[Adjuvant chemotherapy of solid tumors of the gastrointestinal tract: where is the progress?].
Surgical therapy of any malignancy always attempts the complete removal of a cancer from the organism. An adjuvant chemotherapy has the goal to remove remaining tumor-cells, to prevent recurrence of the disease and to improve long term survival. Within the last years there has been a substantial improvement in prognosis due to multi-modal therapeutic regimens including combination-chemo-therapy and innovative radiation-protocols. This review aims to present and to critically review current concepts in the treatment of selected tumors of the gastrointestinal tract.
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Cardiogenic shock after acute myocardial infarction continues to exhibit a high mortality rate. The prognosis can be improved with acute revascularization. ⋯ New treatment approaches such as the calcium sensitizer levosimendan, NO synthase inhibition, complement inhibition, or vasopressin therapy have not yet yielded convincing results. Future therapies will likely address the anti-inflammatory aspect of cardiogenic shock.