Necrosis and perforation of the small intestine of non-vascular origin are uncommon. Single cases have been described occurring in patients with blood and lymphatic malignant neoplasms. We present the case of necrosis and massive perforation of part of the small intestine in a patient diagnosed with diffuse large B-cell lymphoma (DLBCL), prior to commencement of therapy. At admission, the patient had typical symptoms and signs of a diffused peritonitis. Intraoperatively, faecal content was found in the peritoneal cavity and necrosis with a massive perforation of approximately 10 cm of the terminal ileum. Resection of the involved fragment of intestine was performed, followed by closing of the distal stump of the ileum and end ileostomy. The post-operative course was uneventful and the patient was moved to the haematologic department for further treatment of the lymphoma.

Background. Persistent, long-lasting pseudoarthrosis of the scaphoid or scapholunate dissociation results in arthrosis of the radio-scaphoid joint termed scaphoid non-union advanced collapse (SNAC) or scapholunate advanced collapse (SLAC), which causes pain, reduction in wrist movements and weakness of the hand grip. Scaphoid resection followed by „four-corner” midcarpal arthrodesis is a recognized treatment for this condition. Material and methods. The study evaluated the results of treatment of 27 patients with arthrosis of the wrist type SNAC (n = 15) and SLAC (n = 12) after an average of 4 years after surgery (range from 2 to 8 years) Results. The mean numerical pain score for wrist movements was 3.6 (range: 1-5). The mean active range of wrist movement (affected vs healthy hand) was: flexion 27° vs 58° (46%), extension 27° vs 52° (53%), ulnar deviation 16° vs 26° (62%), radial deviation 9° vs 17° (53%), total grip strength 22 kG vs 29 kG (76%), The mean DASH score was 22 (range: 4-36) and the mean Mayo score was 72 (range: 65-80). None of the patients required revision surgery. Of the 16 patients employed prior to the surgery, 10 returned to work after a mean of 4 months of sick leave. Conclusions. 1. The results of the treatment presented in this stu­dy, after a relatively long follow-up period, show a beneficial effect of the surgery on pain intensity and improvement of hand dexterity, at the cost of a mild reduction in wrist movements. 2. It seems that this technique offers good, predicta­ble outcomes and may be recommended for Wa­t­son 2° and 3° SNAC or SLAC wrist arthrosis.