No abstract

Secondary tumours of the gallbladder considered are thought to be rare. Since 1863 only 95 cases have been reported. The case discussed here is only the second one in which the metastatic tumor was a medullary plasmocytoma. But a search for published and confirmed cases indicates that secondary tumors of the gall bladder are not so rare. Metastatic tumors of the gall bladder should be kept in mind in the differential diagnosis of acute cholecystitis, especially in patients with an advanced primary tumor.

Schuster D et al. Metastase eines medullären… TumorDiagn u Ther

This review of 133 arteriovenous (AV) fistulas, created by implantation of polytetrafluoroethylene (PTFE) graft material, reports an infection rate of 16.4% in the first period from 1982 to 1985. The infection rate decreased to 5.6% in the period from 1986 to 1990. Graft infections occurred at a higher rate of 46.2% versus 20% when reoperations because of malfunction, occlusion, aneurysm, or bleeding were necessary.Graft infections can be reduced by the development of standard surgical procedures, by the local and systemic application of antibiotics, and by a careful puncture technique. The treatment of septic graft complications after primary operations resulted in a maintenance of graft function in 50%. After secondary operations the graft had to be excised in all but 1 case.