The penetration of ciprofloxacin in pancreatic juice was investigated in 5 patients with pancreatic fistula. The drug was administered as a single oral dose of 500 mg after which serial samples of pancreatic juice and serum were collected for ciprofloxacin assay. The following pharmacokinetic parameters (means ± SD) were estimated from the serum level versus time curves: clearance 11.51 ± 2.85 (ml/min/kg); V_darea 3.08 ± 1.20 ml/kg; terminal half-life 3.10 ± 0.92 h; mean residence time 5.64 ± 1.40 h. Ciprofloxacin serum levels declined rapidly after the third hour, whereas concentrations in pancreatic juice remained elevated (above 1 mg/l) for nearly 12 h. The pancreatic juice/serum ciprofloxacin concentration ratio increased gradually fom 0.63 ± 0.45 after 0.5 h to 6.18 ± 4.59 after 12 h (means ± SD). Our data indicate that while the drug elimination half-life from the serum is short, the time-course of ciprofloxacin levels in the pancreatic juice conforms to a much slower disappearance rate. In particular, the ciprofloxacin levels achieved in pancreatic juice are constantly greater than the MICs of the bacteria generally responsible for pancreatic infections.

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Between January 1987 and December 1988, at the Surgical Department of Chiarenzi Hospital, five patients underwent endoscopic intratumoral injection of polidocanol for palliative treatment of inoperable carcinoma of the rectum. Histological evaluation was performed in all cases. The patients comprised two males and three females aged 78 to 88 years (mean 83.4). One of them refused surgery for recurrent rectal cancer, four consulted us with impending intestinal obstruction; three were inoperable due to local spread of the tumor and poor general condition, the other was in a poor general condition due to massive metastatic hepatic disease. In all the patients, we observed remission of the obstructive symptoms with no major complications; none of them has required a colostomy. The follow-up period has covered a period of two months to two years. The technique of injection is simple, inexpensive and, properly performed, safe. All these advantages make this type of palliative treatment for rectal cancer interesting, even when compared with laser treatment, urological resectoscope or electric snare resection, and electrocoagulation.