The case of a patient with a 2-day history of symptoms suggesting acute carpal tunnel syndrome is presented. However, an urgent electroneurographic examination revealed median nerve compression at the forearm and magnetic resonance imaging confirmed compression by a mass proximal to the carpal tunnel. Surgical exploration showed a recently thrombosed aneurysm of an epineural vessel. Histological and, later, general and angiological investigations could not reveal the underlying cause of this aneurysm. Preoperative electrodiagnostic examination is recommended in acute peripheral nerve compression to prevent decompression at an incorrect site. If atypical nerve compression is suspected, magnetic resonance imaging may be indicated to detect localized nerve compression and its underlying cause.

Infections due to group B streptococci usually occur in the peri-and neonatal setting or in adults with chronic underlying diseases. A case of pyogenic vertebral osteomyelitis caused by Streptococcus agalactiae in a 54-year-old man suffering from phimosis with urinary retention and urinary tract infection is reported. This case adds to the few existing reports of vertebral osteomyelitis caused by group B streptococci. its insidious onset, and serious neurological complications and fatalities may occur when the diagnosis is unduly delayed.Group B streptococcus (Streptococcus agalactiae), usually associated with perinatal infections, has recently been recognized as an important infectious agent of invasive disease in nonpregnant adults. The majority of cases reported thus far have occurred in elderly patients or those with significant underlying conditions such as diabetes mellitus, malignancy, or liver disease (3). We report the case of a 54-year-old man suffering from phimosis and urinary tract infection who developed group B streptococcal vertebral osteomyelitis with epidural involvement.Case Report. A 54-year-old man was admitted to our hospital for treatment of low back pain. He had suffered from general malaise for several months, occasional chills for one week, and low back pain radiating down the lateral aspect of the left leg for three days. His medical history was unremarkable except for a phimosis that had existed since his childhood, associated with occasional self-limited dysuria. On admission the patient's oral temperature was 37.7~ A tight phimosis was confirmed. Neurological examination revealed tenderness and hyperextension of the lower lumbar spine with bilateral muscular rigidity. There was no sensory or motor deficit of the lower extremities, and reflexes were normal.During recent decades, the spectrum of microorganisms causing vertebral osteomyelitis has shifted from mycobacteria to pyogenic bacteria.Staphylococcus aureus is responsible for up to 85% of cases of pyogenic vertebral osteomyelitis (1), but streptococci and gram-negative rods may also be involved (2). The disease is notorious for 1Division of Infectious Diseases, Department of Internal Medicine, and 2Department of Radiology, University Hospital, Petersgraben 4, CH-4031 Basel, Switzerland.

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Acute hemorrhage from pseudocysts and pseudoaneurysms is a threatening complication of chronic pancreatitis. Whilst surgical intervention still has high perioperative mortality (16.8%), transcatheter arterial embolization is becoming more frequently used for suitable cases and appears to have lower mortality (6.1%). We report on six patients treated in our unit. Four of them underwent primary surgical treatment, the other two were treated by embolisation. One of the latter patients subsequently required laparotomy for further treatment. All six patients survived. Comparing the literature covering the periods between 1951 and 1981 and between 1982 and 1996, transcatheter embolisation seems to be valuable in controlling this type of bleeding, thereby reducing mortality.