A 60-year-old man was treated by extracorporeal shock wave lithotripsy (ESWL) for an impacted ureterstone. Two days after the procedure he developed an acute abdomen. On laparotomy, a small bowel perforation in the area of an adhesion to the abdominal wall was found. The adherent intestinal segment was located exactly in the range of the ESWL field, so that excluding further reasons the shockwave lithotripsy must be assumed to be causative.

Breast-conserving therapy is a safe and cosmetically acceptable alternative to mastectomy for subareolar breast cancer.

8554 Lipome (13 %), 3 H/imangiome (I0 %) und 5 tumor/ihnliche L/isionen (16 % Erfahrungen mit der intraoperativen Bestrahlung (IORT) beim Pankreascarcinom Experiences with Intraoperative Radiation Therapy in Pancreatic CarcinomaSummary. Fourteen patients with pancreatic carcinoma underwent intraoperative electron-beam irradiation (IORT) with a single "boost" dose of up to 25 Gy (11 cases of unresectable tumors and 3 patients during Whipple's procedure). There were no disturbances in wound healing or other IORTrelated early complications. Our experience indicates that IORT continuously reduces tumor-related pain. However, we cannot yet judge the influence of IORT regarding potential improvement of long-term survival. Diverticulitis (45.1%), carcinoma (28.6%), inflammatory bowel disease, and ischemic colitis (11%) were the main etiological factors. The operative procedures for diverticulitis were: primary resection (15 of 41 = 36.6 %) a two-stage procedure (5 of 41 = 12.2 %), Hartmann's operation (16 of 41 = 39.0 %). In colorectal carcinomas, the oncological rules often cannot be strictly adhered to because of the poor general condition of the patients. Total mortality was 19.8 %. The low mortality in diverticulitis was due to consistent primary resection (3 of 41 = 7.3 %).

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