With our standardized LSG technique it is possible to evaluate the positive aspects of the LSG compared with other standardized bariatric procedures like LAGB or LRYGBP.

We report the case of a 72-year-old woman with a covered and perforated appendicitis and periappendicular abscess within the hernial sac (Amyand's hernia) of an incarcerated recurrent inguinal hernia after primary Shouldice repair. Initially, a preoperative CT-scan showed signs of an incarcerated femoral hernia. This would be the first reported case of an incarcerated recurrent Amyand's hernia, which is an extremely rare condition.

CCK-58 has the same potency in inhibiting food intake as CCK-8 in rats, but inhibits food intake longer. This might be due to its tertiary structure resulting in a delayed plasma degradation or a prolonged binding at the CCK receptor. As CCK-58 is the major CCK form in the gut wall and possibly in the circulating blood in humans, the effects of CCK on food intake might have been underestimated in the past.

We report on a female patient who developed post-dural puncture headache (PDPH) after epidural analgesia for delivery. Treatment with epidural blood patch led to complete headache remission and the patient was discharged. Two days later the patient was readmitted with hemihypaesthesia and mild hemiparesis of the right side. Magnetic resonance imaging showed a small left parietal cortical haemorrhage probably following cerebral venous thrombosis (CVT). Coagulation screening detected heterozygous Factor V mutation. Headache is a common symptom of PDPH and CVT. Review of the literature revealed five patients in puerperal state, who developed CVT in close temporal relationship after blood patch treatment for PDPH. Change of headache character with loss of postural influence was reported frequently before diagnosis of CVT was confirmed. These findings may indicate a causal relationship.

A temporary non-surgical approach for treatment of obesity is the gastric balloon that serves as an alternative procedure for many patients with frustrated diet attempts. Deflation and displacement of the balloon resulting in acute intestinal obstruction and subsequent surgical intervention is a rare complication. A BioEnterics Intragastric Balloon was endoscopically implanted in a 35-year-old female with a body mass index (BMI) of 28 kg/m(2). The procedure succeeded without complications, and weight loss was effective during the first 6 months. One year after balloon implantation, the patient presented with abdominal cramps and vomiting due to ileal obstruction. Since endoscopic efforts to remove the deflated and displaced balloon failed, emergency laparotomy and enterotomy were necessary. Vascularization of the dilated small bowel was compromised, but recovered after decompression. Patients' postoperative course was uneventful. The gastric balloon model can be associated with major complications and should be used critically. Removal of the balloon should be assured not later than 6 months when weight loss decreases.