The akinetic bowel loops, hyperechoic thickening of the attached mesentery and free peritoneal fluid are typical for strangulating closed-loop obstruction. An anechoic luminal content is only visible in about half of the patients, but this eye-catcher can lead the investigator to the correct diagnosis. In about one third of patients no signs of bowel obstruction proximal to the strangulated loops are present. Dilatation of the strangulated loop may be absent or mild.

Retrospective Study of Melanoma Patients Treated with Mistletoe Extracts Objective: The aim of the present investigation was to analyze survival time and survival rate of all patients with malignant melanoma who had been counseled at the Tumorambulanz Herdecke of the Community Hospital Herdecke. Patients and Methods: 284 melanoma patients were included in a retrospective questionnaire study. Only those patients were considered for analysis in whom the prognostic factors histology, tumor localization, and Clark level were known. The data of the study population were compared with patient data obtained from the literature. Results: 94 patients were included in the analysis. 66 of whom had received and 7 had not received mistletoe treatment, in the remaining 21 patients there was no information whether or not mistletoe treatment had been given. Thus, we did our study without a clearly defined internal control group. The median survival time among patients treated with mistletoe had been 14.1 years. The 5- and 10-year survival rates were 80 and 68% for the mistletoe-treated patients, respectively. Discussion: The 5-year survival rate of the mistletoe-treated patients is comparable to that of patients without mistletoe therapy while the 10-year survival rate is a little bit lower. This may be due to the fact that, in contrast to the patients from the relevant literature, 33.3% of the patients suffered from lymph node and/or distant metastases already before counseling the Tumorambulanz Herdecke. Moreover, 50% of our patients had melanoma of Clark level IV in contrast to 22.2% or 31% in the relevant literature. Conclusions: In spite of the theoretical reservations against mistletoe treatment in melanoma patients, our retrospective analysis did not show any clues about disadvantages of mistletoe treatment in melanoma patients. A controlled prospective study therefore should prove the efficacy of a mistletoe therapy in patients with malignant melanoma.

The aneurysmal bone cyst (ABC) is well-known for its local expansile growth form and for the high risk of recurrence after treatment. We present the case of a 6‑year-old patient with a large ABC in the metaphysis of the proximal tibia, which showed recurrence only five months after treatment with curettage and autologous bone graft. By using six percutaneous intralesional injections of polidocanol the patient was successfully treated with no recurrence. After 18 months, a mild genu valgum was clinically noted.

No abstract