Two patients are reported who presented with symptoms characteristic of a pancreatic vipoma. The necessity to measure more than one plasma VIP level for diagnosis, and the delay between the onset of illness and diagnosis is illustrated by both cases. Evidence suggests that vipomas are still under reported. The evolution of sophisticated diagnostic and therapeutic modalities over the twenty-five years separating both presentations is discussed.

The presentation and course of 7 patients with splenic artery aneurysms is reviewed. Three presented with abdominal pain, 2 with collapse and rupture and in 2 it was an incidental finding. Four patients had elective ligation-excision of the aneurysm with splenectomy as had one patient operated on as an emergency, with no operative mortality. The aneurysm size ranged from 20 to 45 mm (mean 30 mm) and histology confirmed atheroma. One patient was managed as a myocardial infarct for 8 hours after admission and a ruptured splenic aneurysm was diagnosed at autopsy, an overall mortality of 14%. A 66-year-old woman in poor general health was managed expectantly and was asymptomatic when lost to follow-up after 2 years.

Patients overall had a one in seven chance of having curative surgery in any of the first ten years following diagnosis. Cumulative surgical recurrence rates are similar to those in America. The higher cumulative surgical recurrence rates are similar to those in America. The higher cumulative risk of surgical recurrence in patients with macroscopic disease of the large bowel probably relates to a conservative surgical approach in such patients. There was no operative mortality.