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Case Report: The authors report on a 55-year-old female patient after R1 resection of a malignant thymoma with spindle type epithelial cells (WHO type A, Masaoka stage III) referred for further therapy of an ulcerative colitis. At that time, both adjuvant radiation and cytostatic therapy were not applicable due to severe activity of the ulcerative colitis. Under immunosuppressive treatment with azathioprine and steroids, the patient developed cytomegalovirus (CMV) enteritis which was triggered by therapy-induced leukopenia. After a switch from azathioprine to mycophenolatmofetil (MMF) treatment and administration of cidofovir because of nonresponse to ganciclovir and incompatibility of foscarnet sodium (Foscavir), the patient clinically improved. In addition, the patient was treated with immunoglobulins every 3-4 weeks because of antibody deficiency. At present, 3.5 years after R1 resection, the patient still has no clues of a remaining tumor mass under current immunosuppressive therapy. Ulcerative colitis is also in complete remission stage., Conclusion: This case indicates the very rare features of a syndrome with thymoma and antibody deficiency which was first described by Robert Good. Furthermore, the impact of immunosuppressive therapy and management of opportunistic infections on the course of this disease is obvious.

In 5 out of 35 patients with acute, acute relapsing and chronic pancreatitis, barium enema revealed partial colonic stenosis at the splenic flexure. In 3 patients laparotomy disclosed colonic perforation with abscess, adhesions between colon and pancreas or a marked pancreatic edema. In two patients barium enema follow-up 3-6 months later showed spontaneous resolution of the stenosis. Comparison with 35 cases in the literature shows that colonic stenosis after pancreatitis is usually incomplete, located at the splenic flexure and due to adhesions between the colon and the pancreas. Spasmodic pains in the upper abdomen, increasing constipation and often rectal bleeding or positive guaiac test of the stool may indicate colonic stenosis. Spontaneous resolution is possible, but if operation is indicated the adhesions should be carefully dissected in order to obviate resections of the colon or the pancreas.