[Ulcerative rectocolitis in the pediatric age group. Radical surgical treatment by the pull-through procedure and direct ileo-anal anastomosis]. / La rettocolite ulcerosa nell'età pediatrica. Terapia chirurgica radicale mediante il procedimento dell'endo-rectal pull through ed anastomosi ileo anale diretta.

Ulcerous rectocolitis (URC) is today seen more frequently than in the past. Extended forms and/or those recalcitrant to medical therapy, make use today of radical surgical treatment with fewer functional and anatomic sequelae. Personal experience of seven cases admitted to the Paediatric Surgery Department of the University of Bari is reported, stress being laid in particular on the results of surgical therapy obtained with total colectomy associated with proctomucosectomy according to the Romualdi-Soave technique. After presenting some general remarks on the disease in paediatric age, stress is laid on the need to resort as quickly as possible to radical surgery, respecting the technical suggestions of Lester-Martin. It is maintained that before carrying out surgical therapy it is always advisable to carry out temporary ileostomy as it offers particular advantages deriving from the greater effectiveness of pharmacological therapy on the defunctionalides colon, the noteworthy recovery in general condition favoured by associated NPT and by recognition of the real extent of the disease which often does not correspond to the endoscopic aspects. Finally, it is maintained that Lester-Martin's technical modification if applied correctly leads to normal functional results (continence and number of alvus emptyings) and definitive, stable cure of the disease, thus rendering inopportune, at least in paediatric age, of the use of the ileal pocket.

[Angiographic diagnosis of bleeding Meckel's diverticulum in remission]. / Diagnosi angiografica di diverticolo di Meckel sanguinante in remissione.

The paper reports a case of Meckel's bleeding diverticulum which was diagnosed preoperatively using a selective arteriography of the superior mesenteric artery. The infrequent use of this instrumental test may be due to the small number of examples reported in the literature. In conclusion, the Authors underline that selective arteriography can be used with good results even in cases with hemorrhagic complications during the remission phase.

[Intra- and postoperative complications in the surgical treatment of cholelithiasis]. / Complicanze intra e postoperatorie nel trattamento chirurgico della colelitiasi.

The authors report their experience in biliary tract surgery. From 1974 throughout 1988, 1.186 patients underwent surgery and the commonest operation was cholecystectomy. The most significant complications and the causes of death are reported. Mortality rate was 0.82%.

[Ileal stenosis caused by chronic granulomatous inflammation secondary to a foreign body simulating Crohn disease]. / Stenosi ileale da flogosi granulomatosa cronica da corpo estraneo simulante morbo di Crohn.

A case of ileal stenosis due to foreign body induced chronic granulomatous inflammation simulating Crohn's disease with onset on an ileo-ileostomy carried out 23 years before due to iatrogenic rupture of ileal loop following clandestine abortion is reported. After noting the problem of attributing to the foreign body alone responsibility for the stenosis, the hypothesis that it might have been an acute occurrence of Crohn's disease or the expression of an association of Crohn's disease and granulomatous inflammation due to surgical material is advanced. This for the moment is the only plausible cause. It is concluded that for accurate nosological classification and, therefore, definitive clinical diagnosis, prolonged clinical control of the patient is indispensable.

[Spontaneous hemoperitoneum caused by hemorrhage and the rupture of pancreatic pseudocysts]. / L'emoperitoneo spontaneo da emorragia e rottura di pseudocisti pancreatica.

Two cases of haemoperitoneum due to haemorrhage and rupture of pancreatic pseudocyst in the peritoneal cavity are reported. After mentioning the exceptional nature of this complication in pancreatic pathology, the particular features of these cases are stressed, stress being laid particularly on the usefulness of echography which should be preferred to selective angiography for the usual reasons of speed of execution and harmlessness of the examination which can be carried out at the bedside if a portable echography unit is available.