The modifications suffered by the peri-esophageal anatomical structures in the hiatal hernia disease: a qualitative and quantitative microanatomic study.

This paper presents the results of a surgical and histopathological study regarding the microanatomical modifications of the thoraco-abdominal diaphragm and of the peri-esophageal structures in the hiatal hernias, establishing a cause-effect relationship between these structural modifications and the hiatal hernia. The study was represented by two groups of patients: a control group and a group with hiatal hernia. The study method consisted in intraoperatory biopsy of fragments from the diaphragm as well as from the tissue around the esophagus, which were studied from the histopathological viewpoint, using histological methods and quantitative microanatomy. In the end, the results obtained from the two groups were compared. The microscopic examination revealed the presence of an inflammatory infiltrate located between muscle fibers, especially near blood vessels, at the level of the diaphragm crura and the phreno-esophageal membrane. Also, they found red blood cell at this level, most likely due to pressure from the hernia at this level. From the quantitative micro-anatomical viewpoint, there has been noticed an increase in the percent of the vascular lumen (accentuated vasodilatation) as well as the interstices occupied with the edema and hemorrhage, to the detriment of the muscle fibers, the most significant modifications being met at the level of the crura.

[The Krukenberg tumor caused by an adenocarcinoma of the gallbladder]. / Tumora Krukenberg secundara unui adenocarcinom al veziculei biliare.

This work presents the case of a 62 year-old woman's Krukenberg tumor caused by an adenocarcinoma of the gallbladder. This was the presumptive diagnosis that was confirmed during the operation. The characteristic feature of this case consists of the rarity of the Krukenberg tumors caused by a cancer of the gallbladder, the paraneoplastic pleurisy and the presence of the cells with "a ring with a seal" in the pleural liquid and in the ascites liquid. The paraclinical investigations (echography, computerised tomography) were not able to specify the diagnosis before the operation. The surgical intervention (cholecystectomy and total hysterectomy with bilateral adnexectomy) has had favourable consequences. Nevertheless, the woman died 5 months after the operation.

[Abdominal aorta section caused by abdominal stab wound: discussion of two cases]. / Sectiune de aorta abdominala prin plaga înjunghiata. Consideratii pe marginea a doua cazuri.

Abdominal vascular lesions are generally caused by accidents (most frequently car accidents, but also falling from an altitude, etc.) or by aggression with knives and fire arms. Abdominal vascular wounds, especially those involving the aorta, cause high mortality. Many patients die on the way to the hospital due to massive blood losses, their lesions being determined only through necropsy. Mortality is increased when abdominal vascular lesions are associated with abdominal or thoracic visceral lesions. We present two cases of partial sections of the abdominal aorta caused by stab wounds: a 16-year-old male aggressed by a school-mate and a 45-year-old male who aggressed himself. We discuss the necessity of immediate surgery on patients with abdominal stab wounds in order to determine the localization and gravity of the lesions.