[Surprise in the hernia sac: the intrasaccular tumor of the sigma]. / Sorprese nel sacco erniario: il tumore intrasacculare del sigma.

In this report we define the terms of saccular, extra-saccular and intrasaccular tumor and present a rare case of intrasaccular tumor of the colon; it is remarked a careful clinical examination of patients with inguinal hernias to find a colon tumor; diagnosis in emergency is intra-operative. Two therapeutics options are possible: the simultaneous treatment or the delayed resolution.

[The nasojejunal tube in early postoperative nutrition]. / Il sondino naso-digiunale nella nutrizione postoperatoria precoce.

BACKGROUND: To verify the effectiveness of the nasojejunal tube inserted during operation as an alternative to jejunostomy to perform early enteral feeding. EXPERIMENTAL DESIGN: Prospective study. SETTING: Department of Surgery, General Hospital. PATIENTS: 27 patients undergoing laparotomy because of a gastric pathology. INTERVENTIONS: In 18 patients before construction of the distal jejunum anastomosis the tube was inserted by nasal route and advanced into the jejunum ansa until the end reached 15 to 20 cm down the anastomosis (group A); 9 patients underwent a jejunostomy according to Delany (group B). All the patients started enteral feeding 24 hours after operation and had the same polymeric diet, given to them using the same procedures. MEASURES: postoperative complications, tube intolerance, intestinal tolerance. RESULTS: The degree of non-acceptance of the tube was: absent in 3 patients of group A and in 7 patients of group B (p > 0.05); slight in 6 patients of group A and in 2 patients of group B (p > 0.05); medium in 9 patients of group A and in no one of the group B (p no measurable); high in neither groups. The intestinal tolerance was similar in both groups. CONCLUSIONS: Nasojejunal tube is an effective alternative to jejunostomy to perform early postoperative enteral feeding.

[Klippel-Trenaunay syndrome: clinical and surgical aspects]. / La sindrome di Klippel-Trenaunay. Aspetti clinici e chirurgici.

The Klippel-Trenaunay syndrome is a rare syndrome of uncertain etiology. The characteristic elements are flat angiomatosis, hypertrophy of soft tissue and bone tissue and alterations of the venous system, with the exclusion of hemodynamically significant arteriovenous fistulae. The authors report a clinical case and review the international literature. Treatment is conservative in the majority of cases; surgery is reserved for patients with disabling morphological and functional alterations.

[Colon volvulus]. / Volvolo del colon.

The authors report a clinical case and review the international literature. After an analysis of the incidence and the predisposing factors causing this disorder, they focus attention on the question of therapy. In forms with vital loop non-surgical derotation must be attempted. In the event of the failure of non-invasive treatment and to prevent recidivation these forms are treated surgically, also using videolaparoscopy. In forms with non-vital loop, surgery consists of the section of the necrotic segment and preparation of anastomosis which may be immediate or deferred depending on general and local conditions.

[Biliary ileus. Case report and therapeutic considerations]. / Ileo biliare. Presentazione di un caso e considerazioni clinico-terapeutiche.

The authors, after having described, a case of biliary ileus, analyse the principal pathogenetic aspects of the disease, and underline the diagnostic and therapeutic difficulties. They believe that the simple enterolithotomy represents, initially, the best therapy, in particular with patients in poor clinical conditions.

[The effects of protein-energy deficiency in candidates for gastric resection]. / Gli effetti della carenza energetico-proteica nei pazienti candidati alla resezione gastrica.

The nutritional status of patients subjects to surgical operations represent an important element in determining the incidence of morbidity and mortality. We have examined 19 patients suffering both from benign and from malignant pathology subjected to a gastric resection and treated in the preoperative period for 7-8 days and in the postoperative period for 8-10 days with parenteral nutrition. Nutritional valuation was carried on at the time of admission, in the postoperative period and in proximity to discharge; an accurate observation of possible associated was also carried on. The comparison with the not treated with a nutritional support has shown a smaller incidence in complications of a general character and also in those connected with the operation and a reduction in the postoperative stay in hospital.