Meckel's diverticulum findings on Tc-99m red blood cell scintigraphy in a bleeding leukemic patient confirmed by Tc-99m pertechnetate scintigraphy.

A 25-year-old Caucasian woman with a medical history of acute promyelocytic leukemia presented to the emergency department with massive gastrointestinal bleeding. A bone marrow biopsy excluded hemorrhagic leukemia. Esophagogastroduodenoscopy, colonoscopy, emergency abdominal angiography, abdominal CT scan, and wireless capsule endoscopy were performed but no source of bleeding could be detected. Tc-99m RBC scintigraphy was consistent with a small bowel bleeding focus. The persistent and focal images in the right abdomen were suggestive of Tc-99m RBC trapping in the lumen of a Meckel diverticulum (MD). In accordance with this suspicion, successive Tc-99m pertechnetate scintigraphy was performed after 3 days, consistent with the diagnostic hypothesis. Due to the persisting severe bleeding (with a drop in baseline hemoglobin from 10.4 to 7.1 g/dL), despite 8 units of blood transfusion, emergency surgery was performed. Through a minilaparotomy a segmental small bowel resection, including Meckel diverticulum, was performed. The postoperative course was uneventful.

[Thermal ablation by radiofrequency of hepatic metastasis of colorectal cancer: short-term results]. / Termoablazione mediante radiofrequenza di metastasi epatiche da cancro colorettale: risultati a breve termine.

Radiofrequency (RF) was used to ablate 42 colorectal liver metastases in 20 patients (10 males and 10 females) in a four years period. Median age was 62.2 years, 36 lesions (75%) had 3 cm diameter or less. An open surgical approach was adopted in 13 patients, whereas a percutaneous one in 14. On 27 surgical sessions, RFA was used in 49 procedures for a total of 81 needle applications. Morbidity was 6.0% (3 cases), one patient died on third po day for myocardial infarction. No differences in terms of complete ablation rate was observed in the two approach's groups. Overall survival was 65% with a median follow-up of 18.5 months.

[Prognostic factors of pancreatic carcinoma: analysis of the 5-year-survivor cases]. / Fattori prognostici nel carcinoma pancreatico: analisi dei casi "5-year survivors".

Pancreatic carcinoma remains a letal disease with an overall 5-year survival of less than 5%. Recent reports of increases in actuarial survival after resection have determined some optimism. Our objective was to identify the actual 5-year survival rate of patients with pancreatic carcinoma who underwent a resection with curative intent, analyzing those factors associated with a more favorable prognosis.

[Duodenocephalopancreatectomy for periampullary neoplasm in elderly patients]. / La duodenocefalopancreasectomia per neoplasia periampollare nel paziente anziano.

As life expectancy continue to increase, many elderly patients may be considered for pancreaticoduodenal resection. The purpose of the study was to review our experience with pancreatic resection for periampullary evaluating immediate and long-term results in patients aged 75 or older.