[Colorectal hemorrhages]. / Le emorragie colo-rettali.

The authors review literature published worldwide regarding the possible causes of colorectal haemorrhages and evaluate the probability of determining their site and nature. Knowledge of this probability, alongside an opportune use of presently available diagnostic methods, makes it possible to choose a suitable from of therapy based, according to the case in question, on endoscopic, angiographic or surgical haemostasis. A series of 38 cases is presented, subdivided by etiopathology and site, and two different diagnostic and treatment flow charts are proposed according to whether the haemorrhage is acute and massive or chronic. Diagnosis is,. however, sometimes difficult, even when supported by the latest techniques in scintigraphy, angiography and endoscopy (endoscopic Doppler, intestinal enteroscope). At present, notwithstanding the promising results from endoscopic and angiographic techniques, surgical treatment still gives the highest percentage of curability. This surgical treatment is based on segmental resections in cases of precise localisation of the site of the haemorrhage and on immediate subtotal colectomy in cases of massive bleeding of unknown origin.

Tripartite differentiation (squamous, glandular, and melanocytic) of a primary cutaneous neuroendocrine carcinoma. An immunocytochemical and ultrastructural study.

We report a case of primary cutaneous neuroendocrine carcinoma (PCNEC) with squamous, glandular, and melanocytic differentiation and associated Bowen disease. The paranuclear globular positivity of low-molecular-weight cytokeratins agrees with the ultrastructural observations of paranuclear fibrous bodies in the small neuroendocrine cells, while the diffuse cytoplasmic positivity corresponds to the sparse intermediate filaments in large cells with squamous differentiation. "Transitional forms" are characterized by both diffuse and globular cytoplasmic positivity for cytokeratins and by the ultrastructural evidence of neuroendocrine and squamous features. Therefore the ultrastructural demonstration of intracytoplasmic tonofibrils and tonofilaments, intercellular glandular lumina, lined by well-formed microvilli, and immature premelanosomes in the neurosecretory cells supports the proposed tripartite differentiation of neuroendocrine cells of this case of PCNEC.

[Rectal burns caused by enema]. / Ustione del retto da enteroclisma.

The injuries incident to enemas may vary from oedema of the mucosa to gangrene of the large bowel. The burn of the rectum is very rare, and in mild cases it has an identical course to that of the caustic oesophagitis. The place of corticosteroids, administered by intravenous route or topically, in the therapy of te burn of the rectum is unproven. Healing of the lesion occurs by fibrosis and may result in structure formation, which usually need a treatment only when obstructive symptoms develops.

[Partial paralysis of the right lumbar plexus caused by a traumatic hematoma of the ileo-psoas muscle]. / Paralisi parcellare del plesso lombare di destra da ematoma traumatico del muscolo ileo-psoas.

The authors show a case of paralysis of right femoral nerve, subsequent to extrinsic compression due to traumatic hematoma of ileo-psoas muscle. What emerges from the revitwing of the international literature, as well as from the personal experience is both a complete nosographic framing and the necessity for an early surgical intervention.