[500 days of somatostatin treatment]. / 500 giorni di trattamento con somatostatina.

A group of 11 patients received somatostatin for a minimum period of 30 days. Patients affected by pancreatic fistulae following either chronic and acute pancreatitis of surgery were admitted to the study. Other published reports are not explicit about the possible side-effects of such a long period of full-dose therapy (lasting at least twice the recommended cycle). In this case, having been forced to continue therapy, no significant side-effects were observed and the therapy retained its effectiveness and tolerability up to the end of the study.

[Solitary splenic abscess. Clinical picture, diagnosis and treatment]. / L'ascesso splenico solitario. Quadro clinico, diagnosi e trattamento.

Splenic abscess, especially the solitary type, is a rarely seen condition, although it has been seen more frequently in recent years. On the basis of a case of splenic abscess with unusual features, the literature on the subject, 171 cases published in Italy, Britain, France and Spain in the past 10 years, is reviewed. It is pointed out that the diagnosis is generally difficult only because abscess is not considered. The diagnostic methods with the best results are ultrasonography and CT scanning, although a checkup after the event showed that straightforward X-ray of the chest, if correctly interpreted, may be enough. Scintigraphy is not indicated and arteriography should only be used in the event of special problems. The clinical picture is scanty and insignificant. The various aetiological agents and changes in these over recent years are illustrated, with special attention with regard to immunodepressed patients. The usual treatment is surgical removal. Other methods with more limited indications, such as drainage and medical treatment, are described.

One-stage operation for diverticular disease.

The experience with 59 patients affected by diverticular disease who underwent surgery after failure of medical treatment, is reported. 40 patients showed one or more postoperative complications, 19 none. The operations performed were: in 46 cases one-stage resection with anastomosis, Hartmann's operation in 8 and other procedures in 5. Six patients died: 3 after Harmann's operation, 2 after colostomy and one after anastomosis. The mean stay in bed for complicated cases was 24 days after anastomosis and 36 after Hartmann's operation. Therefore anastomosis is preferred in all cases including those with stenosis, fistula or abscess provided that peritonitis is not present. The anastomosis is performed away from the site of abdominal sepsis. In cases with peritonitis the selected surgical procedure is usually Hartmann's operation.

[Relationship between pancreatic cancer and chronic pancreatitis]. / Relazioni tra il carcinoma pancreatico e la pancreatite cronica.

The best known papers on relations between chronic pancreatitis and tumours of the pancreas are reviewed and a description given of the anatomopathological changes which gradually lead from chronic pancreatitis to cancer. It is maintained that all cases of chronic pancreatis should be considered high risks for pancreatic carcinoma.