[A gastrocutaneous fistula secondary to the percutaneous drainage of a pancreatic abscess. A case report]. / Fistola gastrocutanea secondaria a drenaggio percutaneo di ascesso pancreatico. Descrizione di un caso.

Pancreatic abscesses are a frequent complication of acute pancreatitis and their percutaneous drainage is usually accepted. A 76 years-old male patient admitted for acute pancreatitis (Ranson 3 at admission) has been treated with conservative therapy and percutaneous US directed drainage of the abscess, located between the tail of the pancreas and the gastric fundus. This kind of drainage was able to empty the abscess satisfactorily but it caused the onset of a gastrocutaneous fistula. This one was sutured on the gastric side by metal clips placed by gastroscopy. The patient was discharged on the 60th day in a good condition. An X-ray investigation with gastrografine before the drainage removal is therefore recommended.

Intraoperative colonic lavage in emergency surgical treatment of left-sided colonic obstruction.

PURPOSE: The study contained herein was undertaken to verify if immediate resection with anastomosis with on-site lavage in emergency treatment of left colon obstruction is a safe alternative to the multistage procedure, to look for solutions to practical problems outlined by previous authors, and to check the hospital stay. METHOD: Between 1991 and 1995, all patients (61) admitted with left colon obstruction were treated with intraoperative colonic lavage and primary anastomosis. Personal development of Dudley's technique is reported. Complications and mortality are pointed out. Later, endoscopy was performed to check the status of all survivors. RESULT: Low mortality (2 percent) and major complication rates (3 percent) and short hospital stay (11 days, except for patients with major complications) are reported in our series. CONCLUSION: One-stage surgery with intraoperative lavage is a safe procedure. Patients have a better quality of life (no stoma occurred) with an effective cost-savings.

[Metastasis and hepatic resection surgery. Our experience]. / Metastasi e chirurgia resettiva epatica. Nostra esperienza.

The authors' experience of the surgical management of liver metastasis is discussed. Failure in preoperative assessment influenced surgical procedures and led to questionable choices. However morbidity and mortality were rather good.

[Open abdomen treatment in massive peritonitis. Our experience]. / Trattamento ad addome aperto delle peritoniti massive. Nostra esperienza.

Intractable intra-abdominal sepsis occurring in eight patients was managed by the authors with planned abdomen reexploration. Only the severity of illness can justify such aggressive surgical treatment. Mortality is still high.

[The diagnostic procedure in deep venous thrombosis. The authors' experience]. / Iter diagnostico nella trombosi venosa profonda. Esperienza personale.

Diagnostic flow chart of 101 patients admitted with suspected TVP between 1987 and 1991 is discussed. In all of them Doppler cw and radionuclide venography with pulmonary scanning with albumin Tc 99 were performed. Since the 90's a triplex scanner was employed, usually after Doppler cw examination. Phlebography was considered as a golden backup. Pulmonary embolism was detected in 15% of patients and 2/3 were completely asymptomatic.

[MTBE perfusion via nasobiliary drainage followed by endoscopic lithotripsy in cases of complicated lithiasis of the common bile duct]. / La perfusione con MTBE grazie al drenaggio naso biliare seguito da litotrissia endoscopica nei casi di litiasi della via biliare principale complicata.

Pernasal catheter perfusion with MTBE and subsequent endoscopic lithotripsy is an effective treatment of complicated common bile duct lithiasis in which a first endoscopic attempt has failed. The authors analyzed their experience in 1990.

[The short bowel syndrome: prevention and follow-up. Our experience in the prevention of the short bowel syndrome and in long-term follow-up]. / La sindrome da intestino corto: prevenzione e follow-up. Nostra esperienza nella prevenzione della sindrome da intestino corto e nel follow-up a lungo termine.

Despite improvement in knowledge of the etiopathogenesis of this syndrome, it is still difficult to formulate any prognosis. Our experience in long-term follow-up in order to avoid any possible complications is discussed.

[Carcinoma of the Vater's ampulla: local exeresis or major resection?]. / Il carcinoma dell'ampolla di Vater: exeresi locale o resezione maggiore?

Ampullary carcinoma are uncommon and case reports are fragmentary and small in number. The varied histotypes, tumour grading and staging methods, together with the different risk factors involved and diverse operating procedures make comparison difficult. The paper makes a contribution towards the number of cases reported and discusses the problems arising from this pathology.

[Strangulated obturator hernia as a rare cause of intestinal obstruction (report of 2 cases)]. / L'ernia otturatoria strozzata come rara causa di occlusione intestinale (osservazione di due casi).

The Authors report on tpo cases of strangulated obturator hernia observed in their department during the period 1977-1987 and successfully operated on by mid-line laparotomy, both pith a diagnosis of occlusion of the small bowel. The Authors review the clinical signs and instrumental investigations which may be of use in reaching an early pre-operative diagnosis, which constitutes the only possibility of reducing the mortality associated with this condition. Particular attention is devoted to the somatic characteristics of the patients: elderly, thin, chronic bronchitic, hypertensive cardiopathic. In one of the two cases, there was a concomitant crural hernia. In both cases, which presented a picture of acute intestinal occlusion, the type of surgery opted for was a mid-line laparotomy. In one case, an ileal resection was performed. To close the orifice of the obturator canal, plain suture of the peritoneum was used in one case and a mersilene patch in the other.