[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.

[The role of Enterobius vermicularis in etiopathogenesis of appendicitis]. / Il ruolo dell'Enterobius vermicularis nell'etiopatogenesi dell'appendicite.

The authors present 14 cases of enterobiasis of appendix observed between 1991-94, on a total of 1093 appendectomies. The presence of the parasite was associated, in the majority of cases, to a chronic appendicitis. The symptomatology imitates an attack of acute appendicitis, but the true nature of the disease is diagnosed only through a histological examination. There is probably an etiopathogenic relationship between. E. vermicularis and chronic appendicitis, whereas the relationship between the parasite and acute appendicitis is rare and very disputed.

[Diverticulitis of the cecum: description of 2 clinical cases]. / La diverticolite del cieco. Descrizione di due casi clinici.

The authors describe two cases of cecal diverticulitis pointing out the rarity of the disease in particular in Western countries. The disease is often asymptomatic although in the case of diverticulitis, which represent the most frequent complication of the disease, the patient becomes symptomatic. The symptomatology in these cases is similar to an acute appendicitis with which it is constantly confused. Surgery is the most common therapy and the type of operation is based on the clinical condition of the patient and local anatomical-surgical situation.

[Echinococcal cysts with primary muscle localization: comments on a clinical case]. / Cisti da echinococco a localizzazione muscolare primaria: considerazioni su un caso clinico.

Primary muscular localization of echinococcosis is rare and unknown are the causes that determine it. The authors report a case recently observed and illustrate the etiopathogenetic hypothesis more accredited in the literature. It is concluded that surgical treatment is the best choice, although relapses are possible. Therefore, a long term follow up of the patients including clinical and serological investigations is advisable.

[Medical or surgical treatment of the elderly bleeding ulcer patient]. / Trattamento medico o chirurgico nell'ammalato ulceroso sanguinante anziano.

In recent years there has been a distinct decline in the total number of operations for ulcers while the number performed for ulcerous complications has remained more or less constant. Hesitation between medical and surgical treatment most frequently arises in the case of bleeding especially when the patient is elderly. A retrospective study is conducted on 526 ulcer patients encountered in 1976-84 and a comparison is made with the literature as a means of identifying the limitations of conservative treatment. Certain parameters of possible use in the treatment of bleeding ulcers in the elderly are identified.

[Long-term results of primary choledochal-jejunal anastomosis]. / Esiti a distanza di anastomosi coledoco-digiunali primarie.

Long term of Roux en Y choledochojejunostomy evaluation, performed for choledocholithiasis, inflammatory or neoplastic common bile duct strictures. However the anathomopathological situations are different, when the indication is right, this kind of surgical management shows all its effectiveness also for the low mortality and the absence of long term complications.

[The role of bilio-digestive shunts in surgery of non-neoplastic diseases of the biliary tract and papillary region. Assessment of 70 cases]. / Il ruolo delle derivazioni bilio-digestive nella chirurgia delle malattie non neoplastiche delle vie biliari e della regione papillare. Valutazione di 70 casi.

Indications for and results of bilio-digestive shunt are discussed and basic stages described. The data refer to non-cancerous pathology of the bile ways. It is concluded that the operation should always be carried out in the first instance (comparatively high intracholedochic pressure values, moderate dilatation of the main bile way, calculosis of the papilla) and not just at reoperation. This convinction is backed up by the very low operative mortality, the good long-term results and the operation's comparatively easy performance.