[Post-traumatic hemoperitoneum: role of laparoscopy]. / Emoperitoneo post-traumatico: ruolo della laparoscopia.

The use of laparoscopic as a diagnostic instrument in blunt penetrating abdominal traumas was first proposed by some authors in the 70s. The introduction of sophisticated instrumental tests, such as CAT and echotomography (ETG), confined this method to narrow diagnostic field which was gradually less frequently used. The lively interest expressed by the surgical world and the enormous spread of laparoscopy after the end of the 80s, following the introduction of laparoscopic cholecystectomy, has prompted the renewed use of the laparoscopic technique also in those subjects with blunt abdominal trauma. Over the past 12 months the authors have used laparoscopy in 8 subjects with hemoperitoneum secondary to contusive abdominal trauma in hemodynamically stable conditions, in which instrumental test (CAT and ETG) and peritoneal lavage were positive for the presence of hematic effusion. The use of laparoscopy in 7 patients allowed a wait-and-see approach to be adopted, thus eliminating the need for explorative laparotomy. It was only necessary to proceed with laparotomy in one patient to control bleeding from a major splenic lesion.

[Splenectomy for splenic abscess caused by Salmonella typhi]. / La splenectomia per ascesso splenico da Salmonella typhi.

Splenectomy due to splenic abscess is without doubt an unusual occurrence, especially in Western countries. The paper reports the case of 19-year-old male who underwent splenectomy because of an abscess caused by Salmonella typhi. Following a revision of the literature it appears that only six cases of splenic abscess by S. typhi have been reported since 1940. Splenectomy represents the elective treatment for patients with splenic abscess provoked by any cause.

[The surgical treatment of perforated colonic diverticulitis]. / Trattamento chirurgico delle diverticoliti perforate del colon.

The authors report a consecutive series of 52 patients who underwent urgent operation because of peritonitis by perforated diverticulitis. Urgent colonic resection achieves the best results.

[An analysis of the surgical risk in elderly subjects with neoplasms of the large intestine. A follow-up of 102 consecutive cases]. / Analisi del rischio operatorio in soggetti anziani affetti da neoplasia del grosso intestino. Controllo di 102 casi consecutivi.

Today surgeons find that they have to operate with increasing frequency on elderly patients suffering from colorectal cancer. This study examined 102 patients with this pathology. The findings show that age alone is not a contraindication for surgery. On the contrary decisive negative factors include both concomitant pathologies and emergency surgery because it is not possible to correct any pre-existing imbalances before surgery. The overall mortality rate is 9% of which 4% after emergency surgery. It is therefore possible to conclude that elderly patients can undergo radical surgery irrespective of age.

[Temporary defunctionalizing colostomy, a non-indispensable corollary in the Dixon anterior resection of the rectum for treatment of recto-sigmoid carcinoma]. / La colostomia temporanea defunzionalizzante, corollario non indispensabile nella terapia chirurgica di resezione anteriore secondo Dixon nel carcinoma del sigma-retto.

The frequency and sites of carcinoma of the sigmoid colon and rectum are discussed. The complications associated with Dixon's anterior resection of the rectum are described, with particular reference to factors affecting cicatrisation of the colic anastomoses, followed by dehiscences and their degree of seriousness. A personal serier for the years 1969 to 1975 is presented and the advantages and disadvantages of derivative colostomy are explained. Comparison with similar series in which colostomy was or was not employed is used to elicit the reasons why it may be regarded as superfluous.