[A new case of hepatic adenomatosis. A critical review of the literature]. / Un nuovo caso di adenomatosi epatica. Revisione critica della letteratura.

Liver adenomatosis is a rare disease--only 22 cases are previously described--characterized by multiple adenomas (more than ten) in a normal parenchyma. After a literature review the authors cannot exclude a link between the estroprogestatives use and the development of adenomatosis. Most important risks are bleeding and development of new adenomas, after the operation. On the basis of an extensive literature review, diagnosis features, treatment and follow-up are discussed. The aim of this report is to describe a case of multiple adenomas in a 38 years old housewife treated for seven years with oral contraceptives, admitted to hospital for spontaneous subcapsular haemorrhage due to rupture of adenomas, macroscopically considered suggestive of angiomas during the operation. Right lobectomy was performed and microscopic examination diagnosed multiple adenomas (liver adenomatosis). A repeated CT scan eight months later showed more than three new nodules in the liver. A new right lobectomy and tumorectomy of the nodules in III liver segment (remained after the first operation for the erroneous diagnosis) was performed and over a period of 20 months the patient remains in excellent condition.

[Hepatic cystadenocarcinoma]. / Cistoadenocarcinoma epatico.

The biliary cystadenocarcinoma is a rare liver neoplasm with a preoperative difficult diagnosis to make, but increased by ultrasonography. Is reported the case of a caucasian male 78 years old, operated 11 years previously for partial resection of a benign liver cyst. Recurrent cholangitis and obstructive jaundice required a reoperation for right hepatectomy. Microscopic examination showed a malignant transformation in cystadenocarcinoma.

[The spontaneous rupture of a pyogenic liver abscess. A clinical case]. / Rottura spontanea di ascesso epatico piogenico. Caso clinico.

The authors report a case of a large monolocular liver abscess in a patient with gallbladder and choledocic stones and biliary stent, complicated by rupture into the peritoneal cavity, that required surgical treatment. Surgical exploration versus other approach results the choice treatment, as shown by resolution of the pathology.

[Portal hypertension and enterostomy: a dangerous combination. Colostomy-induced varices as a rare cause of gastrointestinal hemorrhage. Report of a case and review of the literature]. / Ipertensione portale ed enterostomia: un binomio a rischio. Le varici colostomiche come causa rara di enterorragia. Descrizione di un caso e revisione della letteratura.

Variceal bleeding from enterostomy in an unusual complication of portal hypertension. The hemorrhage can be managed in most patients with local measures, but if these manouvres fail, surgical procedures may be required. Treatment options include pressure dressings, stomal revision or disconnection, suture or ligation of stomal varices, bowel resection, and porto-systemic shunting. Recently sclerotherapy and percutaneous transhepatic embolization have been reported. A case of ectopic varices in the site of colostomy complicated by recurrent hemorrhage is described and the therapeutic option utilized is discussed with review of Literature to assess the efficacy of the various treatment options.