Endoscopic treatment of bezoars. A critical review of the literature and presentation of two cases.

The authors report two cases of bezoars. The first was a large gastric bezoar in a patient who had undergone Billroth II gastroresection 40 years earlier. The second was a bezoar located in the distal part of the sigmoid colon accompanied by acute diverticular disease. Both bezoars were removed using endoscopic techniques. The method of exeresis is described together with the characteristics of the different anatomic sites. The authors review the literature focusing on nosology, symptomatology, diagnosis and guidelines for therapy. Considerable attention is paid to the use of endoscopy associated with prokinetic-enzymatic medical therapy. Surgery is reserved for rare cases of endoscopic failure, mostly recorded in the event of trichobezoars following the onset of intestinal occlusions caused by migration, or lastly when the cause of the bezoar is a pre-existing organic or functional stenosis.

[Simple and infected pancreatic pseudocysts. Methods of ultrasonography-guided percutaneous needle aspiration: results]. / Pseudocisti pancreatiche semplici e infette. Metodica dell'agoaspirazione percutanea ecoguidata: risultati.

BACKGROUND: Personal experience in the treatment of seven pancreatic pseudocysts (four infected and one causing a high intestinal occlusion due to compression on the duodenum) is reported. METHODS: In these emergency situations, which are very risky with the traditional surgical treatments, the percutaneous needle-aspiration with needle of Ciba 22 gauge allowed to overcome the critical phase. RESULTS: In none of the cysts there was a Wirsung's obstruction preventing the defluxion towards the papilla, that's why ductal effraction, being the origin of the pseudocyst, healed spontaneously even if it required many needle-aspiration treatments. CONCLUSIONS: This is the needle-aspiration has been the only approach to the complete elision of the cavity. The methodology used has been described in detail.

[Gastric polypoid angioma: a rare cause of bleeding in the elderly. Report of a case and review of the literature]. / L'angioma polipoide gastrico: una rara causa di sanguinamento nell'anziano. Rapporto su un caso e revisione della letteraura.

In 10,700 upper gastrointestinal endoscopies performed between 1990 and 1995; one case of gastric haemangioma was observed. The rarity of this tumour, which represents 0.05% of all the digestive neoplasms is underlined and its features and clinical history are reported. This case and the other four reported in Italy during the last fifteen years are critically reviewed. The various diagnostic-therapeutic pictures emerging from literature are examined.

[Gastric leiomyoblastoma. Its preoperative diagnosis by echo-guided needle aspiration. A report of 2 clinical cases]. / Il leiomioblastoma gastrico. Diagnosi preoperatoria con agoaspirato ecoguidato. Descrizione di due casi clinici.

The authors report two cases of gastric leiomyoblastoma, one benign and one malignant, come to clinical observation for digestive hemorrhage; in both cases a preoperating diagnosis of benignity or malignity was made and in one case even of histotype, thanks to fine needle biopsy. After a short introduction regarding some historical notes, the predictive parameters of malignity, the classification of this rare myoid tumor, the authors discuss the distribution of the pathology in the population, the symptomatology, the diagnostic "iter" with particular regard to the needle biopsy, the surgical treatment, and the indispensable parameters for formulating a correct prognosis.