Large symptomatic simple hepatic cyst with gastric compression treated with percutaneous drainage.

Nonparasitic hepatic cysts consist of a heterogeneous group of disorders, which differ in etiology, prevalence, and manifestations. Simple hepatic cysts are considered nonparasitic ones. These are a result of congenital anomalies of the biliary system, and these may be single or multiple. Generally, hepatic cysts are incidentally found during occasional laparotomy or laparoscopy, necropsy, and even during routine ultrasound or computerized tomography (CT) scan. Nowadays, with improving diagnostic techniques, hepatic cysts are becoming more common. Generally these lesions are asymptomatic. However, if they grow, they may become symptomatic. Symptoms depend on the size and location. When symptoms developed, these must be treated. Compressive complications due to local "liver mass" effect include: portal hypertension, edema due to caval compression, jaundice and arrhythmia and duodenal obstruction. Gastric extrinsic compression by liver cysts has been poorly described. Herein, we present a case of a female in whom percutaneous drainage of a large simple hepatic cysts not complicated was performed in order to reduce signs of gastric compression.

Gastric Dieulafoy's lesion successfully treated by "adjuvant" arterial embolization and endoscopic clipping.

While it is well recognized that peptic ulcer disease is the most common cause of nonvariceal upper gastrointestinal bleeding, other lesions cause of haemorrhage, even if rare, may potentially life-threatening. These include arteriovenous malformations such as Dieulafoy's lesion, defined as caliber-persistent submucosal vessel. The endoscopy with its hemostatic techniques is usually the treatment of choice for such patients. In those cases, in which these techniques fail due to the difficult in the correct localization, angiography with embolization may be a good alternative. The use of microcatheters and new embolic agents have improved this procedure. In fact, transcatheter arterial embolization represents a minimally invasive alternative to surgery when endoscopic treatment fails to control gastrointestinal bleeding, especially for the upper tract. This technique proved to be safe, fast and effective. According to our knowledge, only one case of a Dieulafoy's lesion of the duodenum treated with "adjuvant" embolization followed by laser coagulation has been reported in literature. Herein, we report a case of a Dieulafoy's lesion of the stomach, in which "adjuvant" transcatheter arterial embolization has permitted a more easier endoscopic diagnosis and treatment.

["Cold" nodules of the thyroid gland. (Clinical statistical study)]. / Il nodo "freddo" della tiroide (contributo clinico-statistico).

A series of 718 scintigraphically cold thyroid nodules observed between 1965 and 1976 at the Turin University Endocrine Surgery Centre is presented. This form was more common in women (80%) and mainly occurred in the 3rd and 5th decade of life. Malignancy was present in 88 cases (12.27%): 49 papilliferous tumours, 25 follicular, 9 Hurthle-cell, and 5 anaplastic. A reference is expressed for unilateral lobectomy followed by suppressive management as opposed to total thyroidectomy since malignancy is low in forms where a tumour has a single site in a cold nodule. Furthermore, this approach spares the patient from the severe consequences of inevitable post-operative hypothyroidism. Total resection is, however, mandatory in anaplastic forms. A detailed account is offered of the typical echotomograms associated with individual pathological situations. These are enough to support a preoperative diagnosis of malignancy.

[Histological pathology of the anterior abdominal musculature in old age in relation to postoperative laparocele]. / Patologia istologica della muscolatura addominale anteriore senile in rapporto al laparocele post-operatorio.

The causes of postoperative laparocele in the aged were investigated. Particular attention was paid to the possibility of predisposing factors represented by senile changes in the abdominal muscles. Histological examination of 50 muscle specimens showed that dystrophy and degeneration, with possible loss of tone and firmness, were common after the age of 60 yr, with the result that laparocele might occur even in the absence of the usual causes.