Ruptured aneurysm of the internal iliac artery.

The aneurysms of the internal iliac artery are rare and very often asymptomatic. Because of the anatomic location of this artery, it can be difficult to diagnose this kind of aneurysm, when isolated. Frequently it is diagnosed in consequence of aneurysmatic complication, such as rupture and/or impending rupture. In this work we report our experience concerning 6 cases of ruptured aneurysm of the internal iliac artery, observed in 5 patients. In three of these cases the lesion was isolated. In two cases the patients had already been operated on for abdominal aortic aneurysm, 4 and 6 years before. All the five patients were operated on. In 5 cases we ligated the aneurysm, without using any vascular graft. In one case where the external iliac artery was involved, we used a vascular graft between the common iliac and common femoral artery, in order to repair the vascular axis. One case of mortality was observed and a rare complication occurred in one case. An 83-year-old man treated in emergency for ruptured aneurysm of the left internal iliac artery, with regular post-operative course, was hospitalized again 24 days later with sepsis and pain in the left lower abdomen. A CT scan and a following urography showed a urinary fistula probably due to an ischemic necrosis of a segment of the ureter. A percutaneous nephrostomy has been performed and the patient successfully discharged.

[Diagnostic considerations in 104 cases of aneurysm of the subrenal abdominal aorta surgically treated in 1987]. / Considerazioni diagnostiche su 104 casi di aneurisma dell'aorta addominale sottorenale operati nell'anno 1987.

A series of 104 patients observed and surgically treated for abdominal aortic aneurysms, in the General and Cardiovascular Surgery Department of Milan University during 1987 in analysed. Particular attention is paid to the diagnostic procedures especially in those cases when the condition was found by chance during clinical examinations requested for different pathologies.

[Tumors of the upper excretory tract. Cases contribution and review of the literature]. / I tumori della via escretrice superiore. Contributo casistico e revisione della letteratura.

Authors reviewed 11 cases of urothelial tumors of the upper urinary tract. Clinical history, diagnostic procedures and surgical treatment of 8 patients with tumor in the renal pelvis and of 3 patients with ureteral tumor are described. The aspecificity of clinical finding and the possibility of different urinary tract affections may be responsible of many difficulties in doing early diagnosis using routinary instrumental investigations. Nephroureterectomy is most frequently performed as surgical treatment. The results are correlated with the stage of infiltration of surrounding tissues by tumor. It is necessary an early clinical study of the patients with signs or symptoms referring to urinary tract (hematuria, abdominal pain) using excretory urogram, cystoscopy and urinary cytology in order to lower the delay of surgical procedure after the evidence of clinical finding.