[Treatment of the ingrown toenail by phenol cauterization (ASLUF)]. / Il trattamento dell'onicocriptosi tramite fenolizzazione segmentaria (ASLUF).

BACKGROUND: The aim of this study was to evaluate the clinical and the ethiopatogenetic aspects of the ingrown toenail, treated by usual surgical technique versus phenol wedge cauterization (ASLUF). METHODS: From June 1990 to June 1999, 388 patients (218 male and 170 female patients, age range 9-90 years) were treated by 413 wedge ablation, surgical or chemical. After the operation, patients were controlled after 2 days, 1 week, 1 month, 6 months and 1 year. 109 patients were treated by usual surgical treatment, 260 patients by phenol cauterization (ASLUF), 19 by total ablation. RESULTS: 23 patients presented again ingrown toenail in the same place after few months, 20 patients after surgical treatment and 3 patients after phenol cauterization. All 23 patients were treated again without problems. CONCLUSIONS: In our personal opinion, the treatment of ingrown toenail is necessary soon, without the routine use of antibiotic therapy and the total ablation of the nail is not necessary. On this basis phenol wedge cauterization is the most suitable treatment for ingrown toenail with good cosmetic results, lower recurrence rate and from the functional point of view.

[Giant diverticulum of the duodenum. Case report]. / Diverticolo gigante del duodeno. Caso clinico.

The authors describe the case of a 49-year-old man with a giant diverticulum of the duodenum, with apparently scarce symptoms, pointed out by gastroscopy and X-ray of the upper gastrointestinal duct with barium meal. The removal of the lesion, obtained after surgical operation, showed a diverticulum with a 6 cm diameter, with signs of diverticulitis; the histological test did not point out is degenerative lesions. A survey of the recent literature on the matter is presented.

[Rupture of the duodenum caused by closed abdominal trauma]. / Rottura di duodeno da trauma addominale chiuso.

A duodenal lesion due to blunt abdominal trauma is an infrequent eventi which makes important diagnostic and therapeutic problems. The preoperative diagnosis is not always easy, especially with retroperitoneal lesion or in injured patients. A plain abdominal radiography or a duodenal radiography with soluble contrast medium helps to achieve a proper diagnosis. Prognosis strictly depends on time between injury and surgical procedures. We report two successfully treated lesions of fourth duodenal due to a blunt abdominal trauma.

[Intestinal obstruction due to endometriosis of the ileocecal valve]. / Occlusione intestinale da endometriosi della valvola ileo-cecale.

Intestinal endometriosis can rarely show itself bowel obstruction. An accurate anamnesis, radiological tests and endoscopy are of some use for correct diagnosis. Frequently however, differential diagnosis with others of pathology is not possible either in preoperative or in postoperative management, but by means of histological finding. We present here a case of acute bowel obstruction secondary to ileo-cecal endometriosis.

[Pseudoxanthoma elasticum. A rare cause of upper digestive hemorrhage]. / Pseudoxantoma elastico. Rara causa di emorragia digestiva alta.

Pseudoxanthoma Elasticum (PXE) is a rare inherited elastic tissue disorder with degeneration of elastic fibres involving mainly skin, eyes and the cardiovascular system. Upper gastro-intestinal hemorrhage occurs in 13% of cases and is often resistant to non-surgical methods of treatment. One case report involving recurrent gastric hemorrhage in a young patient with PXE and treated with total gastrectomy is presented. Diagnosis was made, after surgery, by biopsy of skin lesions of the neck. The characteristics of PXE are reviewed and the case is discussed.