Surgical treatment for giant retroperitoneal well-differentiated liposarcoma (WDLPS): case report and literature review.

WDLPS are very rare retroperioneal tumors that can reach huge size before becoming symptomatic. The aim of this article is show the diagnostic management and the surgical approach to giant WDLPS. A standard treatment has yet to be established because the pre-operative diagnosis is very difficult. We present a case of a 69-year-old male patient with progressive increase of abdominal girth, weight loss and light abdominal pain and with an abdominal mass of over 15 kg that displaced the right kidney. A complete tumor resection and right nephrectomy were performed. Histology revealed a well-differentieated liposarcoma. CT scan is the most common imaging technique and laparotomic open radical resection represent the most common surgical approach.

Acute massive bleeding from splenic artery aneurysm rupture: a case report.

Splenic artery aneurysm (SAA) is the most common aneurysm of visceral vessels. Usually the rupture occurs into the free peritoneal cavity and causes massive bleeding, much less frequently the rupture happens into the lumen of the gastrointestinal tract. We describe the case of a 39-year-old male patient with a spontaneous rupture of a splenic artery aneurysm and an acute massive peritoneal bleeding. The case described confirms the rupture of SAA is always a dramatic event and an emergency laparotomy is a life-saving procedure.

[Splenic infarction caused by vascular pedicle torsion]. / Infarto splenico da torsione del peduncolo vascolare.

We report a case of a spleen infarction caused by the vascular pedicle torsion. A 25 year-old-man, heterozygous for HbS, presented with severe abdominal pain especially in the left upper quadrant in front and in the back, fever other symptoms related to acute abdomen. First we excluded most common disease (occlusive one and hematologic one) through conform investigation, then we suspected a spleen problem. So we did further investigation with ultrasonography which showed splenomegaly and the spleen looked twisted with its hilum in contact with previous abdominal wall, moreover (here were are as of decreased signal intensity characteristic of splenic infarction under the capsule and some blood in the Douglas pouch. The patient underwent splenectomy urgently. During the intervention we saw a splenomegaly like the ultrasonography showed, moreover there were a long twisted vascular pedicle and many areas of infarctions, some of which had ruptured causing emoperitoneum. The surgical intervention was successful and the clinical spectrum was solved. The splenic infarction might be clinically silent or to represent a surgical emergency. In front a case of acute abdomen, after exclusion of most common etiology, we underline the importance to suspect a spleen suffering, especially vascular one, when (here was no history of trauma. Considering this fact, a simple not invasive examination like ultrasonography is able to confirm this kind of hypothesis and to give soon information to make the surgical choose.