Conservative treatment of external pancreatic fistulas with parenteral nutrition alone or in combination with continuous intravenous infusion of somatostatin, glucagon or calcitonin.

Treatment with total parenteral nutrition (TPN) alone or combined with continuous intravenous infusion of either somatostatin or calcitonin or glucagon have been carried out upon 45 patients with a high output external pancreatic fistula. No significant difference among these treatment schedules was observed in the percentage of closure of fistulas (85 to 100 per cent of the patients), but patients treated with TPN plus somatostatin had the fistulas close within a significantly (p = 0.000028) shorter period of time. Moreover, this treatment was associated with the strongest inhibition of the output from the fistula (minus 82.3 per cent). Since treatment with somatostatin was not accompanied by any side effect, was followed by a quite rapid closure of the fistulas and allowed an estimated economic savings of about $2,100.00 dollars per patient, it seems to be advisable in the conservative treatment of external pancreatic fistulas.

[A case of duodenal duplication in the adult]. / Su di un caso di duplicazione duodenale dell'adulto.

The authors describe a rare case of duodenal duplication presenting in adult life; the complete preoperative investigations did not substantiate. The diagnosis which can be accomplished in most cases only intraoperatively. The diagnosis is mainly based upon knowledge of the condition and upon pathologic examination.

[Bilemia: diagnosis and conservative treatment. Apropos of a case complicated by hepatic abscess]. / Bilemia: diagnosi e trattamento conservativo. A proposito di un caso complicato con ascesso epatico.

The authors report a case of bilemia of their own--with traumatic genesis--complicated by liver abscess, treated through outside biliary drainage and piloted transhepatic percutaneous drainages along the line of the echotomography and computerized axial tomography (T.A.C.). They report the treatment adopted, and emphasize the importance of the instrumental methods followed in the diagnostical and therapeutical approach of both diseases.

[2 cases of enterorrhagia caused by Meckel's diverticulum. Problems of diagnosis and therapy]. / Su due casi di enterorragia da diverticolo di meckel. Problemi di diagnosi e terapia.

The authors study two cases of enterorrhage due to Meckel's diverticulum. They particularly emphasize the importance of two instrumental inspections: enema and abdominal scintigraphy with 99mTcO4, in the diagnostics of this malformative pathology, and the treatment with H2-blocking substances with the purpose to stop hemorrhage, circumstantiate the diagnostic suspicion, and operate electively.