[Splenectomy for splenic abscess caused by Salmonella typhi]. / La splenectomia per ascesso splenico da Salmonella typhi.

Splenectomy due to splenic abscess is without doubt an unusual occurrence, especially in Western countries. The paper reports the case of 19-year-old male who underwent splenectomy because of an abscess caused by Salmonella typhi. Following a revision of the literature it appears that only six cases of splenic abscess by S. typhi have been reported since 1940. Splenectomy represents the elective treatment for patients with splenic abscess provoked by any cause.

[The surgical treatment of perforated colonic diverticulitis]. / Trattamento chirurgico delle diverticoliti perforate del colon.

The authors report a consecutive series of 52 patients who underwent urgent operation because of peritonitis by perforated diverticulitis. Urgent colonic resection achieves the best results.

[An analysis of the surgical risk in elderly subjects with neoplasms of the large intestine. A follow-up of 102 consecutive cases]. / Analisi del rischio operatorio in soggetti anziani affetti da neoplasia del grosso intestino. Controllo di 102 casi consecutivi.

Today surgeons find that they have to operate with increasing frequency on elderly patients suffering from colorectal cancer. This study examined 102 patients with this pathology. The findings show that age alone is not a contraindication for surgery. On the contrary decisive negative factors include both concomitant pathologies and emergency surgery because it is not possible to correct any pre-existing imbalances before surgery. The overall mortality rate is 9% of which 4% after emergency surgery. It is therefore possible to conclude that elderly patients can undergo radical surgery irrespective of age.

[Ogilvie's syndrome: clinical reality or nosographic error?]. / La sindrome di Ogilvie: realtà clinica o errore nosografico?

The authors report their experience in the management of Ogilvie's syndrome, a rare form of large bowel acute pseudo-obstruction. The study includes fifteen cases of the disease. There were ten males and five female, with a mean age of sixty-two years (range 45-92). Three patients were only treated with medical and conservative measures, one with unsuccessful colonoscopy and twelve (two with colonic perforation) underwent laparotomy. The surgical procedures performed were tube cecostomy (40%), colonic resection with primary anastomosis (27%) and exploratory laparotomy with decompression (13%). The overall morbidity and mortality rate were respectively 0 and 13%. Our epidemiological, clinical and therapeutic results are similar to those reported in the international literature. The pathophysiology of the syndrome is still unknown. It can be "idiopathic" or can complicate other diseases or surgical procedures (urological and gynaecological procedures mostly). Plain abdominal roentgenogram is the most useful diagnostic test, but colonoscopy may be an alternative diagnostic (and therapeutic) weapon. Conservative treatment is the method of choice but when the cecal diameter is more than 12 cm. (impending perforation), when the colon is perforated or when medical measures are unsuccessful, surgical procedure is compulsory. The age of the patient, cecal size, delay in colonic decompression are the most important prognostic factors. Even with a proper management, the prognosis is severe and the mortality rate is high (3-50%).

[Pancreatic pseudocysts. An important surgical problem]. / Pseudocisti pancreatiche. Un importante problema chirurgico.

The pancreatic pseudocyst is a serious complication of acute or chronic pancreatitis. Surgical internal anastomosis can be an adequate solution to this problem. Sixty patients with pancreatic pseudocyst have been referred to our institution in the last 15 years; 47 of them were operated upon. Different techniques were employed according to differences in the pseudocyst wall status and the presence or absence of infection.

[Evaluation of blood cortisol and plasma ACTH in patients with gastroduodenal ulcer]. / Valutazione della cortisolemia e dell'ACTH plasmatico in portatori di ulcera gastro-duodenale (U.G.D.).

A significant blood cortisol level, unaccompanied by changes in ACTH by comparison with normal controls, was noted in 30 subjects with ulcers.