The role of endorectal ultrasonography in preoperative staging of rectal cancer.

OBJECTIVES: The aim of this paper is to enlight the role of endorectal ultrasonography in the preoperative staging of rectal cancer. METHODS: 83 patients having rectal cancer and candidates to surgery were studied with endorectal ultrasonography with a probe at a frequency up to 7.5 MHz probe. Eighteen patients were diagnosed with a cancer at A stage, 38 with a neoplasia at B stage and 37 at C stage. RESULTS: In all patients the examination revealed an involvement of the rectal muscular tunica. Sixtyseven patients presented mesorectal invasion, 17 patients showed the involvement of adjoining structures, and 27 patients presented pathological lymph nodes. CONCLUSIONS: Endorectal ultrasonography allows to distinguish patients having rectal cancer limited to the mucosa or invading sub-mucosa regions from those having a more indepth invasion. Apart from this, endorectal ultrasonography is not able of discriminate reactive lymph nodes from metastatic ones.

Endorectal ultrasound and magnetic resonance imaging (MRI) scan in rectal cancer: a comparative study.

OBJECTIVES: Endorectal ultrasound was compared with magnetic resonance imaging (MRI) in the preoperative staging for patients with Rectal Cancer. Diagnostic accuracy was assessed with regards to the factors that might influence the risk of local relapse such as T, N and CRM (circumferential resection margin). METHODS: From January 2006 to April 2010, 64 patients with rectal cancer were studied preoperatively either by means of MRI scan of the pelvis or endorectal ultrasound scan in order to assess the intramural extension. For 30 out of 64 patients both methods were used (comparing instrumental with histopathological data) while for 34 patients over 64 only ultrasound scan was used. RESULTS: Endorectal ultrasound resulted to be more reliable in defining the T (parietal infiltration of the tumor) whereas MRI better defined CRM. CONCLUSIONS: Both methods are reliable and complementary enabling an accurate staging of patients with rectal cancer.

[Congenital cystic bile duct dilatation: an incidental intraoperative finding]. / Sindrome di Todani: un riscontro accidentale intraoperatorio.

In adulthood, choledochal cysts are often surprisingly discovered during cholecystectomy. We report here on a case of an unsuspected congenital type-IA biliary cyst, according to Todani's classification encountered during laparoscopic cholecystectomy in a 30-year-old woman complaining of acute abdominal pain with an unremarkable preoperative workup. The well-known risk of developing cystic cancer, mainly in the adult, means that an excisional operation is indicated to prevent such complications. Cyst excision and Roux-en-Y hepaticojejunostomy is the definitive treatment of choice, performed at a later stage after radiological and endoscopic confirmation, and after obtaining the patient's consent. Cholangio-MR, and ERCP have proved to be extremely useful for adequate identification of this kind of lesion.