[Cervical-mediastinal emphysema of abdominal origin]. / L'enfisema cervico-mediastinico di origine addominale.

Cervical mediastinic emphysema usually does not demand emergency procedures: nevertheless its ethiology must be promptly assessed though his achievement may prove less than easy owing the vague clinical presentation and to the limits imposed by regional topography. Among the possible etiologic factors one should take into account the rare abdominal source too. Indeed the cervical region is connected to the retroperitoneal space through a virtual "visceral space" via the thoracic cavity and some diaphragmatic break-throughs variable in size. The communication allows, in some pathologic conditions, the unopposed circulation of air and fluids. Our interest in the topic is due to the occurrence of a cervical mediastinic emphysema in a patient suffering from a colonic perforation.

[Biliary cystadenoma and cystadenocarcinoma]. / Cistadenoma e cistadenocarcinoma biliari.

The authors present their experience with 5 biliary cystadenomas (BCA) and 1 cystadenocarcinoma (BCAC). BCA are rare but intriguing lesions of the liver for the possibility of the former to evolve into malignant lesion. Preoperative diagnosis is often difficult also at ultrasound and CT scan. The possibility of BCA and BCAC should be always ruled out in every cystic lesion of the liver. In every doubt lesion surgical exploration is indicated and at least a biopsy should be performed. The procedure of choice for BCA is radical resection, while palliative procedures may be justified only in poor risk patients.

Pancreaticoduodenal graft in the rat: an original microsurgical technique.

The authors describe an original surgical technique for pancreatic transplantation carried out on an experimental rat model which duplicates as closely as possible the anatomic-functional situation of a pancreatic graft in man (one arterovenous vascular peduncle with one functioning kidney only). The technique entails a microanastomosis between the mesenteric artery and the portal vein of the donor organ with the left renal artery and vein of the recipient. This method appears to be technically encouraging and particularly useful in studying the early phases of ischemic graft injuries, a field in which the authors are particularly interested.

[Our experience with the surgical treatment of the solitary ulcer syndrome of the rectum]. / La nostra esperienza nel trattamento chirurgico della sindrome dell'ulcera solitaria del retto.

The authors examine the question of the pathogenesis of solitary rectal ulcer syndrome (S.R.U.S), illustrating the importance of a correct differential diagnosis versus other relevant forms of disease affecting this region, particularly rectal cancer. They describe their experience with both the medical and surgical treatment of the syndrome.

[Esophageal localization of granulosa cell tumor (presentation of a clinical case)]. / Localizzazione esofagea del tumore a cellule granulose (presentazione di un caso clinico).

The authors report on a case of granular cell tumour localized in the lower third of the thoracic oesophagus. The patient, a 49-year-old male, suffering from symptoms of dysphagia over the previous few months, was treated surgically by thoracotomy enucleation of the neoplasm. Despite its slow growth, this rare benign neoplasm, which probably originates in Schwann's sheath, is a candidate for endoscopic or surgical resection.

[Hepatic cystadenocarcinoma: presentation of a clinical case and review of the literature]. / Cistoadenocarcinoma epatico: presentazione di un caso clinico e revisione della letteratura.

The finding of a case of cystadenocarcinoma supplies the opportunity for a reviewing of the literature concerning this rare liver neoplasm. From a diagnostical standpoint, the instrumental tests result non-specific. Only the needle-biopsy of papillary formations set forth through the echography within hepatic formations of cystic type is able to supply diagnoses of cystadenocarcinoma. Yet, the procedure is not exempt from risks. Decisive may be the peroperative histologic testing on fragments of the cyst wall. In consideration of the better prognosis of cystadenocarcinoma in respect of hepatocarcinoma and cholangiocarcinoma, and the risk of relapse, the election surgical treatment should be represented by hepatectomy.

[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.

[Contribution of computerized axial tomography in the study of splenic injuries]. / Il contributo della T.A.C. nello studio dei traumi splenici.

The splenic traumatic from a retrospective study of splenic traumatic lesions, they had the opportunity to observe in the last 2 years, emphasize the importance of T.A.C. (Computed Axial Tomograph). Such inspection, quick to be executed and non-invading, allows a thorough study of abdomen, and is a guide to a correct surgical option.

[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.

[Pancreatic fistulas: evaluation of medical treatment in 50 observed cases]. / Fistole pancreatiche: valutazione del trattamento medico in 50 casi osservati.

The authors, on the basis of their experience concerning the observation and treatment of 50 patients sucering from "pure" pancreatic fistula, appraise the results of the therapy adopted. From their experience it results the Total Parenteral Nutrition (TPN) is the choice protection in such patients. They report some encouraging preliminary results through the use of Somatostatin.

[Carcinoid tumor of the rectum]. / Il carcinoide del retto.

The Authors show a case of rectal ampulla carcinoid, and review the literature thereabout. They suggest the removal through sphincter according to Mason, which technique, in their opinion, can ensure a satisfying radicalness when the diameter of carcinoid is shorter than 2 cm.

[Surgical treatment of cancer of the splenic flexure]. / Il trattamento chirurgico del cancro della flessura splenica.

The authors report their experience in the surgical treatment of the cancer of splenic flexure. The neoplasiae arising in such place are usually diagnosed in a more advanced phase than in the other colon segments. This results in a survival at a shorter interval.

[Major hepatic resections for carcinoma of the biliary tract]. / Resezioni epatiche maggiori per carcinoma del confluente.

The Authors report their experience regarding two primitive tumours of the confluent and one tumour of the gall bladder involving the biliary confluent, all treated by major hepatic demolitions--one left hemihepatectomy and two extended right hemihepatectomies--with removal of the biliary tree en bloc and appropriate reconstruction. These highly demolitionary operations were performed with the aim of achieving greater radicality. The indications for such type of operation, dictated by notions of tumoral biology and reasons of surgical technique, are discussed. The Authors make a comparison of their experience with the data obtained from literature, which up to now reports only twenty-two; no statistical judgment on the effectiveness of the method is therefore possible, even if the results obtained and the theoretical presuppositions would seem to confirm its validity.

The cancer of the papilla of Vater. Diagnosis, treatment and long term results.

Survey of 18 cases of cancer in the Papilla of Vater, which were observed during the years between 1971 and 1979 at the Surgical Clinic of Padua University - Seat of Verona - with particular regard to the diagnostic means and their reliability. The histological investigations gave the following results: All lesions were found to be adenocarcinomas; 6 cases well differentiated, 4 cases fairly well differentiated, 2 cases little differentiated, 3 cases indifferentiated. The following operations were carried out: 15 Duodenopancreatectomies, 3 Internal derivations of the biliary flow, one of which associated with gastroenteroanastomy. Of all the patients who underwent to the radical operation, 1 survived 3 years after the operation, and then was lost to the follow-up, 2 were surviving 19 months after the operation, 2 were surviving 12 months after the operation, 1 was surviving 10 months after the operation, 1 died 18 months after the operation, 7 died between the 2nd and the 12th month after the operation, 1 died in the postoperative period. Of those patients who underwent the palliative operation, none survived longer than one year.

[Cystadenoma of the bile ducts]. / Il cistadenoma dei dotti biliari.

The authors describe one case of cystadenoma of the bile ducts removed by left hemi-hepatectomy. They stress the importance of a complete angiographic examination, both in the arterial and in the venous return phase, for diagnostic purposes and correct planning of the surgical procedure.