[Colorectal tumors and hormonal receptors. A critical review of the literature]. / Tumori del colon retto e recettori ormonali. Una revisione critica della letteratura.

The importance of sexual hormones in the development of cancers of the large bowel is strongly supported experimentally and epidemiologically. The clinical search for the presence of hormonal receptors in the cells of patients operated for tumours of the colon and rectum has been common since 1975. This investigation ought to have opened up new diagnostic and therapeutic prospects for these tumours which have given such a little curative satisfaction. The present review considered reported data. Unfortunately the emerging picture is irregular in cases and results. It is personally considered that these studies are not for the moment likely to produce important novelties for the treatment of tumours of the large bowel tract.

[Problems in emergency surgery. Massive pulmonary embolism. Clinical and diagnostic aspects]. / Problemi in chirurgia d'urgenza. L'embolia polmonare massiva. Aspetti clinici e diagnostici.

In spite of the many advances in diagnosis, pulmonary embolism is still hard to identify, one problem stemming from the similarity of its clinical signs with heart and lung conditions. The present study was carried out on 17 patients affected by massive pulmonary embolism. Clinical aspects and diagnostic problems are discussed, with particular regard to the data supplied by chest X-ray, catheterism of the right cardiac cavities and angiopneumographic investigation.

[Long-term results of gastric resection with reconstruction, using the Billroth I method]. / Risultati a distanza della resezione gastrica con ricostruzione secondo Billroth I.

Clinical, radiological and endoscopic results at follow-up about 1-5 yr after surgery in a series of 62 patients subjected to Billroth I resection are compared with those in the literature. Recurrence of ulcers was observed in 8% (as opposed to 5% with the Billroth II). In addition, there was a marked reduction in the incidence of post-resection diseases, with less serious forms of dumping, sounder digestion, and smaller weight losses.

[Intestinal occlusion caused by endometriosis]. / Occlusione intestinale da endometriosi.

Three cases of intestinal occlusion due to endometriosis, presenting as surgical emergencies, are reported. After a review of the literature on the incidence of endometriosis, the mechanisms underlying the occlusive process and the various anatomopathological pictures are presented. The reasons why no correct preoperative diagnosis was possible and the problems encountered in differential diagnosis, particularly with respect to carcinoma of the colon and the sigma-rectum, are discussed. It is considered that correct preoperative diagnosis is very important to avoid subjecting the non-cancer patient to destructive surgery. The therapy recommended for intestinal occlusion due to suspected endometriosis is presented.

[Use of transhepatic drainage in neoplastic stenosis of the upper biliary tract]. / L'impiego del drenaggio transepatico nelle stenosis neoplastiche della via biliare alta

Rodney-Smith's technique (transtumoral transhepatic drainage) was used palliatively in 6 patients with cancer of the upper biliary tracts. Diagnosis from the symptomatology (essentially obstructive icterus) was not easy, though the picture can almost always be clarified by endovenous and endoscopic retrograde cholangiography and, more particularly, by preoperative and intrahepatic intraoperative cholangiography and choledochoscopy in connection with laparatomy. Two patients survived for 9 months and 2 yr respectively, whereas the remainder died within 30 days of surgery. Despite this high mortality, primarily due to very poor general condition, this type of palliative operation is still the best form of management.

[Acute esophagitis and gastritis caused by caustic acids]. / Esofagiti e gastriti acute da caustici acidi

9 cases of caustic ingestion are reported and the diagnostic and therapeutic problems of the consequent gastritis and oesophagitis conditions discussed. In the case of small quantities of acids at low concentrations, the immediate steps are largely medical and conservative, their purpose being to monitor complications. In cases of massive ingestion, surgery should be as early as possible to avoid secondary lesions to the surrounding viscera and serious electrolytic imbalances; the limit for action with a relatively favourable prognosis is within 5 hours and removal of the damaged segments must be radical and extensive.