[Pancreatic pseudocysts and fistulas]. / False chisturi si fistule pancreatice.

The authors present false pancreatic cysts and fistulae that have been encountered inthe practice of the I-st Clinic of Surgery from Tg-Mures over a period of 10 years (between 1964 ans 1979). The author's personal cases are presented and the rarity of this type of disturbances is stressed. A total of 14 cases are described, of which 8 were false pancreatic cysts and 6 were false pancreatic fistulae. The major complications that occurred in the cases with false pancreatic cysts the most severe was the intra-cyst haemorrhage, that was encountered in 2 patients (of which one developed severe shock), and peritonitis, following rupture of the cyst in the peritoneal cavity. The 6 pancreatic fistulae have developed following surgery (3 cases), trauma (one case), and acute pancreatitis (2 cases). The treatment of the false cysts consisted in the external drainage (two emergencies), and cyst-gastrectomy. Pancreatic fistulae have benefited from fistulo-gastrostomy (two cases), while the remaining 4 patients were treated conservatively. Only one death was recorded in this group of patients.

[Hepatic suppurations requiring segmented or atypical hepatectomies]. / Supuratii hepatice care au necesitat hepatectomii reglate sau atipice

Following studies of cases with hepatic suppurations the authors indicate the necessity for regular or atypic hepatectomies. The extension of the suppurative process in the liver made necessary the ligature of the great sagital vein and the authors show, on the basis of anatomic and topographical data (hepatic segmentation), that it is necessary to extend the hepatectomy to the IV-th para-median segment. The authors also present the indications for bi-segmental right hepatectomy in segments VII-VI as well as of the total left regulated hepatectomy.

[Difficulties in diagnosis and surgical treatment of subacute and chronic thyroiditis]. / Dificultati de diagnostic si tratament chirurgical în tiroiditele subacute si cronice

Out of a total number of 875 cases of thyroid affections of various origins, hospitalized in the two surgical clinics of Tîrgu-Mures, the authors selected 16 cases of subacute and chronic thyroiditis. They indicate the difficulties encountered in establishing the diagnosis before surgery, a fact that determined wide excisions in extremely difficult local conditions. They suggest, as a first therapeutic attitude, a conservative treatment with steroid drugs, antibiotics and roentgentherapy (when necessary), and, if such treatments fail, or when malignancies are suspected, as well as compression phenomena have developed, surgical treatment preceded by an extemporaneous anatomo-pathological examination. When thyroiditis is diagnosed surgery should be limited to decompressing incisions.