[Closed abdominal injuries in patients with multiple injuries. Diagnostic considerations on 74 cases]. / Sui traumi chiusi addominali nel politraumatizzato. Considerazioni diagnostiche su 74 casi.

A diagnostic assessment was made of 74 cases of non-penetrating abdominal wounds observed over the previous 5 years. Laparoscopy performed in 49 polytraumatised patients made a decisive contribution to accurate, early diagnosis, with an indication for emergency surgery in 35 cases (32 visceral lesions and 3 retroperitoneal haematoma), whereas it was clear from the negative finding that surgery was not required in the remaining 14. It is felt that all additional radiological and instrumental diagnostic should be employed, and that careful clinical examination and repeated inspection, preferably by the same surgeon, are important in cases of multiple injury, since the situation may become dramatically worse in the space of a few hours.

[Acute intestinal occlusion caused by pseudo-neoplastic, endometriosic rectosigmoid stenosis]. / Occlusione intestinale acuta da stenosi rettosigmoidea endometriosica, pseudo-neoplastica.

Bilateral hysteroadnexectomy and rectosigmoid resection were successfully employed in a case of acute intestinal occlusion due to endometriotic rectosigmoid stenosis in a 36-yr-old woman. The endometriotic character of the stenosis was only made clear histopathologically. The clinical features of intestinal endometriosis are examined. Its lack of pathognomonic symptoms makes diagnosis difficult and may result in confusion with cancer, even intraoperatively. Ex tempore histological examination is thus fundamental in clinching diagnosis and hence the extent to which intestinal resection is required.