[Reconstruction of the TMJ and ramus in otomandibular dysplasia, by grafting of TMJ and homologous bone branch]. / Reconstruction de l'a.t.m. et du ramus dans les dysplasies otomandibulaires par greffe d'articulation temporomandibulaire et de branche montante d'os homologue.

INTRODUCTION: Otomandibular dysplasia is a syndrome of deformities that can affect all latero-facial structures, although the main clinical manifestations include maxillary and mandibular hypoplasia and possibly the absence of the temporo-mandibular joint. OBSERVATION: A 18-year-old man with otomandibular dysplasia was treated by grafting in a homologous joint and bone branch. DISCUSSION: There is no consensus on the best age to treat the syndrome and on treatment for mandibular hypoplasia and to reconstruct the temporo-mandibular joint. An alternative to the suggested treatments consists in reconstructing the joint and the branch affected by hypoplasia by grafting in a homologous joint and bone branch.

[A splenic autograft in omental pockets following splenectomy for trauma. The authors' personal experience of 10 cases]. / Autotrapianto splenico su tasche omentali dopo splenectomia per trauma. Esperienza personale su 10 casi.

Personal experience on 10 patients splenectomised for trauma and subjected to splenic autotransplantation on omental pockets is reported. After describing autotransplant candidate selection criteria and the surgical technique followed, the flattering results are reported. Particularly interesting was the fact that no local suppuration was encountered and the transplant took in all patients, as demonstrated by scans carried out with labelled red globules and radiocolloid.

[Endometriosis on a cesarean cicatrix. Apropos of 3 cases]. / Endometriosi su cicatrice per cesareo. A proposito di tre casi.

Endometriosis on a caesarean scar is a well-known, though not frequent event. The lesion generally presents as a painful nodule of the abdominal wall during the menstrual cycle. Pain cyclicity is a useful sign for diagnosis. Treatment consists of removal. Three cases are reported.

[Non-traumatic colic perforation in free peritoneum. Apropos of 61 cases]. / Perforazioni coliche non traumatiche in peritoneo libero. A proposito di 61 casi.

Sixty-one non-traumatic perforations in free peritoneum are reported. The principal aetiology is diverticulitis (35 cases) followed by cancer (22 cases). 18 derivations were carried out, 34 colectomies without anastomosis, 5 ideal colectomies and 4 diverticulectomies. Total mortality was 19.7-14% for diverticulitis, 22.2% for perforations at the cancer site, 50% from diastasic perforations. Stress is laid on the need to treat colic perforation by colectomy without anastomosis, confining derivation openeum. Sixty-one cases.

[Leiomyosarcoma of the Meckel's diverticulum (presentation of a new case)]. / Il leiomiosarcoma del diverticolo di Meckel (segnalazione di un nuovo caso).

A new case of Meckel's leiomyosarcoma is described. The rarity of the disease, the problems of differential diagnosis and the difficulty of establishing the malignant nature of the condition and thus the prognosis justify the report together with a review of the most recent literature.

[Total parenteral nutrition in packages. Methods of application in a general surgery department]. / Nutrizione parenterale totale in sacca. Metodiche di applicazione in un reparto di chirurgia generale.

In the period June 1987-March 1988, 80 patients classifiable according to ASPEN criteria were submitted to Total Parenteral Nutrition (TPN) using a single package nutrient mixing technique. The problems relating to the compatibility and stability of the solution are analysed and a protocol is proposed for the preparation of packages and the management of the central venous catheter compatible with the needs of a general surgery department. Personal experience has enabled us to observe the undoubted advantages of this technique: reduction of the time necessary for nursing the TPN patient, greater reliability in controlling speed of infusion and infectious complications, greater comfort for the patient.

[Intra-abdominal rupture of varices of the round ligament: a rare cause of hemoperitoneum in patients with cirrhosis]. / La rottura intra-addominale di varici del ligamento rotondo: rara causa d'emoperitoneo nel cirrotico.

The authors report two cases of haemoperitoneum due to intra-abdominal rupture of the round ligament in cirrhotic patients with portal hypertension. A review of the literature on the subject reveals the rarity of such observations. The eventuality must be borne in mind, however, in the treatment of the haemorrhagic complications of portal hypertension in view of the associated high mortality. Simple ligature of the bleeding varix is the operation which offers the greatest possibility of survival.

[Lesions caused by the ingestion of caustics]. / Lesioni da ingestione di caustici.

The diagnostic and therapeutic approach to the maiagement of lesions caused by ingestion of caustic substances has made substantial progress in the past few years and has now been codified. The linch-pins of the present approach are emergency endoscopy for an immediate assessment of the lesions and total parenteral nutrition to reduce the morbidity in patients whose lesions may be expected to take a long time to heal or may require surgical repair. The diagnostic and therapeutic protocol advocated derives from a close examination of the literature and from personal experience.

[Recent traumatic rupture of the diaphragm in patients with multiple injuries]. / Le rotture traumatiche recenti del diaframma nei politraumatizzati.

The authors report on 16 cases of recent traumatic diaphragmatic lesions in polytraumatized patients referred to them over the period 1979-86. After examining the diagnostic problems relating to this type of lesion, the authors describe the anatomico-topographical, clinical and therapeutic aspects. They conclude by stressing the need to explore the diaphragmatic cupulae systematically in the course of surgery for blunt abdominal trauma.

[Traumatic chylothorax (apropos of a case following a closed vertebral-thoracic injury)]. / Chilotorace traumatico (a proposito di un caso consecutivo a trauma chiuso vertebro-toracico).

The authors report a case of chylothorax due to blunt trauma with fracture of the spine in a man aged 60. After mentioning the possible pathogenesis and clinics of the case shown, the Authors explain the treatment successfully adopted, that is, the ligature of thorax duct at his inlet in the thorax through right thoracotomy on the 5th intercostal space.

[Sulfobromophthalein clearance and survival of cirrhotics after an elective porto-systemic shunt]. / Clearance della bromosulfonftaleina (B.S.F.) e sopravvivenza dei cirrotici dopo uno shunt porto-sistemico di elezione.

Preoperative clearance of a single dose of BSP was assessed in 72 candidates for porto-systemic shunt in cirrhosis of the liver. Comparison between those who had died (24) and those who had survived (48) several years later showed statistically significant differences with regard to equivalent liver volume, first uncorrected exponential (Ki), absolute clearance, and 45' retention. A certain degree of differentiation could be made out among the survivors, whereas those who had died could not be distinguished from the series as a whole, nor could correlations be established with the length of survival. No practical advantage was displayed by the more complex, computer-processed parameters as opposed to those that were more immediately available.