Cecocolic torsion: classification, pathogenesis, and treatment.

Cecocolic torsion is a class of right colon obstruction. Under this heading, the known and the recently identified variants are unified under 1 classification. An algorithm is utilized to trace the pathogenesis of these variants. Recent data, prevailing definitions, and controversies are discussed and resolved. The significance of specific membranes and the blood supply is clarified. New symptoms, clinical and x-ray diagnoses are elucidated. The recommended treatments are outlined.

[Grouping of the International Classification of Diseases for analysis of hospital readmissions]. / Agrupamento da Classificação Internacional de Doenças para análise de reinternações hospitalares.

ICD chapters and three-digit categories are not always appropriate for epidemiological analysis; the former are too generic and the latter too numerous. When the epidemiological focus is not on a specific clinical diagnosis, an intermediate grouping proposal between these two possibilities becomes necessary. Such proposals are not frequent in the literature. We used a two-stage grouping proposal based on hospital admissions volume, internal clinical coherence in each group, and the results of a Cox multivariate model for real data. As a result, we obtained 26 groups for adults and 19 groups for children, among which we chose hernia as the reference category for adults and appendiceal disease for children. The grouping proved adequate for the analysis of readmissions in a large Brazilian general hospital. Procedures similar to those described in this research report can be used to analyze other health problems.

Intussusception of the appendix. A report of four cases and review of the literature.

The clinical and pathologic features of four cases of intussusception of the appendix are reported and the literature is reviewed. All patients had vague abdominal symptoms. The diagnosis of intussusception of the appendix was not made preoperatively in any of these cases. All four patients were females who ranged from 37 to 70 years of age (mean age, 46 years). Examination of the surgical specimens showed tow appendixes that had completely inverted, one with a polyp attached at the base of the appendix forming the intussusceptum and the other with inversion of the appendiceal tip. Three cases were associated with endometriosis and one with a tubulovillous adenoma. Radiologically and endoscopically, the intussuscepted appendix may mimic a neoplastic lesion. Since intussusception may be caused by both benign and malignant conditions, appropriate management will depend on the associated cause.

[Appendico-cecal invagination (considerations on a case)]. / L'invaginazione appendico-ciecale (considerazioni su di un caso).

Taking as their starting point the observation of an isolated case of appendicocecal invagination in a homogeneous series of 4,200 appendicectomies observed, the authors take the opportunity of addressing in some detail the many aspects of the problem posed by this rare condition. With the aid of a review of the literature, an attempt is made to define and explain the aetiology, pathogenesis and classification of such forms. The authors review the various clinical criteria and instrumental aids available for reaching a correct diagnosis, assessing their respective virtues and defects, especially as regards the radiological, ultrasonographic and endoscopic investigations used; they come to the conclusion that none of these is in itself specific for this condition, and stress that a clinical suspicion of appendicocecal invagination can only emerge of the basis of an overall assessment of the various test findings in conjunction with actual clinical experience. Lastly, the authors review the therapeutic possibilities and conclude that surgical therapy, which varies from case to case, is the most reliable approach, in that the endoscopic therapy attempted by some cassies an excessively high degree of risk.

[Appendiceal mucocele]. / Il mucocele appendicolare.

The authors, starding from their own clinical casuistry, critically review the literature, and suggest a new classification of appendicular mucocele based upon the anatomo-pathological aspects. They, moreover, analyse the clinical-therapeutical aspects, and hope the histologic testing of appendix becomes a routine practise.

[Errors and difficulties in diagnosis of cecal volvulus]. / Oshibki i trudnosti diagnostiki zavorota slepoi kishki

Clinical manifestations of the cecum ileus fall into three specific clinico-anatomical types, the knowledge of which permits establishing the correct preoperative diagnosis in a considerable number of cases. A description of these typical clinico-anatomical variants is presented, and some practical recommendations are given.