[A rare cause of peritoneal fistula]. / Fistula abdominala de cauza neobisnuita.

The abdominal pregnancy is an extremely rare variety of the ectopic pregnancy. The symptoms are atypical, which causes a delay in putting the diagnosis, which is established most of the times when complications appear, which are always severe, and endanger the patients lives. This paper presents a rare complication of the abdominal pregnancy, at about 6 months old, stopped in evolution, complicated by an abscess, generalised peritonitis and peritoneal fistula. The diagnosis and treatment of the abdominal ectopic pregnancy are discussed.

Pseudomyxoma peritonei.

The authors report a case of a 60 years old Romanian male with peritoneal pseudomyxoma that was discovered to have a primary location in the greater omentum. Pseudomyxoma peritonei arising into the greater omentum is very rare. It is an original case report and the new data represents a well-balanced summary of a timely subject, with reference to the literature. This it is a significantly advance in our understanding of a particular disease etiology. Until now, only a few primary greater omentum pseudomyxoma peritonei have been described. Clinical and pathologic findings of this case are presented and the topic of primary location in the great omentum of pseudomyxoma peritonei was reviewed. Preoperative ultrasound examination showed the presence of an "eyes of net" tumoral-mass formation, in the greater omentum, and a fluid collection was found in the abdomen (Morrison space and the pouch of Douglas). Notwithstanding, diagnosis of pseudomyxoma was preoperatively considered less probable due to the rarity of the affection and the advanced age. During laparotomy, the presence of the large mass observed at the ultrasound examination was revealed. Mucinous ascites was present with invasive mucinous implants in the peritoneum and in the greater omentum. Operation consisted in the total removal of the mass followed by evacuation of the mucinous ascites. Histological examination confirmed the clinical diagnosis of pseudomyxoma peritonei.

[Clinical and therapeutic considerations on 201 operated hiatal hernias]. / Consideratii clinice si terapeutice pe marginea a 201 hernii hiatale operate.

A total of 201 patients have been operated over the last 8 years, presenting with hiatal hernias. Five of the patients had para-oesophagian hiatal hernia while the remaining 196 had hiatal hernias following slippage. Some 107 hernias were isolated, and had a classical etiopathogeny, with gastro-oesophagial reflux in 85% of the cases. Cardio-vascular disturbances and digestive hemorrhage were present in 15% of the cases. In 89 patients the hiatal hernias were associated with various affections in the supra-mesocolic space. There were 54 patients with biliary affections and 35 with piloro-duodenal affections. The indication for operation was established on the basis of clinical symptoms which included gastrooesophagial reflux, radiological signs of the reflux and indirect signs of oesophagitis. The surgical procedures employed were various, and included a personal procedure. The immediate and the late postoperative results were similar to those reported in the specialized literature.

Trichinous nephropathy.

Lesions of glomerular nephropathy were found in 5 cases of acute trichinosis, characterized by a low proteinuria and hematuria as well as by moderate deficit of the renal function. Renal biopsy revealed lesions of proliferative glomerulitis, while immunofluorescence examination showed granular deposits of IgG and beta1-C-globulin on basement membranes. Serum complement was reduced. These observations suggest an immunological mechanism in the development of the glomerular nephropathy during acute trichinosis.

Some ultrastructural aspects of endemic nephropathy of the Balkans.

Two renal biopsies selected from a large number of specimens taken by renal puncture from patients suffering from endemic nephropathy were studied by electron microscopy. Ultrastructural lesions were seen as electron-dense deposits in the walls of the glomerular capillaries, sometimes associated with glomerular proliferative processes. Such lesions, which are probably the early stages of this obscure renal disease, suggest that an auto-immune mechanism may be involved.

[Renal complications after rifampicin]. / Accidente renale dupa rifampicina

Six observations are presented of patients receiving intermitent rifampicin treatment (900 mg twice weekly) that developed acute renal failure during treatment (4 cases) or when treatment was taken up again, after an interruption of 6 months (2 cases). Following anuria of 4--14 days and nitrogen retention between 248 and 521 mg, the evolution was favourable. Clinical, biological and immunological data (anti-rifampicin antibodies were detected in 1/8 and 1/16 in 3 cases) suggest the immune origin of this type of renal accidents.