[Rectal cancer--diagnostic and therapeutic difficulties]. / Cancerul de rect--probleme de diagnostic si tratament.

This paper aim is to analyze the main diagnostic and therapeutic aspects in rectal cancer; for this purpose we analyzed the Craiova's Surgical II Clinic statistics and we report them to the present literature. There were 179 rectal cancers, diagnosed over 10 years period (between 1995 and 2004); 163 cases were operated on, in 62 cases (38.03%) the surgical intervention aim being curative; global resection of tumor was 84.66%. The operation was preceded by preoperative radiotherapy in 82 cases; all cases diagnosed in the last four years in curative stage of disease were treated by preoperative radiotherapy. The postoperative mortality was 3.68% (6 cases) and the morbidity rate (55 cases - 33.74%) is still important, mainly because of the associated diseases. In conclusion we emphasize the importance of untimely diagnosis and the obligatorily sequential treatment: preoperative radiotherapy curative surgical resection - postoperative adjuvant treatment.

[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.

[Gastric volvulus--complication of a large paraesophageal hiatal hernia]. / Volvulusul gastric--complicatie posibila in herniile hiatale paraesofagiene mari.

The authors present the case of a patient with a large paraesophageal hiatal hernia complicated with organo-axial gastric volvulus. We discuss problems of diagnosis and therapeutical options.

[Cholesterol crystal embolisation in the course of treatment with low-molecular-weight heparins]. / Emboliile cu cristale de colesterol în cursul tratamentului cu heparine cu greutate moleculara mica.

Cholesterol crystal embolisation is a rare complication of anticoagulant treatment of ulcerative atheromatosis to the great arteries. The embolisation is susceptible to affect both, the somatic and the visceral territory; clinical diagnosis is difficult, mainly because of the similarity between the embolisation symptoms and those produced by a complication of primary disease. The diagnosis is certain when the pathological examination reveal the presence of cholesterol crystal in arteriolar lumen, surrounded by inflammatory- cellular reaction (foreign-body reaction). This paper presents three cases in which we noticed clinical manifestation suggestive for cholesterol crystal embolisation, at patients in treatment with low-molecular weight heparins. The complications which were reported in case of cholesterol crystal embolisation could be extremely severe, specially visceral embolisation, they may lead to patient's death.

[Severe nosocomial infection of soft tissue in general surgery]. / Infectiile nosocomiale severe ale partilor moi în chirurgia generala.

This paper aim is to emphasize the severity of soft tissue nosocomial infections, determined by anaerobic bacteria associated with Gram-negative aerobic bacteria: 50% mortality, higher economic costs, disabling morphologic and functional sequels. We present the pathogenic, clinical and therapeutically problems which characterize this type of postoperative infections.