[Original reconstruction technique after duodenopancreatectomy]. / Tecnica originale di ricostruzione dopo duodenocefalopancreasectomia.

The authors present an original reconstruction technique after pancreaticoduodenectomy, with anastomosis between the pancreatic stump and the posterior wall of the stomach, using two Roux-en-Y loops to separate the hepaticojejunostomy from the pancreaticogastrostomy and gastrojejunostomy in order to reduce postoperative complications and mortality. Eighteen consecutive patients underwent the procedure. There was no mortality and no pancreaticogastrostomy leaks occurred. Two (11.1%) gastric bleeds occurred in the first two cases. Twelve cases (66.6%) presented alimentary emesis on postoperative day 5 or 6 after food intake. Three patients (16.6%) had postoperative diarrhea. There were no complications calling for reoperation. The mean hospital stay was 14.4 days. No significant late complications were observed. The procedure is easy and safe with no mortality and with one of the lowest complication rates in the literature.

[Our experience with Spigelio's hernia]. / Nostra esperienza con l'ernia di Spigelio.

The authors present their experience about diagnosis and therapy of Spigelian hernia in five cases observed. Clinical examination is the foundation of the diagnosis and radiological findings (ultrasonography, colonic X-rays, CT and NMR) permit to exclude other pathologies which concern differential diagnosis. They suggest prosthetic repair, similar to the therapy of groin hernias, using a tension-free technique. This method of treatment avoids relapses and does not alter the functionality of muscular and aponeurotic apparatus.

[Boerhaave's syndrome]. / La sindrome di Boerhaave.

The authors report a personal case of "Boerhaave's syndrome" recovered by immediate reconstruction of perforated distal esophagus. They stress the value of early diagnosis by using X-ray study of upper gastrointestinal tract and immediately surgical treatment, very important for favourable prognosis.