[Unusual case of intestinal obstruction at the ileal level: strangulated obturator hernia. A case report]. / Un raro caso di ostruzione intestinale a livello ileale: l'ernia otturatoria strozzata. Report di un caso.

OBJECTIVE: The authors report their experience about treatment of a rare case of intestinal (ileal) obstruction by strangulated obturator hernia. DESIGN: Report of 1 case; evaluation of effectiveness of surgical treatment, 2-years follow-up and revision of literature about its clinical presentation and treatment. SETTING: Operative Unit of General and Thoracic Surgery, Department of Surgical, Anatomical and Oncological Disciplines. Policlinico, University of Palermo. INTERVENTIONS: The patient was submitted to curative and radical surgery. RESULTS: Resolution of the pathology. Follow up (2 years) negative. CONCLUSIONS: Obturator hernia is a rare pathology, with difficult and delayed diagnosis: all these character make dangerous this hernia, with a risk of high morbidity and mortality (delayed diagnosis and treatment). The only useful treatment is surgery, especially in front of intestinal obstruction, with a wide median laparotomy.

[Advantages in the ultrasound guided central venous catherization (new notes of technique)]. / Vantaggi degli ultrasuoni nel posizionamento di un agocannula nella vena giugulare interna (nuove note di tecnica).

The authors analyzed the results of 175 central venous catheterization CVC of internal jugular vein performed with the ultrasound guide (US) from January 1998 to October 2002. The average performing time was 4.5 minutes, 98.2% of success and 4% of complications (one vagal hypotension, one artery puncture, four catheter dislocation, one haematoma). The US guide CVC is a safe procedure with short performing time, low rate of failures and complications and high rate of success; it is helpful in all patients with vascular anatomical variations, with not visualized or palpable landmarks and with coagulation disorders.

[Surgical treatment of epiphrenic diverticulum based on associated functional changes: report of a case]. / Trattamento chirurgico di diverticolo epifrenico modulato sulle alterazioni funzionali associate: presentazione di un caso.

OBJECTIVE: The authors report their experience about the surgical treatment of a epiphrenic diverticulum (ED) associated with motor disfunctions and gastroesophageal reflux. DESIGN: Report of 1 case; evaluation of effectiveness of the treatment. SETTING: Operative Unit of General and Thoracic Surgery, Department of Surgical, Anatomical and Oncological Disciplines. Policlinico, University of Palermo. INTERVENTIONS: Thoracotomic diverticulectomy + esophageal extramucosal myotomy + antireflux procedure. RESULTS: Resolution of syntomatology. Negative the follow up. CONCLUSIONS: ED is the epiphenomenon of esophageal motor disfunctions. The surgical procedure is based on their comprehension and on the study of this factors.