[Unusual clinical presentation of Meckel's diverticulum. A case report]. / Inusuale presentazione clinica del diverticolo di Meckel. Descrizione di un caso clinico.

Meckel's diverticulum (Md) is the most common congenital anomaly of the gastrointestinal tract. It results from an incomplete obliteration of the omphalomesenteric duct during fetal life. It is frequently located on the antimesenteric border of the ileum at 80 cm from the ileum-cecal valve. It contains heterotopic mucosa in 30% of the cases and in 70% of these the mucosa is of the gastric type. The most common complication in childhood is represented by hemorrhage. Preoperative diagnosis is often difficult. Barium enema, Tc-99 scintigraphy and selective mesenteric angiography usually can permit diagnosis. In adults occlusion, perforation, diverticulum infection, Littre's hernia and tumors represent the complications of Meckel's diverticulum. A case of Md is reported because of the unusual clinical presentation.

[Preoperative blood storage and intraoperative blood recovery in elective treatment of abdominal aorta aneurysm]. / Predesposito e recupero intraoperatorio di sangue nel trattamento elettivo degli aneurismi dell'aorta addominale.

We evaluated the efficiency and costs-effectiveness of blood predonation and intraoperative salvage in elective abdominal aortic aneurysm surgery. Between January 1992 and January 1994, 66 patients (59 male and 7 female, aged 69.9 +/- 0.8 years) who underwent elective surgical repair of an AAA were selected for the study. Thirty-six (54.5%) patients (Group 1) intra- and/or postoperatively received homologous blood whereas 30 (45.5%) patients (Group 2) received autologous blood predonation and intraoperative blood aspiration and reinfusion. The two groups were similar for demographic data, aneurysmal diameter and associated diseases and/or risk factors (p = NS). Operative mortality was comparable between the two groups (p = NS). The mean intraoperative blood loss was 803.4 +/- 104.5 ml in group 1 and 812.8 +/- 44.8 ml in group 2 (p = NS). Group 2 patients received intra- or postoperatively a mean of 0.8 +/- 0.2 units of homologous blood (p < 0.001). Aneurysmal diameter did not influence the transfusion requirement between the two groups (p = NS). The cost per unit of homologous banked blood was significantly higher (p < 0.01). Cumulative costs of the procedures did not show statistical differences between the two groups (p = NS). Aortic surgery is the ideal target for predonation and intraoperative blood salvage.