[Liposarcoma of the leg]. / Liposarcoma dell'arto inferiore.

The Authors report an interesting case of liposarcoma of the leg and review the international Literature. Moreover, a particular analysis of different aspects such as anatomy, clinic, diagnosis and treatment has been carried out.

[Digestive hemorrhage from a duodenal neuroendocrine tumor. Diagnostic-therapeutic features and emergency surgical strategy]. / Emorragia digestiva da tumore neuroendocrino del duodeno. Aspetti diagnostico-terapeutici e strategia chirurgica in emergenza.

The Authors report a rare case of duodenal neoplasia in a 17 year old boy. The patient was admitted in an emergency setting for hemorrhagic shock and duodenal perforation. Laparotomy was performed and a huge perforated neoplasia of the duodenum was found. Conservative approach was preferred, since the intraoperative histology was unuseful in choosing the better procedure: thus just a tumorectomy and closure of the duodenum were performed. Pathology examination demonstrated a neuroendocrine primitive duodenal tumors not well differentiated and with high grade of malignancy. The Authors discuss the role of the elements, clinical features and pathology, as well as emergency and postoperative management.

[Pica and intestinal occlusion: a clinical case]. / Pica ed occlusione intestinale: caso clinico.

Accidental or voluntary foreign bodies ingestion is a frequent reported event in emergency departments. Complication, foreign body shape related are not often observed and, once occurred, just few a cases need an open surgery approach, about 1%. The Authors report the case of a young woman with pica admitted to their Department in an emergency setting for acute intestinal obstruction due to the ingestion of not specified amount of elastics, which required an open surgery operation.

["Strawberry" gallbladder: review of the literature and our experience]. / Colecisti "a fragola": revisione della letteratura e nostra esperienza.

The term "strawberry gallbladder" refers to an anatomo-pathological aspect which is included in the wider chapter of gallbladder cholesterolosis. Introducing their experience, the Authors summarize the hypotheses through the years proposed about the etiopathogenesis of this condition the clinical symptoms that it can produce and the diagnostic strategies used to identify it. Moreover the Authors underline that the "strawberry gallbladder" continues to be reported with a significant frequency. They also confirm the opportunity of surgical treatment of symptomatic patients as a valid alternative to medical therapy which is not always effective, it is long lasting, often complex and not completely side effects lacking.

[Gastric antral vascular ectasia (GAVE or watermelon stomach): a case report]. / Ectasia vascolare gastrica antrale (GAVE o watermelon stomach): descrizione di un caso.

Gastric antral vascular ectasia (GAVE), recently described in literature, is an important cause of gastric bleeding. A case of great gastrectasia with vascular ectasia in an elderly male patient is reported. The lesion was characterized by great linear and brush folds along the antrum and body of the stomach, Endoscopically, this folds seems like the watermelon streakings. It could be an acquired lesion probably linked to traumatism on gastric mucosa.

Parietal sierosa for protecting colonic suture lines. Technical note.

Suture line leakage is a frequent, serious problem in colon surgery. We propose the use of a flap of the parietal peritoneum from the paracolic gutter, adjacent to the operative site, to protect right and left colon suture lines. The advantage of this method is that it permits complete exclusion of the sutured intestine from the peritoneal cavity and avoids the risks of leakage from an intestinal suture line within the peritoneal cavity.

Intraductal papillary carcinoma of the parotid gland with low malignancy.

A peculiar case of papillary carcinoma arising in the parotid gland is reported. A 68-year-old woman presented with a right, painless, parotid mass, measuring approximately 3 cm in greatest diameter. A conservative parotidectomy was performed. Histologically, the neoplasm showed exophytic papillary projections into a cavity. The cells were focally suggestive of epidermoidal differentiation, whereas a transitional differentiation was noted in other portions, as in bladder papilloma. Immunohistochemical studies showed strong positivity of the neoplastic cells for cytokeratin and weak positivity for PCNA and Mib-1. We classified this neoplasm among the papillary tumors with a low-grade of malignancy.

[The diagnostic-therapeutic picture in liver injuries: a review of the literature and clinical cases]. / Inquadramento diagnostico-terapeutico nei traumi epatici: revisione della letteratura e casistica clinica.

Approximately 80% of liver trauma cases have a good prognosis and do not create decision-making problems for the surgeon, while in the remaining 20% the correct choice still represents a problem. Recently there has been a trend toward more conservative surgical management with emphasis on hemostasis and debridement, as well as a move toward a non-surgical alternative (surgical abstention) where feasible, relying in such cases on first-line CT scans for trauma evaluation. We report 51 cases of liver trauma observed in the period 1985-1993 graded according to the AAST Liver Injury Scale as follows: 12 grade I lesions (23.5%), 7 grade II lesions (13.7%), 19 grade III lesions (37.3%), 7 grade IV lesions (13.7%), and 6 grade V lesions (11.8%). In managing these cases we relied on two first-line diagnostic procedures: diagnostic peritoneal lavage (DPL) and CT scans. DPL, performed on 10 blunt trauma victims with unstable vital signs, was positive in 7 who thus underwent immediate surgery, and negative in 3 who subsequently underwent CT scan. Another 14 blunt trauma victims with stable vital signs underwent first-line CT scanning. In the event of a CT grade III or IV lesion patients underwent surgery, while patients with a CT grade I or II lesion were followed expectantly. Deaths (14) occurred only among patients with grade III or IV lesions (including 9 multiple trauma victims) who underwent surgery.

[Ultrasonography and biliary calculi: a retrospective study on the diagnostic reliability]. / Ecotomografia e calcolosi biliare: studio retrospettivo sull'attendibilità diagnostica.

The Authors evaluated diagnostic reliability of echotomography in biliary tract lithiasis, reviewing a series of 130 patients (out of 171) who were surgically treated; 30 had proved to be affected with biliary main tract stones. A high rate of false negatives was documented as related to the diagnosis of lithiasis of the main biliary duct.

[Etiopathogenetic and histopathologic aspects of acute necrotico-hemorrhagic pancreatitis in experimental animals]. / Aspetti etiopatogenetici ed istopatologici della pancreatite acuta necrotico-emorragica nell'animale da esperimento.

In this study, the Authors have provoked experimentally acute pancreatitis in the rat by different methods, in order to find out morphological modifications of the pancreas in the initial stage of the disease. In case of biliary and pancreatic duct obstruction with pure pancreatic reflux, both oedema and inflammatory infiltrations were evident, whereas, in the presence of biliary reflux too, more serious histological features were detected. In conclusion, the first sign of alteration in acute pancreatitis could be represented by the association of intraductal hypertension and pure pancreatic reflux.

[Supplemental proposal in the surgical treatment of liver injury. Experimental studies]. / Proposta complementare nel trattamento chirurgico della trancia epatica. Ricerche sperimentali.

Liver resections pose a great variety of problems, not least repair of the cut. The various reconstruction modalities are reviewed and personal experience in twenty rats submitted to surgical removal of the median lobe of the liver with cover of the sectioned surface by means of omental mesh autograft is reported. The results were flattering for the absence of significant complications and for the haematological and haematochemical data obtained which confirm low easily the graft takes, its regenerative potential and the modulator action of peritoneal repair processes.

[Surgical proposals concerning omental mesh graft. Experimental studies]. / Proposizioni chirurgiche dell'innesto omentale a rete. Ricerche sperimentali.

In general surgery, the advantages deriving from the utilisation of omental graft are attributable to the ease with which it takes, its regenerating potential and the modulator action on tissue repair. Personal experience regarding the peritoneization and covering of surgical liver surfaces is reported and the use in various sectors of surgery of omental mesh graft is recommended.

[Preliminary results of tumor marker monitoring in patients with colorectal carcinoma]. / Risultati preliminari del monitoraggio di markers tumorali in pazienti affetti da carcinoma colo-rettale.

A study relating to the preliminary results of the measurement of tumoral markers (TPA, GICA) in patients suffering from colorectal carcinoma is reported. It is possible to state, on the basis of this experience, that the use of the two tumoral markers is justified in the preoperative period above all as a prognostic indicator, while greater clinical utility would seem to derive from their use through serial determinations, in the postoperative follow-up and in the monitoring of patients undergoing antiblastic and radiation treatment.