Gastric perforation in blunt abdominal trauma. Report of two cases and review of literature.

Gastric perforations as a result of blunt abdominal traumas are rare, with a reported incidence of less than 2%. Usually associated with other solid visceral injuries, isolated gastric ruptures following a blunt abdominal injury are extremely uncommon. The severity of injury, timing of presentation, time elapsed since the last meal, as well as the presence of concomitant injuries are important prognostic factors. Contrast-enhanced CT scan is the gold-standard diagnostic tool in haemodinamically stable patients and allows to detect or raise suspicion of injuries to hollow viscera in about 87% of cases. The authors report two cases of patients suffering from gastric injury following a blunt abdominal trauma. The first one with a double gastric laceration treated with suture repair. The second one with a wide laceration and tissue loss along the greater gastric curvature requiring a wedge resection. Both patients had an uneventful recovery. Authors present a brief review of the literature; a search on PubMed using the key words "blunt abdominal trauma" and "gastric injury" was performed, including all studies published in the last 20 years. Finally, the main data extracted from four reviews were examinated. KEY WORDS: Abdominal trauma, Gastric injury, Hollow viscus perforation.

[Streptococcus gordonii extensive multiple subcutanoeus abscesses]. / Ascessi sottocutanei multipli di vasta estensione da Streptococcus gordonii.

We describe extensive multiple subcutaneous abscesses involving the peri-scapular region, the right posterior and lateral peri-trochanteric area and ipsilateral thigh occurring in a 66-years-old woman. Streptococcus gordonii was identified as the unique pathogen. Despite this microrganism is generally considered not pathogenic, it has been previously described as responsible for two cases of peritonitis and one case of endocarditis. The patient has been treated with immediate surgical incision and drainage and was cured after two months of antibiotic therapy, medications and hyperbaric oxygen therapy.