[Hemoperitoneum from post-traumatic ovarian cystoma. Videolaparoscopic treatment]. / Emoperitoneo da cistoma ovarico post-traumatico. Trattamento videolaparoscopico.

Personal experience in a case of ovarian cystoma (misunderstood to the patient herself) broken consequently to a car trauma and cause of an intracystic angiorrhagy and hemoperitoneum is presented. The advantages of videolaparoscopic technique both for the diagnosis formulation and for the surgical treatment are underlined and the use of this new technique is suggested due to its advantages such as quickness, mini-invasiveness and post-operation comfort.

[Laparoscopic surgery in abdominal emergencies]. / La chirurgia laparoscopica nelle urgenze addominali.

The authors report their experience in the use of laparoscopy in the treatment of abdominal surgical emergency; the advantages in the diagnosis and in the correct surgical approach in many cases are underlined. They note furthermore that the laparoscopic exploration of peritoneal cavity can lead to an ideal laparotomy.

[Tubal carcinoma. Clinical and anatomo-pathologic considerations on an unusual lesion]. / Il carcinoma tubarico. Considerazioni cliniche ed anatomo-patologiche su di una lesione rara.

Tubal carcinoma is the rarest neoplasia of the gynecological tract; it is found during the course of abdomino-gynecological surgery with an incidence of 1:1000. The authors report a case of papilliferous tubal carcinoma which was brought to their attention having not been recognised earlier. In fact, diagnosis was made at an advanced stage during the course of emergency surgery 2 days after hospitalisation. Intraoperative histological tests resulted in bilateral adnexectomy (without apparent damage to the tubes) as well as colostomy on the transverse colon due to stenosis of the sigmoid caused by serofibrinous peritonitis. The final histological analysis of the part removed confirmed the intraoperative diagnosis.

[Major resection in severe hepatic trauma. Technical indications and clinical considerations in a case of personal experience]. / La resezione maggiore nel trauma epatico grave. Indicazioni tecniche e considerazioni cliniche su di un caso di personale esperienza.

Before the Second World War overall mortality from liver injuries was 60%. The extraordinary progresses made in elective hepatic surgery, backed by an increasingly detailed physiopathological knowledge and by progress in anesthesia and reanimation techniques, have had a positive effect also on traumatological liver surgery bringing mortality rates dawn to between 10% and 20%. However, in spite of this reassuring success, mortality from liver injury still remains unacceptably high for the most severe lesions on the "Calne scale", in particular 50-60% for 4th degree lesions. A review of the literature regarding this group of patients indicates hemorrhagic shock as being the prime cause of mortality: extensive lobar disintegration associated with severe vascular disinsertion involving the suprahepatic-caval crossroads are responsible for the patient's death in 50% of cases. Associated intra- or extra-abdominal lesions, which are often commonplace, make a decisive contribution to raising the mortality rate for 4th degree lesions. Lastly, the high number of possible postoperative complications contributes to the severity of prognosis in this group of patients. The analysis of a case of severe hepatic injury (4th degree according to Calne's and Lenriot's classifications) with a favourable outcome prompts the author to make a number of clinical and surgical observations, and to conclude that emergency hepatic resection still continues to be a rare indication reserved for cases of absolute necessity for which there is no other possible therapy.

[Myoid tumors of the stomach. Our experience]. / I tumori mioidi dello stomaco. Nostra esperienza.

The authors analyse the incidence of myoid tumours of the stomach in comparison to bowl cancer as a whole and identify the different anatomopathological varieties (benign leiomyoma, leiomyosarcoma and Martin-Stout's bizarre leiomyoma). Symptoms are usually subtle and development slow: important factors are the site of onset (antro-pyloric in 60% of cases, body 25% and cardias 15%), the type of tumour growth (intra- or extraluminal or mixed) and tumour size which may sometimes be considerable. Four categories of patients are identified on the basis of symptoms shown: a) asymptomatic (chance diagnosis), b) aspecific (vague symptoms such as epigastralgia, dyspepsia, ecc.), c) symptomatic (presence of abdominal mass, chronic anemia, ecc.), d) complicated (onset of complications the most frequent of which is acute hemorrhage). The clinical data reported here refers to 4 patients (3 males and 1 female) aged between 53 and 75 years old. In one case diagnosis was made by chance, in 2 cases diagnosis followed acute hemorrhage of the upper digestive tract, and in the case of the woman clinical controls began following the finding of a voluminous abdominal mass. Diagnosis was based on traditional radiology and EGDscopy, as well as ultrasonography and CT. Treatment was surgical in all cases (two enucleations of the lesion and two atypical gastric resections). In the light of the authors' personal experience and data reported in the literature, the discussion focuses attention on the problems of diagnosis and therapy, in particular the various options facing the surgeon in the form of operating tactics.

[Dermoid cysts of the ovary]. / Le cisti dermoidi dell'ovaio.

Primordial germinative cell differentiation anomalies give rise to a whole array of generally benign ovarian tumours which are sometimes of glandular structure and functionally active. In certain cases, they deviate from their normal proliferative line and give rise to malignant tumours of various histological nature. Attention is called to the malignant variations of dermoid cysts and to the importance of careful differential diagnosis for the purpose of correct surgical conduct.