Portal and mesenteric thrombosis in protein S (pS) deficiency.

Portal and/or mesenteric thrombosis is a rare occurrence, and often an underlying hypercoagulable state can be found. We describe a case in which a mesenteric infarction due to mesenteric venous thrombosis occurred as the first manifestation of an inherited type I deficiency of protein S, whereas signs of portal thrombosis emerged later.

[Transverse mesocolon herniation. Description of a clinical case]. / Ernia trans-mesocolica. Descrizione di un caso clinico.

A case of herniation of small bowel through a defect of the transverse meso-colon with secondary herniation through the gastrocolic ligament and re-entry into the greater peritoneal cavity is reported. This form of lesser sac hernia is rare and only one hundred half cases have been reported in literature.

[The autologous splenic reimplant in the rat]. / Reimpianto splenico autologo nel ratto.

In order to evaluate the clinical utility of autologous splenic transplantation in the omental pouch, a pneumococcal challenge was performed in 3 groups of rats, after demonstration of vitality of the intraperitoneal inoculum: Group A: splenectomized rats; Group B: reimplanted rats; Group C: sham operation. No statistically significant difference was found between the first two groups regarding resistance against infection (p less than 0.982), while normal rats proved more resistant (p less than 0.031). Between group A and B significant differences (p less than 0.001) exists only for a more precocious mortality in the first group. The poor clinical utility of the technique is demonstrated.

[Surgical treatment of anal fistula]. / Il trattamento chirurgico delle fistole anali.

The surgical problems posed by a fistula are closely related to the morphology of the channel and its relationship with the sphincter, especially with the striated sphincter. Fistulas are characterised by an extremely variable course and often demand an individual approach. For superior trans-sphincter and supra-sphincter fistulas the channel section method with seton offers the best guarantees of respecting sphincter function by means of slower healing.

[Emergency surgical treatment of acute perforation of the colon]. / Il trattamento chirurgico in urgenza delle perforazioni acute del colon.

Thirty cases of perforated colon observed in the past 10 years in the General Surgery Division of Novara are reported. The therapeutic approach and results obtained are reviewed. Postoperative complications and mortality with the various types of intervention are assessed in the light of personal experience and reported data.

[Apple-peel syndrome. A clinical case report and therapeutic considerations]. / Apple-peel syndrome. Osservazione su un caso clinico e considerazioni terapeutiche.

A recently observed case of proximal jejunal atresia with apple-peel syndrome and associated multiple ileal atresia is reported. Some clinical and anatomopathological features are pointed out. Surgical techniques and medical care are analysed.

[Neoplasms of the duodenum. A description of 2 clinical cases]. / Neoplasie del duodeno. Descrizione di due casi clinici.

Duodenal tumours are a rare pathology, hard to diagnose early because of the unsubstantial symptomatology even though, in recent years, with the advent of improved techniques, a larger number have found their way into the literature. Two cases of duodenal cancer, one an adenocarcinoma localised in the first portion of the duodenum and one a subpapillary leiomyosarcoma are reported. 2 and 5 years respectively after the operation, both patients are in good health and do not present signs of disease.

Gastric choriocarcinoma; an immunohistochemical study.

A case is reported of primary gastric choriocarcinoma occurring in a 73-year-old man, associated with a high serum level of beta hCG. Both primary and lymph node metastases contained exclusively cyto and syncytiotrophoblastic elements. Immunohistochemical localization of chorionic gonadotropin (hCG), placental lactogen (hPL) and pregnancy-specific glycoprotein (SP 1) is described in relation to cytotrophoblastic differentiation. An intramucosal focus of adenocarcinoma supports the hypothesis of the origin of choriocarcinoma from usual gastric cancer.