[Echinococcus cyst of the pancreas: description of a case and review of the literature]. / Cisti da echinococco del pancreas: descrizione di un caso e revisione della letteratura.

The echinococcosis represents a common condition in many parts of the world with maximum incidence in Uruguay (32 cases/100,000/year), in Argentina (21 cases/100,000/year), and in Morocco (7.2 cases/100,000/year). Italy is among the middle-high risk countries with beyond 1000 annual surgeries for hydatid cyst. Liver (45-75%) and lung (10-50%) are the most frequent localizations of echinococcosis. The other localizations represents the 13% of total. The hydatid cyst of pancreas constitutes the 1%. The Authors report the clinical case of a 28 years old woman, admitted for abdominal pain. Abdominal ultrasound, angio-CT and angiography of celiac trunk and superior mesenteric artery have been undertaken and the presence of a 10 x 10 cm lesion in the body-tail of pancreas has been showed, and the diagnosis of pseudocyst or cystadeno-carcinoma of pancreas has been formulated. The patient underwent surgery with body-tail pancreatectomy plus splenectomy. The histopathological examination showed the presence of hydatid cyst contained clear fluid and daughter cysts. The treatment of this infrequent localization of hydatid cyst is exclusively surgical. The tactic and surgical technique must aim to radical cyst's removal, with the maximum saving of the stricken organ, maintaining a good pancreatic function, either exocrine and endocrine.

Total mesorectal excision for surgical treatment of rectal cancer.

BACKGROUND AND OBJECTIVES: The aim of our study was to retrospectively evaluate the results of 2 groups of patients admitted and treated for rectal cancer. METHODS: One hundred and fifty-one patients were available for evaluation. Eighty (group A) were radically operated with the standard technique; 71 (group B) underwent total mesorectal excision (TME). Groups were similar according to demographics, staging, and pathological data. Mean follow-up was 73.5 months. RESULTS: No operative mortality was observed. Complications were 15% in group A and 32% in group B. Local recurrence rates were 41.2% in group A and 12.6% in group B. Distant metastases occurred in 21.2% and 7.6%, respectively, in groups A and B. Cancer-related mortality was 62.5% in the non-TME group and 19.5% in the TME group. Overall 5-year survival rates were 32.4% in group A and 70.5% in group B. Disease-free survival rates were 25% in group A and 62.3% in group B. CONCLUSIONS: TME appears to lower the incidence of cancer-related mortality, with a higher incidence of postoperative complications. Further studies need to be done to assess the real benefits of TME in the surgical treatment of rectal cancer.

[Intestinal occlusion due to a giant lipoma of the cecum]. / Occlusione intestinale da lipoma gigante del cieco.

Lipomas of the colon are localised in 90% of cases at submucous level, they are usually solitary and may be sessile or pedunculated. They are almost always asymptomatic; only when they are of a certain size they become manifest, causing alterations of the alveus, rectorrhagia, abdominal pain or intestinal transit alteration. They are often discovered by chance during endoscopic or radiological examination.

[An appendiceal-vesical fistula in a patient with cystic fibrosis]. / Fistola appendico-vescicale in un malato di fibrosi cistica.

Cystic fibrosis is an hereditary disease in which abnormally viscous secretion of exocrine glands causes chronic pulmonary infections and gastrointestinal disorders. The authors report the case of a patient with cystic fibrosis and appendicitis complicated by appendico-vesical fistula. The appendico-vesical fistula has been described during appendicitis; its association with the cystic fibrosis however has never been reported in the literature.

[Retroperitoneal schwannoma: report of a clinical case and review of the literature]. / Lo schwannoma a localizzazione retroperitoneale: descrizione di un caso clinico e revisione della letteratura.

The retroperitoneal localization of a schwannoma or neurilemmoma undoubtedly represents an unusual occurrence (0.5-0.7% of all sites); this data, together with the absence of a typical clinical picture and the lack of peculiar instrumental signs, make a preoperative diagnosis of this lesion really hard to ascertain. In this paper, on the basis of a case report successfully treated, the Authors review the literature analysing current diagnostic and therapeutic work up, mainly emphasizing controversies in determining a proper preoperative diagnosis among all retroperitoneal tumours.

[Anatomo-surgical considerations in laparoscopic cholecystectomy]. / Rilievi anatomo-chirurgici per la colecistectomia per via laparoscopica.

The Authors emphasize the importance of a perfect anatomo-surgical knowledge for laparoscopic cholecystectomy. Therefore, the anatomic structures of the region are taken into account from a "laparoscopic" point of view, with great care to accessory bile duct, hepatic artery, and cystic artery. Knowledge and confidence with the anatomy of the region are essential to identify abnormal structures and subsequently switch from a laparoscopic to a laparotomic approach.

[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.