Double traumatic diaphragmatic injury: A case report.

INTRODUCTION: Traumatic diaphragmatic injuries are rare complications resulting from a thoracic-abdominal blunt or penetrating trauma. Left-sided diaphragmatic injuries are more commonly reported in literature. Bilateral injuries are extremely rare, occurring in about 3% of the patients and just few cases reported in literature. Traumatic diaphragmatic hernias are definitely a marker of a severe trauma, in fact diaphragmatic injuries are often related to thoracic and abdominal organs injuries. Sometimes the classic clinical signs and symptoms of diaphragmatic injuries may initially not be present so that definitive evaluation is delayed or even missed. CASE REPORT: A 62-years old woman was admitted in Emergency Department after a pedestrian accident. A whole-body CT scan showed multiple fractures (ribs, pelvic and vertebral) but no organ injury. The next CT detected a left-sided posterior diaphragmatic hernia involving transverse colon. Thus we performed an explorative laparoscopy and found a double diaphragmatic injury. A primary repair with non-absorbable sutures and a prosthetic titanized patch was performed.

[Intraperitoneal traumatic rupture of hydatid cyst of the liver: a case report and review of the literature]. / Rottura traumatica intraperitoneale di cisti idatidea epatica: caso clinico e revisione della letteratura.

We performed a subtotal cystectomy on the second and third hepatic segments, with the aid of a radiofrequency dissector device (Ligasure), together with removal of daughter cysts from the peritoneal cavity and irrigation of the peri- toneum with iodine solution. The postoperative course was uneventful and complication-free. A three-year follow-up was carried out without any recurrence. Our review of the recent literature showed that an adequate surgical procedure, proper cleaning of the peritoneal cavity and postoperative medical treatment with albendazole are the most important factors for reducing the incidence of recurrence.

Adrenal epithelioid angiosarcoma: a case report.

We report what to the best of our knowledge is the first case of primary angiosarcoma of the adrenal gland. A 49-year-old woman, with blunt abdominal trauma, was admitted to our department. Computed tomography revealed a suspected rupture of a liver neoplasm and surgical treatment was performed. At laparotomy there was no evidence of liver tumour but a large mass was found in the right adrenal gland. The mass was removed along with the entire periadrenal fat tissue and locoregional lymph nodes. Microscopically, we found diffuse neoangiogenesis with large, hyperchromatic cells. This cellular proliferation, together with the widespread necrosis, distorted the normal appearance of the adrenal gland. No adjuvant therapy was administered. Six months and 1 year later thoracic- abdominal computed tomography and positron emission tomography were performed, and no signs of local recurrence or metastases were observed.

Isolated polyarteritis nodosa of the large bowel: a case report.

Polyarteritis nodosa is a form of vasculitis that affects several organs. Gastrointestinal involvement is frequent, but cases in which the gastrointestinal tract is the only site of disease are rare. In this paper we report a case of a 70-year-old patient with polyarteritis nodosa restricted to the large intestine, who underwent a total colectomy. The patient had no other signs of chronic vasculitis and for this reason surgical treatment resolved the clinical symptoms.