[Kidney and urinary tract injuries. Experience with 113 cases]. / I traumi del rene e delle vie urinarie. L'esperienza di 113 casi.

BACKGROUND: Trauma of the kidney and urinary tract is not rare in emergency surgery and the related treatment needs today high competence and interdisciplinary approach. Aim of the study was to analyze the personal experience in order to find differences in the treatment during the last years especially for trauma of the kidney. METHODS: The authors report 113 cases of kidney or urinary tract trauma out of 16,569 patients admitted in emergency between 1981 and 1995. Fifty patients (44%) underwent surgery. Thirty patients (26%) underwent surgery for kidney trauma but in only 5 (16%) conservative surgery for partial damage was possible. Section of the ureter occurred in one patient. Ten patients had a rupture of the bladder and 9 the rupture of urethra. The cause of trauma was a gunshot wound in 11 patients (22%). Nineteen patients (38%) had also damage to other organs. RESULTS: The results show absence of morbidity or mortality related with urinary tract trauma. CONCLUSIONS: The analysis of these cases shows that the improvement of diagnostic possibilities allowed the reduction of surgical interventions especially for kidney trauma.

[Advantages of reabsorbable intradermal sutures in general surgery. Experience on 201 sutures]. / Vantaggi della sutura intradermica riassorbibile in chirurgia generale. Esperienza su 201 suture.

Surgical wound suture is often considered of minor importance compared to the whole surgical operation. The aesthetical result of a wound suture is still hardly considered in general surgical practice compared to other "traditional" wound sutures. The Authors carried a prospective study an 201 intradermal absorbable sutures in clean general surgery. The results clearly show that with a limited increase of the mean operation time of 90 seconds, for a 10 cm suture, there are such positive clinical, and aesthetical results that it is advisable to use routinely this type of suture in elective clean surgery.

Experimental models in microsurgery.

The development of experimental microsurgery can be considered the natural evolution of a diffuse need to increase precision in many fields of surgery. Microsurgery accelerated the possibility of deepening many unclear aspects of pathophysiology, using miniaturized and reproducible experimental models. We report briefly on the fundamental principles of microsurgery and the most frequently performed and useful models of experimental microsurgery, especially to employ as training models for surgeons, but also as bases for developing new and always-welcome models.

Misplacement of a jugular line in a facial vein.

We report an exceptional misplacement of a central venous catheter, from the right jugular vein where it was introduced, into the right thyro-lingual-facial trunk. A brief description of the clinical course and a literature review on catheter misplacement is presented. This case illustrates the importance of routine use of a chest X-ray, and when necessary contrast medium, to verify the correct location of the catheter tip.

[Splenic abscess]. / Absceso esplénico.

Splenic abscess is rare and may be present either as a localized area in the spleen or as part of a generalized sepsis. A 35 year old man presented with a two month history of anorexia, weight loss, fever, abdominal pain and arthralgia. Multiple abscesses localized in the spleen were diagnosed by CT and splenectomy was performed.