Ectopic parotid: case report.

A recent case led the authors to re-examine the clinical characteristics of the cervical ectopia of the major salivary glands. These glands develop in the embryo between the sixth and seventh week, starting with the formation of endodermal invaginations of the branchial section of the floor of the primitive mouth. These cell cords, initially solid, proliferate in the underlying mesenchyme, starting from the opening of the future excretory duct, and subsequently branch and canalize. During embryogenesis, the endodermal invaginations become closely interconnected with the adjacent lymphatic tissue. It is thus possible for lymphoid tissue to migrate into the parotid or the other major salivary glands, or conversely, for salivary tissue to become included in the cervical lymph nodes. Very rarely, ectopic salivary gland tissue can also be found in other unusual locations, including the neck region, as a result of a developmental abnormality of the branchial apparatus. The base of the neck is the most common location, while ectopia of the mid third of the neck is quite rare. The authors discuss the clinical details and diagnostic procedure leading to preoperative diagnosis. This congenital anomaly can, albeit rarely, degenerate into cancer, and surgical excision is thus imperative.

[Etiopathogenetic and clinical considerations of corpus luteum cysts]. / Considerazioni etiopatogenetiche e cliniche sulle cisti luteiniche del corpo luteo.

The Authors report a case of hemoperitoneum after breaking of luteal cyst of corpus luteum and stress the main characteristics of this pathology. Ovarian cysts are frequently observed in the annexa; they are distinguished in folliculis cysts, luteal cysts, luteal cysts of corpus luteum. Their evolution, influenzed so both by endocrine factors so many from plogistic stimulation, pass through three essential moments: - obliteration for quick cicatrization of the stigma Graafian follicle; - hematic pouring and central softening; - increase of intracavitary fluid that stops with constitution of the fibrous tissue. In the second phase of the menstrual cycle, functional-anatomic changes occur that cause the formation of gravidic corpus luteum or menstrual corpus luteum. The luteal cysts of corpus luteum represent the result of the cystic evolution of the corpus luteum. These cysts are characterized by an intense endocrine activity and can frequently produce a surplus of steroids, particulary of progesterone. They can cause bleeding, often of slight entity but also severe that; these represent a frequent and dangerous complication, especially in women subjected to anticoagulant treatment with warfarin. This drug can determine a raise of intracystic pressure with consequent breaking of the capsule and hemoperitoneum for which is necessary emergency operation like in the case here described.

[A complication in biliary surgery: the biloma]. / Una complicanza degli interventi sulle vie biliari: il biloma.

Authors stress that complications in laparotomic and laparoscopic extrahepatic biliary surgery aren't exceptional. Lesions could be due to section or to stenosis of biliary duct. We can distinguish: intraoperative lesions, which consist in a intraperitoneal bile groan that needs an immediate treatment; lesions that could be found in postoperative period and in any case many days after surgery. Among this complications there is biloma, i.e. a localized uncapsulated extraductal bile collection. Authors refer about their experience and describe clinical findings of this complication. They conclude affirming how biloma treatment doesn't require always resurgery or CT scan drain. Main biliary tract endoscopic decompression could be often useful.

[Acute neoplastic colic obstructions: therapy and postoperative complications. Our experience]. / Le occlusioni acute neoplastiche del colon: terapia e risoluzione di complicanze postoperatorie. Nostra esperienza.

Authors report their experience about neoplastic large bowel obstructions and present two cases of anastomotic leakage resolution by means of transtomy wash-out. They observe that the most important problem in this surgery is anastomotic leakage which, if small, can be solved in a non operative way. According with literature, they also point out anastomotic leakage is commonly due to the impossibility of a correct preparation of colon to operation in emergency. They conclude it is possible, in case of little leakages, to perform trans-stomy wash out which permits a good toilette and sterilization of the colon.

Giant mucinous cystadenoma in a young patient. A case report.

The Authors describe the clinical case of a seventeen-year-old girl who presented with abdominalgia, fever, nausea and vomiting. During surgery it proved necessary to remove not only the appendix but also a voluminous mucinous cystadenoma of the ovary. The authors take this observation as a starting point for a description of the pathophysiological and clinical findings of these neoplasms.

[Hepatic hydatidosis: old and actual therapeutic strategies]. / L'idatidosi epatica: pregresse e attuali strategie terapeutiche.

The authors, reporting on their experience, confirm as the incidence of the hepatic hydatidosis and the complications related to this pathology today are very meaningful. They specify that the objectives to be pursued are: elimination of the parasite, prevention or treatment of the complications, prevention of the development of a new infestation. They dwell therefore upon the various techniques, both conservative and radical, that marked the history of the hepatic hydatidosis surgery, and they conclude affirming that the procedures of eradication of the parasite and the pericystectomy, in particular in laparotomic way, also represents the ideal treatment in consideration of the a little encouraging results of the medical therapy.

[Closed trauma of the spleen. Indications to surgical treatment]. / I traumi chiusi della milza. Indicazioni al trattamento chirurgico.

The Authors mention the historical evolution that led to consider the splenectomy as the ideal operation in patients with post-traumatic lesions of the spleen. They linger then on the actual knowledges about the physiopathology of this organ that determined a substantial change of mind to a conservative treatment, when possible. By reporting their experience of the last decade, they weigh up how every therapeutic choice must be consequent to an accurate clinical evaluation that suggests the surgical abdomen exploration in urgency or, on the contrary, the monitoring of the patient. They linger particularly on the validity of the investigation and quantization of organ lesions and of the subsequent hemoperitoneum. The Authors end affirming that an accurate diagnostic evaluation and the subsequent therapy must take place in a specialized Trauma Center that ensures intensive monitoring and, if necessary, a timely operation in these patients.