Diabetic fibrous breast disease: a clinical entity that mimics cancer.

Three typical cases of fibrous mastopathy associated with diabetes mellitus are described. The histological change is a connective-tissue overgrowth with vasculitis and some proliferation of duct epithelium. The clinical changes are indistinguishable by physical or radiographic findings from malignancy. In young patients with long-standing diabetes the presence of one or more suspicious clinical and imaging findings can suggest the presence of this lesion but a surgical biopsy or, at least, a close follow-up is required.

Spontaneous superior mesenteric vein thrombosis (SMVT) in primary protein S deficiency. A case report and review of the literature.

Superior mesenteric vein thrombosis (SMVT) is an uncommon but important clinical entity that can induce ischemia or infarction of the small and large bowel. It is rare and accounts for 5-15% of mesenteric vascular occlusions. Bowel infarction due to SMVT can present as an acute abdominal disease, requiring urgent laparotomy with resection of the intestinal segment affected. However, the clinical diagnosis of this event remains difficult and invariably requires specific imaging investigations in order to be able to treat the condition as soon as possible. SMVT without bowel infarction can present as persistent, non-specific abdominal pain and nausea with minimal clinical signs, affecting young individuals without any known predisposing disorder, where laparotomy is not an urgent indication. We report a case of a young adult man with SMVT due to a hypercoagulable state (protein S deficiency), in whom an early diagnosis and appropriate anticoagulant treatment prevented any further extension of the thrombotic process and limited the hemorrhagic infarction of the ileum, which simply required a segmental resection.

Conservative and surgical treatment in acute and chronic anal fissure. A study on 308 patients.

The aetiology of anal fissure is not fully understood--why some heal spontaneously and others become chronic remains a mystery. In this study we compared surgical and conservative therapy and investigated which surgical procedure is most useful in the treatment of fissure. There were investigated 308 patients, 157 with acute fissure and 151 with chronic fissure. Healing was achieved in 45 +/- 15 days and in 40 +/- 10 days in acute fissures treated conservatively and surgically, respectively, 40 +/- 15 days and 30 +/- 5 days were required to achieve healing in chronic fissure by conservative and surgical therapy, respectively. Manometric tests showed a decrease in resting pressure and maximum voluntary contraction pressure at one month, and an increase towards the pre-operative level at 4 months for both parameters. There were no recurrences at 5 years in 100 patients (50 males and 50 females).