Paediatric gastric trichobezoar: the Rapunzel syndrome A report of two cases.

Rapunzel syndrome is a rare case of bowel obstruction resulting from hair ingestion (Trichobezoar). The obstruction can occur in any level of intestinal tract, but usually the stomach is primary involved. This syndrome is usually reported in patients affected by Trichotillomania or Pica syndrome, an obsessive-compulsive disorder that are characterized by an irresistible need to eat body hairs or non-digestible substances 1.

Bilirubin level fluctuation in drain discharge after hepatectomies justifies long-term drain maintenance.

Background/aims: Need for abdominal drains after liver resection is debated. However, unrecognized bile leak is relatively frequent: to prevent bile collection we adopted the use of long-term drains. The aim of this study was to validate this policy checking the bilirubin concentration in the drain discharge and serum along the postoperative course.

Indication and contraindication for hepatic resection for liver tumors without fine-needle biopsy: validation and extension of an Eastern approach in a Western community hospital.

Fine-needle biopsy (FNB) is associated with problems, such as tumor seeding, which are not negligible. The aim of this study was to validate prospectively the accuracy of our diagnostic work-up without FNB, not just to address but also to rule out from a surgical program patients with focal liver lesions (FLLs). From September 2001 to July 2003, 89 patients were seen at an outpatient clinic for FLLs.

Ultrasound-guided liver resections for hepatocellular carcinoma.

Imaging-guided interventional procedures have modified the approach to hepatocellular carcinoma including the surgical one. In fact, liver resections can be carried out with no mortality even if cirrhosis is associated, combining the needs for oncological radicality and liver parenchyma sparing mainly because of the extensive use of intraoperative ultrasonography either for tumor staging or resection-guidance. The aid of intraoperative ultrasonography is therefore optimizing the balance between the oncological radicality and the sparing of the highest amount of functioning liver parenchyma.