Self-Expandable Metal Stents for Left Sided Colon Obstruction from Diverticulitis. A Single Center Retrospective Series.

: The incidence of diverticulitis is increasing in western countries. Complicated diverticulitis is defined as diverticulitis associated with localized or generalized perforation, localized or distant abscess, fistula, stricture or obstruction. Colonic symptomatic strictures are often treated with segmental colectomy.

Association of liver steatosis with colorectal cancer and adenoma in patients with metabolic syndrome.

Aim: Metabolic syndrome has been identified as a risk factor for colorectal cancer and adenoma. The aim of our study was to assess the risk of colorectal cancer and adenoma in an adult Italian population with metabolic syndrome.

Patients And Methods: Ninety patients with metabolic syndrome were prospectively compared against a matched population without the syndrome to assess the prevalence of colorectal adenoma.

Endoscopic placement of self-expanding stents in patients with symptomatic anastomotic leakage after colorectal resection for cancer: long-term results.

Anastomotic leak after colorectal resection for cancer is a challenging clinical problem. The postoperative quality of life in these situations is significantly impaired. We prospectively analyzed the effect of placing a self-expanding metal stent (SEMS) at the level of the leak, with or without proximal diverting ileostomy, in 22 patients with symptomatic anastomotic leakage after colorectal resection.

A Retrospective Case-Control Study Evaluating the Bowel Preparation Quality during Surveillance Colonoscopy after Colonic Resection.

Purpose. Bowel preparation for surveillance endoscopy following surgery can be impaired by suboptimal bowel function. Our study compares two groups of patients in order to evaluate the influence of colorectal resection on bowel preparation.

A survey on mortality from non-variceal upper gastrointestinal bleeding: Is the emergency referral system adequate?

Background: Non-variceal upper gastrointestinal bleeding (NVUGIB) is an important cause of mortality and morbidity worldwide. Little information is available on the clinical management of non-variceal upper gastrointestinal bleeding in Italy in relation to the current organization of the Italian Emergency Health Services into Level-I and Level-II Emergency Departments (ED), the latter being more complex structures with greater resources.

Methods: A retrospective survey on clinical, endoscopic, and survival data was conducted by the regional sections of the 3 main Italian gastroenterological societies, AIGO, SIED and SIGE, recording all consecutive episodes of non-variceal upper gastrointestinal bleeding referred to 7 centres (4 of which were Level-II Emergency Departments) in Rome, Italy, during a one-year period.

Traumatic complex wounds, multidisciplinary approach: our experience in a case series.

"Limb-salvage" is a social problem that is rapidly increasing, both in Italy and in the rest of world. Today, as in earlier times, the main causes of open wounds are traumas and such injuries are mainly of II and III stage of Gustilo's classification. Nowadays, the use of modern techniques determined a further dramatic reduction in the infection rates and, above all, in the risk of limb amputation.

Sigmoidorectal intussusception in adults: a case report.

A 75-year-old women was admitted to our hospital due to anal bleeding from 5 days. At clinical examination abdomen was soft but tenderness in the lower quadrants, where a soft, mobile, round mass measuring 10 cm in diameter was palpable. CT scan demonstrated the presence of sigmoido-rectal intussusception.

Primary psoas abscess in a patient affected by acquired immunodeficiency syndrome: a rare case according to the reviewed literature.

Abscesses of the psoas muscle can be divided into primary and secondary. In the primary ones, it is not possible to identify any further infected site. The localization to this muscle is due to its rich vascularization and Staphylococcus aureus is the most frequent aetiological agent of the infection.

Acute emphysematous cholecystitis as a cause of pneumoperitoneum.

The authors report a rare case of acute emphysematous cholecystitis with pneumoperitoneum. Emphysematous cholecystitis is an uncommon variant of acute cholecystitis. Association with pneumoperitoneum is very rare and the finding of a macroscopic perforation of the gallbladder is possible only in a few cases.

Perforated jejuneal diverticulosis. Case report and review of literature.

Acquired (non-Meckel's) jejunoileal diverticulosis is an uncommon disease, generally characterised by vague and unspecific symptoms. This rare condition is mainly expressed as acute complications: gastrointestinal haemorrhage, mechanic obstruction of the small intestine or perforated diverticulum, requiring urgent surgical intervention. The authors report a case of this unusual clinical occurrence characterized by a picture of abdominal pain due to perforation of jejuneal diverticulum.

Iatrogenic intramural hematoma of the duodenum caused by endoscopic therapy of bleeding peptic ulcer. A case report.

The authors report a case of intestinal obstruction resulting from a duodenal intramural hematoma after therapeutic upper digestive endoscopy with injection therapy. Intramural duodenal hematomas are rare clinical entities, mostly caused by blunt traumas. They may also, more rarely, be due to complications of peptic duodenal ulcers, or be the iatrogenic result of an endoscopic biopsy or placement of a percutaneous endoscopic gastrostomy catheter.

Gastrointestinal bleeding in emergency setting: two cases of intestinal angiodysplasia and unusual conservative surgical treatment.

The authors report two cases of gastrointestinal bleeding in an emergency setting caused by angiodysplasia of colon and small bowel. They stress the rarity of the lesion and consider the difficulties involved in obtaining a preoperative diagnosis. The optimal management is uncertain and depends on the severity and rate of bleeding.

Squamous and adenosquamous cell carcinomas of the gallbladder.

Squamous and adenosquamous cell carcinomas (ASC and SCC) are rare subtypes of gallbladder cancer, traditionally considered more aggressive and with a poorer prognosis than adenocarcinoma. We report about two patients affected by an advanced squamous cell carcinoma of the gallbladder. Both had a large tumour in the gallbladder fossa region with infiltration of the liver.

Large extrapleural hematoma in an anticoagulated patient after a thoracic blunt trauma.

We report the 7th case of a traumatic extrapleural hematoma that developed in an anticoagulated patient with a thoracic blunt trauma and rib fractures, and required an emergency surgical treatment. Extrapleural hematoma is a rare and life-threatening condition characterized by a collection of blood between the pleura parietalis and the endothoracic fascia. Related symptoms and chest x-ray findings are not characteristic and may present several hours after the injury, leading to delayed diagnosis and treatment.

[Digestive hemorrhage from a duodenal neuroendocrine tumor. Diagnostic-therapeutic features and emergency surgical strategy].

The Authors report a rare case of duodenal neoplasia in a 17 year old boy. The patient was admitted in an emergency setting for hemorrhagic shock and duodenal perforation. Laparotomy was performed and a huge perforated neoplasia of the duodenum was found.

[Laparoscopy in emergency: treatment of choice in acute abdomen].

From 1992 to November 1999, 225 consecutive cases of acute abdomen were observed: 163 suspicious acute appendicitis, 7 ovarian cysts with suspect torsion, 4 intestinal occlusions, 1 digestive hemorrhage due GIST (Gastro-Intestinal Stromal Tumor), 1 case of hemoperitoneum after laparoscopic appendectomy and 49 cases of acute cholecystitis. In the 225 cases of emergency laparoscopic operations for acute abdomen the diagnostic accuracy has been of 99.5%, with only one case of conversion in to laparotomy for diagnosis.

[Benign schwannoma of the pelvic retroperitoneum. Report of a case and review of the literature].

Benign schwannoma is a tumor arising from Schwann cells (forming the neural sheath of peripheral nerves). The retroperitoneal location is unusual (0.5-5% of cases).

[Primary carcinoma of the cystic duct: a case report and review of the literature].

The Authors, after a short introduction concerning the primary carcinoma of the cystic duct and the exact definition according to Farrar's criteria, report a case occurred to their observation, the 35th case of international literature. In particular the importance of some hemato-clinical parameters and instrumental investigation (ERCP, angio-CT) to underlined in order to surgical indication. In the case here reported cholecystectomy uses informed with partial resection of the hepato-choledochus and excision of some periductal and pericholedochus lymph nodes.