[Emergency pancreatoduodenectomy for severe iatrogenic duodenal injury--case report].

We present the case of a male patient admitted for high flow biliary fistula (> 2000 ml/24h) as a consequence of a prior right nephrectomy by lumbar approach. The patient was operated after the failure of the medical conservative treatment and continous declining medical status. We noted the complete absence of the gastric antrum, duodenum I and II with the intraperitomeal direct display and opening of the Vater papilla, witch was difficult to identify unless common bile duct (CBD) was catheterized by supraduodenal choledocotomy.

[Periampullar diverticulum--related to bilio-pancreatic disorders].

Unlabelled: Periampullar diverticulum (PAD) represent a particular type of duodenal diverticulum, with important pathological effect on the functionality of both the billiary tree and the pancreas. In our retrospective, randomised study, we analised 204 patients who underwent ERCP. We diagnosed 34 PAD (17%).

[Voluminous complicated epigastric hernia].

Epigastric hernia, apparently minor injury, neglected can reach impressive sizes, with major un-esthetic effect. In an unfavorable clinically context (morbid obesity, chronic respiratory failure, ground cancer, diabetes, heart failure) complications occur (incarceration, strangulation) with a complex picture. We present three clinical observations, including a low occlusion by fixed transverse colon necrosis in a strangulated epigastric hernia with pyo-stercoral phlegmon.