Giant diverticulum of the colon: report of two new cases and review of the literature.

Diverticulosis coli affects more than one in three individuals older than 65 in the Western world. Giant diverticulum of the colon is an extremely rare complication of diverticular disease; only 113 cases, mostly situated in the colon sigmoideum, have been reported in the world literature. Two new cases of giant diverticulum of the colon sigmoideum, with totally different clinical presentation, diagnosis, and management, are reported-one being the cause of chronic anemia and the other presenting as an acute abdomen.

True aneurysm of the palmar arch. A resection without reconstruction.

A case of ideopathic true aneurysm of the left palmar arch in a 75-year-old female is reported. Surgical exploration and resection of the aneurysm was done. The need for vascular reconstruction was evaluated by means of a pulse oxymeter on the fingertips intra-operatively.

Late occlusion of a polytetrafluoroethylene femoropopliteal graft due to implant calcification and heterotopic ossification.

A case of late occlusion due to thrombosis in a femoropopliteal polytetrafluoroethylene implant, following 9 years of good function with a 2-month period of impaired flexion of the knee due to heterotopic bone formation around the graft, is presented. The present case is an example of local calcification within the graft and a rare example of heterotopic ossification around the implant.

Migration of Kirschner's pin from the right sternoclavicular joint resulting in perforation of the pulmonary artery main trunk.

The spontaneous migration, in a 62-year-old patient, of a broken Kirschner's pin from the right sternoclavicular joint to the anterior mediastinum, with perforation of the pericardium and puncture of the main trunk of the pulmonary artery resulting in cardiac tamponade, is described. A review of the literature stresses the high risk of migration when pins or wires are used for internal fixation of the shoulder girdle, resulting sometimes in life-threatening situations and the need for major thoracic interventions. It seems mandatory to remove all foreign material after consolidation, certainly when pins or wires are broken or when there is evidence of local bone resorption, as the broken parts may migrate.

[Thrombosis of the middle abdominal aorta during pregnancy. 21-year follow-up].

The unusual case of a 31-year old female, pregnant for the second time and in the sixth week of pregnancy, who developed a very localised low mid-aortic thrombosis with typical claudication and associated clinical findings, is presented 21 years after corrective surgery for this condition. The authors wish to emphasize the fact that this case shows no similarity with the middle aortic syndrome, classically described by Debakey, in which major visceral branches of the lower abdominal aorta are involved. After ruling out, every possible classical cause of this condition, such as described in the discussion of this paper, the authors have to conclude that this situation was caused by increased red cell aggregation of the blood during pregnancy in a woman with moderate degree of hypoplasia of the abdominal aorta.