[Familial adenomatous polyposis. Problems encountered with rectum preservation in surgical treatment and life expectancy].

Familial adenomatous polyposis is a genetically inherited disease with very high risk of colorectal cancer and with a large expression of multiple extracolonic malignancies. In recent years two surgical options are available for the treatment of FAP: total colectomy with ileorectal anastomosis and restorative proctocolectomy with ileoanal reservoir. The preservation of the rectum offers good quality of life and good functional results, but needs an accurate surveillance of the rectal stump and screening for the development of cancer.

[Massive hemorrhage caused by colonic diverticulosis].

Massive hemorrhage from diverticular disease of the colon is a very difficult problem in abdominal emergency surgery. The pathogenesis of bleeding colonic diverticulosis is strictly correlated to the angioarchitecture of the colonic diverticular wall. Here the vasa recta penetrate the colonic wall from the serosa to the submucosa through connective tissue septa.

[Large abdominal incisional hernias, use of prosthesis. Our experience].

Retrospective analysis of risk-factors in 241 patients with large abdominal incisional hernia collected in a 16-year period at the Department of Surgery, University of Pavia, allows the Authors to identify the aetiological mechanism of herniation and to discuss the fundamental technical skills in wall reconstruction. The recurrence rate after primary repair was 30% (63/209 patients). In 32 patients (13.

[Primary malignant neoplasms of the liver. Contribution of echography to the preoperative diagnosis].

Primary malignant hepatic tumors are relatively common and the possibility of radical surgical treatment in the initial stages has modified our clinical approach therefore stressing the validity of a correct screening and follow-up of this pathology. The Authors present their clinical experience in the field enriched by the use of ultrasonography and conclude that this represents a highly effective diagnostic technique whereas it is less reliable in the determination of the nature of the lesion.