Operative and non-operative treatment of injury to solid abdominal organs in adult patients: a single center experience.

Background: In major trauma, lesions of the parenchymatous organs are subject of a controversy as regards the choice between an operative management (OM) in the operating room and a non-operative management (NOM) associated or not with angiography/angioembolization (AG/AE).

Methods: Retrospective study of all consecutive data of patients coded as "traumatic pathology" in the period between 2011 and 2021. Were enrolled 13740 entries of adult patients with abdominal injuries, including at least: either hepatic or splenic or renal injury of AAST-OIS I.

Management and treatment of Fournier's gangrene. Our Emergency Department Experience and literature review.

Fournier's Gangrene (FG) is an extremely serious condition of necrotizing soft tissue infection. The treatment of this critical condition is urgent but much debated, especially as regards the management of larger defects and wound closure, with various techniques being described in the current literature. Through a case series we aimed to present our surgical management of FG treated successfully with Negative Pressure Wound Therapy (NPWT) and performing a loop colostomy.

Repercussions of COVID-19-related national lockdown on Emergency Surgery Department: a longitudinal cohort monocentric study.

Background: COVID-19 lockdown restrictions in conjunction with the pervasive hospital fear endured by the vast majority of the population played a fundamental role in discouraging access to emergency departments (EDs). We aimed at investigating whether and how the COVID-19 outbreak limited the access to ED and affected urgent surgical activities during and immediately after the 2-month pandemic-related national lockdown.

Methods: Data regarding patients who accessed to the surgical ED were retrospectively collected.

Hepatic abscess: An uncommon complication after laparoscopic appendectomy.

Aim: Laparoscopic appendectomy is currently the treatment of choice for acute appendicitis in emergency setting. When appendicitis is clinically suspected, an appendicolith can be found in 30% of the patients. Retained or dropped appendicoliths are an uncommon complication that may occur as a consequence of stone expulsion from the appendix, before or during laparoscopic appendectomies.

Effects of levosimendan on mitochondrial function in patients with septic shock: a randomized trial.

Mitochondrial dysfunction is key feature of septic shock and contributes to the development of sepsis related organ dysfunction. It is characterized by a variable reduction of the respiratory chain (RC) activities, altered mitochondrial morphology and reactive oxygen species production. Recent data have reported the efficacy of levosimendan, a calcium sensitizer, in improving heart performance and organ perfusion in critically ill patients.

Parathyroid carcinoma: the importance of high clinical suspicion for a correct management.

Background. Parathyroid carcinoma is an infrequent clinical entity whose diagnosis is very challenge. Indeed a pre-operative or intraoperative diagnosis of parathyroid carcinoma is reported in less than half cases described in the literature.

Traumatic subclavian arterial rupture: a case report and review of literature.

Subclavian artery injuries represent an uncommon complication of blunt chest trauma, this structure being protected by subclavius muscle, the clavicle, the first rib, and the deep cervical fascia as well as the costo-coracoid ligament, a clavi-coraco-axillary fascia portion. Subclavian artery injury appears early after trauma, and arterial rupture may cause life-treatening haemorrages, pseudo-aneurysm formation and compression of brachial plexus. These clinical eveniences must be carefully worked out by accurate physical examination of the upper limb: skin color, temperature, sensation as well as radial pulse and hand motility represent the key points of physical examination in this setting.

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.

Comparison among preoperative single-slice CT and multi-slice CT in simple, closed loop and strangulating bowel obstruction.

Background/aims: The aim of this study is to compare preoperative single-slice CT (SSCT) and multislice-CT (MSCT) accuracy in the evaluation of patients with bowel obstruction and intestinal necrosis.

Methodology: 64 patients were enrolled. We analyzed the SSCT scans of 30 patients and the MSCT scans of 34 patients with clinical and abdominal plain film evidence of bowel obstruction.

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.

[Thyroid surgery: total and partial resection. Analysis of complications and a review of the literature].

The authors review the recent international literature relating to approximately 36,800 cases of thyroid surgery, analysing the complications associated with total thyroidectomy versus partial resection of the thyroid, with a view to drawing up lines of conduct in terms of indications for surgery of benign disease and suggestions on surgical technique to reduce complications such as recurrent laryngeal nerve injuries (transient and definitive), hypocalcaemia (transient and definitive) and superior laryngeal nerve injuries.

[Classification and management of gynecologic acute abdomen at a secondary level hospital emergency department].

This study retrospectively evaluates the preoperative work-up and the classification and operative treatment of acute abdomen caused by gynaecological disorders in emergency admissions to our department. All female patients admitted in the emergency setting and operated on for gynaecological acute abdomen in our emergency department over the period from 1997 to 2002 were included in the study. A total of 103 patients were identified (54 undergoing emergency operations, 9 operated on within 72 hours, and 40 managed conservatively with medical therapy.

[Conservative approach to IV grade renal trauma].

A case of grade IV renal trauma is reported and the literature reviewed. A 29-year-old man was admitted in an emergency setting for a grade IV renal and splenic trauma as a result of a motorcycle accident. Since the patient was haemodynamically stable and the retroperitoneal haematoma was neither expanding nor pulsating, a conservative approach was adopted and the renal trauma was managed with interventional radiology.

[Multidisciplinary approach to the patient with multiple trauma: a case report].

A multidisciplinary approach to severe polytraumatized patient is very important for a rapid, uncomplicated recovery. Specialized centres with special beds, monitoring equipment, and a multidisciplinary team are required. The authors report a case of a 26-year-old man admitted to their department in an emergency setting for a crush injury (occupational trauma) of the lumbar, gluteal and perineal areas, complicated with septic shock and gas gangrene of the injured areas.