Surgical treatment of the pancreatic stump: preventive strategies of pancreatic fistula after pancreatoduodenectomy for cancer.

Background: The institutions with high volume of pancreatic surgery report morbidity rate from 30% to 50% and mortality less than 5% after pancreaticoduodenectomy (PD). At the present, the most significant cause of morbidity and mortality is pancreatic fistula (PF).

Aim: The purpose of the study is to identify the most important clinical factors which may predict PF development and eventually suggest alternative approaches to the pancreatic stump management.

Colon cancer adrenal metastasis: case report and review of the literature.

The authors report a case of alone right adrenal metastasis from colon carcinoma discovered incidentally by CT scan imaging 4 years after colon resection in a 74-year-old man. The presence of metastasis in the adrenal glands represents the second most frequent cause of "adrenal incidentaloma", following cortical-adrenal adenomas. The most common primary tumors responsible for adrenal metastasis are carcinoma of the lung, breast and kidney.

Local injection of infliximab in severe fistulating perianal Crohn's disease: an open uncontrolled study.

Background: Perianal fistulas are frequent complications of Crohn's disease. Intravenous infliximab can control perianal disease and promote perianal fistula closure. Perifistular infliximab injections have been proposed for patients who are intolerant or unresponsive to intravenous therapy.

Biliodigestive anastomosis with circular mechanical device after pancreatoduodenectomy: our experience.

The authors describe the technique to perform a mechanical biliodigestive anastomosis after pancreatoduodenectomy that could be able to reduce the time of surgical intervention and the major systemic postoperative complication especially in elderly patients. Pancreaticoduodenectomy (PD) is considered to be the most effective procedure for the treatment of tumors of the pancreatic head and periampullary tumors. Postoperative morbidity remains high, reaching 40-50% in some series.

Adenocarcinoma below stapled ileoanal anastomosis after restorative proctocolectomy for ulcerative colitis.

A case of adenocarcinoma arising in a 39-year-old patient after restorative proctocolectomy is reported. The patient underwent an ileal pouch-anal anastomosis with double-stapled technique for severe ulcerative colitis 18 years earlier, without evidence of associated neoplasm or dysplasia in operative specimen. After endoscopic diagnosis of adenocarcinoma, the patient was submitted to excision of the pouch and permanent ileostomy, followed by combined radiotherapy and chemotherapy.