5 -year complex clinical and histopathological follow-up of a case of early gastric carcinoma (signet ring cells type).

The paper presents the case of a male patient, hospitalized for acute abdomen due to perforated callous ulcer. Though the clinical appearance suggested a benign pathology, the histopathological exam of the resection piece showed multicentric early gastric carcinoma, signet ring cell type. At the patient's request, total gastrectomy was not performed, a conservative solution being chosen instead.

Gastrostomy with peritoneal collar versus percutaneous endoscopic gastrostomy.

The present study aimed to perform a medico-surgical comparative analysis of the 2 most widely used techniques: gastrostomy with peritoneal collar versus percutaneous endoscopic gastrostomy, based on the vast clinical experience in an Upper Digestive Surgery Clinic. A retrospective study was carried out between January 2010 and January 2015 on the patients admitted for a surgical solution for feeding. The indications, preoperative preparation, surgical techniques, and postoperative outcomes were analyzed.

Laparoscopic cholecystectomy in patients aged 60 years and over - our experience.

To analyze the efficiency of laparoscopic cholecystectomy for the population aged 60 years and over admitted with acute cholecystitis, the clinical features and associated pathology presented by these patients and the impact of these factors on the choice of surgical technique. A retrospective study was carried out between February 2010 and February 2015, on patients aged 60 years and over, operated in emergency for acute cholecystitis in our clinic. All data were extracted from the registered medical documents and operatory protocols.

Complex histopathological and surgical aspects in a case of giant malignant gastric perforation.

We present the case of a 52-year-old male patient, hospitalized on an emergency basis in the University Emergency Hospital in Bucharest, after being diagnosed with pneumoperitoneum acute abdomen, for which emergency surgery was mandatory. A 3,5-4 cm malignant gastric perforation, ascitis and peritoneal carcinomatosis were found. The histopathological exam revealed infiltrative mucinous gastric carcinoma with epiploic metastasis.

Stereometric parameters change vs. Topographic Change Analysis (TCA) agreement in Heidelberg Retina Tomography III (HRT-3) early detection of clinical significant glaucoma progression.

Purpose: to investigate the sensitivity and specificity of the stereometric parameters change analysis vs. Topographic Change Analysis in early detection of glaucoma progression.

Methods: 81 patients with POAG were monitored for 4 years (GAT monthly, SAP at every 6 months, optic disc photographs and HRT3 yearly).

Inter-test reference height variability--a major error factor in Heidelberg Retina Tomography glaucoma progression analysis based on stereometric parameters changes.

Purpose: To investigate the role of reference height inter-test variability upon the variability of the stereometric parameters.

Materials And Method: 204 glaucomatous patients underwent a complete ophthalmological exam, including Heidelberg Retina Tomography 3 (HRT-3). The exclusion criteria were optic disc or retinal pathology that might interfere with the detection of glaucoma progression, TSD >30μm.

Oesophageal stenosis dilatation through retrograde trans-gastrostomal approach in a patient with systemic scleroderma.

Aim: The paper presents the surgical solving of an oesophageal stenosis, using a device of pneumatic dilatation with trans-gastrostomal approach, in a patient with multiple disabling handicaps, secondary severe malnutrition and previously diagnosed with scleroderma.

Materials And Method: The patient was admitted with severe cachexia (37 kg, 170 cm), characteristic byzantine face with microstomy, distal phalanges resorption in both superior limbs and complete dysphagia, with limitation of mouth opening.The Barium swallow test revealed distal oesophageal stenosis,with an important dilation of the oesophagus above.

Economic analysis of medical management applied for left colostomy.

Purpose: This paper presents an analysis of surgical treatment costs for left colostomy, aiming to calculate a medium cost per procedure and to identify the means to maximize the economic management of this type of surgicale procedure.

Materials And Method: A retrospective study was conducted on a group of 8 patients hospitalized in the 4th Surgery Department,Emergency University Hospital Bucharest, during the year 2012 for left colic neoplasms with obstruction signs that were operated on with a left colostomy. The followed parameters in the studied group of patients were represented by medical expenses, divided in: preoperative, intra-operative and immediate postoperative (postop.

Peritoneal fibrinolytic activity and adhesiogenesis.

Introduction: Postoperative adhesions after abdominal or pelvic surgery remain an important clinical problem causing infertility, pain and bowel obstruction. Their prevention and treatment remains poorly understood and inadequate. The formation of adhesions is caused by the organization of a fibrin matrix, an organization that takes place during the coagulation process when there is suppression of fibrinolysis.

Interleukin 6 and lipopolysaccharide binding protein - markers of inflammation in acute appendicitis.

The rate of incidence of acute appendicitis is 12% in the case of male patients and 25% in case of women, which represents about 7% of the world population. The appendectomy rate has remained constant (i.e.

Post-surgery morbidity and mortality in colorectal cancer in elderly subjects.

Aim: Surgical procedures with curative or palliative intention in colo-rectal neoplasm in subjects aged over 80 represent a surgical challenge due to the issue they raise: benefits versus increased morbidity. In Romania, according to demographic predictions, the population over the age of 65 will double in the next half century. This, correlated with the increased incidence of colo-rectal cancer in subjects pertaining to the 60- 69 age period and higher, determined us to identify the factors that can influence the occurrence of complications and post-surgery deaths in subjects over 80 years of age that were operated on for colo-rectal cancer.

Specifics of diagnosis and treatment in synchronous colorectal cancers (SCC).

Introduction: SCC have an incidence of 1,8% up to 12,4% and could have more simultaneous localizations.

Material And Method: Between January 2004 and January 2011, 214 patients with CRC have been operated on in our ward; from those, eight patients had multiple colorectal neoplasms.

Results: The majority of SCC (six cases) was hospitalized under emergency status, with incomplete or complete bowel obstruction through colonic obstructive tumour.

Lipopolysaccharide binding protein (L.B.P.)--an inflammatory marker of prognosis in the acute appendicitis.

LIPOPOLYSACCHARIDE BINDING PROTEIN (LBP) is an important mediator of the inflammatory reaction. A multitude of factors can determine the genic transcription activation and the increase of the LBP in the blood and the human body humours: Il1, Il 6, lipopolysaccharides, Gram-negative bacteria, as well as non-infectious agents. This paper is a prospective study performed on 147 patients admitted for acute appendicitis in 2010-2012 and evaluates the dynamics of LBP in acute appendicitis, by identifying the correlations between the pre- and post-operatory levels of LBP (up to 72 hours after surgery) and the anatomopathological type (i.

[Clinical case--voluminous diaphragmatic hernia--surgically acute abdomen: diagnostic and therapeutical challenges].

We present the case of a 58-year old male patient admitted in the surgery section of the University Emergency Hospital of Bucharest and diagnosed with acute abdomen. The minimal clinical-paraclinical investigation (i.e.

[Clinical and morphological features in a case of recent gastric carcinoma (the signet ring cell carcinoma type)].

The article presents the case of a male patient, hospitalized due to severe pain in the upper abdomen area, nausea, and vomiting. The patient was diagnosed with surgical acute abdomen, for which emergency surgery is performed. Upon penetration into the peritoneal cavity, stomach inspection shows at the medio-gastric level, on the greater curvature, a callous gastric ulcer, with a central perforation.

[Amyand's hernia--a clinical case].

Amyand's hernia, a rare entity in the surgical pathology, presupposes the presence of the vermiform appendix inside a inguinal hernia sac (1). The hernia sac peritonitis by appendix swelling is even more rare, very few cases being presented in the surgical literature (1). The preoperatory diagnosis of Amyand's hernia is therefore very difficult.

Splenectomy--a therapeutic option in splenic marginal zone cell lymphoma.

We present the case of a 65 years old male, admitted in the Hematology Department of the Universitary Emergency Hospital Bucharest, complaining of physical asthenia and weight loss; periodical medical examination has revealed splenomegaly and leucocytosis with lymphocytosis, persistent for the past 3 years. The clinical and paraclinical exam demonstrated splenomegaly (21 cm in diameter on computer tomography scan), hepatomegaly and generalized lymphadenopathies. The laboratory tests confirmed leucocytosis with lymphocytosis--a clonal population of B lymphocytes CD20+ CD19+ CD23+/- CD79b+(low), CD43+ FMC7+ CD5+ CD38+ ZAP70+ cyclin D1-.

[A rare cause of pneumoperitoneum].

We provide the description of a 77 year old patient, admitted into the IC unit, with whom the surgical intervention was required by the presence of a massive pneumoperitoneum observed during abdominal CT. Anamnestic and clinical information was scarce; the patient had been admitted into the gastroenterology unit with the following diagnosis: acute pancreatitis, renal failure, atrioventricular block, while the hemodynamic instability made hospitalisation into the IC unit mandatory. Anatomopathological lesions secondary to a major vascular damage at the level of the celiac trunk and at the superior mesenteric level were noticed intraoperatively: total gastric necrosis with perforation, splenic infarction, entero-mesenteric infarction, abdominal wall necrosis.

[Retroperitoneal tumor].

This paper presents the case of a 69 year old patient who has a benign retroperitoneal tumor (lipofibroma) presenting differential diagnosis problems (in special preoperative one, and intraoperative technique difficulties, revealing the fact that, in this case, paraclinical investigations have an orientative value, without offering etiologic information, and do not allow a clear preoperative strategy. Tumor resection was performed under an intraoperative histologically diagnosis of lipofibroma of the retroperitoneal region. Postoperative evolution was good.

[Retroperitoneal appendicular abscess].

This article presents a 28 years old male patient case with a retroperitoneal collection of apendicular origin. After few comments about clinical and paraclinical aspects, the authors emphasise the particular aspects of differential diagnosis and surgical approach which, finally, lead to a full recovery of the patient.

[Recurrent dermatofibrosarcoma protuberans].

The present paper tends to emphases by one hand the necessity of the histological examination, as a routine exam, on every surgical procedure, even minor ones, and by the other hand, the difficulties of the differential diagnostic, including by histological means, in lesser importance lesions. In this line we will present the case of female patient who had a lesion labeled as a postoperative granuloma and it proved to be a malignant neoplasia.

[Gastric schwannoma ].

The article presents the case study of a 78-year-old , female patient with a gastric schwannoma, with the symptoms of a superior digestive hemorrhage and secondary anemia. A surgical operation was performed and the patient was healed. The preoperative diagnosis carried out by means of echographic, endoscopic and computed tomography examinations was gastric tumour.