Duodenal pancreatic heterotopy diagnosed by magnetic resonance cholangiopancreatography: report of a case.

We describe herein the case of a heterotopic pancreas that caused stenosis in the second portion of the duodenum. A 46-year-old man presented with upper abdominal pain and a 12-month history of intermittent vomiting. There was no history of melena, hematochezia, hematemesis, clay-colored stools, jaundice, or hepatitis and he did not describe any food dyscrasias, although fatty foods and alcohol seemed to make the symptoms worse.

[Annular pancreas in adults: diagnostic considerations on a case].

Annular Pancreas (AP) is a rare congenital anomaly that usually presents in childhood with symptoms referable to duodenal obstruction; nonetheless, this condition can manifest in adulthood with abdominal pain, pancreatitis, duodenal ulcer, pancreatic head mass. The Authors hereby discuss a case of AP observed in a 63 year-old patient in which EUS played a decisive role in achieving a certain diagnosis.

[Primary carcinoma of the cystic duct: a case report and review of the literature].

The Authors, after a short introduction concerning the primary carcinoma of the cystic duct and the exact definition according to Farrar's criteria, report a case occurred to their observation, the 35th case of international literature. In particular the importance of some hemato-clinical parameters and instrumental investigation (ERCP, angio-CT) to underlined in order to surgical indication. In the case here reported cholecystectomy uses informed with partial resection of the hepato-choledochus and excision of some periductal and pericholedochus lymph nodes.

[Non-parasitic splenic cysts].

Nonparasitic cysts of the spleen are uncommon and often result from blunt abdominal trauma. Nonsurgical management of blunt splenic injuries increases the number of observations of the post-traumatic cysts. Complications (infection, rupture and hemorrhage) are lifethreatening, difficult to diagnose and require urgent surgical management.

[Use of fibrin glue in the treatment of entero-cutaneous fistulas].

The Authors present methods and results of the treatment of chronic fistulas complicating abdominal surgery in 5 patients. The use of human fibrin glue is described and its therapeutical usefulness is pointed out.

[Surgical treatment of toxic megacolon in ulcerative rectocolitis. Analysis of 16 patients].

The clinical aspects, surgical treatment and outcome of 16 consecutive patients treated for toxic megacolon secondary to ulcerative colitis at the 1st department of surgery at the university of Rome between 1976 and 1987 were reviewed. The surgical management consisted in total colectomy and immediate ileo-rectal anastomosis, without protective ileostomy in 14 patients and total colectomy with terminal ileostomy and ileorectal anastomosis in 2 patients, 5 months later. No postoperative mortality was observe the immediate complications were: anastomotic leakage, (one case) and rectal bleeding (three cases).

Delayed bilateral ureteral fistula following abdominoperineal resection: a case report.

A case of delayed bilateral ischemic necrosis of the pelvic ureter in a 66-year-old woman submitted to abdominal perineal resection and hysterectomy for advanced rectal cancer, is reported. Five days after the operation urine was observed in the perineal cavity. External urine diversion was carried out by catheterizing the ureteral stumps through the perineal cavity.

Mediastinal angiofollicular lymph node hyperplasia, hyaline-vascular type with mucocutaneous manifestations.

A never previously reported association between mediastinal angiofollicular lymph node hyperplasia (ALNH) of the hyaline vascular type and mucocutaneous manifestations in a twenty-one-year-old man is described. Mucocutaneous lesions, unresponsive to medical therapy, promptly disappeared after resection of the mediastinal mass, indicating, as suggested for the plasmacell type, a close relationship between the systemic manifestations and ALNH.

Hydatid hepatothoracic fistulas. A report of 30 cases.

A retrospective study was carried out on 30 patients with hepatothoracic transdiaphragmatic fistulas, classified as hepatopleural (5 cases), hepatopulmonary (11 cases), biliopleural (1 case) and biliobronchial (13 cases). Investigations included chest X-rays, bronchography, plain abdominal films, cholecystocholangiography, liver scanning, ultrasonography and CT scanning. Twenty-nine patients were submitted to 32 operations: two were performed in 1 case and three in another.

Primary tumors of the small intestine.

From 1950 through 1984, 48 cases of primary tumors of the small bowel were treated at the First Surgical Clinic of the University, La Sapienza, of Rome. Forty-three were malignant and five were benign tumors: 13 in the duodenum, 16 in the jejunum and 19 in the ileum. Abdominal pain, weight loss and obstruction were the most common complaints at admission.

Lung cancer: long-term survival after surgical treatment.

The authors have carried out an analysis on a series of 1802 patients with lung cancer. 1254 patients were considered operable (69.5%) and 828 were resected.