"Solitary" necrotic nodule of the liver: an enigmatic entity mimicking malignancy.

Aim: The aim of the study is to further investigate the clinicopathological features of solitary necrotic nodules.

Material And Methods: Twenty-three archived cases of solitary necrotic nodule of the liver, which were preoperatively misdiagnosed as liver metastases were studied. The pathological findings were correlated with the clinical data of the patients.

Primary torsion of the greater omentum. An obscure and unusual cause of acute abdomen.

A 36-year-old man was admitted with a 3-day history of severe abdominal pain in the right upper abdomen and was initially diagnosed with acute cholecystitis or acute retrocecal appendicitis. The patient was transferred to the department of surgery for close surgical observation. CT of the entire abdomen was performed just before the operation, which demonstrated inflammation in the omental fat.

Use of vacuum assisted closure in vascular graft infection confined to the groin.

Purpose: In this report we share our experience with the use of the VAC system as a less invasive means of graft preservation and an effective alternative to routine muscle flap closure, in patients with groin wound healing complications following lower limb vascular procedures. We also review the English literature regarding the use of VAC therapy on infected groin wounds when the infection affects the prosthesis.

Patients And Methods: eight patients treated with delayed healing of a groin incision following a femoral artery surgery.

Interstitial magnetic resonance lymphography with gadobutrol in rabbits and an initial experience in humans.

The purpose of this study was first to evaluate gadobutrol as a contrast agent for interstitial Magnetic Resonance Lymphography (MRL) in rabbits, and second, to extend the study to humans, if the initial results were satisfactory. In our experiment, gadobutrol was injected into twelve white New Zealand rabbits. In nine animals, 0.

Idiopathic hypertrophic pyloric stenosis combined with left paraduodenal hernia in an adult.

Objective: We report a case of primary hypertrophic pyloric stenosis combined with a paraduodenal hernia in a 35-year-old woman.

Clinical Presentation And Intervention: The patient presented with signs of obstructive ileus. CT of the abdomen revealed a marked dilatation of the stomach and the proximal jejunum as well as a circumferential thickening of the antral-pyloric region with characteristics indicating hypertrophic pyloric stenosis.

Adrenal pseudocyst presenting as acute abdomen during pregnancy.

Pseudocysts of the adrenal gland are rare lesions, which are usually discovered as incidental findings. Since they are in the majority of cases non-functioning, they become symptomatic only when they are complicated with rupture, haemorrhage or infection. We present a case of a 28-year-old woman in the 26th gestational week, who developed an acute abdomen due to a haemorrhagic pseudocyst of the left adrenal.

Primary hydatid cyst of the thigh.

Echinococcosis of the musculoskeletal system is found in 0,5-4% of the patients suffering from hydatid disease. We describe a case of primary hydatid cyst of the posterior thigh in a 73 year-old woman, who presented with a painless mass. The diagnosis was set intraoperatively after biopsy of the cyst wall.

A rare form of isolated mesenteric Castleman's disease presenting as an abdominal mass (isolated mesenteric Castleman's disease).

Castleman's disease is a rare disorder characterized by proliferation of the lymphoid tissue. The most frequent location of the disease is the mediastinum. The location of the disease in the mesentery is rare and it is usually associated with the generalized form of the disease.

A variant of the double gallbladder. A possible cause of cholelithiasis?

Congenital duplication of the gallbladder is a rare anatomical malformation, which is usually discovered as an incidental finding during cholecystectomy. We report a case of a double gallbladder in a 45-year-old woman, which was discovered during laparoscopic cholecystectomy for symptomatic cholelithiasis. As it was not possible to identify the anatomical structures safely, the procedure was converted to open cholecystectomy.

A particular case of a "captive forceps" in the esophagus.

We present a particular case of a "captive" forceps in the esophagus in an attempt to remove a foreign body in a patient with previous esophageal post-caustic stenosis. The mechanism of incarceration and the surgical therapeutic option consisting of open thoracic surgery are detailed and argumented. Postoperative course was favorable, though the patient developed a small esophageal fistula visible at radiology without any clinical expression.

Detection of tract formation for prevention of bile peritonitis after T-tube removal. Case report.

Bile leakage after removal of T-tube is a relatively rare complication caused by inadequate tract formation around the tube. We report a case of bile peritonitis after removal of a latex T-tube. The patient underwent reoperation and a new T-tube was introduced.

Micronized purified flavonoid fraction (MPFF): a review of its pharmacological effects, therapeutic efficacy and benefits in the management of chronic venous insufficiency.

Initially, the progression of chronic venous insufficiency is related to venous hypertension. The earliest complaints or symptoms, as well as vessel wall deterioration, valve restructuring, and, eventually, varicose veins, result not only from elevation of pressure, but also from a cascade of biochemical events related to both the macro- and the microcirculation. Thickening and remodelling of the venous wall are influenced by two parameters: abnormal shear stress and hypoxia that activate the endothelium first at the level of valve cusps and then in large veins.

Acute bowel obstruction - the main complication of colorectal cancer. Therapeutical options.

Aim: to choose the proper therapeutical approach in obstructing colorectal cancer.

Material And Method: 77 (29.2%) obstructing colorectal cancers, 88.

Splenectomy versus spleen-preserving surgery for splenic echinococcosis.

Background/aims: The spleen is the third most common location of hydatid disease after liver and lung. The aim of this study was to analyse the long-term outcome of surgical treatment of patients with splenic echinococcosis comparing splenectomy with spleen-preserving surgery.

Methods: During a period of 25 years (1976-2001), 19 (5.

Hypoplasia of the right hepatic lobe combined with a floating gallbladder.

Agenesis or hypoplasia of the right hepatic lobe combined with a floating gallbladder is an extremely rare condition. We report a case of hypoplasia of the right hepatic lobe, discovered in a 65-year old female. This was an incidental finding at CT scan for staging of a right colonic cancer.

The esophagogastric junction cancer: diagnosis and surgical treatment challenges.

Aim: To present our experience in esophagogastric cancer.

Material And Method: Fifty nine subjects with esophagogastric junction cancer (52 men and 7 women, aged between 41 and 74 years), selected from 79 esophageal cancer patients admitted in the last 20 years (1982-2002) were analysed. The diagnosis was established on the clinical picture (esophageal syndrome 54 cases, weight loss 51 cases, anemia 49 cases), on the imaging tests (chest X-ray, barium swallow and CT scan) and endoscopy.

Experimental surgery in infrarenal aorta and sigmoid ischemia.

Aim: Colon ischemia is a rare but serious complication in surgery of the infrarenal aorta, due to ligation of the inferior mesenteric artery and the ischemia-reperfusion syndrome. In order to investigate the degree of intestinal damage, we employed experimental surgery in pigs, applying the usual protocol for elective repair of the infrarenal aorta (AAA or Y graft).

Methods: Three groups of pigs were operated on.

Plummer-Vinson syndrome.

Plummer-Vinson syndrome is characterized by dysphagia, iron deficiency, anemia and the presence of esophageal web or webs. Two cases of this syndrome are reported in middle-aged women, which were treated over the last eight years. Both patients presented with dysphagia, anemia, sideropenia, glossitis and cheilitis.

'On-line' alterations of contralateral jugular blood gas profile during carotid clamping.

The aim of this work was to record the metabolic status of the brain (pH, PCO(2) and PO(2)) during carotid endarterectomy (CEA), with the use of an intravascular multiparameter sensor (Paratrend 7) via retrograde catheterization of the contralateral jugular vein. Twenty-four patients with ASA grades II and III scheduled for CEA were included in the study. After induction of anesthesia, the contralateral internal jugular vein was punctured retrogradely and the sensor was introduced.

Disruption of the small-intestine mucosal barrier after intestinal occlusion: a study with light and electron microscopy.

It is known that the gut may serve as a reservoir for various microorganisms, which under specific circumstances may intrude into the systemic circulation, causing systemic infections. The aim of the present study was to estimate the "critical time" of disruption of the small-intestine mucosal barrier in conditions of experimentally induced intestinal occlusion, based on the histopathological alterations observed under light and electron microscopy. Forty rabbits underwent small-intestine obstruction through ligation with a nonabsorbable suture.

Cystic tumors of the pancreas. Considerations upon 34 operated cases.

Aim: To point out the morphologic, clinic and therapeutic aspects of pancreatic cystic tumors.

Material And Method: 34 pancreatic cystic tumors (21 males and 13 females, aged between 21 and 68 years), admitted in the last 15 years were analyzed. They were true cysts in 3 cases (9.

An unusual case of retroperitoneal accessory spleen with vascular supply directly from the aorta.

We report on a case of a retroperitoneal accessory spleen with vascular supply directly from the aorta. A 47-year old woman presented with a six-month history of epigastric pain, intermittent nausea and vomiting. The CT scan of the abdomen revealed the presence of a retroperitoneal tumor between the spleen, left kidney and pancreas.

Oxygen free radicals in abdominal aortic surgery. An experimental study.

Background: In aortic reconstruction, intestinal and muscular ischaemia in the lower limbs occurs during cross-clamping of the aorta. After restoration of blood flow, reactive oxygen intermediates may lead to systemic injury to local or remote organs. In this study we investigated the usefulness of a shunt and vitamin E administration against the oxidant load generated in ischaemia-reperfusion phases.