[Spontaneous rupture of the femoral artery after radiotherapy: a case report].

Radiation-induced arteriopathy is a well-known disease whose incidence is not known and which usually arises chronically many years after radiation therapy. When it arises acutely, spontaneous rupture or, more rarely, thrombosis of the involved vessel may occur. Spontaneous rupture can occur within 4 to 32 weeks of radiotherapy, and usually affects the carotid artery involved in radiotherapy of the neck and head.

[Treatment of the peritoneal carcinomatosis by cytoreductive surgery and intraperitoneal hyperthermic chemotherapy (IHPC): postoperative morbidity and mortality and short-term follow-up].

Background: In order to treat the peritoneal carcinomatosis from abdominal neoplasms has been recently proposed complete peritonectomy associated with IntraPeritoneal Hyperthermic Chemotherapy (IHPC).

Aim Of The Study: Estimate of postoperative morbidity and mortality and short-term outcome.

Methods: Twenty-four patients with peritoneal carcinomatosis or positive cytology at peritoneal washing were treated in our Department from January 2005 to October 2007.

Primary aortoduodenal fistula: a challenge to the vascular surgeon.

Primary aortoduodenal fistula is a serious and rare complication of abdominal aortic aneurysms. This life-threatening disease results most commonly from an abdominal aortic aneurysm, with the fistula forming between the aorta and the third or the fourth portions of the duodenum. Diagnosis is often difficult and urgent adequate surgical treatment as soon as possible is the only therapeutic option to save the lives of these patients.

[Endovascular treatment (EVAR) in patients with abdominal aortic aneurysms and synchronous neoplasms].

The association between abdominal aortic aneurysms (AAA) and cancer is becoming more and more frequent, giving rise to several questions regarding the therapeutic and surgical management strategies for both diseases. Endovascular aneurysm repair (EVAR) is the treatment of choice for complex and high-risk patients. In this study we reviewed our experience with patients concomitantly affected by any type of cancer and AAA treated by EVAR at our institution over the last six years.

Iatrogenic axillary artery injury from humeral neck fracture repair. A rare and unusual event in which and aggressive strategy was mandatory to save a child limb.

Humeral neck fracture is rarely associated with injury of the nearby axillary artery and in the English literature only 29 such cases have been reported. An injury of the distal axillary artery secondary to reduction and fixation of a humeral neck fracture is a very rare and unusual complication, to the best of our knowledge has never been reported in literature. In this paper we report the case of entrapment of the distal axillary artery in the humerus rhyme fracture in a 9-year-old child who suffered a nighttime car-accident with her father.

[US-guided percutaneous management of femoral artery pseudoaneurysms by thrombin injection: personal experience and review of the literature].

Treatment of femoral artery pseudoaneurysms includes US-guided compression, endovascular coil embolisation or stenting, thrombin injection and open surgical repair. Thrombin injection is currently the standard approach to all non-complicated pseudoaneurysms of the peripheral arteries. Between January 2001 and December 2004, 59 pseudoaneurysms of the femoral artery were submitted to percutaneous US-guided thrombin injection in our surgery division.

Endovascular repair of intrathoracic left subclavian artery aneurysm with stent grafts: report of a case and review of the literature.

At present, the standard management of subclavian artery aneurysms is surgical repair. Endovascular treatment of these aneurysms with implantation of a covered stent graft is a relatively new technique that appears to be both feasible and safe. We present the case of a large true aneurysm of the left intrathoracic subclavian artery that was successfully treated with two stent grafts on March 2001.

Using the angio-seal to achieve hemostasis in prosthetic endovascular surgery: report of three cases.

At least 10% of patients who undergo bilateral aortofemoral bypass are at risk of needing a reoperation for late prosthetic thrombosis because of reduced outflow as the disease progresses. To prevent occlusion of the prostheses, we performed endovascular surgery with transprosthetic access for distal stenosis. We report our experience of using the Angio-Seal with transprosthetic access after angioplasty in three patients who had undergone bilateral aortofemoral bypass.

Laparoscopic approach to postoperative adhesive obstruction.

Background: Some authors have assessed the feasibility of laparoscopy in the treatment of postoperative adhesive obstruction, but conclusions about its effectiveness are related to different selection criteria used for surgery. This paper reports on our experience in laparoscopic adhesiolysis and analyses the results on the basis of the selection criteria used.

Methods: From January 1993 to December 2001, 65 patients were submitted to laparoscopic adhesiolysis for small bowel obstruction according to specific selection criteria.

Liver abscess due to acute cholecystitis. Report of five cases.

Acute cholecystitis is one of the most frequent causes of admissions to surgical departments. The development of liver abscesses is an uncommon and underrated complication of acute cholecystitis. In this study we report on our experience with the treatment of 5 cases of liver abscesses secondary to acute cholecystitis.

[Superextended lymphadenectomy (D4) in the treatment of gastric adenocarcinoma].

Background: The incidence of paraaortic lymph node metastasis (N4) in relation with the site of the tumour, and survival in patients with gastric cancer who underwent gastric resection and superextended lymphadenectomy (D4), have been analyzed.

Methods: The frequency of paraaortic lymph node metastasis was studied in 132 patients who underwent gastrectomy with D4 lymphadenectomy during the period June 1988 - December 2000. Six patients with plastic linitis and 3 with carcinoma of the gastric stump were excluded from the analysis.

[Esophageal non-variceal hemorrhage: a clinical and epidemiological study].

Aim of this study was to evaluate the incidence of esophageal bleeding in a group of 3741 consecutive patients with acute non variceal upper gastrointestinal hemorrhage observed between January 1990 and January 1999 in the First Division of General Surgery--University of Verona. In 627 patients (16.8%) the source of bleeding was exclusively esophageal; and the most frequent causes of esophageal bleeding were reflux esopagitis (408 cases) and Mallory Weiss syndrome (185 cases).

Endoscopic treatment of esophageal granular cell tumors.

There are no standard guidelines for the treatment of granular cell tumor (GCT). The aim of our study was to describe three cases of esophageal GCT and, on the basis of our experience, analyze the indications for and results of their endoscopic treatment. When deciding whether to proceed with surgical or endoscopic resection, endosonography plays a key role in establishing whether the tumor is confined to the submucosa.

[Goseki classification in adenocarcinoma of the cardia].

Background: To assess an additional prognostic value of Goseki histological classification to TNM staging system in adenocarcinoma of the cardia.

Methods: Sixty-one patients curatively resected for advanced (T2, T3 and T4) cardia cancer at the I Division of General Surgery, University of Verona were classified in four different grades according to Goseki. Survival curves were estimated with Kaplan-Meier method and compared by the log-rank test.

[Endoscopic, percutaneous and laparoscopic treatment for acute biliary pancreatitis].

Aim Of The Study: The aim of this study is to evaluate the results of acute gallstone pancreatitis treatment and to discuss indications in relation with the different forms of the disease.

Material And Method: From january 1992 to june 2001, 137 patients have been treated for an acute gallstone pancreatitis. Diagnostic criteria were given by the history, clinical examination, biochemical and radiological findings.

[Results of surgical treatment of acute cholecystitis. Prospective study of 280 cases].

The Authors reported the results of surgical treatment of acute gallstone cholecystitis (AGC) in patients in whom different selection criteria have been applied. Two-hundred-eighty patients with a clinical and/or ultrasonographic diagnosis of ALC were admitted to the 1st Division of General Surgery-University of Verona Italy between January 1992 and June 2001, the patients were divided into five groups according to clinical features, laboratory tests and echographic signs. A specific approach was used in the different groups.

[Contribution to the knowledge on natural history of giant hepatic angioma].

Hepatic haemangiomas are mostly discovered by chance because of their limited dimensions. Their treatment is optional and very often an observing conservative strategy is adopted whilst a danger is foreseeing from different facts. Very different is the case of giant haemangiomas discovered because their bulk and discomfort coming from the compression exerted on near structures.

[Digestive system neoplasms originating from the autonomic nervous system. Diagnostic, therapeutic and prognostic issues].

The gastrointestinal autonomic nerve tumors (GAN tumor) are uncommon stromal tumors of the intestinal tract and retroperitoneum. The distinction of GAN tumors from other gastrointestinal stromal tumors is based on electron microscopic findings. However further study of additional cases is needed to fully characterize both their gross and microscopic features and to further characterize the natural history of such tumors.

[Gastrointestinal stromal tumors (GIST). Our experience].

Nine cases of gastrointestinal stromal tumors (GISTs) observed in the period between 1993 and 1999 and treated with radical surgery are presented. Patients were studied with instrumental examinations (ultrasonography, TC, EGDS, RSCS, endoscopic ultra-sound) which permitted to make a temporary diagnosis of "suspect gastric or bowel neoplasm". Only after surgical resection of the neoplasm it was possible to make a definitive diagnosis, based on histologic examination of the operating piece.

[Results of preoperative staging using endosonography in rectal cancer].

Background And Aim: The latest reports using transrectal ultrasound (TRUS) for the preoperative staging of rectal cancer show a diagnostic accuracy between 78 and 97% with regard to the local spread of disease, and between 62 and 86% for the diagnosis of lymph node metastasis. The correct choice of surgery depends on correct preoperative staging, as does the indication for any preoperative neoadjuvant treatment. The aim of this study was to evaluate the diagnostic precision of the method used by the authors since 1993 by comparing the preoperative transrectal ultrasound stage (uTMN) with the postoperative histological stage (pTNM).

[Chronic rupture of abdominal aortic aneurysms. (Report of 3 cases)].

Rupture of an abdominal aortic aneurysm often presents with an abdominal pain, hypotension and a pulsatile abdominal mass. In the last years same clinical reports describe patients with less apparent clinical signs who were found later in their evaluation to have a contained rupture of an abdominal aortic aneurysm. The diagnosis may be delayed by consideration of other disease causing similar symptoms (herniated disc, renal colic).

[Echo-guided compression in the treatment of femoral pseudoaneurysms secondary to cardiological interventional procedures].

Purpose: To analyze perspectively a set of 13 patients affected by femoral artery pseudoaneurysm treated with Us-guided compression.

Material And Methods: From January to December 1997 we observed 13 patients (7 females and 6 males; mean age: 67.4 years old) affected by femoral artery pseudoaneurysm which were treated with Us-guided compression.

[Mallory-Weiss syndrome. Outcome of 160 cases].

The Mallory-Weiss (M-W) syndrome is responsible for about 7.5% of all bleedings of oesophageal origin. Emergency endoscopic treatment allows to obtain a rapid diagnosis as well as an effective treatment.

[Recurrence of stomach cancer following surgery].

The purpose of this article is to review the incidence and characteristic of first recurrence in a group of 182 patients who underwent curative surgery with extended lymphadenectomy (> or = D2). The median follow up was 46.4 months (range 14-111).

[Epidermoid carcinoma of the thyroid].

About thyroid neoplasms the epidermoidal carcinoma represents an ingrown minority (0.3-0.74%).