[Amyand's hernia--case presentation and a discussion about diagnosis problems and surgical treatment].

We present the case of a 62 years old patient, with multiple associated tares, which was operated in emergency for an Amyand's hernia. The appendix was perforated and generated a big pussy collection (aprox. 200 ml) in the hernia sac.

[Emergency pancreatoduodenectomy for severe iatrogenic duodenal injury--case report].

We present the case of a male patient admitted for high flow biliary fistula (> 2000 ml/24h) as a consequence of a prior right nephrectomy by lumbar approach. The patient was operated after the failure of the medical conservative treatment and continous declining medical status. We noted the complete absence of the gastric antrum, duodenum I and II with the intraperitomeal direct display and opening of the Vater papilla, witch was difficult to identify unless common bile duct (CBD) was catheterized by supraduodenal choledocotomy.

[Gastric metastasis of clear cell renal carcinoma].

We report the case of a patient operated in 2003 for renal clear cell carcinoma (CCRC), when left nephrectomy was performed. In the years following occur: lung (2004) and brain (2006) metastasis, pathological bone fracture in right femur (2007), which needed a complex treatment: polichimiotherapy, cobaltotherapy, right temporal metastasectomy, right femoral fixation with metal rod. In our clinic was hospitalised for serious upper gastrointestinal bleeding, severe anaemia (haemoglobin 5.

[Surgical management of Meckel's diverticulum in adults--retrospective analyses of 62 cases].

Meckel's diverticulum (MD) is the most common congenital anomaly of the small intestine. We searched and analyzed the records of 62 cases with MD admitted in University Emergency Hospital Bucharest between 2001-2009. Sex ratio was M:F 3:1, with 74% male and 26% female.

[Panuveitis--difficulties in diagnosis and treatment].

We report the case of a young patient who had a past history of HSV encefalitis and presented for decreased vision in her left eye associated with pain and red eye.

[Duodenal carcinoid].

Carcinoid tumors of the duodenum are extremely rare. We present two cases (observation) of duodenal carcinoid tumors. The main clinical manifestation in both cases was upper GI tract hemorrhage associated to severe anemia.

[Porcelain gallbladder--diagnostic and therapeutic features].

Porcelain gallbladder (PG) is a rare entity. It's frequently associated with cholecyst lithiasis (90%). Diagnosis is established based on imaging assays (simple abdominal radiography, ultrasound and/or abdominal CT).

[Purtscher retinopathy--case report].

The authors present the case of a 27 years old man who came to our clinic for sudden, painless and profound bilateral loss of visual acuity in both eyes, 14 days ago, during hospitalization for an acute episode of abdominal pain. The clinical aspect correlated with the personal pathological aspects permitted us to establish the diagnosis of Purtscher retinopathy.

[Voluminous complicated epigastric hernia].

Epigastric hernia, apparently minor injury, neglected can reach impressive sizes, with major un-esthetic effect. In an unfavorable clinically context (morbid obesity, chronic respiratory failure, ground cancer, diabetes, heart failure) complications occur (incarceration, strangulation) with a complex picture. We present three clinical observations, including a low occlusion by fixed transverse colon necrosis in a strangulated epigastric hernia with pyo-stercoral phlegmon.

[Optic nerve melanocytoma--associated with age related macular degeneration].

We report the case of a 73 year old patient who presented for decreased vision in his right eye, ocular examination revealed a pigmented tumour in the left optic disc (optic nerve melanocytoma). We briefly mention another case of optic nerve melanocytoma in a 6 year old, Caucasian patient.

[Merkel cell carcinoma in unusual location].

We present a case of Merkel cell carcinoma with buttock location at a 70 years old patient. In literature there are described about 600 observations, of which more than half located in the head and neck. Despite early diagnosis--less than five months after occurrence--a thorough exploration (ultrasonography of soft tissues, pelvi-abdominal CT, histopathological and immunohistochemical examination), correct treatment (broad surgical exeresis, local postoperative radiotherapy) and appropriate follow-up, the patient had a negative evolution.

[Late pancreatic metastasis from primary Grawitz tumor--surgical management].

Renal cell carcinoma (Grawitz tumor) is an epithelial tumor able, to develop, in some cases, very late metastases. The most frequent localization are: lung, bones and liver. Pancreatic metastasis are rare and appear late, sometime even after 12 years from primary renal tumor.

[Primary antiphospholipid syndrome].

Antiphospholipid syndrome (APS) is a disorder characterised by recurrent arterial or venous thrombosis and/or pregnancy losses, in the presence of persistently elevated levels of anticardiolipin antibodies and/or evidence of circulating lupus anticoagulant (these abnormalities are detected by blood tests). Primary APS occurs when there is no evidence of associated diseases. APS in the presence of an underlying disease, usually systemic lupus erythematosus, is called secondary APS.

[Malignancy of familial adenomatous polyposis. Diagnosis and treatment].

Familial adenomatous polyposis with features of malignancy find in a 23 years old patient, whose diagnosis has been established on endoscopical basis. Total proctocolectomy is performed with terminal ileostomy. Histopathologically, the diagnosis is revealed, with establishing of multiple areas of malignancy in rectum and sigmoid colon.

[Prophylactic antibiotics in neurosurgery].

Because of a low risk of infection (around 2-3%), prophylactic use of antibiotics in neurosurgery is a controversial issue. Some neurosurgeons consider that there are strong arguments against the use of antimicrobials (promotion of antibiotic-resistant strains of bacteria, superinfection and adverse drug reactions) and meticulous aseptic techniques could be more usefully than prophylactic antibiotics. On the other hand, despite of being rare, the consequences of a neurosurgical infection can be dramatic and may result in a rapid death, caused by meningitis, cerebritis, abscess formation or sepsis.

[Macular hole--a rare complication of toxocariasis].

Macular hole is a condition that characterizes older patients, being rare in adolescent patients and exceptionally at children. The etiopathogenic mechanism of most macular holes in children and adolescent is idiopathic. The suggested etiopathogenic mechanism is vitreoretinal traction due to a toxocara granuloma for a 9 years old girl.

[Immunologic and bacteriologic study of severe acute appendicitis. Diagnostics and therapeutic considerations].

Acute appendicitis remains an up to date issue, being the most frequent cause of surgical acute abdomen round the globe. The complications that occurs creates important therapeutically difficulties. The study, based on 114 cases, had analyzed not only the pathogen flora (type, association, frequency of certain germs, the relation between them and different pathological lesion), but also the immune response of the organism to septic aggression.

[Pancreas divisum--a rare cause of chronic pancreatitis].

Pancreas divisum (P.D.) is a congenital anatomic variant, characterized by the nonunion of dorsal and ventral pancreatic ducts.

[Gallbladder leiomyoma].

Leiomyoma, benign tumor generated by wall's smooth muscle proliferation, is extremely rare revealed. In our experience we only find one case, randomly discovered on the immediate examination of the bladder at the end of the laparoscopic cholecystectomy. The echographic exam may suggest sometimes the diagnosis but the presence of the stones makes it harder, especially when the bladder has scleroathrophic lesions.