[Carcinomas of the colon and rectum. Clinical studies and case reviews].
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Biomedical subjects
Publications and source records attributed to F Varola.
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A case of jejunum-ileum multiple diverticulosis observed during a cholecystectomy due to cholelithiasis, is reported. Stress is laid on this unusual localization of diverticulosis in the small intestine. The clinical picture can be silent or present an acute or chronic symptomatology and radical surgical treatment can performed or not. When the disease involves all the intestine, without presenting serious inflammatory phenomena and without clinical symptoms (as in the case observed), medical and not surgical treatment can be envisaged.
A series of malignant cancers of the oesophagus operated in the period 1968-1978 is reported. The importance of preoperative denutrition is considered and the various nutritional techniques are outlined, with a note on their advantages and defects. Right intrathoracic oesophagogastroplasty carried out in malignant cancers of the middle third of the oesophagus is particularly discussed. This surgical technique is held to be preferable to intestinal transpositions in substitution of the oesophagus, and the results obtained in this series support the opinion.
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1) Haemobilia must be kept in mind as a cause of gastrointestinal haemorrage. 2) The presence of an hepatic artery aneurysm gives a peculiar triad of symptoms: abdominal pain, gastrointestinal haemorrage and jaundice. 3) Selective angiography is the elective diagnostic aid. 4) The diagnosis may be difficult also at operation, because the aneurysms can be very small. 5) The most used surgical treatment are ligation of the hepatic artery, the excision of aneurism, the endoaneurysmorrhaphy or the end-to-end anastomosis.
True and pseudo-cysts of the pancreas are described and their aetiology, pathology, laboratory tests, radiological examination, differential diagnosis, symptomatology and surgical management are illustrated. A series of 22 cases of pancreatic cyst is presented. Surgical management consisted of 14 cystogastrostomies, 3 cystoduodenostomies, 2 resections of the tail of the pancreas, 1 internal drainage between the fistular segment of the gland and the gastric cavity, and 2 external drainages with a Pezzer tube. It is felt that internal drainage is the operation of choice. Of the surgical techniques available, a preference is expressed for cystogastrostomy and cystoduodenostomy.
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On the basis of a thourough anatomosurgical study of Vater's ampulla and after a critical survey of all surgical techniques for the sphincter of Oddi, the indications for and technique of total papillosphincteroplasty are presented. The results obtained in 544 total papillosphincteroplasties, their possible complications and failure supported by long-term (from 6 months to 7 years) follow-up are discussed. The conclusion is drawn that papillosphincteroplasty is to be considered the surgical technique of choice in the treatment of benign pathology of the main bile way.
Cholecystosis conditions include those diseases of the gallbladder whose aetiopathogenesis is to be sought in a hyperplasia of the tissues making up the cholecystic wall (hyperplastic forms) and in an overload of this wall on the part of organic substances or minerals such as lipides or calcium salts (thesaurismosic forms). After discussing the classification, pathological anatomy, aetiopathogenesis, frequency, symptomatology, laboratory and radiological examinations, prognosis complications and treatment of these conditions, a personal series of 36 surgically treated cholecystoses is reported.
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