Starting from the observation of a case of late diagnosed left-side hernia after traumatic rupture of diaphragma, the authors consider the increasing incidence of this pathology during the years. The increased frequency of thoraco-abdominal traumas and the more sophisticated diagnostic tools, permit an earlier diagnosis nowadays. In our patient the diagnosis was made late on the basis of the standard x-ray of the thorax. The CT scan of the thorax and of the abdomen gave more informations. Left thoracotomy enabled a wide exposure of the herniated viscera; the breakthrough of the diaphragm was repaired by means of interrupted suture and it was necessary to apply two prostheses of synthetic material.

Adult↗

PubMedDate not supplied

[Fournier syndrome: multidisciplinary approach].

Fournier's gangrene, a form of necrotizing fasciitis, is an uncommon, fulminant, rapidly progressing subcutaneous infection of the scrotum and genito-perineal region, and may occur in all age groups. Most cases involve a mixed synergistic infection of aerobic and anaerobic bacteria, and occur as a result of one of this mechanisms: local trauma, extension from a perineal, periurethral or ischiorectal infection. It is associated with a high mortality rate. Predisposing factors included diabetes mellitus, steroids or chemotherapy, alcohol abuse, malignancy and radiation therapy. This disease requires prompt treatment: early diagnosis, antibiotic therapy, nutritional support, immediate extensive surgical debridement and hyperbaric oxygen therapy. The use of etherologue serum is a valuable adjunct in the therapy of Fournier's gangrene. We report a case of Fournier's syndrome treated with etherologue serum immuno-therapy, together with the conventional multidisciplinary approach. The postoperative course was uneventful and the patient was discharged on day 50 post intervention in good general conditions. The 3 years follow-up showed no recurrence of the disease. In conclusion we remark that the survival can be improved in patients with Fournier's gangrene by multidisciplinary approach.

Combined Modality Therapy↗

PubMedDate not supplied

[Chromoendoscopy in the diagnosis of precancerous lesions of the esophagus. Our experience].

The elements of an unfavourable prognosis for oesophageal cancer are frequent metastasis, high incidence of local recurrence and mainly the difficulty of an early diagnosis. Alcohol, tobacco and precancerous lesions are the most important risk factors of these tumours. According to literature, the authors suggest the method of chromoendoscopy, with vital staining by lugol or blue toluidine for endoscopic; guidance to biopsy in the aimed screening of patients, whose habits--alcohol, smoking--should cause, in time, the rising of lesions with neoplastic potentiality. Endoscopy with bioptic test is the best diagnostic investigation. In fact sensibility and specificity of these investigations increase using this method with vital staining.

Coloring Agents↗

PubMedDate not supplied

[Calculosis of the cystic duct].

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Cholecystectomy↗

PubMedDate not supplied

[Cystadenoma of the epididymis. Report of a case].

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Adolescent↗

PubMedDate not supplied

[Laparoscopic surgery in varicocele: description of the technique and preliminary data].

UNLABELLED: The aim of this work is to remark the scientific worth of the laparoscopic approach in patients with varicocele. PATIENTS AND METHODS: From March 1993 to December of the same year 15 patients suffering from varicocele have been treated with a laparoscopic procedure. The technique is widely described in the next pages. RESULTS: Twelve patients have completed the 3 months follow-up whereas five among them have reached the 6 months control. The results are really interesting specially under a functional point of view. DISCUSSION: The noninvasive advantages provided by laparoscopy are always important, but is the worth of the results we have obtained under a functional point of view and the success in inducing pregnancy in some patients that lead us to remark the utility of this procedure comparing it, with the therapeutic proposals nowadays performed. They are: traditional surgery according to Ivanissevich or Palomo procedures percutaneous transvenous embolization under radiological guide varicocele vein ligation under local anesthesia. CONCLUSIONS: Laparoscopic varicocelectomy represents according to us and some other authors a proposal with a better response if compared to traditional surgery, specially under a functional aspect. Under a costs-benefits evaluation it may be considered more convenient than the radiological approach.

Adolescent↗

PubMedDate not supplied

[Intestinal bleeding from an ulcerated diverticulum of the small intestine. A clinical case].

A case of occult bleeding of the upper intestinal tract in a patient with secondary polycythaemia and aortic valve stenosis is described. Routine tests failed to disclose the origin of the bleeding and the patient's condition continued to deteriorate. On the 23rd day after admission, laparotomy was performed, and an ulcerated diverticulum diagnosed. Resection of the diverticulum was done immediately. The patient had an uneventful post-operative recovery and was dismissed from the hospital 15 days later. Our experience underscores the necessity for early laparotomy in cases of gastrointestinal bleeding of obscure origin.

Aged↗

PubMedDate not supplied

[Clinical manifestations in benign breast diseases. The surgeon's role in the evaluation of signs and diagnostic work-up].

From January 1988 through December 1995, 1022 patients having a breast disease have been operated on in our center. Of them 342 had a breast malignancies whereas 680 beared a benign breast disease. Benign breast pathology presents to the physician two main problems, they are: i) the need to rule out a breast cancer, which often may be simulated by special clinical presentation ii) the need to determine if eventually such a benign lesion can degenerate into a malignancy. We conclude according to our experience and following several authors that although a very careful diagnostic evaluation must be performed for every breast lesion, only few benign lesions arising with particular patterns can change into a breast cancer.

Breast Diseases↗