Minerva chirurgica
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The authors describe a case of intraperitoneal anorectal injury. Such injuries now have an improved survival rate as a result undoubtedly of superior resuscitation, early operative management and early use of antibiotics. Civilian life rectal wounds are usually of the penetrating type. ⋯ This is accomplished by a divided--end colostomy. Local wound care must be given for the inevitable infected foreign tract. When sepsis occurs, the surgeon must be prepared to handle it adequately by appropriate incision and drainage.
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During the last decade, the increase of drug traffic and close customs' control have led smugglers to attempt various methods to pass through customs undetected. One method is the ingestion of large numbers of drug-filled packets (usually containing cocaine), together with anticholinergics inhibiting intestinal peristalsis, by a smuggler, called "body-packer" or "mule". The up-to-date approach to cocaine-packet ingestion is conservative medical management during the spontaneous evacuation of the "ovules". ⋯ This case gave reasons for a discussion on the specific features of bowel obstruction in cocaine packet ingestion. The bowel obstruction of cocaine-packet ingestion should be carefully considered and promptly treated because of the potentially lethal consequences (death rate of 56% of cases) of transmucous absorption of cocaine contained in "ovules". In fact, while opioid intoxication can be fought with specific antagonists towards opioid receptors (naloxone), the lack of a specific antidote makes cocaine poisoning particularly dangerous.(ABSTRACT TRUNCATED AT 250 WORDS)
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Lipomas occur through the intestinal tract, from the hypopharynx to the rectum, the colon having the highest incidence, where lipomata are the commonest benign neoplasm after adenomata. Nevertheless they are uncommon. CASE REPORT. 1) A 68-year-old man presented as an emergency with abdominal pain associated with bowel obstruction. ⋯ CONCLUSION. Colonic lipomas, although unusual, continue to present difficulties in the preoperative differentiation between malignant and benign colonic neoplasm. Two cases of colonic lipomas are reported.
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The authors, with this works, call fellow members attention, how is complicate the diagnosis and the following surgical treatment of the associated lesions caused by pancreatic trauma. The pancreatic traumas are today object of discussion for the surgical treatment, and for the lesions associated. In this work is described the experience of some years accumulated in the Emergency Department of the Liguria Region.
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The authors report their experience on local anesthesia for inguinal hernia repair in 164 patients. They describe the neuroanatomy of the inguinal region as well as the technique of loco-regional anesthesia. ⋯ Local anesthesia was very well tolerated by the patients, sometimes with the addition of mild sedation. The postoperative course was definitely shortened by the use of local anesthesia, and all patients were able to take a regular diet and to walk few hours after surgery.