Hand-Sewn Versus Stapled Small Bowel Anastomoses in Patients With Secondary Mesenteric Ischemia.

Introduction: Although stapled anastomoses have been widely evaluated in the context of the elective surgery, few reports compared manual with stapled anastomoses in patients undergoing emergency surgery. The aim of this study is to compare the outcome of hand-sewn end-to-end anastomoses with stapled side-to-side and stapled end-to-side anastomoses in patients undergoing small bowel resection for acute mesenteric ischemia secondary to intestinal obstruction.

Methods: From January 2015 to June 2021 all the hemodynamically stable patients undergoing emergency surgery with small bowel resection for intestinal obstruction were enrolled in this study.

Usefulness of damage control approach in patients with limited acute mesenteric ischemia: a prospective study of 85 patients.

To evaluate the efficacy of the damage control approach by two-step surgical procedure in not critical patients (without sepsis or septic shock) with peritonitis from limited acute mesenteric ischemia. From April 2013 to April 2020, 85 patients [49 (57.7%) women and 36 (42.

Impact of SARS-Cov-2 pandemic on Emergency General Surgery. A single-center observational study.

Introduction: Several articles have been published on impact COVID-19 infection about reduction of surgical activity. We have focused on the differences between our surgical activity in an Emergency General Surgery department in "Cardarelli" Hospital in Naples.

Methods: This retrospective study compared the patients treated from March 9, 2020 to April 27, 2020 (Italian lockdown time) and the patients treated in the same period of 2019.

Treatment of acute diverticulitis with open abdomen technique.

Aim: The aim of this study is to highlight our experience about the use of open Abdomen's technique as strategy for the management of complicated colon diverticulitis with a delayed anastomosis or colostomy.

Materials And Methods: Thirty patients, with III and IV Hinchey stage, have been undertaken to a surgical procedure with Open Abdomen technique and application of Ab-thera device. A second surgical look was made after 48-72 hours in order to evaluate the possibility to do an anastomosis or colostomy.

Advantages of Damage Control Strategy With Abdominal Negative Pressure and Instillation in Patients With Diffuse Peritonitis From Perforated Diverticular Disease.

. To evaluate the results of Damage Control Strategy (DCS) in the treatment of generalized peritonitis from perforated diverticular disease in patients with preoperative severe systemic diseases. .

Damage control surgery for perforated diverticulitis with diffuse peritonitis: saves lives and reduces ostomy.

Introduction: Over the last decade, damage control surgery (DCS) has been emerging as a feasible alternative for the management of patients with abdominal infection and sepsis. So far, there is no consensus about the role of DCS for acute perforated diverticulitis. In this study, we present the outcome of a multi-institutional series of patients presenting with Hinchey's grade III and IV diverticulitis managed by DCS.

Non-Operative Management of Blunt Liver Trauma: Safety, Efficacy and Complications of a Standardized Treatment Protocol.

Objective: To evaluate the safety and effectiveness of NOM (non-operative management) in the treatment of blunt liver trauma, following a standardized treatment protocol.

Methods: All the hemodynamically stable patients with computed tomography (CT) diagnosis of blunt liver trauma underwent NOM. It included strict clinical and laboratory observation, 48-72h contrast enhanced ultrasonography (CEUS) or CT follow-up, a primary angioembolization in case of admission CT evidence of vascular injuries and a secondary angioembolization in presence of vascular injuries signs at follow-up CEUS.

Negative pressure therapy alone or with irrigation in the management of severe peritonitis.

Background: Ogilvie was the first to publish on open abdomen (OA) for the treatment of the damages caused by penetrating abdominal wounds in war events. Research improved those devices that allow a controlled, homogeneous and continuous extraction of contaminated fluids from all abdominal recesses, which are nowadays the base of the "Open Abdomen" technique.

Materials And Methods: From August 2012 to February 2016 at the Department of Emergency Surgery of Cardarelli Hospital in Naples, 40 patients affected by Severe Peritonitis have been treated with OA technique.

Primary anastomosis in emergency surgery of left colon cancer.

Introduction: Colorectal cancers are second leading cause of death in Western countries. There are about 1500 deaths per year in Italy due to colorectal cancer in both sex 1.

Materials And Methods: 224 patients, 127 women (56.

International consensus conference on open abdomen in trauma.

Background: A part of damage-control laparotomy is to leave the fascial edges and the skin open to avoid abdominal compartment syndrome and allow further explorations. This condition, known as open abdomen (OA), although effective, is associated with severe complications. Our aim was to develop evidence-based recommendations to define indications for OA, techniques for temporary abdominal closure, management of enteric fistulas, and methods of definitive wall closure.

Unusual bleeding of a giant cell fibroblastoma: a soft tissue sarcoma of the skin mimicking metastatic melanoma.

A 56 year-old man presented to the emergency department after a spontaneous bleeding of a giant mass located on the right axilla. Clinical diagnosis was recurrent hemorrhagic nodular melanoma. Ten months previously a malignant melanoma had been removed from the dorsum by radical excision and surgical margins had been disease-free (MM: Breslow IV, Clark IV, lung and lynphnode metastases).

Role of tridimensional endoanal ultrasound (3D-EAUS) in the preoperative assessment of perianal sepsis.

Purpose: The aim of this study was to evaluate the accuracy of tridimensional endoanal ultrasound (3D-EAUS) in the diagnosis of perianal sepsis comparing the results with the surgical findings, considered as reference standard.

Methods: From January 2009 to January 2013, all the patients referred for the assessment and treatment of perianal sepsis with suspected anorectal origin were enrolled in the study. All patients gave informed written consent.

Penetrating cardiac injuries. Two case reports.

Introduction: Penetrating cardiac injuries is still a diagnostic problem at this time. Their management requires immediate surgical intervention and excellent surgical critical care postoperatively.

Presentation Of Cases: A 15-year old male patient was stabbed with a knife to the right chest.

[Intestinal reconstruction after dehiscence of a jejunal suture in a patient submitted to aorto-enteric fistula repair: a case report].

Aorto-enteric fistulas are serious complications of aortic surgery that require swift, effective surgical intervention. We report a case of a secondary aortoenteric fistula treated with prosthesis replacement and an intestinal suture subsequently complicated by the dehiscence of the previously constructed anastomosis. We opted for reconstruction re-intervention, closing the intestinal lesion by means of a mechanical suture above the jejunal dehiscence, making a side-to-end jejuno-jejunal Roux anastomosis and an end-to-side anastomosis at the base of the loop.

Clinical symptoms of intestinal vascular disorders.

Despite advances made in the diagnostic and therapeutic field, acute intestinal ischemia remains a highly lethal condition. This is related to the variability of symptoms and the absence of typical laboratory alterations in early stage.

[Our experience in the management of patients with Mirizzi syndrome].

The authors report their experience in the management of patients with Mirizzi Syndrome (MS) admitted, over a period of 15 years, at the General Surgery of Emergency Department of Cardarelli Hospital, Naples, Italy. All patients were admitted and surgically treated in emergency save for one. Out of 12 patients, cholecystectomy was performed in 7 cases.

[Mainly abdominal "complex" polytrauma. Considerations on surgical strategy and clinical case report].

The Authors want to present un uncommon case of polytrauma managed with surgical treatment at the Trauma Center of the A. Cardarelli Hospital in Naples. Chest, abdomen, pelvis, and left lower limb have been severely injured.

[Conservative treatment of the digestive fistulas: personal experience].

Objective: The authors, thanks to experience obtained in an Unit for the treatment of digestive fistulas, discuss the possibility of a conservative treatment for the anastomotic fistulas.

Material And Methods: From 2000 to 2003 were treated thirty-five patients with post-anastomotic gastroenteric fistulas marked according to their localization, way end output (51.5% high, 42.

[The congenital cystic dilatation of the liver and bile ducts (CDB): our experience].

The congenital cystic dilatation of the liver and bile ducts (CDB) is a very uncommon disease. It often appears in females and most frequently in paediatric patients. Its etiopathogenesis is not yet completely defined.