Structural metatarsus adductus deformity, surgical case report.

Structural metatarsus adductus deformity may be corrected through the use of closing abductory base wedge osteotomies of all five metatarsals. Although technically demanding, surgical precision is increased through the use of oblique wedges and a combination of screw and cerclage wire fixation. In the severe case, an opening wedge osteotomy of the inner cuneiform (Fowler procedure), with homogenous bone implantation, may be concomitantly used. Both techniques are described in this brief case presentation.     

Pheochromocytoma. A case report]

The pheochromocytoma is a catecholamine-secreting tumor, localized in the adrenal gland in 90% of the cases and in extra-adrenal site in the remaining 10%. It can be single or associated with other endocrine neoplasms. On the basis of the case presented, the several clinical manifestations, the treatment of the disease and especially the recent development in imaging as MIBG, TAC, RNM are discussed.     

Utricular papillomatosis. A case report]

A case of utricular papillomatosis is reported herein. A 50-year-old male patient consulted our hospital with a complaint of asymptomatic macrohematuria. Endoscopic examination revealed papillomatous tumor tightly growing within the utricle. Transurethral resection of the tumor was performed. Histopathologically, the tumor consisted of numerous villous structures with slender fibrovascular cores and overlying cuboidal cells in 2 to 3 cell layers. Invasive growth or cellular atypia could not be found. Utricular papillomatosis is rare, and only one similar case was reported to my knowledge in the English literature for the last five years. Such rarity and peculiar clinicopathological characteristics prompted us to report this case.     

Gastric leiomyoblastoma. A case report]

The authors report a case of gastric leiomyoblastoma, a rare benign neoplasm that can sometimes undergo a malignant course. The main clinical an pathological issues are reviewed, in order to offer guidance as to the best suited surgical approach.     

A Morgagni-Larrey hernia. A case report]

The paper reports a case of Morgagni-Larrey hernia observed by the authors. The etiopathogenesis is described and the importance of surgery is underlined even in asymptomatic cases in order to ensure a benign postoperative outcome.     

Duodenal adenocarcinoma. A case report]

The duodenal carcinoma is a rare malignant neoplasm (1-6% of all the tumors of the digestive tract). In this paper the authors review the clinical and diagnostic approach to the disease and discuss both the palliative and curative surgical therapy.     

Reconstruction of tarsus and metatarsus with free iliac flap--a case report and review of literature]

Procedure and late results of treatment of 17 year old female with severe trauma of right foot by agricultural machine are presented. Defects included soft tissues of the dorsal foot, II-IV metatarsal bones, cuneiform bones and majority of the navicular bone. The patient was first treated in a regional hospital and due to infection an amputation of the lower extremity distal part was considered. In our department an emergency necrectomy was carried out, general and local antibiotics were administered and the wounds were split skin grafted. Complete one stage reconstruction of the soft tissues and bones with free osteocutaneous iliac flap was performed three months later. Deep circumflex iliac vessels were anastomosed end-to-side to the only uninterrupted posterior tibial vessels. Two axial K-wires were used to stabilize vascularized bone graft. A fragment of the ilium 8.5 x 6.0 x 1.5 centimeters of favourable arcuate shape was used to reconstruct longitudinal and transversal arches of the foot. The vascularized bone graft healed three months after the reconstruction. The patient recovered full weight bearing capability after a year. No complications were observed in the donor site in spite of the fact that the patient was pregnant and had a normal uncomplicated delivery.     

A choledochal diverticulum. A case report]

Due to the rarity of choledochal cystic dilatation, the authors report a clinical case of common bile duct diverticulum. This diverticulum was histologically composed of gastric ectopic mucosa (pyloric type) and it clinically caused chronic abdominal pain (in a young woman). The authors analyse the literature of the above pathology.     

Adrenal cystic lymphangioma. A case report]

Adrenal cysts are uncommon. A case of left adrenal cystic lymphangioma in 16 year old boy is reported. The adrenal cyst was a chance finding during radiological investigation for abdominal pain. Ultrasound and CT scan showed the cyst and suggested the correct diagnosis of cystic lymphangioma of the left adrenal gland. The patient underwent surgery and a left adrenalectomy was performed. Histology confirmed the previous diagnosis of cystic lymphangioma.     

Verneuil's suppurative hidradenitis. A case report]

The Authors reports a case of Verneuil's disease in a perineal location. They focus on etiopathogenetic aspects and problems of differential diagnosis, before reviewing the various therapeutic options. Surgery is the only effective therapy and takes the form of an extensive excision of the cutaneous zone affected with 2nd intention recovery, or a dermoepidermal auto-graft. A long follow-up is important to monitor the possible recurrence of lesions generally due to the incomplete removal of the area affected by the process.     

Descending necrotizing mediastinitis. A case report]

Descending necrotizing mediastinitis which may occur as a complication of neglected oropharynx infection is an uncommon disease, although it is lethal in most cases. Trismus and dyspnea are usual with palpable crepitation located in the cervico-thoracic area. Early diagnosis can be confirmed with accuracy by CT scan. Treatment is based on early mediastinal drainage by cervical approach, intravenous antibiotics and reanimation. The reported case had a favorable outcome.     

Cervical thymic cysts. A clinical case report]

The presence of thymic residues in a laterocervical site is very rare, as is cystic degeneration. The paper reports the case of a six-year-old boy who presented a swelling in a left laterocervical site; preoperative tests (especially echography and fine needle aspiration) identified the cystic nature of the swelling which was then confirmed intraoperatively; histological test diagnosed a thymic cyst. The paper analyses the embryological, anatomopathological and clinical aspects of these formations and underlines the difficulty of making a differential diagnosis from other neck pathologies, especially branchial cysts. In conclusion, preoperative tests can only determine the cystic component but not the thymic origin of these formations which can only be confirmed by final histological tests.     

Gas embolism during hysteroscopy. A case report]

A case of gas embolism during hysteroscopy in a young woman suffering from sterility is reported. Although this surgical procedure is considered safe, however, when complications do occur, they can be severe and rapidly fatal. The importance of an accurate intraoperative monitoring for a rapid diagnosis and treatment remarkably improve the clinical picture of the patient.     

Ophthalmomyiasis with subretinal tracks. A case report]

A 12-year-old White Boy presented with unilateral loss of vision and a severe vitreal inflammatory reaction after he had been struck in the eye by a flying object. After treatment with corticosteroids the vitreous cleared and the fundus could be seen. Indirect ophthalmoscopic examination and fluorescein angiography showed subretinal tracks consistent with the diagnosis of ophthalmomyiasis posterior.     

Congenital urethrocele in children. A case report]

Congenital urethrocele is a fairly rare disease in children. The authors report the case of a 9-year-old child presenting with a penoscrotal mass. Pressure on the mass produced urine. The diagnosis of urethrocele was established by ultrasonography and cystourethrography. Urethroplasty was successfully performed.     

Replantation surgery of the penis. A case report]

By the case of a subtotal traumatical amputation of the penis seen in our services, we discuss the advantages of a replantation by microsurgical technique. After presentation of the operational procedure and the management of the postoperative course the results of a thorough examination by questioning, physical examination, neurological examination including EMG testing of the bulbo-cavernous-reflex, Rigiscan NTM and angiography of the penal arteries are discussed. A review of the literature shows the advantages of the microsurgical technique but also the astonishing results by the former, conventional technique which still presents a possibility if microsurgery is not available.     

Giant diverticulum of the bladder. A case report]

Vesical diverticula are a common pathology of the urinary bladder, generally secondary to cervico-urethral obstruction. Frequency of giant diverticula is not reported in the literature. The Authors present a case of giant vesical diverticulum (20 x 30 cm in diameter) due to prostatic adenoma in which any referable symptomatology was absent. The Authors debate the reasons for which progressive development of the diverticulum has been related with the improvement of the frequency and urgency previously presented by the patient.     

Posterior urethral polyps in children. A case report]

Posterior urethral polyps are rare. A case is reported in a 7-year-old boy presenting with pain and burning micturition. Ultrasound and cystography revealed the diagnosis by showing a round solid structure in the bladder neck. Cystoscopy confirmed the diagnosis by showing its implantation base at the summit of the verumontanum. The polyp was removed by endoscopic resection and histological examination of the resection specimen showed a fibrous polyp. A brief review of the clinical features, diagnostic methods, natural history and treatment of this benign tumour is presented.