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The authors report their experience of 21 cases of post-traumatic hernias of the diaphragm. On the basis of the results obtained by discussion of etiologic, diagnostic and therapeutic patterns they make at the conclusion that the high mortality, associated with diaphragmatic hernias, can be reduced only with a short time of diagnosis and a prompt surgical treatment of the associated lesions.

The diagnostic delay which accompanies the colon-rectum neoplastic desease makes that complications are often the first signal. This work means to prove, according to our experience, that the incidence of these complications is high and that only in a few patients undergoing emergency treatment is possible a one-stage procedure with radical purpose. In our survey, since Genuary 1975 to December 1993, 473 patients (255 males and 218 females) affected of colon-rectum cancer were treated: among these 54 (11.5%) underwent emergency surgery. The neoplasm was located: in the rectosigmoid junction in 25 cases (46.3%) in the caecum or in the right colon in 10 cases (18.6%), in the left colon and in the hepatic flexure in 6 cases (11.1%), in splenic flexure in 4 cases (7.4%), and in the trasversum colon in 3 cases (5.5%). According to Astler & Coller classification 22 patients (40.8%) were C2, 17 (31.5%) were D, 11 (20.4%) were B2, 3 (5.5%) were A, and only 1 patient (1.8%) was C1. 16 patients (29.7%) underwent a one-stage procedure, 8 (14.9%) had a first stage with a colostomy added together with resective procedure, and 3 (5.5%) patients had a Hartmann procedure. In 27 (50%) patients was possible only a palliative procedure. Finally, 10 patients (18.5%) had post-operative complications such as anastomotic fistula, wound's leakage or subphrenic abscess, and 11 patients (20.4%) died for cardiac insufficiency, ARDS, renal failure or cerebral stroke.

Congenital cysts of the choledochus and of the glandulae mucosae biliosae are rare anomalies generally observed in pediatric age: it is in fact exceptional to detect them in adults. There seems also to be a difference in the occurrence among the various races since the disease is more frequently seen in the Japanese and in women. In the Western world the incidence of this pathology has rated to be 1 out of 26,000 hospitalizations, consequently the personal experience and familiarity of every surgeon with this disease will be naturally limited. The authors describe the case of a women, aged 21, under observation as carrier of cystoduodenostomy after congenital cyst of the choledochus. A calculosis of the common hepatic duct as well as the stenosis of the previous cystoduodenostomy are also discovered. The abscission of the cyst and the confection of a Roux's en Y loop hepaticojejunostomy with the separation of the previous gastrojejunostomy are then performed. According to the authors, the complete abscission of the cyst and the Roux hepaticojejunostomy should be considered the surgery of choice when the local situation and the patient's general condition allow it because this treatment reduces the occurrence of late postoperative accidents such as lithiasis and cholangitis and the possibility of malignant degeneration of the cyst. Two years after the operation, the patient is in excellent health conditions.

The authors considered a series of 13 patients undergone surgical operation for primary malignant lymphoma of digestive system, with gastric, gastro-jejunal, jejunal, ileal and colic localization. They examined diagnostic and therapeutic features and the follow-up data. According to literature, the authors remark the importance of roentgenology and endoscopy, that together with bioptic data may reach a definite and early diagnosis; an elective and wide surgical exeresis seems useful in early stages, showing a better prognosis and epithelial malignancies. IV stage patients, however, had a very poor survival; a quick management appears today the only factor affecting long-term results in these patients.

The authors show a case of popliteal artery aneurysm they had the opportunity to observe. In consideration of the high percentage of surgical failures; recorded in the treatment of the complicate forms, they point out the importance of precocious diagnosis. The Authors think the termino-terminal arterial anastomosis after aneurysmectomy has very limited indications.

The Authors report their experience concerning 10 cases operated on for non-parasitic cysts of liver, among which a case of multicystic liver and a biliary pseudocyst. They emphasize the necessity, in symptomatic patients, for a selective treatment, but, where possible, with complete removal of cystic wall. The interventions performed also include six typical hepatic resections (two right hepatectomies, one of which extended to the fourth segment, and four minor resections), which revealed to be an effective therapeutical means, exempt from significant postoperative complications.