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In order to assess the relative incidence of varicocele (V) alone and V+ coincidental didymo-epididymal morphological abnormalities (DEMA) and the role of these pathologies on the pre- and post-surgical sperm outcome, 151 selected (previous exclusion of cases with bilateral V, seminal infections, antisperm autoAb) patients (aged 20-41 yrs) affected by left V at Doppler ultrasonography, underwent both ultrasound scrotal content examinations and semen analyses (sperm density, total sperm count, forward motility and normal morphology employing as frequency distribution) before and after varicocelectomy (on months 4-8-12, taking for statistical comparison the maximal post-surgical sperm value registered vs. mean correspective pre-treatment value). One-hundred two (67.5%) patients exhibited V alone (group A), whilst 49 (32.5%) patients showed V+DEMA (group B). As regards V, DEMA lesions (testis size12 ml; epididymides abnormalities: increased head (11 mm) and/or tail (6 mm) diameter, multiple microcysts; large idrocele) were omolaterally in 21/49 (42.8%) eterolaterally in 11/49 (22.5%) or bilaterally in 17/49 (34.7%). An additional group of 25 patients, exhibiting the above ultrasonic DEMA lesions alone without V, served as controls (group C) for semen statistical analysis in the pre-surgical period only. In this phase among groups A vs B, A vs C, B vs C, frequency distributions of all sperm parameters studied (excepted for density not significative only between B and C group patients) were significantly different. The following data were registered from A, B and C patient groups respectively: a) azoospermia was present in 12.7%, 34.8% and 24%; b) oligozoospermia (20 mil/ml) in 39.2%, 49% and 48%; c) normozoospermia in 48.1%, 16.3% and 8%; d) total sperm count was40 millions/ejaculate in 44.1%, 91.9% and 76%; e) asthenozoospermia (forward motility25%) was present in 32.3%, 71.4% e 72%; f) teratozoospermia (oval form30%) was present in 34.3%, 62.3% and 48%. In the post-surgical follow-up examinations, significative changes with ameliorated frequency distributions of all semen parameters were observed within group A only, while these same parameters remained unmodified within group B patients, thus being together a significative difference between groups A vs B higher than that observed in the pretreatment. The coexistence of DEMA+V seems to determine two important effects on sperm output: a) in the pre-treatment, this selection judgement allowed to distinguish a different frequency distribution of semen parameters between patients affected by V alone and V+DEMA; b) since patients with V alone in comparison with V+DEMA patients groups had a favourable sperm outcome, the assessment of DEMA in patients with V seems to be mandatory for a better sperm prognostic judice.

A 33-year-old man was hospitalized for hyperpyrexia and pain in the left upper quadrant of his abdomen. Abdominal ultrasound showed a mass in the inferior pole of the spleen. A computed axial tomography of the abdomen and a liver and spleen scintigraphy confirmed a space-occupying lesion in the spleen but were not able to define its nature. A FNAB performed during abdominal ultrasound showed cells with elliptic nuclei and elongated pale blue cytoplasm, separated from each other by empty spaces of varying width. The presence of a hemangioma or lymphangioma of the spleen was suspected. A splenectomy was performed. The histologic findings were compatible with a cavernous hemangioma. After a review of the literature, the role of FNAB of the spleen is discussed as a reasonable diagnostic approach that assists the clinician in making therapeutic decisions in the management of the space-occupying lesions in the spleen. The possibility of differentiating benign from malignant lesions is pointed out, particularly those of endothelial nature. Finally, the differential diagnosis between hamartoma and hemangioma of the spleen is discussed. The two words, in times past, were often used for the same lesion, producing a confusion of names in literature.

Personal experience with 100 cases of jejunostomy for feeding purposes is reported. Stress is laid on the advantages of this feeding technique which include simple, surgical technique, easy administration of diet, speedy metabolic response and the moderate nature of the complications.

We report the first case, in our knowledge, of dietary intolerance only to the rice in childhood. Gastrointestinal symptoms and shock-like state in relation to the ingestion of ground rice were observed in a 5-month-old girl. At 34 months she was still clinically intolerant to this food.