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The authors attempt an approach of a controversial problem of contemporary surgery and stress the following significant aspects:--the frequency of multiple colon cancers is of 3%, approximately 25% of the cases being associated with benign proliferative lesions:--the intra-operatory diagnosis of multiple colon cancers is difficult (3 out of 12 cases); intrasurgical exploration may give rise to problems in connection with the insufficiency of the exploration, or the inaccessibility of unique tumors, thus existing the risk of leaving in place a developing tumor, that can be discovered at a new intervention (one case); the operability of multiple colon cancers is similar to that of the unique malignant lesions, depending on the extension, the variety and the focal distribution of the neoplastic lesions.

Based on the experience acquired in 20 cases the authors discuss the use of the mannitol solution in the surgery of the colon. The colic voiding was evaluated in 19 cases as very good, a fact that stresses the efficiency of this method of mechanical preparation of the colon. The method is very well tolerated by the patients, and the secondary biological modifications are not significant. Contraindications are limited to the very aged (above 75 years), in patients with cardiac disease, or in those with hepatic and renal diseases, as well as in those with occluding forms of neoplasies.

In the last two decades the iatrogenic retraction of the quadriceps muscle, which occurs in infants and young children following large numbers of injections performed in the thigh, has polarized the attention, especially as a result of the increasing frequency, and of the invalidating effects. The authors describe the symptoms that allow to make a diagnosis, both for the complete form, and for the form that involves the upper part of the thigh, a form that was studied and explained from the viewpoint of its mechanism, by one of the authors. Provided that the disease is correctly identified in a early stage, and the application of an adequate treatment, will led to recovery without sequels. In the case of the chronic form only surgery may lead to satisfactory results. The technique is described, of the quadriceps desinsertion, as it is performed in Clinic for Infantile Surgery and Orthopaedics from Bucharest. Since the results of the surgical treatment are of good quality in only 85% of the cases, the particular importance in stressed, of the preventive treatment.

A study was carried out on the principal alterations of the common bile duct in pancreatic neoplasms by gross and microscopic morphological examinations and intraoperative cholangiographies. Correlation of the data furnished evidence of various coinvolvement mechanisms of the lower common bile duct by the neoplastic process, mechanisms that lead to a closer understanding of the clinical symptomatology and interpretation of intraoperative cholangiographies.

Based on 17 observations the authors review the major etiopathogenic, evolutive, clinical and therapeutic aspects of pancreatic fistulae. In 14 cases the cure was achieved by medical treatment while surgery was resorted to in only three cases. The medical measures are discussed, as well as the indications for surgical treatment.

The present paper reports on the first autochtonous case of amoebic hepatic abscess in Romania in a patient in which the epidemiologic survey showed that there had been no possible import infection. The amoebic abscess was located in the superoexternal area of the right hepatic lobe. Subsequently a major complication developed: a tendency to pleuropulmonary invasion with the formation of fluid in the right pleural cavity. The diagnosis, suggested by the aspect of the abscess cavity, was established by the presence of the parasite in the flaky pleural exudate obtained by puncture, by cultures in Loeffler medium and by serum immunofluorescence. The abscess was evacuated surgically and a specific treatment with Chloroquine and Metronidazol combined with antibiotics and a symptomatic medication was prescribed. The patient recovered and was discharged 51 days after surgery.

The authors present the case of a female patient aged 19 years with chorionepithelioma, multiple pulmonary metastases, and an unique intestinal metastasis, complicated by severe digestive haemorrhage and haemoperitoneum. Surgery was carried out in risky conditions and consisted in segmental enterectomy and subtotal hysterectomy, and bilateral adnexectomy. The postoperative evolution was unsatisfactory, and the patient died following continued digestive bleeding, probably due to coagulation disturbances induced by prolonged loss of blood. Although the disease is encountered and treated in ob-gyn departments, the general surgeon can be confronted by such complications of this affection which may take on extremely severe aspects, and where surgery, provided that is performed sufficiently early, can save the patient's life.

It was tested the possibility to evidence the pneumococcal capsular antigen, by coagglutination, directly in CSF, using a specific coagglutinating reagent for all the 10 serological types of S. pneumoniae more frequently encountered in our country. Were investigated 134 CSF from purulent meningitis, out of which 37 were of probable pneumococcal etiology, on the basis of bacterioscopic examination, 26 of other etiology and 71 of unknown etiology. The results obtained showed 28 (75.7%) positive reactions in the fluids from probably pneumococcal meningitides on the basis of the positive bacterioscopic examination. The specificity of the reactions is demonstrated by the negative reactions with the fluids from meningitides of other etiology, as well as by the concordance between the antigen serotype from the liquid and that of the isolated S. pneumoniae strain. For a good test sensitivity could argue the positive reactions obtained with 6 CSF from meningitides of unknown etiology.