Severe spontaneous properitoneal hemorrhage following ventral hernia repair caused by viral infection: report of a case

The authors report a case of severe spontaneous hemorrhage in a patient who underwent surgical repair of an upper umbilical ventral hernia with placement of a polypropylene mesh. On the third postoperative day the patient experienced bleeding in the properitoneal space (above and below the mesh), which spread up to and along the retroperitoneal area, causing severe hypovolemic shock. Postoperative investigations finally identified a virus as the cause of the complication.

[Primary anastomosis in the neoplastic colonic obstruction]

The authors report their own experience on the treatment of large bowel obstruction caused by a neoplastic stenosis. During a 36-month period 110 operations for emergency large bowel obstructions were performed: 59 (53.6%) underwent primary anastomosis without colostomy (28 right colectomy, 16 left colectomy, 9 sub-total and 6 total colectomy). Total group post-operative mortality was 2.9% as a result of cardio-pulmonary complications. Morbidity was 19.8%, included a 3% of anastomotic leak underwent surgical treatment. Our results suggest that resection and primary anastomosis can be performed with acceptable morbidity and mortality in a high proportion of cases of emergency large bowel obstructions.

[Elevated atrial natriuretic peptide (ANP) levels and normotension in Bartter's syndrome in childhood]

The authors describe a case of Bartter's syndrome, a variety of disease in the newborn, and they point out the most specific of the disease symptoms, that is the normal PA in presence of elevated plasma renin activity. So it was necessary to determine the ANP, the values of which, controlled for a period of 18 months, appeared above the normal ones. The authors conclude that this date would better explain the apparently contradictory date of the normotension.

[Prevention of acute hypertensive encephalopathy in the course of acute post-streptococcal glomerulonephritis in children: considerations in 31 cases]

The authors analysed 31 cases of an acute hypertensive glomerulonephritis. The antihypertensive efficacy of two medicines: a vasodilator (dihidralazine) and a diuretic (Furosemide) was underlibed an these patients. Their efficacy was evident not only in the stabilization of P.A. around normal values on three days, but also on the disappearance of signs of on hypertensive encephalopathy whereas these ones were present.

[Does the therapy with indomethacin interfere with growth in Bartter's syndrome in childhood?]

The authors describe a new-born form of Bartter's syndrome treated for about 6 years with Indomethacin in a quantity of 2 mg/Kg/die except short periods, during which it was given triamterene in a quantity of 2 mg/Kg/die. While with the first medicine the growth of height has had an average increase of about 9 cm a year, with the second one there hasn't been any result neither on growth nor on the rest of symptomatology. The A.A. on the base of recent experimental data think that the deficiency of height could be due to a scanty affinity of peripherical receptors and SmC, that could be removed from the provision of Indomethacin.

[Evaluation of kidney damage in neonatal anoxia syndrome: a 1-year follow-up]

In thirty-three newborns with anoxic syndrome was valued the renal injury making use of usual parameters of renal function (Blood urea nitrogen, creatinine, FeNa, Clcr) and furthermore the rate of urinary excretion of beta 2-microglobulin, a marker of tubular damage. All the parameters at the beginning of follow-up were altered. Further monitoring of these showed that BUN, creatinine, FeNa, Clcr were normalized in a short time. Differently beta 2-microglobulin was altered up to the end of follow-up in thirty-one newborns; the values were much lower than original. These results show an high incidence of tubular suffering in the ischemic-anoxic syndrome and a tendency to protract in the time.