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Article ; Online: Unusual presentation and treatment of biliary ileus with long term follow up: case report and review of the literature.

Zulian, Viola / Vasquez, Giorgio / Feo, Carlo V

2013 Volume 84, Issue 1, Page(s) 99–102

Abstract: Gallstone ileus is a rare complication of cholelithiasis. It accounts for 25% of nonstrangulated small bowel obstructions in patients over the age of 65 years. The morbidity and mortality rate of gallstone ileus remains very high, partly because of ... ...

Abstract	Gallstone ileus is a rare complication of cholelithiasis. It accounts for 25% of nonstrangulated small bowel obstructions in patients over the age of 65 years. The morbidity and mortality rate of gallstone ileus remains very high, partly because of misdiagnosis or delayed diagnosis. The two surgical options are: a) enterolithotomy with removal of impacted stone, cholecystectomy, and fistula repair at the same surgical operation (i.e., "one-stage" procedure) and b) enterolithotomy with stone extraction followed or not by elective biliary surgery. The latter is the most popular surgical approach, whereas enterolithotomy combined with cholecistectomy and fistulectomy is indicated only in selected cases. In this article, a case of biliary ileus with unusual presentation treated by entherolithotomy alone with long term follow up is described, and the literature on this subject is reviewed and discussed.
MeSH term(s)	Aged, 80 and over ; Follow-Up Studies ; Gallstones/complications ; Humans ; Ileus/diagnosis ; Ileus/etiology ; Ileus/surgery ; Jejunal Diseases/diagnosis ; Jejunal Diseases/etiology ; Jejunal Diseases/surgery ; Male ; Time Factors
Language	English
Publishing date	2013-01
Publishing country	Italy
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	418927-9
ISSN	2239-253X ; 0003-469X
ISSN (online)	2239-253X
ISSN	0003-469X
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Article: Open Abdomen Management and

Occhionorelli, Savino / Zese, Monica / Cultrera, Rosario / Lacavalla, Domenico / Albanese, Marco / Vasquez, Giorgio

Gastroenterology research and practice

2017 Volume 2017, Page(s) 5187620

Abstract: Objective: Laparostomy can be applied in trauma, abdominal sepsis, intra-abdominal hypertension, or compartment syndrome. Systemic infections, especially if complicated by : Methods: This is a single-centre retrospective case series of 47 cases ... ...

Abstract	Objective: Laparostomy can be applied in trauma, abdominal sepsis, intra-abdominal hypertension, or compartment syndrome. Systemic infections, especially if complicated by Methods: This is a single-centre retrospective case series of 47 cases admitted to our Department, which required laparostomy procedure; we analyzed the type of surgery, temporary abdominal closure, duration of open abdomen, complications, SOFA score, mortality with Results: We found that patients with Conclusions: Management of the OA is often burdened by sepsis or septic shock, especially when complicated by
Language	English
Publishing date	2017-12-07
Publishing country	Egypt
Document type	Journal Article
ZDB-ID	2435460-0
ISSN	1687-630X ; 1687-6121
ISSN (online)	1687-630X
ISSN	1687-6121
DOI	10.1155/2017/5187620
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Article: Solitary fibrous tumour of gluteus: a case report about an uncommon localization of a rare neoplasm.

Occhionorelli, Savino / Pigato, Ilaria / Malvicini, Enzo / Pascale, Giovanni / Stano, Rocco / Rinaldi, Rosa / Vasquez, Giorgio

Journal of surgical case reports

2016 Volume 2016, Issue 6

Abstract: Solitary fibrous tumour (SFT) is a rare benign tumour that occurs most frequently in the pleura. It is considered rare in soft tissues. We report a case of a middle-aged woman that presented a solitary fibrous tumor of gluteus. The tumour was composed of ...

Abstract	Solitary fibrous tumour (SFT) is a rare benign tumour that occurs most frequently in the pleura. It is considered rare in soft tissues. We report a case of a middle-aged woman that presented a solitary fibrous tumor of gluteus. The tumour was composed of mesenchymal spindle-shaped cells positive for CD34 and bcl-2. Although rare, SFT should be included in the differential diagnosis of mesenchymal soft tissue tumours. The clinical presentation and imaging can be helpful for a better pre-operative diagnosis.
Language	English
Publishing date	2016-06-22
Publishing country	England
Document type	Case Reports
ISSN	2042-8812
ISSN	2042-8812
DOI	10.1093/jscr/rjw111
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Article: Asymptomatic and early pseudoaneurysm of posterior superior pancreaticoduodenal artery and right gastric artery complicating acute pancreatitis: A case report.

Occhionorelli, Savino / Morganti, Lucia / Cappellari, Lorenzo / Stano, Rocco / Andreotti, Dario / Vasquez, Giorgio

International journal of surgery case reports

2016 Volume 28, Page(s) 344–347

Abstract: Introduction: Arterial pseudoaneurysm is a rare and life-threatening complication of pancreatitis, seen more often in chronic than in acute pancreatitis. It involves mostly the splenic artery, while only in 10% of the case it appears in ... ...

Abstract	Introduction: Arterial pseudoaneurysm is a rare and life-threatening complication of pancreatitis, seen more often in chronic than in acute pancreatitis. It involves mostly the splenic artery, while only in 10% of the case it appears in pancreaticoduodenal and gastric artery. This case report described an asymptomatic pseudoaneurysm of the posterior superior pancreaticoduodenal artery and of the right gastric artery, which occurred after 13days from the episode of acute pancreatitis and, then it was treated with vascular angioembolization. Presentation of case: A 71 year-old female was admitted to the Emergency Surgery Department for severe acute pancreatitis. After 13days from the onset, pseudoaneurysms were detected with a control contrast-enhanced computed tomography and they were localized in a branch of the right gastric artery and in a branch of the posterior superior pancreaticoduodenal artery. The patient underwent angiography and the pseudoaneurysms were treated with platinum coil embolization, without complications or further bleeding. Discussion: This is an unusual case because of the low incidence of arterial pseudoaneurysm as acute pancreatitis complication (1.3-10%), and the uncommon localization in the pancreaticoduodenal arteries. Conclusion: It is important to be aware of pancreatitis-related arterial pseudoaneurysms, as they have a mortality of 90% if not recognized and treated, not only in chronic but also in acute pancreatitis, and to work out a scheduled follow-up with abdominal computed tomography or pancreatic contrast-enhanced ultrasound in order to control and prevent late onset complications.
Language	English
Publishing date	2016-10-18
Publishing country	Netherlands
Document type	Journal Article
ISSN	2210-2612
ISSN	2210-2612
DOI	10.1016/j.ijscr.2016.10.036
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Article ; Online: The surgical approach to near-total small bowel infarction in a patient with massive portomesenteric thrombosis. Case report.

Occhionorelli, Savino / La Manna, Alessandra / Stano, Rocco / Morganti, Lucia / Vasquez, Giorgio

Annali italiani di chirurgia

2016 Volume 87, Issue ePub

Abstract: Aim: To describe an acute portomesenteric venous thrombosis, with massive small bowel infarction, which is managed with small bowel resection, primary anastomosis, and open abdomen management (OAM).: Case report: A 76-year-old male patient was ... ...

Abstract	Aim: To describe an acute portomesenteric venous thrombosis, with massive small bowel infarction, which is managed with small bowel resection, primary anastomosis, and open abdomen management (OAM). Case report: A 76-year-old male patient was admitted to the surgical ward, complaining spread abdominal pain. Contrast Enhanced Computed Tomography (CECT) diagnosed massive bowel ischemia, caused by portomesenteric thrombosis. He had negative coagulation tests for thrombophilia, while he presented concomitant risk factors (cancer, previous venous thrombosis, obesity). Surgery was performed, including open abdomen management, and the patient was discharged one month after surgery. No recurrences of portal thrombosis were found in one-year follow-up. Discussion: Mesenteric venous thrombosis (MVT) diagnosis could be difficult to establish and it often presented itself late with peritonitis. Currently, CECT scanning is considered the gold standard for MVT, because it identifies not only filling defects in the portomesenteric system, but also possible complications, such as bowel ischemia. Standard initial treatment of MVT included heparin anticoagulation alone or in combination with surgery. When peritoneal signs initially are present, immediate surgery is indicated. During laparotomy, assessment of bowel viability and of the border between ischemia and vivid bowel could be more difficult to define. A planned "second-look" operation remains the gold standard for final bowel viability assessment. Conclusions: OAM strategy could possibly play an important role, also in case of resection for bowel ischemia, in improving survival in critically patients with increased risks of complications of re- anaesthesia and re-laparotomy. Key words: Acute Mesenteric Ischemia, Open Abdomen, Portal vein, Venous Thrombosis.
MeSH term(s)	Aged ; Anticoagulants/therapeutic use ; Humans ; Infarction/surgery ; Intestine, Small/blood supply ; Intestine, Small/pathology ; Intestine, Small/surgery ; Male ; Mesenteric Ischemia/diagnostic imaging ; Mesenteric Ischemia/etiology ; Mesenteric Ischemia/therapy ; Mesenteric Veins/diagnostic imaging ; Portal Vein/diagnostic imaging ; Thrombectomy/methods ; Treatment Outcome ; Venous Thrombosis/etiology
Chemical Substances	Anticoagulants
Language	English
Publishing date	2016-05-23
Publishing country	Italy
Document type	Case Reports ; Journal Article
ZDB-ID	418927-9
ISSN	2239-253X ; 0003-469X
ISSN (online)	2239-253X
ISSN	0003-469X
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Article ; Online: Delayed diagnosis of blunt carotid trauma in a seat belt syndrome with associated abdominal wall injury A case report.

Occhionorelli, Savino / Andreotti, Dario / Tartarini, Daniela / Cappellari, Lorenzo / Stano, Rocco / Morganti, Lucia / Vasquez, Giorgio

Annali italiani di chirurgia

2016 Volume 5

Abstract: The aim of this case report is to be aware of occult carotid lesions in thoracic- abdominal trauma because, carotid artery injury consequent to blunt trauma is rare, affecting less than 1% of patients as reported in literature. A 45-years-old female, ... ...

Abstract	The aim of this case report is to be aware of occult carotid lesions in thoracic- abdominal trauma because, carotid artery injury consequent to blunt trauma is rare, affecting less than 1% of patients as reported in literature. A 45-years-old female, involved in a traffic accident, arrived to Emergency Room hemodynamically stable, with a Glasgow Coma Scale of 15, complaining abdominal pain, without any neurological signs. She underwent Computed Tomography (CT) scan that showed a complete disruption of left abdominal wall muscles, associated with massive bowel loops herniation. No free air nor other visceral injuries were found. The radiological brain evaluation was negative for neurological injuries. Considering the nature of the trauma, an explorative laparotomy was performed. During the fifth postoperative day, the patient presented neurological side signs with right facial-brachial-crural hemiparesis and expressive aphasia. Head and neck CT scan revealed a lesion of the left common carotid artery with distal embolization of the internal carotid. A left-carotid-axis revascularization procedure and a surgical endarterectomy were immediately performed. Patient was discharged after 20 days without neurological consequences. Physicians should be aware of neck vascular injuries when evaluating patients with multiple trauma, even in neurological asymptomatic patients without seatbelt abrasions of the neck skin. Key words: Abdominal Hernia, Carotid artery, Seat belt, Surgery.
MeSH term(s)	Abdominal Injuries/diagnostic imaging ; Abdominal Injuries/etiology ; Abdominal Wall/diagnostic imaging ; Accidents, Traffic ; Aphasia/etiology ; Carotid Artery Injuries/diagnosis ; Carotid Artery Injuries/diagnostic imaging ; Carotid Artery Injuries/etiology ; Carotid Artery Injuries/surgery ; Carotid Artery Thrombosis/etiology ; Carotid Artery, Common/diagnostic imaging ; Carotid Artery, Internal ; Delayed Diagnosis ; Endarterectomy, Carotid ; Female ; Hernia, Abdominal/diagnostic imaging ; Hernia, Abdominal/etiology ; Humans ; Middle Aged ; Multiple Trauma/diagnostic imaging ; Multiple Trauma/etiology ; Paresis/etiology ; Seat Belts/adverse effects ; Tomography, X-Ray Computed ; Wounds, Nonpenetrating/diagnosis ; Wounds, Nonpenetrating/diagnostic imaging ; Wounds, Nonpenetrating/etiology
Language	English
Publishing date	2016-11-28
Publishing country	Italy
Document type	Case Reports ; Journal Article
ZDB-ID	418927-9
ISSN	2239-253X ; 0003-469X
ISSN (online)	2239-253X
ISSN	0003-469X
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Article ; Online: Benign multicystic mesothelioma of peritoneum complicating acute appendicitis in a man: a case report.

Occhionorelli, Savino / Tartarini, Daniela / Pascale, Giovanni / Maccatrozzo, Stefano / Stano, Rocco / Vasquez, Giorgio

Journal of medical case reports

2016 Volume 10, Page(s) 44

Abstract: Background: Benign multicystic mesothelioma is a rare pathology. Few cases are reported in the medical literature and acute presentation is extremely uncommon.: Case presentation: We describe an acute clinical presentation of the neoplasm that ... ...

Abstract	Background: Benign multicystic mesothelioma is a rare pathology. Few cases are reported in the medical literature and acute presentation is extremely uncommon. Case presentation: We describe an acute clinical presentation of the neoplasm that revealed itself with signs and symptoms attributable to acute appendicitis in a 41-year-old white man. Abdominal echography and computed tomography scans demonstrated the presence of a mass in direct contiguity with cecal fundus, but diagnosis remained unclear. Our patient underwent surgery and complete removal of the neoplasm. Only a definitive histological examination defined the nature of the lesion. No signs of relapse were demonstrated 1 year after the operation. Conclusions: We showed that an acute presentation of a benign neoplasm represents a diagnostic and therapeutic challenge for the surgeon, because of the difficult differential diagnosis that acute presentation can sometimes pose and the trouble that an emergence treatment can imply.
MeSH term(s)	Adult ; Appendicitis/complications ; Appendicitis/diagnosis ; Appendicitis/surgery ; Humans ; Male ; Mesothelioma, Cystic/complications ; Mesothelioma, Cystic/diagnosis ; Mesothelioma, Cystic/surgery ; Peritoneal Neoplasms/complications ; Peritoneal Neoplasms/diagnosis ; Peritoneal Neoplasms/surgery
Language	English
Publishing date	2016-02-27
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	2269805-X
ISSN	1752-1947 ; 1752-1947
ISSN (online)	1752-1947
ISSN	1752-1947
DOI	10.1186/s13256-016-0826-6
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Article ; Online: The Surgical Management of Acute Gastric Volvulus: Clinical Outcomes and Quality of Life Assessment.

Tamburini, Nicola / Andolfi, Ciro / Vigolo, Chiara / Sanzi, Marcello / Resta, Giuseppe / Marino, Serafino / Rubino, Serena / Cavallesco, Giorgio / Occhionorelli, Savino / Vasquez, Giorgio / Anania, Gabriele

Journal of laparoendoscopic & advanced surgical techniques. Part A

2020 Volume 31, Issue 3, Page(s) 247–250

Abstract: Background: ...

Abstract	Background:
MeSH term(s)	Acute Disease ; Aged ; Aged, 80 and over ; Female ; Hernia, Hiatal/surgery ; Humans ; Laparoscopy/adverse effects ; Male ; Middle Aged ; Patient Satisfaction ; Postoperative Complications/etiology ; Postoperative Period ; Quality of Life ; Recurrence ; Retrospective Studies ; Stomach Volvulus/surgery ; Surveys and Questionnaires ; Treatment Outcome
Language	English
Publishing date	2020-10-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	1381909-4
ISSN	1557-9034 ; 1092-6429
ISSN (online)	1557-9034
ISSN	1092-6429
DOI	10.1089/lap.2020.0779
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Article ; Online: Management of blunt splenic injuries Retrospective cohort study of early experiences in an Acute Care Surgery Service recently established.

Occhionorelli, Savino / Morganti, Lucia / Andreotti, Dario / Cappellari, Lorenzo / Stano, Rocco / Portinari, Mattia / Vasquez, Giorgio

Annali italiani di chirurgia

2015 Volume 86, Page(s) 413–420

Abstract: Aim: To identify patients with splenic injuries, who should benefit from a conservative treatment, and to compare inhospital follow-up and hospital length of stay (LOS), in patients treated by non-operative management (NOM) versus immediate-splenectomy ( ...

Abstract	Aim: To identify patients with splenic injuries, who should benefit from a conservative treatment, and to compare inhospital follow-up and hospital length of stay (LOS), in patients treated by non-operative management (NOM) versus immediate-splenectomy (IS). Material of study: A retrospective cohort study on consecutive patients, with all grade of splenic injuries, admitted between November 2010 and December 2014 at the Acute Care Surgery Service of the S. Anna University Hospital of Ferrara. Patients were offered NOM or IS. Results: Fifty-four patients were enrolled; 29 (53.7%) underwent IS and 25 (46.3%) were offered NOM. Splenic artery angioembolization was performed in 9 patients (36%) among this latter group. High-grade splenic injuries (IVV) were more represented in IS group (65.5% vs 8%), while low grade (I-II) were more represented in NOM group (64% vs 10.3%). Failure of NOM occurred in 4 patients (16%). Hospital LOS was longer in IS group (p=0.044), while in-hospital and 30-day mortality were not statistically significant different between the two groups. Conclusions: Hemodynamically stable patients, with grade I to III of splenic injuries, without other severe abdominal organ injuries, could benefit from a NOM; the in-hospital follow-up should be done, after a control CECT scan, with US. Observation and strictly monitoring of splenic injuries treated with NOM do not affect patients' hospital los. Key words: Non-operative management, Splenic Rupture, Surgery.
MeSH term(s)	Adult ; Aged ; Conservative Treatment/utilization ; Disease Management ; Embolization, Therapeutic/utilization ; Emergency Service, Hospital/statistics & numerical data ; Female ; Hemoperitoneum/etiology ; Hemoperitoneum/therapy ; Hemostatic Techniques ; Hospital Mortality ; Hospitals, University/statistics & numerical data ; Humans ; Injury Severity Score ; Italy ; Length of Stay/statistics & numerical data ; Male ; Middle Aged ; Multiple Trauma/therapy ; Retrospective Studies ; Spleen/injuries ; Splenectomy/utilization ; Surgery Department, Hospital/statistics & numerical data ; Unnecessary Procedures ; Wounds, Nonpenetrating/therapy
Language	English
Publishing date	2015
Publishing country	Italy
Document type	Journal Article
ZDB-ID	418927-9
ISSN	2239-253X ; 0003-469X
ISSN (online)	2239-253X
ISSN	0003-469X
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Article ; Online: An approach to complicated diverticular disease. A retrospective study in an Acute Care Surgery service recently established.

Occhionorelli, Savino / Zese, Monica / Tartarini, Daniela / Lacavalla, Domenica / Maccatrozzo, Stefano / Groppo, Giacomo / Sibilla, Maria Grazia / Stano, Rocco / Cappellari, Lorenzo / Vasquez, Giorgio

Annali italiani di chirurgia

2016 Volume 87, Page(s) 553–563

Abstract: Aim: Acute diverticulitis is a frequent disease in the Western Countries. The increase number of patients admitted in the Surgery Departments led the necessity of new Scores and Classifications in order to clarify, in absence of clear guidelines, the ... ...

Abstract	Aim: Acute diverticulitis is a frequent disease in the Western Countries. The increase number of patients admitted in the Surgery Departments led the necessity of new Scores and Classifications in order to clarify, in absence of clear guidelines, the best treatments to offer in the different situations. Methods: A retrospective study of ninety-nine patients treated in our Department from June 2010 and March 2015. Results: In our study 41 patients were treated conservatively, the remaining 58 were operated, 56 laparotomic and 2 laparoscopic. 5 patients submitted US guided drainage of abscess which failed in 2 cases. 25 submitted Hartmann's Procedure (HP), 29 Primary Resection and Anastomosis (PRA), 3 Contemporary Closure of Perforated Diverticula (CC) and just 2 Laparoscopic Peritoneal Lavage and Drainage (LPL). We related different Hinchey groups and up-groups with the treatments approached, identifying patients risk factors, ASA score and complications. Discussion: The treatment of perforated diverticulitis is debated. CT scan is becoming an useful instrument to make a correct diagnosis. Hinchey I and II patients are preferentially treated conservatively except in cases of complicated presentations. Hinchey III and IV are necessarily treated with surgical approach. We analyze the different types of intervention currently approached. Conclusion: We believe in PRA in Hinchey III and IV selected patients, HP is the gold standard in higher ASA scores patients but the low number of stoma reversal remains an open problem. Many studies are ongoing concerning LPL and now there are insufficient data to think of a widespread use of this technique. Key words: CT scan, Diverticular Disease, Hartmann's Procedure, Intr-abdominal abscess, Laparoscopic Peritoneal Lavage and Drainage (LPL), Peritonitis, Primary Resection and Anastomosis (PRAHinchey Classification, US and CT guided drainage.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Diverticulitis, Colonic/complications ; Diverticulitis, Colonic/surgery ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Surgicenters
Language	English
Publishing date	2016
Publishing country	Italy
Document type	Journal Article
ZDB-ID	418927-9
ISSN	2239-253X ; 0003-469X
ISSN (online)	2239-253X
ISSN	0003-469X
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