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In order to evaluate the efficacy and tolerability of mesalazine (5-ASA) in the prophylaxis of symptomatic relapses, of major complications and of microhemorrhagic phenomena in diverticular disease of the large intestine (MDC), prospective clinical study was conducted on patients with light-moderate symptomatic MDC under treatment with sulbactam-ampicillin 1.5 g/12 h i.m. and rifaximine 400 mg/12 h per os for 7 days. Follow-up period of 5 years with seriated checkups and laboratory and instrumentation controls. End points are represented by the relapse on inflammation and/or by the occurrence of major complications. On enrollment, 166 patients were randomized to receive mesalazine (Pentacol tablets--SOFAR S.p.A.) 400 mg b.i.d. per os for 8 weeks (81 patients; group M) or no supplementary treatment (85 patients; group C). After 4 years of follow-up, 44 patients dropped out of the study (9 because of major complications, 3 for massive hemorrhage, and 32 drop outs). Symptomatic relapses occurred in 51 patients (12 M; 39 C), while minor diverticular hemorrhages occurred in 43 patients (12 M; 31 C), with an estimated probability of remaining free respectively from symptomatic relapse (p=0.00005) and from microhemorrhagic phenomena (p=0.001) decisively in favor of the group treated with mesalazine. The duration of abdominal pain due to diverticolitis was also shorter in patients of group M (p=0.0002), while the incidence of major complications and side effects was comparable in the two groups. In conclusion, supplementary treatment with mesalazine in patients affected with MDC--at a follow-up limited to 48 months--proved to be well tolerated and effective in reducing the frequency of symptomatic relapses and microhemorrhagic phenomena and in reducing the duration of abdominal pain.

Materials and Methods: To assess the efficacy of mesalazine in treating acute diverticulitis and preventing diverticular disease (DD) complication. 166 patients with symptomatic DD were randomly assigned to receive mesalazine Pentacol (400 mg b.i.d., orally; M group) or no additional treatment (controls; C group)., Results: After a 12 months follow-up, 26 patients experienced a symptomatic relapse (8%M vs 27% C, p=0.003), with a higher rate in C group for the patients with a history of previous diverticulitis (p=0.006) and independently of the diverticular site (sigmoid p=0.041; colon and sigmoid p=0.044). Minor diverticular haemorrhages were less frequent in M group (p=0.016), with a significant difference only for the patients with sigmoid diverticula (p=0.023); abdominal pain persisted for a shorter time in the treated group (p=0.0015)., Conclusions: No significant difference was found between the two groups for the incidence of DD major complications.

A case of papillary cystic tumour of the pancreas in a young woman is reported. The review of the literature permits to stress the rarity of this tumour with a good prognosis.

Since CT permits non-invasive imaging of the peripancreatic anatomy, the relationship between early CT findings and objective prognostic signs was evaluated in fifty-five patients with acute pancreatitis. The tomographic severity of pancreatitis was graded in 5 degrees in accordance with classification reported by Hill. An association of CT findings with objective clinical prognostic signs results in more accurate early identification of patients with a high risk of complications. Therefore early CT evaluation of the pancreas is recommended in patients who, upon clinical evaluation, appear to have pancreatitis of moderate or severe degree.

Three patients with intestinal metastases from a malignant melanoma are presented. The pathological and clinical findings are reviewed. The symptoms are variable , but usually include unexplained anemia, gastrointestinal bleeding, abdominal pain and intestinal obstruction. X-ray examination of gastrointestinal tract can reveal multiple metastatic lesions with so-called typical "Bull's eye" sign. Surgical excision is indicated and extended survival due to improved chemotherapy and immunotherapy is stressed.