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Primary cecal lymphoma are very rare. The case is reported of an elderly woman having voluntary preliminary chemotherapy with consequent cecum perforation due to tumoral necrosis, some days after the first chemotherapy. The diagnostic, clinical and therapeutic protocol is analysed and stress is laid on the rare clinical cases described. Resection is advisable in the still delimited forms in order to avoid surgical complications due to preliminary chemotherapy and in order to classify precisely the neoplasm.

Bochdalek's hernia is a congenital posterior diaphragmatic defect, resulting from persistence of the pleuroperitoneal canal of embryonic life. Bochdalek's hernias are rare occurrences in adult patients and they present commonly with digestive symptoms and need surgical therapy. This article describes a case of an 88-year-old female with symptomatic right Bochdalek defect containing intra-abdominal viscera with no hernial sac.

The incidence of synchronous carcinoma of colon-rectus is rising in relation to a greater oncogenic environmental charge and increased average life expectancy. There is also a risk of not recognising the disease (especially small carcinoma or multicentric neoplasm). After a Literature review, two clinical cases are described by the authors. They recommend an extensive use of preoperative colonoscopy and a careful intraoperative exploration of the viscera. It is also important that patients undergo periodical postoperative endoscopic controls.

Fournier's syndrome or necrotizing fasciitis is a rare infection with high mortality rate. Old patients especially with diabetes mellitus, liver and renal failure are more affected. This disease requires prompt treatment: early diagnosis, antibiotic therapy, nutritional support and immediate extensive surgical debridement are necessary. Two clinical cases are presented.

The study included 20 patients affected by cholelithiasis and choledocholithiasis. Al patients underwent cholecystectomy; after choledochotomy, choledochal stones were removed using a Fogarty's biliary catheter (no. 5) and, subsequently, the papilla was calibrated by inserting the end balloon of the catheter, which and been filled with 0.3 cc of water, beyond the level of the papilla itself. The catheter was then withdrawn. No T-tubes were left in the common bile duct in any patient, no post-operative complications were observed and all patients were dismissed within seven days.

A case of gallbladder torsion complicated by sigmoid volvulus and sub-torsion of the ileus is reported because of the difficulty of diagnosis, conditioned by polymorphic symptomatology, the expression of a variety of causes and contributing causes that play an important role in the greater or less onset of dramatic symptomatology, and because of the rarity of the pathology.

Various techniques are used for the anatomo-functional study of bilio-digestive anastomoses on jejunal loop autonomized according to Roux. Here a transparietojejunal endoscopic investigation is proposed that permits direct sight of the anastomosis, biliary sampling for cultural examination and dilatative type therapeutic manoeuvres, biopsies or extractions of residual stones from the bile ways that would not otherwise be possible without further surgery. A clinical case is reported.

Two cases of pseudo-obstruction of the colon (Ogilvie's syndrome) are presented. Increasing abdominal distension and the pain suggested surgical treatment for both patients. The operation showed in the first case a marked dilatation of the transverse colon and sigmoid, in the second the dilatation of the ascending and transverse colon, without any distal obstruction. Enterotomy was performed only in the first case, as the diameter of the colon was more then 10 cm. The authors, by review of the literature and their own experience, propose a critical revision of the syndrome, discussing the physiopathology of the rising disease.

A particular case of Meckel's diverticulum, with phlegmonous appendicitis and mesenteric cyst associated, is presented. The Authors discuss the etiophatology, explaining the anatomic and clinical found situation.