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    Acute splenic torsion in children: which is the best treatment? A case report

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    Wandering spleen is a clinical entity which rarely affects children and adolescents. This condition can be asymptomatic or responsible of chronic pain, but it appears as a surgical emergency when an acute twisting occurs. The risk of post-splenectomy sepsis in the pediatric population suggests a conservative approach whenever possible, and also in case of acute torsion, most authors prefer to preserve the spleen and perform a splenopexy. The Authors describe a case of a child with acute splenic torsion, in whom a conservative surgical approach was initially adopted. The conservative option has to be balanced with the risk of prolonged thrombocytopenia, multiple transfusions and a possible second procedure to remove the spleen

    Sodium retention in chronic liver disease: lack of a natriuretic factor?

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    An acute volume expansion in water diuresis has been induced in 8 patients with liver cirrhosis and in 8 normal subjects, taken as controls. A two hour postinfusion urine sample has been utilized to obtain the urine fraction with natriuretic activity. This activity was assayed in 16 rats. Our results confirm a significantly lower natriuretic activity of cirrhotic urine fractions than those of controls

    Hematometra in uterus didelphis: a pitfall in teenagers with lower abdominal mass. Report of two cases

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    Müllerian malformations represent a wide spectrum of anomaly of the female reproductive tract, usually detected at birth or at puberty. The presence of uterus didelphys and obstructed hemivagina, associated with ipsilateral renal agenesis, is known as Herlyn-Werner-Wunderlich syndrome, a rare congenital anomaly. Two cases of uterus didelphic and hematometra caused by vaginal septum are reported; the girls had a delayed diagnosis due to absence of a specific clinical feature. Clinicians must be aware of the existence of these malformations. An adequate radiological study is mandatory to assess the anatomic conformation, and to optimize the therapeutic procedures
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