Alberto Fersini

By Pasquale Cianci, Nicola Tartaglia, Alberto Fersini, Sabino Capuzzolo, Libero Luca Giambavicchio, Antonio Ambrosi and Vincenzo Neri

Objective: Cholelithiasis represents a very frequent health problem with higher prevalence in developed countries. The aim of this chapter is to underline, also by submitting our surgical experience, some diagnostic deceptions and the timing of treatment.

Part of the book: Updates in Gallbladder Diseases

By Pasquale Cianci, Alberto Fersini, Nicola Tartaglia, Sabino Capuzzolo, Libero Luca Giambavicchio, Antonio Ambrosi and Vincenzo Neri

The use of imaging modalities and minimally invasive surgery plays an important role in the current management of adrenal tumors. Ultrasonography frequently allows for the incidental diagnosis of adrenal masses. The most frequent adrenal pathologies encountered are hypercortisolism (Cushing’s syndrome), primary hyperaldosteronism (Conn’s syndrome), and pheochromocytomas. Clinical presentation of these adrenal tumors can often be non-specific, or such lesions may present as “incidentalomas” in patients who undergo imaging for clinical reasons unrelated to the adrenal glands. Adrenal malignancy is suggested by morphologic characteristics found on imaging studies: increased size, irregular borders, local invasion, and large necrotic areas. The risk of malignancy increases for larger adrenal masses. Minimally invasive surgery has become the initial choice for the treatment of adrenal tumors with retroperitoneal and transperitoneal approaches. This chapter describes the surgical indications and compares the various minimally invasive surgical approaches for the therapeutic management of adrenal masses.

Part of the book: Clinical Management of Adrenal Tumors

By Vincenzo Neri, Nicola Tartaglia, Alberto Fersini, Pasquale Cianci, Mario Pacilli, Giovanna Pavone and Antonio Ambrosi

The block of the portal flow by obstacles in prehepatic, hepatic or posthepatic site and alterations of the splanchnic blood flow are the pathological conditions that lead to portal hypertension. The portal hypertension can cause also others gastroduodenal lesions, potentially hemorrhagic, in addition to esophageal varices commonly developed and habitual source of bleeding in these patients. The gastroduodenal lesions associated with portal hypertension, usually encountered in the clinical practice, are portal hypertensive gastropaty, gastric antral vascular ectasia, gastric and duodenal ulcer, isolated gastric varices. The pathophysiology and clinical, diagnostic and therapeutic features of these lesions are examined.

Part of the book: Esophagitis and Gastritis