Diego Falchetti - Academia.edu (original) (raw)
Papers by Diego Falchetti
Journal of pediatric gastroenterology and nutrition, Aug 1, 1998
The American Journal of Gastroenterology, Dec 1, 1999
Gastrointestinal (GI) lipomas are benign, usually single, slowly growing tumors (1, 2). Their occ... more Gastrointestinal (GI) lipomas are benign, usually single, slowly growing tumors (1, 2). Their occurrence in the GI tract is most common in the colon, but they can be found also in the small bowel and very rarely in the stomach, where they account for 5% of all GI lipomas (3, 4). Although most gastric lipomas (GL) are usually detected incidentally (2), they can cause severe symptoms such as obstruction, invagination, and life-threatening hemorrhages (5, 6). To date, only three cases of GL have been reported in childhood (7). We describe the case of an 11-yr-old girl with asymptomatic giant GL, who has not received any treatment until now. New diagnostic insights, therapeutic options, and indications for treatment in asymptomatic patients are discussed.
Journal of Pediatric Surgery, May 1, 1991
Biliary atresia is the most common indication for orthotopic liver transplantation (OLT) in child... more Biliary atresia is the most common indication for orthotopic liver transplantation (OLT) in children. The polysplenia syndrome anomalies, which occur in approximately 10% of children with biliary atresia, may represent special difficulties at liver transplantation. We have reviewed our experience with this syndrome in 116 children with biliary atresia who underwent liver transplantation between March 1984 and December 1989. The main features of the polysplenia syndrome, which included absence of the inferior vena cava, preduodenal portal vein, midgut malrotation, aberrant hepatic artery, and situs inversus, were encountered in 12 of the 116 children (10.3%). Severe portal vein hypoplasia (3.5 mm or smaller) was also present in 7 of these children. Eight patients received a complete and four received a reduced liver graft. The vascular anomalies increased the technical difficulty of OLT but could be surmounted, although they did contribute to the peroperative death of one child. The 1-month survival rate was 83% for the 12 children with features of the polysplenia syndrome and 88% for the other 92 children with biliary atresia alone.
Digestive and Liver Disease, Oct 1, 2007
Journal of Surgical Research, 2021
Background: Recently laparoscopic repair of pediatric inguinal hernia has been mainly oriented to... more Background: Recently laparoscopic repair of pediatric inguinal hernia has been mainly oriented to video-assisted percutaneous ligation of peritoneal sac. Assessment of contralateral defect and a better cosmesis are recognized benefits of this procedure, however there are still some drawbacks often related to the subcutaneous knot. As an alternative to open surgery we propose an original one-access technique with intraperitoneal knot. Patients and methods: Between January 2009 and December 2019 we operated laparoscopically for inguinal hernia 61 non-consecutive patients (22F - 39M; aged 2 months - 17.5 years) selected for having associated contralateral or umbilical hernia, occasional diagnosis during one-trocar laparoscopy, presence of a ventriculo-peritoneal shunt or recurrence after open or laparoscopic repair. Every patient was treated with one-trocar trans-umbilical intraperitoneal closure of the inguinal ring using an operative laparoscope. Postoperative follow-up was 12 months...
Journal of Pediatric Surgery Case Reports, 2020
действительнозначных процессов на R с траекториями в B b (где B b-класс действительнозначных боре... more действительнозначных процессов на R с траекториями в B b (где B b-класс действительнозначных борелевских функций), которые при T → ∞ сходятся в B b по распределению к некоторому процессу Φ. Цель настоящей заметки-доказать сходимость взвешенных средних величин Φ T (X t) на [0, T ] при T → ∞, где (X t) t 0действительнозначный процесс, имеющий локальное время. Наш метод основан на стохастической версии формулы для времени пребывания, использующей разложение Карунена-Лоэва. Мы описываем одно применение этого результата для оценки инвариантного маргинального распределения эргодического диффузионного процесса. Ключевые слова и фразы: локальное время, формула для времени пребывания, разложение Карунена-Лоэва, сходимость по распределению.
Digestive and Liver Disease, 2018
Transplantation Proceedings, 1998
Journal of Pediatric Surgery, 1998
European Journal of Pediatric Surgery, 1988
Digestive and Liver Disease, 2006
Digestive and Liver Disease, 2007
The decision whether to perform endoscopy in children with suspected reflux oesophagitis is not a... more The decision whether to perform endoscopy in children with suspected reflux oesophagitis is not a straightforward one. Few symptoms are specific for oesophagitis and the diagnosis is not always correlated even to visual findings on endoscopy. The aim of this study was to define the role of endoscopy and especially of histology in the diagnosis of reflux oesophagitis and to examine the correlations between symptoms, endoscopic findings and histology in children with suspected gastroesophageal reflux disease. One hundred and thirty-six patients with a clinical diagnosis of reflux oesophagitis, aged 1-18 years (mean 8.43; standard deviation +/-4.4), were enrolled from 12 Italian Paediatrics Gastroenterology Centres; symptom score, endoscopic and histologic oesophagitis scores were observed before and after therapy with proton pump inhibitors. Before therapy, a high correlation between the prevailing symptom score and endoscopic score was demonstrated, but not with histologic score: there was a significant tendency for histologic grade to exceed visual findings. After therapy, endoscopic score and histologic score were significantly improved. Oesophageal biopsies increase the diagnostic accuracy of upper endoscopy. Histologic grading is often much more important than the endoscopic appearance, so that endoscopic oesophageal biopsies are very important aids in the diagnosis of oesophagitis. Appropriate clinical evaluation of symptoms must occur before endoscopic examination.
The European Journal of Surgery, 1999
Objective: To achieve hepatic portal revascularisation and decompression of extrahepatic portal h... more Objective: To achieve hepatic portal revascularisation and decompression of extrahepatic portal hypertension in children with cavernoma and obstruction caused by idiopathic portal vein thrombosis. Design: Selected cases. Setting: Teaching hospitals, Belgium and Italy. Subjects: 11 children who weighed between 5.9 and 54 kg (2 emergencies) with symptomatic extrahepatic portal hypertension. Intervention: Interposition of venous autograft between the superior mesenteric vein and the distal (umbilical) portion of the left portal vein. Main outcome measures: Improvements in symptoms and endoscopic appearance after operation. Results: 2 bypasses had to be redone because they stenosed; all 11 were patent at the time of writing (median follow-up 6 months, range 1-32 months). Conclusion: The bypass effectively relieved symptoms of extrahepatic portal hypertension by restoring normal hepatic portal blood flow.
Journal of Cystic Fibrosis, 2008
Posters S25 limits, a known low risk metastasis disease in papillary thyroid cancer, a chest X-ra... more Posters S25 limits, a known low risk metastasis disease in papillary thyroid cancer, a chest X-ray unmodified and the description in the scientific literature of iodine-131 uptake in focal bronchiectasis mimicking metastatic thyroid cancer induced to monitor clinical status without further investigations. Her serum TG remained undetectable at sixmonth follow-up and I-131 whole-body at one-year follow-up showed the same lung focal hot spots. A chest computed tomography scan was performed confirming the presence of bronchiectasis involving both lung fields without evidence of pulmonary metastasis. Aberrant uptake of radioactive iodine is present not only in known inflammatory disease of the lung, aspergilloma and respiratory bronchiolitis but false positive iodine uptake can be present also in case of pulmonary involvement in CF.
La Pediatria medica e chirurgica : Medical and surgical pediatrics
Swenson's procedure, first described in 1948 for Hirschsprung's disease, consists in rese... more Swenson's procedure, first described in 1948 for Hirschsprung's disease, consists in resection of aganglionic intestine and distal colo-anal anastomosis provided a precise dissection of extra peritoneal rectum. Potential jeopardy of pelvic vessels and nerves stimulated alternative surgical techniques to prevent complications on bladder and genital function. We performed in laparoscopy Swenson's procedure after Toupet, taking advantage from closer view and magnification of this technique, in a 15 months girl. Laparoscopy simplified and made safer pelvic dissection and resulted in a better postoperative period and cosmetic outcome.
Surgical Endoscopy, 2004
Transanal endorectal resection and colonic pull-through (TERPT) is a good technique for the manag... more Transanal endorectal resection and colonic pull-through (TERPT) is a good technique for the management of Hirschsprung's disease. This procedure is feasible in the vast majority of patients and is associated with excellent results, early postoperative recovery, and no visible scars. We report the case of a patient who developed early postoperative severe constipation after TERPT due to unusual folding of the muscular cuff rim, which tightly narrowed the pulled-through colon. This complication was diagnosed and treated by laparoscopy. To prevent it, we recommend splitting of the aganglionic muscular cuff during TERPT.
Journal of Urology, 2009
Editorial Comment This is an important study on the ability of five common urological pathogens (... more Editorial Comment This is an important study on the ability of five common urological pathogens (Escherichia coli, Enterococcus faecalis, Klebsiella pneumoniae, Staphylococcus aureus and Pseudomonas aeruginosa) to adhere and form biofilms on commercially available ureteral stents. Also, it was evaluated the impact of heparin coating on stent compression, tensile and coil strength. This research opens new avenue to a very common and up-to-date problem that is bacterial encrustation and adhesion to stents. It could help modifications in stent design and also in developing drugs to inhibit bacterial adhesion and biofilm formation. I recommend this article as a reference for study design and methodology to all researchers interest in the issue of stent incrustation by bacteria.
Journal of pediatric gastroenterology and nutrition, Aug 1, 1998
The American Journal of Gastroenterology, Dec 1, 1999
Gastrointestinal (GI) lipomas are benign, usually single, slowly growing tumors (1, 2). Their occ... more Gastrointestinal (GI) lipomas are benign, usually single, slowly growing tumors (1, 2). Their occurrence in the GI tract is most common in the colon, but they can be found also in the small bowel and very rarely in the stomach, where they account for 5% of all GI lipomas (3, 4). Although most gastric lipomas (GL) are usually detected incidentally (2), they can cause severe symptoms such as obstruction, invagination, and life-threatening hemorrhages (5, 6). To date, only three cases of GL have been reported in childhood (7). We describe the case of an 11-yr-old girl with asymptomatic giant GL, who has not received any treatment until now. New diagnostic insights, therapeutic options, and indications for treatment in asymptomatic patients are discussed.
Journal of Pediatric Surgery, May 1, 1991
Biliary atresia is the most common indication for orthotopic liver transplantation (OLT) in child... more Biliary atresia is the most common indication for orthotopic liver transplantation (OLT) in children. The polysplenia syndrome anomalies, which occur in approximately 10% of children with biliary atresia, may represent special difficulties at liver transplantation. We have reviewed our experience with this syndrome in 116 children with biliary atresia who underwent liver transplantation between March 1984 and December 1989. The main features of the polysplenia syndrome, which included absence of the inferior vena cava, preduodenal portal vein, midgut malrotation, aberrant hepatic artery, and situs inversus, were encountered in 12 of the 116 children (10.3%). Severe portal vein hypoplasia (3.5 mm or smaller) was also present in 7 of these children. Eight patients received a complete and four received a reduced liver graft. The vascular anomalies increased the technical difficulty of OLT but could be surmounted, although they did contribute to the peroperative death of one child. The 1-month survival rate was 83% for the 12 children with features of the polysplenia syndrome and 88% for the other 92 children with biliary atresia alone.
Digestive and Liver Disease, Oct 1, 2007
Journal of Surgical Research, 2021
Background: Recently laparoscopic repair of pediatric inguinal hernia has been mainly oriented to... more Background: Recently laparoscopic repair of pediatric inguinal hernia has been mainly oriented to video-assisted percutaneous ligation of peritoneal sac. Assessment of contralateral defect and a better cosmesis are recognized benefits of this procedure, however there are still some drawbacks often related to the subcutaneous knot. As an alternative to open surgery we propose an original one-access technique with intraperitoneal knot. Patients and methods: Between January 2009 and December 2019 we operated laparoscopically for inguinal hernia 61 non-consecutive patients (22F - 39M; aged 2 months - 17.5 years) selected for having associated contralateral or umbilical hernia, occasional diagnosis during one-trocar laparoscopy, presence of a ventriculo-peritoneal shunt or recurrence after open or laparoscopic repair. Every patient was treated with one-trocar trans-umbilical intraperitoneal closure of the inguinal ring using an operative laparoscope. Postoperative follow-up was 12 months...
Journal of Pediatric Surgery Case Reports, 2020
действительнозначных процессов на R с траекториями в B b (где B b-класс действительнозначных боре... more действительнозначных процессов на R с траекториями в B b (где B b-класс действительнозначных борелевских функций), которые при T → ∞ сходятся в B b по распределению к некоторому процессу Φ. Цель настоящей заметки-доказать сходимость взвешенных средних величин Φ T (X t) на [0, T ] при T → ∞, где (X t) t 0действительнозначный процесс, имеющий локальное время. Наш метод основан на стохастической версии формулы для времени пребывания, использующей разложение Карунена-Лоэва. Мы описываем одно применение этого результата для оценки инвариантного маргинального распределения эргодического диффузионного процесса. Ключевые слова и фразы: локальное время, формула для времени пребывания, разложение Карунена-Лоэва, сходимость по распределению.
Digestive and Liver Disease, 2018
Transplantation Proceedings, 1998
Journal of Pediatric Surgery, 1998
European Journal of Pediatric Surgery, 1988
Digestive and Liver Disease, 2006
Digestive and Liver Disease, 2007
The decision whether to perform endoscopy in children with suspected reflux oesophagitis is not a... more The decision whether to perform endoscopy in children with suspected reflux oesophagitis is not a straightforward one. Few symptoms are specific for oesophagitis and the diagnosis is not always correlated even to visual findings on endoscopy. The aim of this study was to define the role of endoscopy and especially of histology in the diagnosis of reflux oesophagitis and to examine the correlations between symptoms, endoscopic findings and histology in children with suspected gastroesophageal reflux disease. One hundred and thirty-six patients with a clinical diagnosis of reflux oesophagitis, aged 1-18 years (mean 8.43; standard deviation +/-4.4), were enrolled from 12 Italian Paediatrics Gastroenterology Centres; symptom score, endoscopic and histologic oesophagitis scores were observed before and after therapy with proton pump inhibitors. Before therapy, a high correlation between the prevailing symptom score and endoscopic score was demonstrated, but not with histologic score: there was a significant tendency for histologic grade to exceed visual findings. After therapy, endoscopic score and histologic score were significantly improved. Oesophageal biopsies increase the diagnostic accuracy of upper endoscopy. Histologic grading is often much more important than the endoscopic appearance, so that endoscopic oesophageal biopsies are very important aids in the diagnosis of oesophagitis. Appropriate clinical evaluation of symptoms must occur before endoscopic examination.
The European Journal of Surgery, 1999
Objective: To achieve hepatic portal revascularisation and decompression of extrahepatic portal h... more Objective: To achieve hepatic portal revascularisation and decompression of extrahepatic portal hypertension in children with cavernoma and obstruction caused by idiopathic portal vein thrombosis. Design: Selected cases. Setting: Teaching hospitals, Belgium and Italy. Subjects: 11 children who weighed between 5.9 and 54 kg (2 emergencies) with symptomatic extrahepatic portal hypertension. Intervention: Interposition of venous autograft between the superior mesenteric vein and the distal (umbilical) portion of the left portal vein. Main outcome measures: Improvements in symptoms and endoscopic appearance after operation. Results: 2 bypasses had to be redone because they stenosed; all 11 were patent at the time of writing (median follow-up 6 months, range 1-32 months). Conclusion: The bypass effectively relieved symptoms of extrahepatic portal hypertension by restoring normal hepatic portal blood flow.
Journal of Cystic Fibrosis, 2008
Posters S25 limits, a known low risk metastasis disease in papillary thyroid cancer, a chest X-ra... more Posters S25 limits, a known low risk metastasis disease in papillary thyroid cancer, a chest X-ray unmodified and the description in the scientific literature of iodine-131 uptake in focal bronchiectasis mimicking metastatic thyroid cancer induced to monitor clinical status without further investigations. Her serum TG remained undetectable at sixmonth follow-up and I-131 whole-body at one-year follow-up showed the same lung focal hot spots. A chest computed tomography scan was performed confirming the presence of bronchiectasis involving both lung fields without evidence of pulmonary metastasis. Aberrant uptake of radioactive iodine is present not only in known inflammatory disease of the lung, aspergilloma and respiratory bronchiolitis but false positive iodine uptake can be present also in case of pulmonary involvement in CF.
La Pediatria medica e chirurgica : Medical and surgical pediatrics
Swenson's procedure, first described in 1948 for Hirschsprung's disease, consists in rese... more Swenson's procedure, first described in 1948 for Hirschsprung's disease, consists in resection of aganglionic intestine and distal colo-anal anastomosis provided a precise dissection of extra peritoneal rectum. Potential jeopardy of pelvic vessels and nerves stimulated alternative surgical techniques to prevent complications on bladder and genital function. We performed in laparoscopy Swenson's procedure after Toupet, taking advantage from closer view and magnification of this technique, in a 15 months girl. Laparoscopy simplified and made safer pelvic dissection and resulted in a better postoperative period and cosmetic outcome.
Surgical Endoscopy, 2004
Transanal endorectal resection and colonic pull-through (TERPT) is a good technique for the manag... more Transanal endorectal resection and colonic pull-through (TERPT) is a good technique for the management of Hirschsprung's disease. This procedure is feasible in the vast majority of patients and is associated with excellent results, early postoperative recovery, and no visible scars. We report the case of a patient who developed early postoperative severe constipation after TERPT due to unusual folding of the muscular cuff rim, which tightly narrowed the pulled-through colon. This complication was diagnosed and treated by laparoscopy. To prevent it, we recommend splitting of the aganglionic muscular cuff during TERPT.
Journal of Urology, 2009
Editorial Comment This is an important study on the ability of five common urological pathogens (... more Editorial Comment This is an important study on the ability of five common urological pathogens (Escherichia coli, Enterococcus faecalis, Klebsiella pneumoniae, Staphylococcus aureus and Pseudomonas aeruginosa) to adhere and form biofilms on commercially available ureteral stents. Also, it was evaluated the impact of heparin coating on stent compression, tensile and coil strength. This research opens new avenue to a very common and up-to-date problem that is bacterial encrustation and adhesion to stents. It could help modifications in stent design and also in developing drugs to inhibit bacterial adhesion and biofilm formation. I recommend this article as a reference for study design and methodology to all researchers interest in the issue of stent incrustation by bacteria.