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Papers by Giuseppe Scalisi

World Journal of Gastrointestinal Endoscopy, 2013

The advantages of endoscopic retrograde cholangiopancreatography over open surgery have made it t... more The advantages of endoscopic retrograde cholangiopancreatography over open surgery have made it the predominant method of treating patients with choledocholithiasis. After sphincterotomy, however, 10%-15% of common bile duct stones cannot be removed with a basket or balloon. The methods for managing &amp;amp;amp;amp;amp;amp;amp;quot;irretrievable stones&amp;amp;amp;amp;amp;amp;amp;quot; include surgery, mechanical lithotripsy, intraductal or extracorporeal shock wave lithotripsy and biliary stenting. The case presented was a referred 82-year-old Caucasian woman with a 7-year-old plastic biliary endoprosthesis in situ. To the best of our knowledge the examined endoprosthesis is the oldest endoprosthesis in situ reported in the literature. Endoscopic biliary endoprosthesis placement remains a simple and safe procedure for patients with stones that are difficult to manage by conventional endoscopic methods and for patients who are unfit for surgery or who are high surgical risks. To date no consensus has been reached regarding how long a biliary prosthesis should remain in situ. Long-term biliary stenting may have a role in selected elderly patients if stones extraction has failed because the procedure may prevent stones impaction and cholangitis.

World Journal of Gastrointestinal Endoscopy, 2014

Pancreatic pseudocyst formation is a well-known complication of pancreatitis. It represents about... more Pancreatic pseudocyst formation is a well-known complication of pancreatitis. It represents about 75% of the cystic lesions of the pancreas and might be located within or surrounding the pancreatic tissue. Sixty percent of the occurrences resolve spontaneously and only persistent, symptomatic or complicated cysts need to be treated. Complications include infection, hemorrhage, gastric outlet obstruction, splenic infarction and rupture. The formation of fistulas to other viscera is rare and most commonly occurs within the stomach, duodenum or colon. We report a case of a patient with a pancreatic pseudocyst in communication with the common bile duct. There have been only few cases reported in the literature. We successfully managed our case by performing an endoscopic ultrasound-guided drainage of the pancreatic collection and a contemporaneous stenting of the common bile duct. Performed independently, both drainages are effective, safe and well-coded and the expertise on these procedures is widespread. By our knowledge this therapeutic approach was never reported in literature but we retain this is the most correct treatment for this very rare condition.

Journal of gastroenterology and hepatology, 2014

Digestive and Liver Disease, 2014

Gastroenterology Research and Practice, 2009

Background and Aim. Gallbladder wall thickening and impaired contractility are currently reported... more Background and Aim. Gallbladder wall thickening and impaired contractility are currently reported in cirrhotic patients and often related to portal hypertension and hepatic failure. The purpose of this work was to evaluate, by ultrasonographic method, gallbladder wall thickness and gallbladder emptying after a standard meal in normal subjects and in patients with compensated liver cirrhosis without gallstones. Methods. Twenty-three patients with Child-Pugh class A liver cirrhosis and twenty healthy controls were studied. Gallbladder wall thickness (GWT), gallbladder fasting volume (FV), residual volume (RV), and maximum percentage of emptying (%E) were calculated. Measurements of mean portal velocity, portal vein flow, and serum albumin were performed too. Statistical analysis was assessed by Student's "t test" for unpaired data. Results. GWT was 0.60±0.22 cm in cirrhotic patients and 0.21 ± 0.06 cm in controls (P < .0001). FV and RV were, respectively, 37.8 ± 3.7 cm 3 and 21.8 ± 3 cm 3 in cirrhotic patients, 21.9 ± 4.2 cm 3 and 4.6 ± 2.2 cm 3 in healthy volunteers (P < .0001). %E was smaller in cirrhotics (42.6 ± 7.8) as compared to controls (80.3 ± 7.2; P < .0001). Conclusions. In patients with compensated liver cirrhosis without gallstones gallbladder wall thickness is increased whereas its contractility is reduced. These early structural and functional alterations could play a role in gallstone formation in more advanced stages of the disease.

Journal of Medical Case Reports, 2011

Adrenal myelolipoma is a rare, benign neoplasm that is usually asymptomatic, unilateral and nonse... more Adrenal myelolipoma is a rare, benign neoplasm that is usually asymptomatic, unilateral and nonsecreting. It develops within the adrenal gland and is composed of mature adipose tissue with elements of the hematopoietic series. We describe the case of what is, to the best of our knowledge, one of the largest secreting adrenal myelolipomas reported in the literature. A 52-year-old Caucasian man of medium build who had had moderate hypertension for three years presented to our hospital. He had no other significant symptoms. His hypertension was pharmacologically treated. He came to our hospital to undergo abdominal ultrasonography during a clinical checkup. The ultrasound scan showed the presence of a voluminous hyperechoic mass interposed between the spleen and the left kidney. It was reported as a myelolipoma of the left kidney on the basis of its structural characteristics and position. Computed tomography confirmed our diagnosis. All preoperative biochemical tests were normal, with the exception of high serum cortisol, which was being overproduced by the lesion and was probably responsible for the patient&amp;amp;amp;amp;amp;#39;s hypertension. He underwent successful surgery, and his postoperative course was uneventful. The pathologic examination of the lesion confirmed the diagnosis of adrenal myelolipoma. The patient&amp;amp;amp;amp;amp;#39;s blood pressure returned to within the normal range. The &amp;amp;amp;amp;amp;quot;incidental&amp;amp;amp;amp;amp;quot; discovery of an adrenal mass requires careful diagnostic study to plan adequate therapeutic management. Both of the primary investigations at our disposal, ultrasound and blood tests (adrenal hormones), helped in rendering the diagnosis and allowed us to move toward the most appropriate treatment, taking into account the size of the tumor and its probable hormonal production.

European Journal of Gastroenterology & Hepatology, 2013

We report a case of an 84-year-old woman with a history of resected cutaneous melanoma who presen... more We report a case of an 84-year-old woman with a history of resected cutaneous melanoma who presented with asthenia, weight loss, and severe anemia. An esophagogastroduodenoscopy showed five black-pigmented submucosal tumors with large ulcerations in the antrum of the stomach and in the duodenum, suspected metastases from melanoma. Histopathological examination indicated the presence of melanin-containing tumor cells and confirmed an ulcerated pigmented melanoma. To examine the entire gastrointestinal tract, capsule endoscopy was performed and it showed a simultaneous massive involvement of the jejunum and ileum, with more than 40 lesions. This case highlights the importance of a complete endoscopic gastrointestinal examination in patients with melanoma metastatic to the bowel and suggests that capsule endoscopy is an easy, noninvasive, and effective diagnostic procedure to investigate small-bowel involvement.

Cases Journal, 2009

The case of an atypical hepatic angiocavernoma is referred. The lesion, first described as a hypo... more The case of an atypical hepatic angiocavernoma is referred. The lesion, first described as a hypoechogenic area compared to the surrounding parenchyma, with anechogenic shoots inside, suggestive for vascular structures developed one year later into a totally asonic area with frayed margins. This change is very unusual and uncommon for this kind of lesions.