Spontaneous closure of a residual fistula after surgical closure of a traumatic aorto-right ventricular fistula. Report of one case We report a 16-year-old boy, who suffered a right ventricle penetrating injury caused by a sharp blade, that evolved to cardiac tamponade. He underwent surgery and was discharged four days later. Thirteen days later, a cardiac murmur was found. An echocardiography showed an aorto-right ventricular fistula. Surgical closure was performed through an aortotomy on cardiopulmonary by pass. The control echocardiography showed a small residual fistula, which closed spontaneously three months later.

Two stage hepatectomy and colectomy among patients with bilateral liver metastases. Report of eight cases Background: Two stage hepatectomy takes advantage of the compensatory regeneration of the liver after a fi rst non curative hepatectomy, to achieve a curative excision in a second intervention. Aim: To report an initial experience with two stage hepatectomy. Material and Methods: Out of sixty four patients who underwent hepatectomy in our institution in the presented period, eight met criteria for colorectal primary and bilateral liver metastatic disease, which we report. Results: Eight patients were subjected to a right portal ligation. In four, a simultaneous metastasis excision in the left lobe was performed. Four to eight weeks later, fi ve were subjected to a right hepatectomy. One patient, that had a relapse of a previous hepatectomy and colectomy, was explored, ligated and afterwards subjected to surgery plus radiofrequency. The six patients that were subjected to excisions were followed for 3 to 39 months. One patient died due to massive pulmonary relapse at 18 months, two were operated again and subjected to radiofrequency, without evidence of residual disease. Two patients have no evidence of relapse and one had a relapse in a rib. Conclusions: In our series, two stage hepatectomy among patients with colorectal cancer and liver metastasis, but its long term results must be evaluated.