Gossypibomas, among abdominal foreign bodies, represent a certain reality with significant legal implications. Prevention should prevail and all efforts should be made in such respect. Laparoscopic approach is possible in selected cases (small swabs, encapsulated, no complications).

Morgagni hernia occurs after a congenital retrosternal diaphragmatic defect; it is a rare form of diaphragmatic hernia (1-3% of cases). In general, this pathology is diagnosed in children; in adults it is frequently discovered in emergency or incidentally. We prospectively evaluated a series of 8 patients admitted to First Surgical Clinic, St. Spiridon Hospital, Iasi during the period 2011-2017. Out of 8 patients, 6 were operated on, one patient refusing surgery (followed periodically); the patient who was 91 years old had serious associated diseases that made surgery contraindicated. Symptomatology was nonspecific: in 5 cases Morgagni hernia was discovered during the exploration of an associated pathology, either with cardiopulmonary symptoms of dyspnea or palpitations. In 2 cases, the clinical aspect suggested an occlusive syndrome (the herniated organ is usually the transverse colon). The laparoscopic approach was used in all cases: two conversions were recorded due to the tight adherences of the herniated viscera (gastric, colon, epiplon). In 4 cases, the surgical cure of hernia was performed by suture and in 2 cases with prosthesis: dual mesh in one case and polypropylene mesh in another case. We did not register morbidity and the mean postoperative stay was 4 days (range 2-6 days). Hernia Morgagni betrays a rare pathology. The most common is asymptomatic but in complicated cases it is a cause of acute surgical abdomen. Surgical treatment is indicated even for asymptomatic cases due to serious complications Morgagni hernia may develop. The laparoscopic approach is ideal, as reduction of viscera in the abdomen is easy and the defect will be repaired by suturing or using a prosthesis, depending on its size.

This study shows that the laparoscopic approach for PPU is feasible; the procedure is safe, with no increased risk of duodenal fistulae or residual intraperitoneal abscesses. We now consider the laparoscopic approach for PPU as the "gold standard" in patients with Boey score 0 or 1.

Background. Pancreaticoduodenectomy is the potentially curative treatment for malignant and several benign conditions of the pancreatic head and periampullary region. While performing pancreaticoduodenectomy, early neck division may be impossible or inadequate in case of hepatic artery anatomic variants, suspected involvement of the superior mesenteric vessels, intraductal papillary mucinous neoplasm, and pancreatic head bleeding pseudoaneurysm. Our work aims to highlight a particular hind right approach pancreaticoduodenectomy in selected indications and assess the preliminary results. Methods. We describe our early hind right approach to the retropancreatic vasculature during pancreaticoduodenectomy by mesopancreas dissection before any pancreatic or digestive transection. Results. We used this approach in 52 patients. Thirty-two had hepatic artery anatomic variant and 2 had bleeding pancreatic head pseudoaneurysm. The hepatic artery variant was preserved in all cases out of 2 in which arterial reconstruction was performed. In nine patients with intraductal papillary mucinous neoplasms the pancreaticoduodenectomy was extended to the body in 6 and totalized in 3 patients. Seven patients with adenocarcinoma involving the portomesenteric axis required venous resection and reconstruction. Conclusions. Early hind right approach is advocated in selected cases of pancreaticoduodenectomy to improve locoregional vascular control and determine, safely and early, whether there is mesopancreas involvement.

Open Life Sci. 2016; 11: 524-532 while infections with E. granulosus s.s. which are highly infectious for humans are more commonly encountered in Romania and Hungary.Keywords: Echinococcus granulosus, genotype, DNA sequences, human, pig, central-eastern Europe IntroductionThe larval stages of the tapeworm Echinococcus granulosus sensu lato (s.l.) are the causative agents of cystic echinococcosis (CE), one of the most important cestode infections causing morbidity and mortality in humans and significant economic losses in livestock. Around one million or more people are currently suffering from CE globally and the financial burden of the disease on the livestock industry is substantial, with up to two billion dollars lost annually [1]. Recent molecular phylogenetic analyses have revealed that E. granulosus is a complex of spesies/genotypes with at least five different species: E. granulosus sensu stricto (s.s.) (genotypes G1-G3), Echinococcus equinus (G4), Echinococcus ortleppi (G5), Echinococcus canadensis (G6-G10), and Echinococcus felidis ("lion strain") [2][3][4].CE remains one of the most important helminth zoonoses in many regions of Europe, especially the Mediterranean littoral (Spain, Italy, Greece and Turkey) and southeastern countries such as Bulgaria and Romania. The disease seems to be less prevalent in the UK, Central Europe, the Baltic States and the Scandinavian countries [5,6]. Surveys that addressed the incidence of CE over the last decade from central-eastern Europe has reported a relatively greater incidence in Romania (average incidence annual rate was 0.29 per 100,000 population) and Ukraine (0.30), whereas in Hungary (0.07), Poland (0.08) and Slovakia (0.10) lower numbers of human cases were documented [7]. This also is due to the fact that E. granulosus s.s., which is responsible for the majority Abstract: Central-eastern Europe is an endemic region for cystic echinococcosis where multiple species of intermediate hosts are commonly infected with Echinococcus granulosus sensu lato tapeworms of major medical and veterinary importance. Investigations of the genetic variation of 25 Echinococcus isolates from five countries (Slovakia, Romania, Ukraine, Hungary, Poland) were undertaken using three mitochondrial DNA markers. The 18 isolates from pigs derived from Slovakia and Ukraine and the four human isolates from Slovakia, Poland and Ukraine were identified as E. canadensis G7, whereas the three human isolates from Romania and Hungary were classified as E. granulosus sensu stricto G1. This study reports the first confirmed human case of E. granulosus s.s. in Hungary. The haplotype G7A with two polymorphic sites relative to the most common regional variant of E. canadensis G7 was recorded in both pigs from Ukraine and in a single pig isolate from Slovakia. The results of this study support the circumstantial evidence that E. canadensis G7 with low infectivity for humans is highly prevalent in the northern parts of the region (Poland, Slovakia, forest-steppe zone of Ukraine),