4). Open(41) and laparoscopic (10) surgery were used. No mortality, morbidity -15(29%), fistula Grade B -4 (8%), Spleen infarctions-7 (14%), clinically significant spleen infarctions and splenectomies-0. CT and CTA revealed three types of splenic blood supply after DSPPSVR: with gastro-epiploic arcade (GEA) as a main collateral artery (n8, 16%), with short gastric arteries (SGA) as a main collateral (n6, 12%) and intermediate type (n36, 72%). Conclusion:In SPDP SVR in 1/3 of cases only GEA or only SGA are the main collaterals, supplying the spleen, in 2/3 of cases both ways are involved. CT and CTA are mandatory before abdominal surgery for patients after SPDP SVR.

We present the case of a 54-year-old female patient with a family history of multiple endocrine neoplasia type II, with a genetic study for MEN 2 IIA EXON 11, CG6B c634, onset with hypertensive heart disease and diastolic dysfunction, tomographic finding of bilateral adrenal tumor by imaging. A conventional transabdominal adrenalectomy was performed, finding a right tumor with a capsule corresponding to pheochromocytoma with a weight of 1,100 g of 14.5 cm of greater diameter with invasion of the capsule without breaking it, and a left adrenal tumor corresponding to pheochromocytoma with a weight of 950 g of 15 cm of greater diameter. Keywords: Pheochromocytoma, Multiple endocrine neoplasia, adrenalectomy, retroperitoneum, adrenal gland."

In the setting of abdominal blunt trauma, damage to the pancreas is a infrequent complication(0.2 / 3.1%), although when the spleen is damage the lesion to the tail of the pancreas is not as infrequent as the single pancreatic trauma alone. primary closure and repair in an unstable patient can be applied trying to prevent excessive surgical time, but with the risk of developing a pancreatic fistula in the post operative period. in the following case report, we present the case of a young male with splenic and pancreatic trauma, who developed a pancreatic fistula and that required multiple surgeries in order to control this serious complication.26 yo male who under went emergency laparotomy secondary to blunt abdominal trauma, with splenic and distal pancreatic injury, who after multiple surgeries developed type b pancreatic fistulae with impossibility to perform ercp with stent placement as a treatment, so he was referred to our service for surgical evaluation.Patient with adequate surgical evolution discharged 4 days after surgery without biochemical leak evidence, currently on 2nd month of followp as out patient with good clinical evolution.Surgical resection is a feasible as a secondary treatment for non endoscopicaly fitpatients for treatment pancreatic fistulae with good results in third level high volume centers.