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On an average of 100,000 of livebirths congenital obstructive gastric syndromes range from 1 to 3 cases. The syndrome of the congenital antral membrane represents 5% of the total reported cases. It is mostly located 1 to 3 centimeters above the pylorus-duodenal connection and it may occur both in infants and toddlers. In very young patients it might be difficult to differentiate an hypertrophic stenosis of pylorus from a pyloric spasm. In older babies the obstacle to food passage may be moderate and the pathology may not be evident or it can be treated with simple medial therapy. This report presents the case of a 15 months old female with congenital antral membrane.

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A case of anal agenesia with recto-cutaneous fistula is presented. The recto-cutaneous fistula in an intermediate or high anomaly seldom noticed so that it is not included in the common classifications. The surgical approach performed by us was that described by Mollard. The anterior perineal pull-through, under proximal protective enterostomy, allow to reduce the rate of postoperative complications and sequences and obtain--as in our patient--a normal continence and sphincteric function with an excellent esthetic outcome.

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A very rare case of mesenteric teratoma, detected by routine ultrasound screening at 20 weeks' gestation, is reported. The patient, a male newborn delivered at 40 weeks' gestation in good condition, was successfully operated on at birth. The post-operative course was regular and the baby is currently doing well.

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Morgagni's hernia is an uncommon type of diaphragmatic hernia fairly exceptional in pediatric age. A case of Morgagni's hernia, observed by chance in a 15-month-old infant, is presented. The authors present the fundamental embryogenic stages of the diaphragm and stress the clinical manifestations and diagnostic procedures to reach the diagnosis, as well as the advantages of early treatment in order to prevent possible complications.

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The authors report their experience about 35 peripheric vascular injuries in childhood and adolescence. They analyze the epidemiological and clinical data and underline the usefulness of careful clinical and instrumental diagnosis. In order to obtain the best result they stress the importance of early revascularization by suturing in short lesions and by autologous tissue in longer lesions. Furthermore, they stress the importance of repairing venous injuries. Bone fractures have to be stabilized before vascular repair, subject to this not requiring prolonged ischemia. The authors conclude that only a multidisciplinary approach can ensure better results.

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A case of delayed separation of the umbilical cord is reported. Ultrasonography and radiographic examination of the stump showed connection with the bowel. During surgery the cord was found to contain the appendix. The authors hypothesize that this anomaly represents a small omphalocele, resulting from failure of the gut to withdraw completely from the umbilical cord, or, less likely, a hernia.

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The treatment of ten cases of ectopic anus is presented in this paper. The association of constipation with perineal anus due to alignment disturbance of the external sphincter triple loop system during evacuation has been described by Hendren (1978), Leape and Ramenofsky (1978), Upadhyaya (1984) et al. Hendren, Leape and Ramenofsky described two valid surgical techniques for this association. In this paper we describe the effect of non-invasive treatment in patients affected by symptomatic "primary" perineal anus. We also describe the effect of posterior anal transplant via the perineum in six infants and children with vulvar anus. This approach gave good results within three months without having to perform more complex operative techniques (Peña for example). Posterior anal transplant leads not only to an esthetic improvement but also to an improvement in fecal continence, which is sometimes deficient due to reduced anorectal angulation. It appears to us that an adequate perineal spur plays an important complementary role in the complex mechanism which controls fecal continence.

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The Authors shortly describe some essential aspects of the gall-bladder primitive cancer, and state their experience about 19 cases of malignant neoplasms observed out of 2280 operations on biliary duct. They confirm the extremely severe prognosis of such disease due to diagnostic delay. As a conclusion, they affirm the simple cholecystectomy is the choice operation in the precocious forms, and suggest the preventive cholecystectomy in the risk patients for such pathology.

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