Objective. We conducted an extensive review of the literature and tried to cite the most recent recommendations concerning the pheochromocytoma (PHEO).Methods. Pub Med and Google Scholar databases were searched systematically for studies concerning pheochromocytomas (intra-adrenal paragangliomas) from 1980 until 2016. Bibliographies were searched to fi nd additional articles.Results. More than four times elevation of plasma fractionated metanephrines or elevated 24-h urinary fractionated metanephrines are keys to diagnosing pheochromocytoma. If the results are equivocal then we perform the clonidine test. If we have not done it already, we preferably do a CT scan and/or an MRI scan. Th e patient needs pre-treatment with α1-blockers at least 10-14 days before operation. Alternatives or sometimes adjuncts are Calcium Channels Blockers and/ or β-Blockers. Several familial syndromes are associated with PHEO and genetic testing should be considered.Conclusions. Th e biggest problem for pheochromocytoma is to suspect it in the fi rst place. Elevated metanephrines establish the diagnosis. With the proper preoperative preparation the risks during operation and the postoperative period are minimal. If there is a risk of the hereditable mutation, it is strongly suggested that all the patients with pheochromocytoma need clinical genetic testing.

Background and Objectives:The purpose of this study was to analyze the surgical technique, postoperative complications, and possible recurrence after laparoscopic ventral hernia repair (LVHR) in comparison with open ventral hernia repair (OVHR), based on the international literature.Database:A Medline search of the current English literature was performed using the terms laparoscopic ventral hernia repair and incisional hernia repair.Conclusions:LVHR is a safe alternative to the open method, with the main advantages being minimal postoperative pain, shorter recovery, and decreased wound and mesh infections. Incidental enterotomy can be avoided by using a meticulous technique and sharp dissection to avoid thermal injury.

The term “adrenal incidentaloma” is a radiological term. Adrenal incidentalomas are adrenal tumors discovered in an imaging study that has been obtained for indications exclusive to adrenal conditions (Udelsman 2001; Linos 2003; Bulow et al. 2006; Anagnostis et al. 2009). This definition excludes patients undergoing imaging testing as part of staging and work-up for cancer (Grumbach et al. 2003; Anagnostis et al. 2009). Papierska et al. (2013) have added the prerequisite that the size of a tumor must be “greater than 1cm in diameter”, in order to be called incidentaloma. Although in the most cases these masses are non-hypersecreting and benign, they still represent an important clinical concern because of the risk of malignancy or hormone hyperfunction (Barzon et al. 2003). Th e adrenal tumors belong to the commonest incidental findings having been discovered (Kanagarajah et al. 2012).

Gas gangrene is a life-threatening condition implying necrosis of dermis and hypodermis, along with necrosis of the superficial muscular aponeurosis. Fournier s gangrene is a subtype of the disease affecting the perineal and genital area. The aim of this study is to analyze the clinical presentation, diagnosis, medical, and surgical treatment of three cases of gas gangrene affecting uncommon locations in the human body, treated with extensive surgical debridement followed by the vacuum assisted closure method in two of these cases. Three cases of gas gangrene affecting uncommon locations treated surgically in our Department are presented. In one case the perineal and scrotal region was infected with invasion of the lateral abdominal wall and the peritoneal cavity. In the second case the axillary regions were infected bilaterally and in the third case the left axillary and subscapular regions were infected after a left arm disarticulation. All cases were treated successfully with successive surgical debridement and/or the vacuum-assisted closure method. Gas gangrene is a curable disease if diagnosed early and treated effectively with successive surgical wound cleaning and debridement. The vacuum assisted closure method can be helpful in promoting wound healing.

Primary aldosteronism is the most common and a treatable case of secondary hypertension. Only patients with unilateral adrenal diseases are eligible for surgery, while patients with bilateral and non-surgically correctable PA are usually treated by mineralocorticoid receptor antagonist (MRA). Thus, the distinction between unilateral and bilateral aldosterone hypersecretion is crucial.

Density less than 10 HU is in most cases characteristic of a lipid rich benign adenoma. More than 10 HU or/and history of malignancy raise the possibility for cancer. 1 mg dexamethasone test and plasma metanephrines should be done in all patients. If there is history of hypokalemia and/or resistant hypertension we test the plasma aldosterone to plasma renin ratio (ARR). Newer studies have shown that tumours even nonfunctioning and less than 4 cm may increase the metabolic risks so we may consider surgery at an earlier stage.

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