A patient with hepatocaval injuries was treated successfully by direct suprahepatocaval hemostasis, and right lateral sectoriectomy after elective extrafascial clamping of Glisson's capsule. Anatomical conditions favorable for clamping were assessed from data in the published literature, and a personal series in which this technique was employed. A Gans' incision of at least 20 mm in length conditions the possibility of direct control of the right lateral pedicle, and was performed in 65 to 80 p. cent of cases. The proximal part of the incision reveals only the anterior border of the lateral pedicle where as the distal portion uncovers the first important right anterior pedicle of the segment VI, this being observed most frequently. At this level, extrafascial isolation of the lateral pedicle is usually rapid and precise (approximately 70 p. cent of cases). Adaptation of treatment of lesions of the homonymous sector is then possible under controlled surgical conditions of comfort and safety.

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[Localized cecal ischemia of primary appearance. A re-appraisal].

Localized ischemic lesions of the caecum should be classified among ischemic colitis. However, a separate study is justified to their original clinical presentation due to the fact that these lesions are, on one hand small, and on the other hand, sit in the right lower quadrant of the abdomen. For each of an appendicitis, operation will be performed quicker than in ischemic colitis in their usual presentation. The treatment is variable, including abstention, localized excision-suture, right hemicolectomy. Results are usually good. Coelioscopy in the future may have a place as in one of our three observations and must be evaluated.

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