ABSTRACT
Se presenta el caso de un paciente con dolor epigástrico de intensidad progresiva, cuyos estudios de imágenes revelaron la presencia de una lesión quística de la cabeza de páncreas. Se realizó una pancreato-duodenectomía. El estudio anatomopatológico reveló un quiste hidatídico de la cabeza de páncreas, siendo el primer caso publicado en nuestra literatura nacional.
We report a 56 years old male consulting for a progressive epigastric pain lasting eight months. An abdominal ultrasound and a magnetic resonance showed a cystic lesion in the head of the pancreas and bile duct dilatation. He was operated, performing a pancreatoduodenectomy with a Roux en Y gastrojejunoanastomosis. The patient has a postoperative pneumonia but the rest of the evolution was uneventful and was discharged at the tenth postoperative day. The pathological diagnosis of the surgical piece was a pancreatic hydatid cyst.
Subject(s)
Humans , Male , Middle Aged , Pancreatic Diseases/surgery , Pancreatic Diseases/diagnosis , Echinococcosis/surgery , Echinococcosis/diagnosis , Magnetic Resonance Imaging , Pancreatectomy , Treatment OutcomeABSTRACT
En este artículo, basado en el análisis retrospectivo de 67 tomografías computadas de abdomen-pelvis de los últimos tres años, presentaremos las características de la pared intestinal, en particular su coeficiente de atenuación, como metodología para orientar el diagnóstico diferencial de engrasamientos de la pared intestinal.
Background: CAT scan is used for the diagnosis of abdominal pain and bowel lesions. Bowel wall thickening is an unspecific finding, but the analysis of the radiological attenuation of the wall and its morphology can be helpful diagnostic hints. Aim: To analyze the diagnostic value of radiological attenuation of bowel wall thickenings. Material and methods: Retrospective review of 67 CAT scans (performed in 44 women and 23 males, aged 12 to 89 years), where a bowel wall thickening was observed. The intensity of radiological attenuation of thickening was grouped in five categories, from white to black and denominated as white, grey, water hale, fat hale and black patterns. Results: The most common patterns observed were grey and water hale in 42 and 43 percent of cases, respectively. These patterns corresponded mostly to inflammatory, infectious, vascular and tumor lesions. Ischemic intestinal lesions had a white pattern. Conclusions: The radiological attenuation pattern of bowel wall thickenings can be helpful for etiological diagnosis.
Subject(s)
Humans , Male , Adolescent , Adult , Female , Child , Middle Aged , Aged, 80 and over , Intestinal Diseases , Tomography, X-Ray Computed , Intestinal Diseases/pathology , Pelvis , Radiography, Abdominal , Retrospective StudiesABSTRACT
Background: Interpretation of abnormal foci with high tracer uptake may require morphological correlation. Fusion of functional images obtained by single photon emission computed tomography (SPECT) and anatomical images obtained by computed tomography (CT) or magnetic resonance (RM) allows an integrated comprehension of complementary information. Aim To demonstrate that SPECT/CT fusion with external markers is useful in clinical practice to clarify the location and pathological meaning of questionable foci. Material and methods: Thirty four pairs of images from separate equipments (31 SPECT/CT and 3 SPECT/RM) pertaining to 29 patients, were fused. Fifty one foci of abnormal tracer uptake of uncertain pathological meaning were analyzed. These were classified before and after the fusion as probably malignant or probably benign. Results: Seventy percent of patients had a differentiated thyroid carcinoma. The fusion localized 100 percent of foci. Nine percent had a normal and 26 percent an abnormal anatomy. Before fusion 82 percent of foci were classified as potentially malignant. This figure changed to 59 percent after the fusion (p <0.01). Therefore the suspicion of malignancy was presumptively confirmed in 72 percent of foci and fusion results would have reached a 27 percent of incremental diagnostic value in 14 cases that changed of category (11 with differentiated thyroid carcinoma, one with colorectal cancer, one with a nasalEwingsarcoma and one with a brain tumor). Conclusions: The fusion of SPECT and CT is useful in selected patients, specially those with differentiated thyroid carcinoma. The fusion of SPECT and RM is also feasible.
Subject(s)
Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Carcinoma/diagnosis , Magnetic Resonance Imaging/methods , Radiopharmaceuticals , Thyroid Neoplasms/diagnosis , Tomography, Emission-Computed, Single-Photon/methods , Tomography, X-Ray Computed/methods , Carcinoma , Carcinoma , Image Enhancement/methods , Iodine Radioisotopes , Retrospective Studies , Sensitivity and Specificity , Subtraction Technique , Thyroid Neoplasms , Thyroid NeoplasmsABSTRACT
Background: Surgeons and radiologists commonly believe that common bile duct dilates after cholecystectomy. Aim: To measure common bile tract diameter before and 12 years after a cholecystectomy for cholelithiasis. Material and methods: Prospective study of 85 patients (aged 20 to 71 years, 68 fenmales) subjected to a cholecystectomy and followed for 12 years. AH were asymptomatic and had abdominal ultrasound to measure common bile duct diameter, seven days before and 12 years after the surgical procedure. Results: Common bile duct diameter before and 12 years after surgery was 4.6+0.9 and 5.0+1.8 cm respectively (p=NS) among 69 patients aged íess than 60 years. The figures for 16 patients aged more than 60 years were 5+0.8 and 6.7+1.9 (p <0.03). Conclusions: Among patients below 60 years of age there is no significant change in bile duct diameter 12 years after surgery. In subjects over 60 years of age there is a significant increase in this diameter.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Cholecystectomy , Cholelithiasis/surgery , Common Bile Duct , Age Factors , Chi-Square Distribution , Cholecystectomy/adverse effects , Common Bile Duct/surgery , Dilatation, Pathologic/etiology , Dilatation, Pathologic , Follow-Up Studies , Postoperative Period , Prospective StudiesABSTRACT
Abstract: The development of the US and CT has increased the request of exams to confirm or to discard the diagnosis of acute abdomen of appendicular origin. The objective of this paper is to characterize the appendix normal findings in helical unenhanced CT. 235 computed CT were reviewed. The average diameter of the appendix was of 6,18mm, with a standard deviation of 1,29mm; air was seen at the appendix lumen in 76% of them. The periappendicular fatty was normal in 98,9% of the patients.
El desarrollo del ultrasonido (US) y tomografía computada (TC) ha aumentado la solicitud de exámenes para confirmar o descartar el diagnóstico de abdomen agudo de origen apendicular. El objetivo del trabajo es caracterizar los hallazgos del apéndice normal en TC helicoidales efectuadas sin contraste. Se revisaron 235 TC. El diámetro promedio del apéndice fue de 6.18 mm con una desviación estándar de 1.29 mm; el 76% de ellos presentaban aire en su interior. En el 98.9% de los pacientes, el tejido adiposo periapendicular fue normal.
Subject(s)
Humans , Appendix/diagnostic imaging , Tomography, X-Ray Computed/methods , Abdomen, Acute/diagnostic imaging , Sensitivity and SpecificityABSTRACT
Due to the development of multidetector computed tomography, digestive tract pathology can now be better studied, being specially accurate, in diagnostic and staging of malignancy. We discussed imaging characteristics of the most common gastric malignancy, adenocarcinoma, emphasizing studying techniques and findings.
El desarrollo de la tomografía computada multidetector ha permitido estudiar de mejor manera la patología del tubo digestivo, siendo de especial utilidad en el diagnóstico y la etapificación de las neoplasias malignas. Se discuten las características epidemiológicas y en exámenes de imagen del adenocarcinoma gástrico, la principal neoplasia gástrica maligna, de alta incidencia en Chile, con énfasis en la técnica del estudio y los hallazgos tomográficos pre y postoperatorios.
Subject(s)
Humans , Stomach Neoplasms/diagnostic imaging , Adenocarcinoma/diagnostic imaging , Tomography, X-Ray ComputedABSTRACT
El estudio radiológico del intestino delgado ha sido históricamente difícil debido a sus complejas características anatómicas. El desarrollo de la Tomografía Computada (TC) ha revolucionado el estudio de la patología abdominal en general y en la actualidad, gracias a la Tomografía Computada Multidetector (TCMD) es posible la caracterización de la mayor parte de los trastornos que afectan al intestino delgado. En la obstrucción intestinal la TCMD permite determinar con claridad el sitio exacto de la obstrucción, e identificar sus complicaciones intra abdominales. La enteroclisis por tomografía computada recientemente desarrollada es un método ambulatorio y bien tolerado que ha demostrado ser de extraordinaria ayuda para la identificación y caracterización de las neoplasias de intestino delgado, la enfermedad de Crohn y estudio de la obstrucción intestinal incompleta. Finalmente el desarrollo de la angiografía por tomografía computada permite estudiar la isquemia mesentérica tanto del punto de vista vascular como de sus consecuencias en la pared intestinal y demás órganos intra abdominales en un mismo tiempo.
The radiological study of small intestine has been historically difficult due to its complex anatomical characteristics. Development of Computed Tomography (CT) has revolutionized the study of the abdominal pathology in general. Now thanks to Multidetector Computed Tomography (MDCT) is possible the characterization of the pathology that affect the small intestine. In the intestinal obstruction the MDCT allows to clearly determine the exact site of the obstruction and identify its intra abdominal complications. Recently development of enteroclisis for computed tomography is an ambulatory well tolerated method that has shown the extraordinary help for identification and characterization of small intestine neoplasias, Crohn disease and study of incomplete intestinal obstruction. Finally, the development of computed tomography angiography allows to study mesenteric ischemia as much as the vascular point of view and its consequences in the intestinal wall and other abdominal organs at the same time.
Subject(s)
Humans , Male , Female , Intestine, Small , Tomography, Spiral Computed , Inflammatory Bowel Diseases/diagnosis , Intestines , Intestinal Neoplasms/diagnosis , Intestinal Obstruction/diagnosis , TomographyABSTRACT
Colonoscopía virtual o colonografía por tomografía computada es una técnica prometedora para la investigación del cáncer colorectal, basada en la evidencia de que la detección temprana de pólipos adenomatosos, reducirá la gama de la mortalidad. Desde 1994 ha experimentado un desarrollo notable con avances tecnológicos en software y en hardware, que ha permitido la obtención de imágenes de alta calidad, comparables con colonoscopía convencional. La mayor parte de los cánceres colorectales se originan de los pólipos adenomatosos que se desarrollan y crecen lentamente durante muchos años. La detección y el retiro de estas lesiones podían prevenir el desarrollo del 95 por ciento de los cáncer de colon(2). Los adenomas se dividen en tres grupos: tubular que representan el 80 - 85 por ciento de los pólipos adenomatosos, es más pequeño que 10 milímetros y se asocia a los grados bajos de displasia; tubulovellosos, que representa el 15 por ciento de los pólipos adenomatosos, tiende a ser mayor (> 10 milímetros) y ello se asocia a los altos grados de displasia y vellosos, que representan menos del 5 por ciento de los pólipos adenomatosos, son generalmente de gran tamaño (2 - 3 centímetros.) y tienen un mayor riesgo del malignidad. Saber el tipo de adenoma permite definir el tratamiento a seguir.
Virtual colonoscopy or colonography by computed tomography is a promising technique for screening of colorectal cancer, based in the evidence that early detection of denomatosous polyps will reduce the range of mortality. Since 1994 it has experienced a remarkable development with technological advances in software and hardware, which has allowed the obtaining of comparable images of high quality with conventional colonoscopy. Most of the colorectal cancers are originated from adenomatosous polyps that are developed and grown slowly during many years. The detection and removal of these lesions could prevent the development of 95 percent and more of colonic cancer. The adenomas are divided in three groups: tubular, which represent the 80 85 percet of the adenomatosous polyps, are smaller of 10 mm and they are associated to low degrees of displasia; tubulovellosos, which represent 15 percent of the adenomatosous polyps, tend to be greater (> 10 mm) and they are associated to high degrees of displasia and vellosos, represent less of 5 percent of the adenomatosous polyps, are generally of great size (2 - 3 cm.) and have a greater risk of malignancy. Knowing the type of adenoma is the treatment that will be decided to follow.
Subject(s)
Humans , Male , Female , Colonography, Computed Tomographic , Colorectal Neoplasms/diagnosis , Colonic Neoplasms/diagnosisABSTRACT
El desarrollo de la resonancia magnética ha permitido estudiar y caracterizar la mayor parte de las enfermedades hepáticas con mayor sensibilidad y especificidad que los demás métodos de estudio por imágenes, evitando los riesgos de exposición a la radiación ionizante y al medio de contraste yodado propios de la tomografía computada. Se describen las principales indicaciones de la resonancia magnética para el estudio de las lesiones focales benignas y malignas del hígado, como hemangioma, hiperplasia nodular focal, adenoma y carcinoma hepatocelulares, colangiocarcinoma intra hepático y metástasis, y la utilidad de la resonancia magnética en el diagnóstico y seguimiento de la enfermedad hepática difusa, tanto inflamatoria como metabólica.
The development of the magnetic resonance has allowed to study and characterize the hepatic diseases with greater sensitivity and specificity than the other methods of study, avoiding the risks of ionizing radiation. We discuss the main indications of the magnetic resonance for the study of the benign and malign lesions of the liver, like hemangioma, focal nodular hiperplasia, adenoma, hepatocarcinoma, colangiocarcinoma and metastasis, also the utility of the magnetic resonance in the diagnosis of the diffuse hepatic disease.
Subject(s)
Humans , Female , Pregnancy , Liver Diseases/diagnosis , Liver/pathology , Magnetic Resonance Imaging , Liver Neoplasms/diagnosisABSTRACT
El tránsito de intestino delgado con sulfato de bario permite una adecuada visualización de las alteraciones endoluminales, pero con limitaciones tales como no visualizar el compromiso y extensión extraparietal. La Resonancia Magnética aparece como una alternativa, con beneficios como evitar radiación y permitir la evaluación de detalles anatómicos de la pared intestinal y estructuras adyacentes. En once pacientes con alteración del tránsito intestinal, se realizó resonancia magnética, usando agua en un volumen de 1500 cc como contraste oral administrado en un corto período de tiempo, obteniendo imágenes en resonador de 1.5 Tesla, con gradiente de 25 mT/m. Las imágenes se compararon con estudio de intestino con bario para determinar tiempo de tránsito, parámetros de distensión y caracterización de la patología. Una correlación de 90.9 por ciento y un valor Kappa de 0.82 (correlación excelente) del intestino delgado patológico y de las estructuras extraluminales adyacentes se logró con resonancia magnética, haciendo de esta técnica una alternativa válida y efectiva al estudio convencional del intestino delgado con bario en nuestra serie; sin embargo se requieren estudios con muestras mayores para confirmarla.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Adenoma/diagnosis , Crohn Disease/diagnosis , Intestine, Small/pathology , Intussusception/diagnosis , Jejunal Neoplasms , Water , Magnetic Resonance Spectroscopy/methods , Magnetic Resonance Spectroscopy , Contrast Media/administration & dosage , Contrast Media/therapeutic use , Barium SulfateABSTRACT
El hígado graso es una entidad patológica que se caracteriza por acumulación de glóbulos de grasa dentro de los hepatocitos. Es una patología que en ultrasonido se diagnostica cada vez más, sin embargo es necesario usar algunos criterios para su diagnóstico. Nuestro objetivo fue estandarizar criterios ultrasonográficos, correlacionándolos con anatomía patológica, para diagnóstico de esteatosis y su cuantificación en grados de severidad (leve, moderado, severo). Este estudio mostró una concordancia moderada entre el ultrasonido y biopsia.
Subject(s)
Adult , Fatty Liver/pathology , Fatty Liver , Ultrasonography , Biopsy , Evaluation StudyABSTRACT
Introducción. Existe controversia en el algoritmo de estudio de obstrucción de la vía biliar (VB). La colangiopacreatografía endoscópica retrógrada (ERCP) ha sido el examen de referencia. La colangioresonancia (CPRM) es un examen no invasivo con buena correlación entre observadores al evaluar la VB, pero aún cuestionada en nuestro medio por su mayor costo. El US convencional focalizado detecta dilatación de VB y disminuye los costos del algoritmo de estudio, seleccionando los pacientes que debieran referirse a otros métodos de estudio más costosos o invasivos (CPRM-ERCP). Objetivo. Comparar la validez, valores predictivos y cambios de probabilidad post-test de CPRM y US focalizado a la VB, en el estudio de pacientes con ictericia o sospecha de obstrucción biliar. Materiales y métodos. Se realizó un ensayo clínico pareado ciego. La muestra la constituyeron pacientes con sospecha de patología obstructiva de la VB a los cuales se les solicitó CPRM entre Enero-Julio 2003. Se les realizó US 24 hr antes o después de la CPRM por ecografistas de diferente experiencia. La CPRM se realizó con protocolos estándar, se registró el uso de Gadolinio y secuencias adicionales. El estándar dorado lo constituyeron la cirugía, la ERCP, seguimiento de al menos 30 días y revisión de informes de Anatomía Patológica. Se clasificó el riesgo de obstrucción de la VB en alto, moderado o bajo. Análisis. Se construyeron tablas de contingencia de 2x2 para estimar los valores del test: Sensibilidad (S), Especificidad (E), Valores predictivos positivo (VPP) y negativo (VPN), Likelihood ratios (LR) y probabilidades pre y post test. Resultados. Muestra constituida por 76 pacientes de los cuales 64 han completado el seguimiento. En el grupo de Alto riesgo en 21 pacientes se comprobó obstrucción, en 1 de los de moderado, en ninguno de los de bajo riesgo y en 2 de los no clasificados. La prevalencia de obstrucción (probabilidad pre-test) fue de 24/64 (37.5 por ciento). El US encontró dilatación d
Subject(s)
Humans , Male , Adolescent , Adult , Female , Child , Middle Aged , Gallstones/diagnosis , Cholangiography/methods , Cholestasis/diagnosis , Bile Ducts , Likelihood Functions , Magnetic Resonance Imaging , Cholangiopancreatography, Endoscopic Retrograde/methods , Ultrasonography , Cost Efficiency Analysis , Choledocholithiasis/diagnosis , Follow-Up Studies , Jaundice/diagnosis , Predictive Value of Tests , Risk Factors , Sensitivity and SpecificityABSTRACT
Background: The post cholecystectomy syndrome comprises a series of vague symptoms referred by patients subjected to this surgical procedure. These symptoms are unspecific and their association with the operation is dubious. Aim: To assess the frequency of digestive symptoms among patients subjected to a cholecystectomy ten years ago. Patients and methods: One hundred patients subjected to a cholecystectomy between 1987 and 1990, were contacted by mail. They were invited to a clinical interview and to an abdominal ultrasound examination. Results: Two invited patients had died of an acute myocardial infarction. Therefore, 98 patients (78 women), aged 30 to 85 years old, were assessed. Seventy two percent had diverse dyspeptic symptoms, 90 percent had no food intolerance and 94 percent had gained weight after the operation. Ninety six percent was satisfied with the surgical results, 3 percent had severe symptoms due to gastroesophageal reflux or depression. One patient had a residual choledocholithiasis and refused any treatment. Conclusions: Cholecystectomy is well tolerated and has good long term results
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Cholelithiasis/surgery , Cholecystectomy, Laparoscopic/adverse effects , Postcholecystectomy Syndrome/etiology , Postoperative Complications/epidemiology , Weight Gain , Cohort Studies , Treatment Outcome , Dyspepsia/etiology , Flatulence/etiology , Abdomen , Cholecystectomy, Laparoscopic/statistics & numerical dataABSTRACT
El rol de la radiología en el diagnóstico de la pancreatitis aguda (PA) y de sus complicaciones ya ha sido establecido. Las distintas clasificaciones que se han creado para determinar la gravedad de esta enfermedad (dentro de ellas la más conocida es la de Balhtazar) no se correlacionan adecuadamente con el manejo ni con el pronóstico del paciente. Por otra parte, muchos de los términos clínico-radiológicos para caracterizar las PA, no son ampliamente aceptados y más aún, son definidos en forma distintas por los diversos autores. El año 1992 el simposio sobre PA en Atlanta estableció una nueva clasificación con el fin de unificar criterios. Esta clasificación es usada en forma sistemática desde el año 1998 en el Hospital Clínico de la Universidad de Chile, existiendo una buena correlación con la evolución clínica de los pacientes. Se presenta la clasificación de Atlanta 1992, para su difusión y discusión en el resto de los servicio de imágenes del país
Subject(s)
Humans , Pancreatitis/classification , Clinical Evolution , Pancreatitis, Acute Necrotizing , Pancreatitis , Pancreatitis/complicationsABSTRACT
Background: morbidly obese subjects have a high incidence of complications. The poor results of dietary treatments, has prompted the search of new therapies for obesity and among these, surgical procedures. Aim: To report the long term results of horizontal gastroplasty with roux en Y anastomosis in morbidly obese subjects. Patients and methods: fifty patients with an initial body mass index of 41.3 ñ 6 kg/m2 have been subjected to a horizontal gastroplasty with roux en Y anastomosis. During the study period, surgical techniques were modified, reducing the gastric pouch size, adding a truncal vagotomy, cholecystectomy, and increasing the length of the roux en Y loop from 70 to 100 cm. Twenty five patients have been followed for two years. Results: There was no operative mortality and one patient had an anastomotic leak that required 35 days of hospitalization. During follow up, in one patient, the stapled suture line loosened. After two years of follow up, weight decreased from 112 ñ 19 to 77.2 ñ 14 kg. Conclusions: horizontal gastroplasty with roux en Y anastomosis achieved an adequate weight loss with a low rate of complications in this group of morbidly obese subjects
Subject(s)
Humans , Female , Male , Adolescent , Adult , Middle Aged , Anastomosis, Roux-en-Y , Gastroplasty , Obesity, Morbid/surgery , Anastomosis, Roux-en-Y/adverse effects , Gastroplasty/adverse effects , Follow-Up Studies , Treatment Outcome , Body Mass Index , Weight LossABSTRACT
Background: Sixty percent of adults has typical symptoms of gastroesophageal reflux in Chile. Aim: To report the clinical and laboratory features of patients with gastroesophageal reflux. Patients and methods: Five hundred thirty four patients (255 male) with gastroesophageal reflux were included in a prospective protocol that included clinical analysis, manometry and endoscopy in all patients, barium swallow in 427, scintigraphy in 195, acid reflux test in 359, 24 h pH in 175, and differential potential of gastroesophageal mucosa in 73 patients. Results: There was no correlation between the severity of symptoms and the endoscopical severity. Patients with Barret esophagus were 12 years older, were male in a greater proportion and had a higher proportion of manometrically incompetent sphincters than patients with esophageal reflux but without esophagitis or with erosive esophagitis. Severity of acid reflux, measured with 24 h pH monitoring was proportional to the endoscopical damage of the mucosa. There was a close relationship between the mucosal change limit determined with differential potentials and with endoscopy. No short esophagi were found. Conclusions: Patients with symptoms of gastroesophageal reflux must be assessed using several objective measures to determine the severity of their pathological alterations
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Gastroesophageal Reflux/diagnosis , Case-Control Studies , Esophagoscopy , Heartburn/epidemiology , Manometry , Esophagitis, Peptic/epidemiology , Barrett Esophagus/epidemiology , Deglutition Disorders/epidemiologyABSTRACT
The imaging diagnosis of begign and malign focal solid hepatic disease are analized by the authors
Subject(s)
Diagnostic Imaging/methods , Liver Neoplasms/diagnosis , Adenoma/diagnosis , Angiography , Carcinoma, Hepatocellular/diagnosis , Cholangiocarcinoma/diagnosis , Diagnosis, Differential , Hemangioma/diagnosis , Liver Neoplasms , Liver Neoplasms , Liver Neoplasms/classification , Nuclear Medicine , Magnetic Resonance Spectroscopy , Tomography, X-Ray Computed , UltrasonographyABSTRACT
Ninety two patients with cholelithiasis (57 female), aged 15 to 80 years old and that were not operated, were followed during a period of 9 to 14 years. Thirteen patients were initially asymptomatic. Of them, seven had complications or symptoms during follow up and 2 were operated. Among the 69 symptomatic patients, 38 (55 percent) were not operated and 17 (25 percent) did not have symptoms again. Ten patients died during follow up, 4 due to complications of biliary tract stones. The present finding suggest that the evolution of cholelithiasis in Chile is more aggressive than abroad and an early surgical treatment is warranted
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Cholelithiasis/epidemiology , Gallstones/epidemiology , Cholecystitis/epidemiology , Cholelithiasis/complications , Cholecystitis/complications , Follow-Up Studies , Cause of DeathABSTRACT
Laparoscopic antireflux surgery is a minimally invasive procedure that should have similar results than classical surgical treatment. To report the results of a prospective study of laparoscopic antirelux surgery, 32 patients with gastroesophageal reflux and without Barret's esophagus, were subjected to endoscopy, amnometry and measurement of intraesophageal pH before and after laparoscopic surgery. Tehre were no postoperative deaths or complications. Gastroesophageal sphincter pressure and abdominal sphincter lenght increased from 9.1ñ3.9 to 13.0ñ3.5 mm Hg and from 8.1ñ6.2 to 13.5ñ5.4 cm after surgery (p<0.01). There was a decrease in acid reflux in 82 percent of patients. In conclusion, laparoscopic antireflux surgery reproduces exactly the results of open surgical procedures
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Laparoscopy/statistics & numerical data , Gastroesophageal Reflux/surgery , Evaluation of Results of Therapeutic InterventionsABSTRACT
An epidemiological survey about the incidence of upper gastrointestinal bleeding during 3 periods (1980, 1985 and 1990), was performed in 9 chilean hospitals. Its annual incidence decreased in 1990, when compared to 1980. Likewise the etiologies changes, with an increase in the incidence of duodenal ulcers and a decrease in the incidence of erosive gastritis and bleeding of unknown origin in 1990. A seasonal variation with higher bleeding rates in autumn was also recorded