Enfermedad vesicular inaparente o microlitiasis en pacientes con pancreatitis aguda: una situación clínica frecuente / Occult gallbladder disease or microlithiasis in patients with acute pancreatitis: a frequent clinical situation

Patients admitted with the diagnosis of AP to a clinical hospital were included in the study. According to an abdominal ultrasound study, patients were classified as having or not cholelithiasis. A duodenal biliary drainage was performed in 15 patientes with AP and without gallbladder stones. Results: Patients without cholelithiasis had recurrent AP more often than patients with biliary AP (53 and 3.3 percent respectively). Excessive alcohol ingestion did not rule out the possibility of biliary etiology. In 6 patients, the analysis of duodenal bile showed cholesterol crystals, and cholecystectomy confirmed the existence of gallbladder disease in 54. All of them remained asymptomatic during a follow-up period of four years. One patient refused surgery, with subsequent development of galls tones and recurrent episodes of AP. In other 4 patients, gallbladder disease was confirmed by percutaneous gallbladder puncture or during cholecystectomy. No recurrence of AP were observed during the follow-up. Conclusions: Microlithiasis or "occult" gallbladder disease accounts for at least 67 percent of the original "non-biliary" AP. Duodenal bile analysis is a useful and necessary technique for the evaluation of patients with "non-biliary" actue pancreatitis. Careful clinical and echographic follow-up of this subgroup of patients with AP is mandatory

Manejo actual de la laringotraquebronquitis en niños / Present management of the laryngel-tracheal-bronchitis in children

Las enfermedaes respiratorias infantiles constituyen la causa más frecuente de consulta al pediatra. Las características anatómicas de la vía aérea, la predisposición alérgica y las condiciones epidemiológicas hacen al niño más vulnerable al contagio con agentes virales. La laringotraqueobronquitis es una enfermedad de etiología viral y su curso normal dura aproximadamente una semana, descartando el tratamiento antibióticvo, en la mayoría de los casos. La evaluación médica es el método de disgnóstico más importante. Las medidas generales de tratamiento, como ambiente tranquilo, estímulos mínimos y reducción de estrés y dolor, son factores que favorecen la regresión espontánea de la obstrucción de la vía aérea