Use of a polytetrafluoroethylene tube and patch in the repair of a difficult duodenal stump

In the cases where a primary anastomosis is unable after a duodenal resection, special care must be taken to avoid any complication in the duodenal stump such as suture dehiscence. Wall inflammation is an important factor in the development of this complication. We report a case of a 35-year-old woman who had previously undergone to pyloric exclusion due to a wall defect occurred after a bilio-digestive anastomosis, which complicated with a posterior duodenal stump dehiscence. The acute edema of the stump walls that resulted after it because exposure to bile conducted to heroic measures for its closure: first, the use of a polytetrafluoroethylene tube as duodenostomy and posteriorly a patch of the same material for its final closure. Both gave successful results in the repair of a refractory duodenal stump dehiscence.

Absceso hepático amebiano neonatal: presentación de un caso / Amebic liver abscess in newborn: report of a case

El abseso Hepático Amebiano (AHA) en neonatos es una patología no muy frecuentes. Existen pocos casos relatados en la literatura mundial. Se trata de un paciente de 20 días de nacido, femenino que presentó una masa abdominal palpable, deposiciones diarreicas amarillentas e icte'ricia. Una tomografía abdominal demostró una masa quistica localizada en el lóbulo hepático derecho. Los exámenes de laboratorio confirmaron la etiología amebiana. El tratamiento clínico instaurado fracasó y se procedió al tratamiento quirúrgico. Los resultados de patología confirmaron el diagnóstico de (AHA). Ocho días después de la resección quirúrgica el paciente falleció debido a una enterocolitis necrotizante.

Syphilitic rectal ulcer associated with perforation of the hard palate: case report

We report a case of a patient that presented with a perforated hard palate as a late complication due to an unsuspected syphilis. This disease first presented as a rectal ulcer which was misdiagnosed as an amebic proctitis. The patient received antiamebic treatment with a satisfactory outcome. He did not return for late control of the latter treatment and returned seeking medical advise six years later with the former complication. He tested positive for syphilis and appropiate treatment was performed. In addition, the ORL department recommended a palate prosthesis.

Helicobacter pylori en pacientes con gastritis y ulcera gástrica / Helicobacter pylori in patients with gastritis and gastric ulcer

Seventy patients symptoms and signs compatible with gastritis and/or peptic ulcer were included in the study; they were 41 women and 29 men, with an age range of 9-84 years, and they underwent upper endoscopy. Brushing of the antrum was performed and 4 biopsies were taken from it. With the gastric mucus, a smear was prepared for Gram staining; one sample of tissue was placed directly in urea medium and another tissue sample in Skirrow medium; and two samples of tissue were stained with Hematoxylin-eosin and examined under the light microscope. Those patients who were taking antibiotics capable of inhibiting growth of Helicobacter pylori (Hp), the last four weeks prior endoscopy, were excluded from the study. Twenty-six patients (37.1 percent) were positive (+) for Hp the culture in urea medium. Of these 26 patients, 15 (21.4 percent) were also positive by the Skirrow method, and 11 (15.7 percent) by Gram stain. Epigastric pain was the most predominant sympton in (+) patients (80.7 percent) and (-) patients (68.1 percent) for Hp. Superficial acute gastritis within the antrum was the most frequent endoscopic finding in (+) (84.6 percent) and (-) (68.1 percent) patients. Chronic superficial gastritis was the predominant microscopic finding in (+) (42.3 percent) and (-) (38.6 percent) patients as well. Microscopic examination was positive for Hp in 6 (23 percent) patients by H-E stain. According to these results, there was no statistically significant difference in symptoms, endoscopic and microscopic findings between positive and negative patients for Hp

Fístula colecisto-duodenal asintomática en una paciente con diabetes mellitus e hipotiroidismo primario: presentación de un caso / Asymptomatic cholecystoduodenal fistula in patient with diabetes mellitus and primary hypothyroidism: report of a case

The case of a 60-year-old woman with diabetes mellitus type II and primary hypothyroidism, who presented a clinical picture compatible with intestinal obstruction is reported. An abdominal sonogram revealed acute calculous cholescystitis and ileus. A plain film of the abdomen showed dilatation of small bowel loops. She underwent celiotomy, once stabilized, and gallstone ileus + cholecystoduodenal fistula were diagnosed intraoperatively. Resection of the ischemic segment of distal jejunum and the stone, cholecystectomy and primary repair of the fistula were performed. In spite of the systemic complications (metabolic, cardiovascular and pulmonary), that appeared postoperatively, the patient had a favorable outcome. This patient had an acute calculous cholecystitis anda spontaneous biliary-enteric fistula with intestinal obstruction, without preveious symptoms of biliary tract disease preceding the episode of bowel obstruction

Ascariasis de la vesicula biliar: reporte de dos casos y revisión de la literatura / Ascariasis of the gallbladder: report of 2 cases and review of the literature

Se relatan dos pacientes quienes presentaron un cuadro clínico compatible con colelitiasis; y, en quienes el diagnóstico de ascariasis de la vesícula biliar fue hecho sonográficamente. En el primer paciente, la colecistectomía fue curativa, y corroboró la presencia del parásito. En el segundo paciente, se administró citrato de piperazina. Un segundo sonograma realizado después del tratamiento, no reveló dentro de la vesícula biliar; y el paciente permanece asintomático hasta ahora. Se pone énfasis en la utilidad que la ultrasonografía brinda en el diagnóstico de la ascariasis de la vesícula, y durante la vigilancia en aquellos pacientes quienes son manejados con terapia médica solamente

Poliposis multiple familiar. / Familial multiple polyposis

La poliposis multiple familiar es una enfermedad hereditaria, autosomica, dominante, heterocigota, no ligada al sexo y que usualmente se desarrolla en la puberdad.Los pacientes que no son tratados oportunamente desarrollaron irremediablemente un gree y todos los miembros de la familia deben ser investigados. La enfermedad puede estar asociada a otros tipos de tumores los mismos que pueden presentarse concomitante con la poliposis, proceder a ella, o aparecer posteriormente, por lo que en presencia de caulquiera de estas patologias, debe investigarse la existencia de las otras. El tratamiento puede ser mediante proctocolectomia con ileostomia permanente o con conservacion del recto y anastomosis ileorectal o ileosigmoidea baja, con extirpacion y fulguracion de los polipos rectales previo a la colectomia o posterior a ella, segun las circunstancias Se debe practicar un control endoscopico periodico del segmento rectal preservado cada tres meses de por vida