[Morphopathological changes before and after biliodigestive derivation in experimental cirrhosis induced by biliary ligation in the rat]. / Cambios morfopatológicos pre y postderivación biliodigestiva en cirrosis experimental por ligadura de vía biliar en rata.

OBJECTIVE: Study of the hepatic morphological and biochemical changes in an experimental model of cirrhosis in rat by ligation of the common bile duct before and after bilioduodenal anastomosis. DESIGN: Ligation of the common bile duct in a group of 80 female Wistar rats during 30 days. Liver biopsy for histological studies and staining, blood samples for biochemical determination were taken, and a bilioduodenal anastomosis was constructed. 30 days later new liver specimens and blood samples were taken. A control group consisted of 10 rats. RESULTS: 30 days after biliary obstruction histological changes were characterized by occurrence of bile canalicular proliferation and portal fibrosis that rounded hepatic lobules. No well-defined nodules indicative of cirrhosis were seen. There was cholestasis with an increase in serum bilirubin, alkaline phosphatase and transaminase levels, and a decrease of albumin levels. Survival was 63.7%. Thirty days after biliary diversion (60 days after ligation) the normal lobular pattern was disorganized and regenerative nodules indicative of cirrhosis appeared, separated by narrow fibrous connective tissue septa, in 65% of rats. Bilirubin levels returned to normal values. Alkaline Phosphatase and transaminase levels remained high and albumin levels remained low. Overall survival was 25%. CONCLUSIONS: 30 days after biliary obstruction there are no regeneration nodules indicative of cirrhosis. There is a precirrhotic change, biliary fibrosis. Biliary diversion does not improve the histological changes and regeneration nodules and cirrhosis appear in 65% of animals.

[Acute lower massive digestive hemorrhage due to a jejunal angiomatoid hamartoma. Case report]. / Hemorragia digestiva baja aguda masiva debida a hamartoma angiomatoide yeyunal. Aportación de un caso.

Acute hemorrhage of the lower digestive tract is massive in 20% of the cases, requiring emergency surgery. In such cases, a preoperative diagnosis of the point of bleeding is essential. In order to determine this, any combination of oral panendoscopy, rectal sigmoidoscopy, colonoscopy, arteriography and isotopic studies should be used. The most frequent causes are right colonic angiodysplasia and colonic diverticulosis. The authors present a case of lower digestive bleeding due to an angiomatoid hamartoma located in the first jejunal segments, a rare pathology as a cause of hemorrhage. The diagnosis was obtained by selective arteriography. Oral panendoscopy and colonoscopy were also performed.