Endoscopic management of symptomatic choledocholithiasis in pregnancy without the use of radiations.

We report a case of 26-year-old woman at 10th week of gestation with cholestatic jaundice due to a common bile duct (CBD) stone managed by endoscopical retrograde cholangiopancreatography (ERCP). The procedure was successfully carried out without the use of ionizing radiations and under trans-abdominal ultrasonographical (US) control. A few cases are reported in literature in which ERCP was performed without fluoroscopy examination. We believe that ERCP with US guidance is an effective and safe procedure to treat symptomatic choledocholithiasis in pregnant women.

Prevalence of Helicobacter pylori infection in two Spanish regions with different incidence of gastric cancer.

It is a cross-sectional study, comparing the prevalence of Helicobacter pylori infection (prevalence of IgG antibodies to H. pylori) in the healthy population of Ubrique and Grazalema (mountain location, mortality from stomach cancer 20/100,000) and in Barbate, (coastal location, mortality from stomach cancer 10/100,000) in the province of Cadiz, southern Spain. The subjects were randomly selected, 163 men and 169 women, 18 years or older; 179 persons were studied in the inland, and 154 in the littoral in January 1997. Of the 332 subjects investigated, 43% were positive, a mean antibody titer of 337 IU/1 (95 % CI: 254-420), and 56% were negative, with a mean titer of 18 IU/1 (95% CI: 15-19). In the coastal population, 30% has positive titers and 54% in the mountain location. By age: 18-40 years, 30% of littoral and 41% of inland population had positive titers; 41-60 years, 35% of those living in the littoral and 58% of inland population had positive titers; > 60 years, 24% of coastal inhabitants and 62% of those living in the inland had positive titers. Living in mountain locations in the province of Cadiz involves a greater ecological risk for H. pylori infection (p < 0.05).

[Subphrenic adipose tissue, an infrequent cause of increased distance between the diaphragm and liver. Radiological study and echographic comparison]. / Tessuto adiposo sub-frenico, causa non frequente di aumento della distanza tra diaframma e fegato. Studio radiologico e confronto ecografico.

Nine obese patients (4M/5F) showing on a standard chest-X-ray a right subdiaphragmatic radiolucent area were submitted to ecography. This method excluded pathologic causes and showed adipose tissue as the cause of the increased distance between diaphragm and liver. Besides, ecography showed some limits in the evaluation of adipose area, because of the difficulty in studying obese patients.