[Evolution in the epidemiology of non-variceal upper digestive hemorrhage from 1985 to 2006]. / Evolución en la epidemiología de la hemorragia digestiva alta no varicosa desde el año 1985 hasta 2006.

OBJECTIVES: to describe changes occurred in the characteristics of patients suffering from non-variceal upper gastrointestinal bleeding, and in this condition s epidemiology. METHODS: a prospective study was carried out to examine the occurrence and causes of non-variceal upper digestive bleeding in the corresponding health department at Virgen de las Nieves Hospital in Granada, Spain. In this study three periods of time were compared. Group 1 (1985): 284 patients; group 2 (1996): 259 patients; and group 3 (2006) 291 patients. RESULTS: in group 1 the incidence was 71/100,000 inhabitants; in group 2, 64/100,000; and in group 3, 66/100,000. Mean age in 1985 was 57.4; in 1996, 59.6; and in 2006, 62.38. In all groups a majority of cases were men (75.4, 69.5, and 72.2%, respectively). Major causes included duodenal ulcer (1: 40.5%; 2: 43.2%; 3: 40.5%), gastric ulcer (1: 24.3%; 2: 30%; 3: 18.9%); LAMG (1: 53.3%; 2: 43.2%; 3: 9.6%); neoplasia (1: 1.7%; 2: 1.9%; 3: 5.2%), and vascular injuries (1: 0.5%; 2: 1.5%; 3: 9.3%). The death rate was 2.5% in 1985; 1.5% in 1996; and 1% in 2006. CONCLUSIONS: a significant increase in mean age over the years was detected. The most frequent cause of hemorrhage was duodenal ulcer followed by gastric ulcer. Of significance is an increase in the proportion of neoplasms above of vascular injuries in the later group as apposed to the earlier one. We found no significant difference in mortality between groups.

[Retrospective study of Crohn disease at a hospital in Andalucía (1978-1988)]. / Estudio retrospectivo de la enfermedad de Crohn en un hospital de Andalucía (1978-1988).

We reviewed 46 cases of Crohn's disease diagnosed during the period between 1978-1988, with the intention to analyse the age, sex, presentation, evolution, complications and diagnosis. The majority of patients were women, with a mean age of 39. In the last years we have seen an increment in our number of cases. The mean time to diagnosis was about 3.5 years. The main symptoms were abdominal pain, diarrhoea and loss of weight. The complications was of 40% in colonic disease and 75% when the affection was in ileum and colon. During the evolution 4 patients died, 2 of them from their Crohn's disease. One patient had a colonic carcinoma. In 15% of the cases there was a previous appendectomy. The most frequent radiological findings were in the small intestine: lack of haustration and cobblestone appearance. In the colon: lack of haustration and ulceration. The most frequent endoscopical findings were ulcers and a cobblestone appearance.

[Primary pulmonary hypertension associated with portal hypertension in a cirrhotic female patient]. / Hipertensión pulmonar primaria asociada a hipertensión portal en paciente cirrótica.

We present the case of a 28-year-old woman with hepatic cirrhosis, portal hypertension and hypersplenism associated with primary oligosymptomatic pulmonary hypertension, who had a survival somewhat longer than usual (10 years since she was diagnosed as pulmonary hypertension). The patient died in hepatic coma after upper gastrointestinal bleeding. The association between portal and pulmonary hypertension is rare, its true prevalence not being known and its pathogenesis being unclear. We remark the diagnostic tools and therapeutic possibilities.