[Acquired enterovesical fistulas]. / Fístulas enterovesicales adquiridas.

We report on 23 patients with acquired vesicoenteric fistula treated during the past 12 years: 48% of these were of inflammatory etiology (11 cases), 35% were caused by neoplasms (8 cases) and 17% were iatrogenic (4 cases). The most frequent symptoms were pneumaturia and fecaluria (78% of cases). Cystoscopy was the most useful diagnostic procedure in detecting fistula (13 of 18 cases). Other imaging techniques, though less effective for diagnosis, were useful in assessing the status of the GI tract and, at times, in determining the etiology of the fistulae. Treatment depends on the etiology, localization and patient general condition. The technique most frequently applied in our series was resection of the fistulous tract, together with the compromised intestinal segment, and bladder suture.

[The determination of tissue CEA in colorectal adenocarcinomas: an immunohistochemical study]. / Determinación del CEA tisular en adenocarcinomas colorrectales: un estudio inmunohistoquímico.

We carried out a CEA immunohistochemical study on 80 colorectal carcinomas, using the PAP methodology. Also we studied peritumoral "normal" mucosa on 69 cases. All tumoral (80/80) and the major part of normal colonic mucosa (68/69) cases stained positively. We present our experience with this immunohistochemical staining using a qualitative semi-quantitative evaluation, as an easy and reliable procedure. This permits to obtain, by immunostaining, a better homogeneous group of tumours (Apical, Mixed and Cytoplasmic, or Weak and Strong), necessary to further correlation with various tumoral parameters. On the basis of this evaluation, we found: A staining of weak intensity (65/68) of Apical type (55/68) in the vast majority of the normal, peritumoral mucosa. In tumors we found a prevalence of strong intensity (67/80), in relation to its major content of CEA. With respect to the type of immunostaining, although Apical staining (32/80) exists the Cytoplasmic (34/80) is predominant together with the Mixed type (14/80). This is expression of the alterations in secretion and distribution of the tissue CEA. We analyze the difficulties of such classification caused by the tumoral heterogeneity and we include other data whose significance is not always clear.

[Surgical treatment of Zenker's diverticulum. Apropos of 14 cases]. / Tratamiento quirúrgico del divertículo de Zenker. A propósito de 14 casos.

We present our experience in the surgical treatment of 14 cases of Zenker's diverticulum, diagnosed from January, 1969 to December, 1988. In 11 cases we performed one stage diverticulectomy; in 4 cases, manometric findings required cricopharyngeal myotomy. In 3 cases surgical treatment was not indicated; 2 patients had liver cirrhosis and high surgical risk and the third patient declined the treatment. Current treatment is discussed.