[Anorectal diseases. Diagnosis and treatment]. / Enfermedades anorrectales. Diagnóstico y tratamiento.

The presentation of the book Enfermedades Anorrectales. Diagnóstico y tratamiento edited by Dr Fernando López-Ríos (Madrid: Harcourt Brace, 1999) consisted of two parts. In the first part, the structure, goals and characteristics of the work were explained by its editor. In the second part, after a brief survey of the history of colorectal surgery, Dr López-Ríos discussed the importance of understanding colorectal surgery as a subspecialization of general surgery.

[Carcinoma of the Vater's ampulla and colonic carcinoma with synchronous onset]. / Carcinoma de ampolla de Vater y carcinoma colónico de aparición sincrónica.

We report the case of a female patient who presented with a very unusual association: an early invasive adenocarcinoma of the ampulla of Vater and a synchronous carcinoma of the right colon, in the absence of familial polyposis coli. Six years before a hysterectomy was performed because of uterine leiomyomata. The treatment was a Whipple's resection and, after three months, a right colectomy.

[Massive lower digestive hemorrhage caused by jejunal cavernous hemangioma detected with scintigraphy]. / Hemorragia digestiva baja masiva debida a hemangioma cavernoso yeyunal no detectado por escintigrafía.

We report the case of a patient who needed urgent surgical assistance because of massive lower gastrointestinal hemorrhage secondary to a jejunal angiodysplasia (cavernous hemangioma). These lesions are a rare cause of gastrointestinal bleeding of obscure origin. The use of preoperative diagnostic techniques such as oral fiber-optic endoscopy, barium intestinal studies and scintigraphy have little value when the origin of lower gastrointestinal bleeding is in the small bowel. The best yield is obtained with celiac or superior mesenteric angiography. There are some cases in which only an exploratory surgical laparotomy is useful for the diagnostic supported by intraoperative enteroscopy guided by the surgeon.

[Intraoperative echography in the diagnosis of obstructive jaundice of undetermined cause]. / Aportación de la ecografía intraoperatoria en el diagnóstico de las ictericias obstructivas de causa no filiada.

Intraoperative ultrasonography was performed in a consecutive series of 11 patients with obstructive jaundice. On two occasions, the examination modified the preoperative diagnosis, diagnosing liver metastasis in a patient with hydatid cysts and in another by detecting gallstones in the main biliary duct in which ERCP was suggestive of an ampullary tumor. Ultrasound made a definitive diagnosis of choledocholithiasis in one case, and pancreatic carcinoma in three cases all of which had a preoperative diagnosis of biliary obstruction of undetermined cause. The examination defined accurately the level of obstruction and the extent of a carcinoma of the bile ducts in two patients and it helped in obtaining cytological samples from a pancreatic tumor mass. Its use is recommended when the cause of biliary obstruction cannot be accurately diagnosed preoperatively.

[Acute abdomen due to eosinophilic gastroenteritis. A study of 2 cases]. / Abdomen agudo por gastroenteritis eosinofílica. Estudio de dos casos.

Report of two cases of eosinophilic gastroenteritis. In both cases the presentation was an acute abdomen syndrome. The etiological diagnosis was postoperative, because in the preoperative period there were no data characteristic of this entity. Probably this disease is more frequent than reported and although the treatment is medical, there are some cases in which surgery is justified.

[Localized giant pseudopolyposis in Crohn disease]. / Pseudopoliposis gigante localizada en la enfermedad de Crohn.

A case is presented of Crohn's disease of prolonged evolution in a 32-year-old male, with clinical manifestations of intermittent obstruction due to localized giant pseudopolyposis in the colon. The bibliography is reviewed, anatomophathologic aspects are analyzed and the problems of differential diagnosis are remarked.