Variaciones de la configuración ductal pancreática: factor predisponente de pancreatitis recurrente / Variations of pancreatic ductal configuration: predisposing factor of recurrent pancreatitis

El páncreas es un órgano de origen endodérmico, que se desarrolla de dos esbozos intestinales separados, uno dorsal y otro ventral,a partir de la cuarta o quinta semana de gestación. El páncreas se origina en el intestino anterior en la parte correspondiente a lafutura segunda porción duodenal. Allí se originan dos brotes: uno posterior o dorsal que aparece a principios de la cuarta semanay crece rápidamente en el mesenterio dorsal y el otro brote es anterior o ventral. Este último da origen a dos brotes, uno origina unaparte del páncreas y otro a la vía biliar e hígado. Existen diferentes variantes anatómicas, derivadas de este desarrollo embrionario;su conocimiento es de vital importancia en pacientes con persistencia de dolor abdominal y episodios de pancreatitis recurrente.El objetivo de este artículo es una revisión de las variantes anatómicas del conducto pancreático que pueden manifestarse como pancreatitis idiopática recurrente. (AU)

The pancreas is an organ of endodermal origin, which develops from two separate intestinal sketches, one dorsal and one ventral,from the fourth or fifth week of gestation. The pancreas originates in the anterior intestine in the part corresponding to the futuresecond duodenal portion. There two shoots originate: one posterior or dorsal that appears at the beginning of the fourth week andgrows rapidly in the dorsal mesentery and the other outbreak is anterior or ventral. The latter gives rise to two outbreaks, oneoriginates a part of the pancreas and another to the bile duct and liver. There are different anatomical variants, derived from thisembryonic development; their knowledge is of vital importance in patients with persistent abdominal pain and episodes of recurrentpancreatitis. The objective of this article is a review of the anatomical variants of the pancreatic duct that can manifest as recurrent idiopathic pancreatitis. (AU)

Drenaje endoscópico de un quiste hidatídico fistulizado a la vía biliar intrahepática / Endoscopic drainage of a liver hydatic cyst open to intrahepatic bile ducts

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Tumor desmoide de pared abdominal. Reconstrucción con doble prótesis de PTFE y polipropileno / Demoid tumor or the abdominal wall. Reconstruction using both PTFE and polypropylene prostheses

Los autores presentan un caso de tumor desmoide de pared abdominal originado en una cicatriz quirúrgica antigua en una mujer de 32 años. Precisó varias intervenciones para la reconstrucción de la pared abdominal, por infección inicial del material protésico con Staphylococcus aureus, logrando eventualmente la reparación del defecto aponeurótico con la colocación combinada de una malla de politetrafluoroetileno expandido intraperitoneal y de polipropileno extraperitoneal por debajo del tejido subcutáneo (AU)

Neumatosis portal hepática secundaria a diverticulitis del colon sigmoide / Hepatic portal pneumatosis secondary to sigmoid colon diverticulitis 299

Los autores presentan un caso de neumatosis del sistema portal y venoso hepático como consecuencia de una diverticulitis del colon sigmoide en un varón de 59 años. La enfermedad se inició con fiebre en agujas de origen incierto durante 3 semanas. El diagnóstico se sospechó al realizar una TAC que puso de manifiesto gas en el parénquima hepático, en la vena mesentérica inferior y en el mesocolon sigmoide. La laparotomía confirmó la presencia de un absceso entre las hojas del meso del sigma con fistulización a los vasos sigmoideos y tromboflebitis séptica de la vena mesentérica inferior (AU)

[Acute abdomen as a complication of a duodenal duplication cyst]. / Abdomen agudo como complicación de un quiste de duplicación duodenal.

The authors report an exceptional case of acute abdomen caused by the necrosis and perforation of a duodenal duplication cyst in a 23 year-old-patient. The cyst was located at the anterior and lateral surface of the duodenum, between its first and second portion. The patient underwent a cephalic duodenopancreatectomy (Whipple's procedure) because of the intimate adherence of the necrotic and inflammatory mass to duodenum and head of the pancreas. The histological examination of surgical specimen confirmed the diagnosis, showing a cystic structure lined with an epithelium and a common muscle wall shared by the cyst and the duodenum. There was no communication between the cyst and duodenal lumen.

[Anisakidosis of the colon as a cause of acute abdomen]. / Anisakidosis del colon como causa de abdomen agudo.

We report a case of acute abdomen caused by the invasion of the ascending colon by larvae of Anisakis simplex in a 57 year-old-woman whose initial symptoms were colic abdominal pain, diarrhea and fever. The diagnosis was done by the histological study of the surgical specimen in which two parasites were morphologically identified in the submucosa. Although a causal relationship of the disease with the ingestion of crude fish could not be established initially, there were antecedents of ingestion of anchovy in vinegar (Engraulis encrasicholus) and dyspeptic symptoms for several months.

[True pancreatic cysts in adults]. / Quistes verdaderos del páncreas en el adulto.

True or congenital cysts of the pancreas in adults are extremely rare entities. We describe two cases of true cysts located in the head of the pancreas, which presented with symptoms of epigastric pain, palpable mass and jaundice. CT scan was useful to demonstrate the location and extent of the lesion and its relation with neighbouring structures, but failed to determine the nature of the cyst. Diagnosis was obtained by the histological study of the cystic wall at surgery.