[Occult bladder cancer in incarcerated inguinal hernia. Report of a case and review of the literature]. / Cáncer de vejiga oculto en hernia inguinal incarcerada. Aportación de un caso y revisión de la literatura.

OBJECTIVE: To describe a case of incarcerated inguinal hernia containing bladder carcinoma. METHODS/RESULTS: A case of urothelial bladder neoplasm presenting with perforation and scrotal abscess is described. The clinical features, incidence and diagnostic aspects are discussed and the literature briefly reviewed. CONCLUSION: The association of malignant tumor and hernia of the abdominal wall is uncommon, particularly those involving the inguinal zone. To our knowledge, only 8 cases have been reported from 1965 to 1995, accounting for 5.3% of all hernia sac-associated tumors. The location of this type of tumor delays diagnosis and the outcome is generally poor.

[Amyloid intestinal pseudo-obstruction as initial manifestation of IgA multiple myeloma]. / Seudo-obstrucción intestinal amiloidea como manifestación inicial de mieloma múltiple IgA.

Amyloidosis is a well known complication of Multiple Myeloma. Although involvement of the gastrointestinal tract is common in patients with Amyloid, severe symptoms are no frequent, nevertheless vascular deposits may produce gastrointestinal ischemia and bleeding and perforation. Injured mucosae of the intestinal well may produce malabsorption and the neuromuscular infiltration determine alterations of gastrointestinal motility. Although renal and cardiac disfunction is the most frequently cause of death in these patients, intestinal pseudo-obstruction bears a serious prognosis. We present a case of a patients who was operated because of a presumptive diagnosis of intestinal obstruction, which small bowel was infiltrated with Amyloid and which bone marrow demonstrated multiple myeloma.

[The effect of moderate surgical aggression on the immune system. The usefulness of the Multitest as a method for studying immune activity]. / Efecto de la agresión quirúrgica moderada sobre el sistema inmunitario. Utilidad del Multitest como método de estudio de la actividad inmune.

With the aim of studying the effect of moderate surgical aggression on the immunity system, a group of 22 patients was selected, who were not affected by immuno-depressive factors apart from the surgery itself. Changes in the nutritional state of these patients were analyzed using anthropometric, biochemical and immunity procedures, with regard to levels of immunoglobulin, complement and lymphocytic populations at different times during the first 30 postoperative days. Alterations were observed both in humoral and cellular immunity in the sense of temporary immunodepression. These changes were not reflected in the skin reaction tests to antigens in the Multitest (R). The origin and significance of postsurgical immunodepression was discussed, as well as the need for developing investigation models, both clinical and in the laboratory, in order to shed some light on the dilemma of the physiopathology of the immunity system in surgical patients.

[Chronic intestinal ischemia. Apropos of a case successfully treated with surgery]. / Isquemia intestinal crónica. A propósito de un caso resuelto satisfactoriamente mediante cirugía.

A case is presented of chronic intestinal ischemia due to arteriosclerotic obstruction of the celiac trunk and superior mesenteric artery. The diagnosis was reached by right transfemoral aortography. Surgical treatment was direct reimplantation of the superior mesenteric artery on the anterior aspect of the healthy aorta and installation of a retrograde Dacron graft between the aorta and common hepatic artery. The patient's postoperative course was satisfactory, with total remission of the symptomatology; revascularization was confirmed by a new aortography at six months. The diagnostic and therapeutic problems posed by this pathology are commented.