[Surgical treatment of hypertrophic stenosis of the pylorus at a general surgery service]. / Tratamiento quirúrgico de la estenosis hipertrófica del píloro en un servicio de cirugía general.

The authors purpose was to demonstrate that pyloromyotomy can be successfully carried out by nonspecialist surgeons. Eighty three cases admitted over a twelve-year period to the Department of Pediatrics of Montecelo Hospital, a district general hospital, were reviewed. Extramucosal pyloromyotomy was performed by general surgeons under general anaesthesia in all cases. There were no deaths. Three infants had postoperative complications and required treatment. All cases underwent prophylactic antibiotics and no wound infections were recorded. When compared with other published series, our study shows that extramucosal pyloromyotomy can be carried out safely by general surgeons and that prophylactic antibiotic treatment can decrease morbidity. Postoperative complications are not related to damage of the duodenal mucosa or the type of skin incision.

[An experimental model of continuous biliary and vascular access in the free rat: a study of the changes in biliary function under the influence of the parenteral administration of amino acids]. / Modelo experimental de acceso biliar y vascular continuo en rata libre: estudio de las alteraciones de la función biliar por efecto de la administración de aminoácidos por vía parenteral.

Total parenteral nutrition is associated with different hepatic alterations such as cholestasis, steatosis or cholelithiasis. To study such alterations anaesthetised rats, in which the enterohepatic circulation of bile acids is interrupted, have been widely used. A model of free moving rat with venous and biliary catheterization has been developed in this work. This overcomes the interferences induced by anaesthesia as well the alterations in hydrostatic pressure or restraint-induced stress present in other models. The use of our animal model has confirmed previous data from anesthetised rats indicating that parenteral solutions of amino acids induce a cholestasis effect, with decreases in bile flow but not significant change in bile acid secretion.

[Enteral nutrition in the postoperative period: advantages of the polymeric diets over the elemental ones]. / Nutrición enteral en el postoperatorio: ventajas de las dietas poliméricas sobre las elementales.

The authors present their experience with catheter jejunostomy for post-operative enteral feeding in 74 cases. The patients were retrospectively divided into two groups according to the type of diet administered; the first group, of 8, received a second generation powdered elemental diet while the other, of 63, received a normocalorific polypeptide fluid diet. The aim was to compare the clinical differences between the contribution of elemental and polymeric diets. Of the 74 jejunal catheters, 3 were not used in the long run, while the overall figure of complications in the 71 remaining cases was 12% (9 patients): there were 3 cases of catheter complications and 6 of gastrointestinal complications which made it necessary to suspend the diet in 2 patients due to untreatable diarrhea (more than 4 movements per day), and in 4 due to clinical pictures of abdominal distension, pain and occasional vomiting. In analysing these complications in terms of diet type, it was found that in the first group (on oligomeric diets) 50% suffered gastrointestinal complications, i.e. 4 of the 8 (with diarrhea in 1 case and distension in 3), while only 2 of the patients, 3.2%, in the second group, of 63, suffered this type of complication. In conclusion, it is affirmed that the contribution of liquid polymeric diets significantly simplifies post-operative enteral nutrition, minimising intestinal complications.