Randomized clinical trial with topical diltiazem for post-hemorrhoidectomy wound healing. / Ensayo clínico aleatorizado con diltiazem tópico para la cicatrización de heridas posthemorroidectomía.

Anal sphincter spasm contributes to the delay in surgical wound healing after hemorrhoidectomy. A prospective, experimental, randomized, double-blind trial was conducted on two groups of patients that underwent closed hemorrhoidectomy. There were 26 patients in each group. Group A received topical diltiazem in the anal region three times a day. Group B received a placebo. Cicatrization time was documented for 6 weeks through digital photography. Mean healing time for the group treated with diltiazem was 3.19 weeks (22.33±0.884 days) and 3.92 weeks (27.44±1.130 days) for the control group (p=0.012 95% CI). At week three, the wounds in 73.07% of the patients in the diltiazem group had healed, compared with 46.15% of the patients in the control group.

Topical diltiazem for pain after closed hemorrhoidectomy. / Diltiazem tópico en el dolor postoperatorio de hemorroidectomía con técnica cerrada.

BACKGROUND: Anal sphincter spasm contributes to the appearance of postoperative pain following hemorrhoidectomy. AIM: To determine the efficacy of topical diltiazem in the control of post-hemorrhoidectomy pain. MATERIAL AND METHODS: A randomized, prospective, experimental, double-blind study was conducted on 2 groups of patients in the postoperative period of closed hemorrhoidectomy. Each group consisted of 17 patients. Group A received topical diltiazem in the anal region 3 times a day and group B received a placebo. Ketorolac was administered to both groups as rescue therapy. RESULTS: In group A, the mean score on the visual analog scale was 2.97±1.18cm at 24h, 1.51±1.18cm at 48h, and 0.84±0.92cm at 72h. In group B, it was 6.82±1.9cm at 24h, 5.3±1.66cm at 48h, and 4.32±2.13cm at 72h (P<.001, 95% CI). The mean number of analgesic doses in group A was 2.41±0.87 at 24h, 1.11±0.85 at 48h, and 0.94±0.96 at 72h. In group B, it was 3.82±0.52 at 24h, 3.64±0.70 at 48h, and 2.88±1.26 at 72h (P<.001, 95% CI). CONCLUSIONS: In this study, topical administration of diltiazem resulted in a statistically significant reduction of postoperative pain in patients that underwent closed hemorrhoidectomy.

[Perianal cutaneous amebiasis. Report of two cases]. / Amibiasis cutánea perianal. Informe de dos casos.

Perianal cutaneous amebiasis is a rare entity, with 0.03% to 0.07% reported incidence. We present two cases of perianal cutaneous amebiasis, both in male patients. Diagnosis was established by biopsy, with demonstration of Entamoeba histolytica trophozoites. Treatment with metronidazol was performed with good outcome. Although incidence of perianal cutaneous amebiasis is low, this entity must be kept in mind when painful atypical ulcers appear in this region. Diagnosis must be confirmed by identification of the parasite and treatment must be established with antiamebic extra-luminal drugs.

[Meckel diverticulum in patients older than 85 years.]. / Divertículo de Meckelen pacientes mayores de 85 años.

Meckel's diverticulum is an uncommon cause of acute abdominal pain in patients older than 85 years old. We present two female patients, older than 85 years old, treated surgicaly with symptomatic Meckel's diverticulum. This diagnosis wasn't suspected in a preoperative way in both cases. Complications of Meckel's diverticulum are rarely considered in the geriatric population.

Colon por enema doble contraste en el enfermo pediatrico. / Colon by double contrast enema in pediatric patient

Se presenta la experiencia en 17 pacientes pediatricos estudiados en la practica privada, por medio de colon por enema con doble contraste encontrandolo de utilidad en el diagnostico de padecimientos congenitos poliposis unica y familiar multiple observando en la mayoria de los pacientes la asociacion de mas de un diagnostico. No se presentaron complicaciones atribuibles al procedimiento