[Bacterial translocation: the effect of supplements with dietary fiber in enteral diets in an experimental model of methotrexate-induced enterocolitis]. / Translocación bacteriana: efecto de los suplementos con fibra dietética a dietas enterales, en un modelo experimental de enterocolitis inducida por metotrexate.

Bacterial translocation, described by 1979 by Berg and Garlington as the movement of viable bacteria through anatomically intact intestinal mucosa to the mesenteric ganglia, is suspected of playing an important role in the development of sepsis with no apparent focus, fundamentally in polytraumatized and sever surgical patients: even now, with the wide range of antibiotic and chemotherapy agents available for treatment, this sepsis represents a high rate of hospital morbid-mortality. To assess the function as barrier of the intestinal mucosa and the influence of dietary fiber thereon, we studied bacterial translocation measured as positive cultures of the mesenteric lymphatic ganglia in an experiment model of enterocolitis induced by the intraperitoneal injection of 20 mg/kg of Methotrexate (MTX), using 72 male S-D rats, half of which were used as control group. These animals were sub-divided into four series according to the diet they were to receive. In addition to bacterial translocation, we examined the intestinal mucous parameters (mucosa weight, protein and DNA content, and number of mitoses) to quantify the potential trophic effect of dietary fiber on the intestinal mucosa. In the group subject to enterocolitis, there were no significant differences in the bacterial translocation with the series fed with defined-formula diets supplemented or otherwise with dietary fiber. Only the series receiving standard feed showed a significant reduction of bacterial translocation. pectin improved all mucous parameters when compared with the other diets studied. In the control group, the bacterial translocation rate was zero in all dietary series.

[Pancreatoduodenal traumatism. Apropos of 18 cases]. / Traumatismo pancreatoduodenal. A propósito de 18 casos.

We present our experience on pancreato-duodenal trauma surgically treated; we have studied the etiopathogenesis of the lesions and the severity of the condition, which is related to their anatomical relationships and to the difficulties of the early diagnosis. We emphasize the value of non invasive diagnostic methods, particularly immediate ultrasonography, CAT and exceptionally RECP. Abdominocentesis with peritoneal lavage and the insertion of a catheter through a minimal jejunostomy, for the nutritional support of the patient and to prevent complications merits special mention.

[Perforated duodenal ulcer in children]. / Ulcus duodenal perforado en la infancia.

We face a case of duodenal ulcer perforation a nine year old child who's diagnosis was not detected before operating. This is an unusual case and it is not normally observed in the differential diagnosis of the acute abdominal pain in the infancy. The lack of the radiological signs of perforation contributed to the diagnosis mistake before operating.

[Spiegel's hernia. Apropos of 10 cases]. / Hernia de Spiegel. A propósito de diez casos.

We present our recent experience in the last ten cases of Spiegel's hernia, studying its form of presentation and clinical manifestations. We studied emergency cases because they presented intestinal obstruction and were handled as a surgical emergency. We remark the noninvasive diagnostic methods, mainly echography. The surgical treatment for repair of the hernial defect and the material used was the same in every case. The morbi-mortality of the series was null and there was no recurrence in the period in which we studied and followed-up the series.

[Complete section of the choledochus caused by non-penetrating trauma of the abdomen. Use of minimal catheter jejunostomy]. / Sección completa del colédoco por traumatismo no penetrante de abdomen. Utilización de la yeyunostomía mínima a catéter (YMC).

A case is presented of complete section of the choledochus as the sole lesion in closed abdominal trauma. A study is made of the difficulties of an early diagnosis of this pathology, as well as techniques for intraoperative localization and repair. Emphasis is placed on the use of peritoneal lavage as a preoperative diagnostic method and Tc99m HIDA scintigraphy of the biliary tract. The surgical technique is reviewed, assuming that the most physiological and anatomic procedure is end-to-end choledochoduodenostomy using reabsorbable sutures. We recommend the use of minimal transcatheter jejunostomy (YMC) as a method for immediate replacement of bile juice and inhibition of secretion, as well as the possibility of postoperative physiological nutrition using this approach.