Fibrolamellar hepatocellular carcinoma: a rare entity diagnosed by abdominal ultrasound.

We present the case of a young man with a hepatic mass in which ultrasound gives great and immediate support for diferential diagnosis.

Spanish multicenter study to estimate the incidence of chronic pancreatitis.

OBJECTIVE: To estimate the incidence of chronic pancreatitis in Spain as diagnosed with endoscopic ultrasound (EUS), and to assess the risk factors and complications detected. MATERIAL AND METHOD: A descriptive, observational study of chronic pancreatitis cases diagnosed in Spanish health care centers with an EUS unit. A structured questionnaire was used to evaluate the incidence of the disease (cases identified over 18 months: from January 2011 to June 2012), risk factors, EUS criteria, Rosemont classification, and frequency of local complications. RESULTS: Twenty-three centers were selected serving a total reference area of 14,752,704 population. During the study period 1,031 chronic pancreatitis cases were diagnosed, with an incidence of 4.66 cases per 105 inhabitants/year (95% CI: 4.65-4.67). Tobacco and alcohol use appear as risk factors in 63.8% and 66.7% of cases, respectively. Of these, 53.3% met > 5 EUS criteria for chronic pancreatitis, and 69% had findings suggestive of or consistent with chronic pancreatitis according to the Rosemont classification. Most prevalent complications included calcifications (34.7%), pseudocysts (16%), and presence of an inflammatory pancreatic tumor (10.4%). CONCLUSIONS: The incidence of chronic pancreatitis in Spain is similar to that of other European countries. Given the widespread use of the technique, EUS units are key in detecting the disease, and their activity and results allow to estimate the incidence of chronic pancreatitis over wide, representative population areas.

Prevalencia de síntomas digestivos en mujeres adultas normales y su asociación a la litiasis biliar / Prevalence ofdigestive symptoms in normal adult women and it association with biliary lithiasis

The aim of this work was to study the prevalence of biliary diseases and digestive symptoms in normal adult women. Four hundred nineteen women were chosen; of these 145 were discarded due to previous gastrointestinal disease (20), previous gastrointestinal complaints (38) and previous cholecystectomy (85). Two hundred seventy six women were subjected to abdominal ultrasound examination; of these, 53 had cholelithiasis and in three a gallbladder cancer was suspected (and confirmed by surgery). Considering women with previous cholecystectomy, cholelithiasis and gallbladder cancer, a 33.6 per cent prevalence of biliary diseases can be inferred. An interrogation about gastrointestinal symptoms was performed to women subjected to ultrasound examinations by 2 professionals unware of ultrasound results. A high frequency of pyrosis, food intolerance and constipation was found, not observing differences between women with or without cholelithiasis. However, these last women had a higher frequency of upper abdominal pain. Both groups had also a high rate of previous surgical procedures

Comparación de la anastomosis esofagoyeyunal mecánica vs manual para gastrectomía total en pacientes con cáncer gástrico / Comparison between mechanical and manual esophagojejunal anastomosis for total gastrectomy in gastric cancer patients

Se realizó un estudio prospectivo en 53 pacientes con cáncer gástrico sometidos a gastrectomía total comparando la técnica manual frente a la mecánica, en la anastomosis esofagoyeyunal. En 35 pacientes se realizó la técnica manual y en 18 la técnica con stapler. No hubo mortalidad operatoria en la serie. El tiempo operatorio, la incidencia de fístula y otras complicaciones postoperatorias fueron similares en ambos grupos. La frecuencia de infección de la herida operatoria, la presencia de absceso subfrénico y la estadía postoperatoria fueron significativamente menores en pacientes sometidos a la técnica mecánica. Este procedimiento es fácil de realizar, es reproducible de un cirujano a otro, no requiere de gran experiencia previa como la técnica manual y es una buena alternativa cuando es necesario hacer una anastomosis esofagoyeyunal alta