[Ultrasonographic aspects of cystic papillary tumor of the pancreas. Apropos of 2 cases]. / Aspectos ecográficos del tumor papilar quístico del páncreas. A propósito de 2 casos.

Cystic papillary pancreatic tumor is an infrequent neoplasm of unknown origin which is presented almost exclusively in young women. It is characterized by an anodyne clinical symptomatology with it frequently treated as an accidental finding. Ultrasonography and computerized axial tomography have a priority role in the study of this entity but the definitive diagnosis is based on the histologic findings. The treatment of choice is surgical removal and although it is a malignant tumor, good evolution is observed with recurrence not being expected. Two new cases of cystic papillary tumor are presented comparing the ultrasonographic appearance of the same with other pancreatic cystic neoplasms. Although the ultrasonographic findings are not characteristic they may be suggestive of papillary tumor.

[The prognostic value of the endoscopic signs in the recurrence of peptic ulcer hemorrhage]. / Valor pronóstico de los signos endoscópicos en la recidiva de la hemorragia por ulcus péptico.

The endoscopic signs of hemorrhage in bleeding peptic ulcers are considered as prognostic factors for rebleeding and mortality. The value of these signs has been examined in several studies of patients with known high risk factors. In this survey, we studied the prognostic value of the endoscopic signs of hemorrhage in bleeding peptic ulcer in a group of patients without clinical risk factors such as age > 60 years, concomitant malignancy or respiratory and heart disease. Endoscopic findings were examined in fifty patients without rebleeding (group I) and twenty five with rebleeding (group II). Endoscopic findings results were spurting arterial bleeding in 9.3% of the cases, oozing hemorrhage in 17.3% of the cases, visible vessel in 9.3% of the cases, and adherent clot in 82.3% of the cases. In 9.3% of the cases endoscopic findings were negative. No statistical differences were found in the endoscopic signs among the two groups. The visible vessel and the spurting arterial bleeding cases presented in more than 50% of the rebleeding, (visible vessel and spurting arterial 57.1%). Oozing hemorrhage and the adherent clot were present in 30% of the cases. The endoscopic signs of bleeding can assist in choosing the group of patients with prospective high risk of rebleeding and possible candidates for the new treatment of endoscopic hemostatic therapy.

[Extraintestinal manifestations of chronic inflammatory intestinal disease]. / Manifestaciones extraintestinales de la enfermedad inflamatoria crónica intestinal.

Intestinal Inflammatory Chronic Disease includes a series of pathological entities of unknown etiology, basically characterized by inflammatory lesions in the digestive tube. Importance of this disease, which frequency has grown in the last few years, lies in the fact that not only affects the intestine but also other organs, originating systemic manifestations which, occasionally, modify the evolution and therapy of these patients. Because of this fact, we try, in this work, to provide a general overview of the extra-intestinal pathology associated with Crohn's disease and ulcerative colitis.

[Acute viral hepatitis A and C: report of a case]. / Hepatitis viral aguda A y C: a propósito de un caso.

We present a case of acute hepatitis by simultaneous A and C virus infection. The coinfection was suspected due to the high levels of transaminases lasting more than 9 months after onset of the illness. During the early stages of the illness, the patient had IgM antibodies to hepatitis A virus. Serological tests for hepatitis B and C viruses, cytomegalovirus and Epstein-Bar virus were negative. Due to the persistently high transaminase levels, we repeated the serology, detecting positive results for hepatitis C antibody, while hepatitis B serology remained negative as well that for all other virus tested. With these findings, we believe that a patient with hepatitis A of long duration, requires additional serological examinations to determine the possibility of coinfection by another virus.

[Digestive hemorrhage caused by gastric varices: usefulness of the techniques of endoscopic sclerosis]. / Hemorragia digestiva por varices gástricas: utilidad de las técnicas de esclerosis endoscópica.

Upper gastrointestinal hemorrhage secondary to gastric varices still has a high death rate. Fourteen patients were admitted to our unit with bleeding gastric varices from November 1989 to August 1991. Endoscopic injection sclerotherapy obtained control of the bleeding in 92.3%; however, recurrences occurred in 33% of these cases in the first 24-48 hours, with a death rate of 50% during the second stage of the upper gastrointestinal hemorrhage. Total mortality rate was 21.4%. Of the fourteen patients, nine exhibited junctional varices, while five hand fundic varices. In ten of the fourteen patients, gastric varices developed during esophageal sclerotherapy. While hospitalized, it was observed that patients with gastric varices in the fundus had more recurrences and mortality, than those located next to the cardio-esophageal junction. Sclerosis of the varices only obtained temporary control of the bleeding with greater frequency of recurrences and mortality.