Apendicitis aguda perforada. Manifestación de una hernia inguinal incarcerada / Perforated acute appendicitis. Manifestation of an incarcerated inguinal hernia

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[Retractile mesenteritis. Report of 3 cases]. / Mesenteritis retráctil. A propósito de tres casos.

Mesenteric panniculitis is an infrequent pathology; the diagnosis is made by the pathologist and it is characterized by inflammation, fibrosis and retraction of the mesenteric fat. We report three new cases of retractile mesenteritis or mesenteric panniculitis, two cases presented with intestinal obstruction and the other had an abdominal tumour. In all cases the pathological diagnosis was retractile mesenteritis.

[Cytomegalovirus enteritis and colitis in nonimmunodepressed patients, a primary disease or superinfection?]. / Enteritis y colitis por citomegalovirus en pacientes no inmunodeprimidos, afectación primaria o sobreinfección?

Cytomegalovirus disease is an opportunistic infection that is seen in patients with inmunodeficiencies. The group most commonly affected are AIDS and transplanted patients. Only a few cases of cytomegalovirus disease in non-immunocompromised patients have been reported. In localized disease, the gastrointestinal tract is the most frequently affected. We report two cases of acute abdomen caused by cytomegalovirus enteritis and colitis (histopathological diagnosis) without any underlying immune disorder. The role that the cytomegalovirus infection might play in the development of the clinical manifestations in these two cases is discussed. Without an established immunodeficiency we must be careful to attribute to cytomegalovirus infection the direct responsibility of the lesions. In the reported cases, the existence of intestinal ischemia is more than just a clinical hypothesis and pathological examination is inconclusive. The absence of an immunocompromised state, the presentation as an acute abdomen and the clinical course forwards intestinal occlusion in the first case are not characteristic of cytomegalovirus enteritis and colitis. We conclude that the two reported cases are in fact an ischemic enteritis upon which cytomegalovirus enteritis and colitis was superimposed, an association that has not been reported before.

[Synchronous colonic and rectal carcinomas]. / Carcinomas sincrónicos de colon y recto.

We present a retrospective study of 360 patients with surgically treated colorectal neoplasm between 1982 and 1990, in order to determine the incidence of synchronous colorectal carcinomas; and to analyze diagnosis procedures, detection time, pathology and treatment strategies. The incidence of synchronous carcinomas was 5.5% (20 cases). Only 30% of them were diagnosed preoperatively, and up to 40% were discovered in the pathological examination. In 2 patients 3 synchronous tumors were well found. All the synchronous neoplasms were differentiated, 65% of them were Dukes stage A. Synchronous colorectal polyps were found in 80% of patients. Complete exploration of the colon preoperatively by a routine pan-colonoscopy is recommended. In regard to the treatment of patients with synchronous colorectal carcinomas, partial colectomies are indicated as long as oncological criteria are followed, and the colon had been fully explored.