[Anorexia nervosa or somatic disease]. / Anorexia nerviosa o enfermedad somática?

We have studied 18 patients with anorexia nervosa with antroduodenal manometry for 24 hours and also 24 hours oesophageal pH studies. After the first 12 hours of measurements we started treatment with Cisapride (n = 8) or Erythromycin (n = 10) in a blind study. The results of measurements reveal a severe gastroesophageal reflux in 4 patients. Antroduodenal manometry showed dysfunctions in gastric motility, without relation with weight loss or duration of the disease. Cisapride and more so Erythromycin favor gastrointestinal motility.

¿Anorexia nerviosa o enfermedad somática? / Anorexia nervosa or somatic disease?

Hemos efectuado un estudio con 18 pacientes diagnosticados de anorexia nerviosa, consistente en manometría antroduodenal y pHmetría de 24 horas. A las 12 horas de registro se inició tratamiento con cisaprida (n=8) o eritromicina (n=10) de forma aleatoria. Los resultados de la pHmetría revelan reflujo gastroesofágico severo en 4 pacientes. La manometría pone de manifiesto la existencia de alteraciones de la motilidad gástrica, sin relación con la pérdida de peso ni con el tiempo de evolución. La cisaprida y sobre todo la eritromicina, actúan favorablemente sobre las alteraciones de la motilidad (AU)

[Intussusception: barium vs. pneumatic reduction]. / Invaginación intestinal: Neumoenema versus enema de bario.

At the Hospital Niño Jesús air pressure enema has recently replaced the use of barium as treatment of choice in the reduction of intussusception. The purpose of this study was to review the air enema reductions done from June 1992 to February 1994 in 137 patients (group II) and to compare them with a previous series of 153 patients that underwent barium reduction treatment (group I). The groups were similar with regard to sex, age and presentins symptoms as well as clinical signs. Successful reduction was achieved in 131 patients (85.6%) out of 146 attempts treated with barium enema and in 124 patients (90.5%) out of 134 attempts treated with air enema. Among the unsuccessful reduction cases, operation was performed in 22 cases in group I and in 13 cases of group II. In the group I there were two perforations during the reduction attempt, while in group II we did not have any with the air enema. There were two recurrent intussusceptions following barium enema reduction and nine following air enema reduction in the first 48 hours. Patients treated with air enema stayed less days at hospital (1,6 days) than those treated with barium (3 days). We believe that the air enema treatment is easy to perform, is lower in cost and presents less morbility, and that it should be considered as the treatment of choice in the initial management of intussusception.

[Neuroblastoma IV-S. A multicenter study. Work Group of Pediatric Oncology. Spanish Society of Pediatric Surgery]. / Neuroblastoma IV-S. Estudio multicéntrico." Grupo de Trabajo de Oncología Pediátrica". Sociedad Española de Cirugía Pediátrica.

A retrospective multicentric study of 23 patients with stage IV-S neuroblastoma treated in 10 national Pediatric Surgery Departments between January 1988 and December 1992, is presented. All cases were classified as stage IV-S following staging criteria proposed by Evans et al. The age diagnosis was an average of 3 months. An acute clinical course was seen in 7 patients. Primary sites of the tumor were: adrenal gland in 6 patients (30.5%), abdominal paravertebral in 3 (13%) and unknown in 2 (9%). Distant tumor sites were: liver in 20 patients, bone marrow in 9, and skin in 5. There were not systematic therapeutic approach, in 16 cases (69%) the primary tumor was resected, 18 (78%) received chemotherapy, the liver was irradiated in 3 (13%), and 1 case (4%) received no treatment at all. One children died. The overall disease-free survival is 95.6% at 43 months post-diagnosis. A common treatment protocol is proposed, with systematic determination of N-myc oncogene which will indicate the appropriate therapy.

[Intestinal pseudo-obstruction secondary to systemic neuropathies and myopathies]. / Pseudoobstrucción intestinal secundaria a neuropatías y miopatías sistémicas.

The term intestinal pseudo-obstruction, is applied to a group of clinical disorders in which there are obstructive symptoms, in the absence of a mechanical agent, secondary to a disorder of intestinal motility. In this report, we show manometric studies done in four patients, with acute intestinal pseudo-obstructions, secondary to von Recklinghausen's neurofibromatosis (VRNF), in two patients, and in one patient with Duchenne's muscular dystrophy (DMD) and in another with Werdnig-Hoffmann's disease (WHD). We studied 24 hours antroduodenal motility, specially during phase 3 of the migratory motor complex (CMM), which showed a neuropathic disorder in one case of von Recklinghausen's disease and a myopathic disorder in patients with Duchenne's muscular dystrophy and Werdnig-Hoffmann's disease. We analysed results and conclusions and specially the kinetic action of erythromycin.

[Cervical thymic cysts in children]. / Quistes tímicos cervicales en niños.

Two cases of Cervical Thymic Cysts are communicated, a seven old year boy and a four year old girl, operated on the last three years. Both children suffered for one month an asymptomatic cervical mass. Preoperative studies included: Roentgenogram study, Ultrasound, CT scan and 131 I scan. The diagnosis was established by excision and Histological study. The clinical, anatomical and histological characteristics, were similar to the few published cases (79 cases).

[Non-Hodgkin's lymphoma as a cause of intestinal obstruction in school-age children]. / Linfoma no-Hodgkin causa de obstrucción intestinal en edad escolar.

Between 1972 and 1988, twenty-four children with abdominal non-Hodgkin's lymphoma (NHL) were treated. Five children between 6 and 12 years old had intestinal obstruction due to mesenteric-intestinal mass of the NHL class. We report clinical and morphological features, emphasizing the importance of radical surgery from the therapeutic and prognostic points of view these resectable abdominal forms.

[Cholelithiasis in childhood]. / Colelitiasis en la infancia.

11 patients with cholelithiasis treated at our department, since 1979, are presented. Although cholelithiasis is a typical disease in adults, its frequency in childhood is very low. The rate of cholelithiasis with hemolitic diseases were of 18% and idiopathic in 55%. The main clinical symptom was recurrent abdominal pain, refer to epigastric or right subcostal side. The diagnosis was done with echography and in all cases a cholecistectomy were performed. The results and complications of these cases are presented.