[Leiomyoma-dependent ileal invagination as a cause of intermittent intestinal obstruction]. / Invaginación ileal dependiente de leiomioma como causa de obstrucción intestinal intermitente.

We report the case of a 35-years-old-woman with history of abdominal surgery who presented several episodes of intermittent intestinal obstruction. Postoperative adhesions were suspected; laparoscopy surgery was made and uterine and anexial inflammation was observed. She was discharge with the diagnosis of inflammatory pelvic disease. Posteriorly, she was admitted with a new episode of intestinal obstruction. At laparotomy, intestinal intussusception was founded due to the presence of intestinal leiomyoma. We stress the relevance of two possible etiologies of intestinal obstruction; the coexistence of them difficult the diagnosis. Epidemiology, clinical presentation and diagnosis of leiomyomas of small intestine were reviewed.

[Physiological reflux in proximal esophagus (assessment with simultaneous pH monitoring in proximal and distal esophagus in healthy subjects]. / Reflujo fisiológico en esófago proximal (valoración mediante pHmetría simultánea en esófago proximal y distal en sujetos sanos).

Two-level pH monitoring was performed for 24 hours in 20 healthy subjects to document the presence of reflux episodes and to obtain reference values for reflux studies. The pH probes were placed 5 and 20 centimetres above the LES by means of a manometric technique. Significant differences were found at these two levels. At the proximal esophageal level 18 of the 20 subjects had reflux episodes. Five centrimetres above the lower esphageal sphincter the total reflux time was 1.35%, 2.05% in the upright and 0.15% in the supine positions. At 20 centimetres level it was significantly lower: 0.5% the total percent time with pH below 4, 0.8% and 0% in the upright and supine positions respectively. The mean reflux time was about 40% of the distal value, but the same pattern of reflux was observed at two levels of the esophagus. This technique is useful in documenting the cephalad extend of GER and allows to identify normal GER patterns at different levels of the esophagus.

[Acute pancreatitis in thrombotic thrombocytopenic purpura. Apropos 2 cases]. / Pancreatitis aguda en el seno de la púrpura trombocitopénica trombótica. A propósito de dos casos.

Thrombotic thrombocytopenic purpura (TTP) is a syndrome characterized by fever, microangiopathic hemolytic anemia, thrombocytopenia, renal disease and neurologic changes. The development of little thrombi in the systemic microcirculation is thought to play an important role, however the etiology is unknown. We present two cases in which pancreatic disease was the first manifestation of TTP.

Desferrioxamine in the treatment of porphyria cutanea tarda: ineffectiveness of intramuscular administration.

Four patients suffering from porphyria cutanea tarda received intramuscularly 10-15 g per month of desferrioxamine for periods ranging between 21 and 50 months. Porphyrin excretion was serially analyzed during this treatment. Desferrioxamine administration did not induce remission of the disease, which was subsequently achieved after treatment either with phlebotomies or chloroquine. Therefore, chronic intramuscular administration of desferrioxamine alone is ineffective in porphyria cutanea tarda.