[Home parenteral nutrition in the management of patients with chronic idiopathic intestinal pseudo-obstruction]. / Nutrición parenteral domiciliaria en el manejo de pacientes con pseudoobstrucción intestinal crónica idiopática.

Home parenteral nutrition is indicated in all those patients who are unable to cover all their needs orally or enterally during prolonged periods of time, and who do not require any other general care other than the parenteral nutrition. Our objective is to prove the use of home parenteral nutrition as a nutritional support in patients with severe forms of chronic idiopathic intestinal pseudo-obstruction. In our unit, three patients with this disease, have received home parenteral nutrition between 1993 and the present date. One patient received it during four months, with the catheter being removed due to a fungemia. At present she is being maintained with oral and enteral nutrition. The other two patients continue in the program: one since October 93 and the other since July 94. The hydroelectric alterations caused during the episodes of sub-occlusion make more frequent changes in the composition of the parenteral nutrition necessary, compared to other types of patients. The low incidence of complications and the degree of acceptance by the patient makes this technique an ideal method for the long term nutritional support.

[Biliary lithiasis in childhood]. / Litiasis biliar en la infancia.

We have reported 28 cases of pediatric cholelithiasis in our hospital between 1980 and 1990. We found risk factors in 15 of these cases (53.6%). The most frequent risk factors were hereditary spherocytosis, cholestasis and obesity. A high frequency of non-hemolytic cholelithiasis was noted. Lithiasis was a casual finding in 13 cases (46.4%). The most frequent symptom was nonspecific abdominal pain, which occurred in 8 patients. Diagnosis was made with echography in every case. The range of time in which the patients were followed ranged between 1-5 years. Eight children required surgery. Among the other twenty, twelve were asymptomatic and six improved spontaneously. The mean age at the moment of diagnosis was younger in the children that spontaneously recovered than in children with permanent lithiasis. Therefore, for this reason, we recommend an observation period before surgery in children younger than 3 years of age.