[Jejunal metastasis from choriocarcinoma. A three-case report]. / Coriocarcinoma metastásico a yeyuno. Reporte de tres casos.

Five per cent of patients presenting with choriocarcinoma develop small bowel metastasis. Tumors of the small bowel are rare and the metastases are generally from lung and breast carcinoma or from melanoma. Clinical presentation is vague and the majority of cases are autopsy findings. The main symptoms are related to the presence of abdominal tumor or hemorrhage, or bowel obstruction or perforation. We present the cases of three patients with small bowel metastasis from choriocarcinoma. A 24-year-old woman with bowel obstruction secondary to intussusception caused by a metastatic choriocarcinoma polypoid mass and two men, one 18 years old and the other 24 years old, with a history of testicular tumor, who presented with gastrointestinal bleeding due to small bowel metastasis from choriocarcinoma, 2 and 10 months after orchiectomy, respectively. Management was endoscopic in one case and surgical in the other two. Two patients died in the early postoperative period and one patient died during the first year of follow-up. Choriocarcinoma metastases are very rare and their main clinical manifestations are hemorrhage and bowel obstruction. Management can be either medical or surgical. The majority of patients with choriocarcinoma respond to chemotherapy but prognosis is worse for those patients presenting with small bowel metastasis.

[Retroperitoneal cystic lymphangioma in an adult: case report]. / Linfangioma quístico retroperitoneal en un adulto: informe de caso.

Retroperitoneal cystic lymphangyoma is a benign lesion, extremely rare in adults. In most cases is asymptomatic. The objective of this report is to present the case of an 82 year old woman who presented abdominal pain, food intolerance and a palpable abdominal mass located toward the upper right quadrant. The abdominal CT scan showed a cystic lesion below the liver which extended to the retroperitoneum. The patient underwent laparotomy achieving complete resection of the lesion and she was discharged soon after. After six months of follow up, she has not presented recurrence. The presentation of this lesion is very rare, generally as a consequence of congenital malformations of the lymphatic vessels. These lesions must be considered as part of the differential diagnosis of the cystic type tumors. The ultrasound and abdominal CT scan are useful for diagnosis. Surgical resection is the only therapeutic option.

[Transmesenteric intestinal plication for intestinal occlusion secondary to disseminated adhesions. A 12-year experience]. / Plicatura intestinal transmesentérica para la oclusión intestinal secundaria a adherencias diseminadas. Experiencia de 12 años.

OBJECTIVE: To report the experience with intestinal plication in patients with adhesive intestinal obstruction that was followed up to 12 years. BACKGROUND: To diminish the high recurrence rate of adhesive intestinal obstruction, there are surgical techniques of intestinal plication. In 1977 Blanco modified a pre-existing transmesenteric technique that is the used in our institution. METHOD: We studied the medical records of 32 patients who underwent intestinal plication using the transmesenteric technique. The postoperative evaluation was based in recurrence and mortality. RESULTS: There were 32 patients, 56% women and 44% men, with a mean age of 50 years. All patients had a history of intraabdominal surgical procedures. The postoperative evaluation was satisfactory. The success rate was over 90%. The recurrence rate was 9.3% and we had no mortality. The mean follow-up was 3.5 years (median 3 [range 1-12] years). There were no significant differences between this technique and the Noble and Childs-Phillips plication techniques. CONCLUSIONS: This technique of intestinal plication is useful in the surgical management of patients with adhesive intestinal obstruction.

[Retrograde intussusception posterior to gastrojejunal anastomosis. Report of a case]. / Intususcepción retrógrada posterior a gastroyeyunoanastomosis. Informe de un caso.

OBJECTIVE: We report a case of retrograde jejunogastric intussusception in a patient with previous gastric surgery who required surgical treatment for its resolution. BACKGROUND: While intussusception is relatively common in children, it is infrequently seen in adults. Five percent of all cases occur in adults and in 90% of these, there is a lead point, a well-definable pathologic abnormality. Retrograde jejunogastric intussusception is a rare complication after gastrojejunostomy. The most common symptoms are pain, nausea, vomiting and blood per rectum. Diagnosis of adult intussusception is often difficult and is base in clinical suspicion and noninvasive techniques. METHOD: A case of a retrograde intussusception in a patient after gastric surgery who presented with abdominal pain and gastrointestinal bleeding. RESULTS: The patient underwent surgical treatment with reduction of the intussusception. The postoperative evolution was satisfactory. CONCLUSIONS: Management of intussuception in adults is usually laparotomy and in 90% of cases, a pathologic lesion will be identified. Retrograde jejunogastric intussusception is also managed surgically and simple reduction is the accepted form of treatment in most cases.

[Gastrointestinal neurofibromatosis. A rare cause of abdominal surgery]. / Neurofibromatosis gastrointestinal. Una causa poco frecuente de cirugía abdominal.

OBJECTIVE: Report two cases of gastrointestinal neurofibromatosis that required surgical intervention for their resolution. BACKGROUND: Neurofibromatosis is a congenital disease which is classified in two types. In neurofibromatosis type 1 or Von Recklinghausen's disease the patients have some classical manifestations as cafe au lait pigmentation, bony abnormalities and neurofibromas of both peripheral and central nerves. In up to 25% of the patients with neurofibromatosis 1, the gastrointestinal tract is involved. The most affected organs are the stomach and the jejunum. The symptoms of the patients with gastrointestinal neurofibromatosis are related to gastrointestinal bleeding or obstruction. METHOD: Two patients with gastrointestinal neurofibromatosis that required surgical intervention for the resolution of their manifestations. RESULTS: Two cases of gastrointestinal neurofibromatosis, one of them had as her main clinical feature gastrointestinal bleeding, and the other patient intestinal obstruction. They were submitted to exploratory laparotomy finding gastrointestinal neurofibromatosis in both as the cause of their symptomatology. CONCLUSIONS: The management of gastrointestinal neurofibromatosis could need surgical intervention, and when this is done the postoperative evolution is satisfactory.

[Gastrointestinal stroma tumor with gastric involvement. Presentation of a case and review of the literature]. / Tumor del estroma gastrointestinal con afección a estómago. Presentación de un caso y revisión de la literatura.

BACKGROUND DATA: Gastrointestinal stromal tumors (GIST) are considered the most common group of non-epithelial neoplasms of stomach and small bowel. OBJECTIVE: To present a case report and literature review. METHOD: Sixty-seven year-old white male with abdominal mass and gastrointestinal bleeding. Laboratory and X-ray test were done resulting in gastric leiomyosarcoma suspect. RESULTS: Patient underwent to exploratory celiotomy with subtotal gastrectomy with splenectomy. Immunohistochemistry results confirms gastrointestinal stromal tumor diagnosis of the stomach.