Instrument for dilatation of stenotic colorectal anastomosis.

The use of a modified Starck dilator in the treatment of anastomotic stenosis in the distal 15 cm of the rectum is described. This technique is a suitable alternative for use in hospitals where more sophisticated instrumentation is not available.

[Digestive hemorrhage secondary to segmental portal hypertension: an infrequent cause of hemorrhage]. / Hemorragia digestiva secundaria a hipertensión portal segmentaria: una causa de hemorragia poco frecuente.

Isolated obstruction of the splenic vein leads to the appearance of a relatively uncommon form of portal hypertension, the diagnosis of which depends on a high rate of awareness, and it can be successfully treated by splenectomy. A case is described of segmental portal hypertension, with special emphasis on the difficulty of its diagnosis and the measures used. Therapeutic possibilities are commented.

[Odditis. Pathologic reality or tactics necessity]. / Odditis. Realidad patológica o necesidad táctica.

In 14 patients with secondary odditis, a biopsy of the papilla was studied, in one case encountering moderate peri and intrafascicular fibrosis and in another, erosion of the papillary mucosa with impaction of biliary material. In 6 biopsies obtained from patients with perforated liver cysticerocosis, submucosal edema of the biliary tree was observed in only 3. On the basis of these studies an analysis is made of the different percentages published, which are highly variable, and results are compared to those reported in larger series. Papillary affectation in lithiasis was related to trauma produced by impaction or expulsion of calculi and the indications for realization of sphincteroplasty or biliodigestive derivation are listed, showing a tendency toward a progressively greater restriction of surgery. The absence of sphincter disease in hepatic cysticercosis perforated into the biliary tract is signalled, the only alterations being edema, which is reversible with treatment of cysticercosis.