[Barrett esophagus. An epidemiological study in an area of Spain]. / Esófago de Barrett. Estudio epidemiológico en una comarca.

Barrett's esophagus is defined as the replacement of squamous normal mucosa by columnar specialized epithelium, being its main importance its preneoplastic potential. In this retrospective study on 5303 gastrointestinal endoscopies, done in 8 years, we describe, for the first time the gross prevalence and incidence rates in a Spanish country. We found 28 cases of Barrett's esophagus, what means a prevalence rate of 0.53% of all endoscopies, and an incidence rate of 26.4/100,000 inhabitants of our hospital referred population, with an estimated incidence rate of 3.3 cases/100,000 inhabitants/year. The prevalence rate of Barrett's esophagus adenocarcinoma--3 cases--was 10.71%, and the incidence rate of 1 case/104 Barrett's esophagus/year, follow-up similar to that of other authors.

[Resolution with steroid therapy of an idiopathic esophageal fistula in a patient with AIDS]. / Resolución con tratamiento esteroideo de una fístula esofágica idiopática en un paciente con SIDA.

We present a case of AIDS with idiopathic esophagic fistula which had a positive response to steroid therapy. We discuss the diagnostic potential and the therapeutic attitude in these cases.

[Granular cell tumor of the esophagus]. / Tumor de células granulosas de esófago.

Granular cell tumor is a neoplasm usually benign, which only in two percent of the cases affects the esophagus. Histologically it is composed by two kind of cells: granular and angled body cells. The histogenesis of this tumor remains controversial; however, it has been recently demonstrated, by immunohistochemical methods, the presence of proteins that are specific of the nervous system. The diagnosis is frequently done incidentally and by endoscopic biopsy. We report a case of granular cell tumor of the distal esophagus found incidentally during a routine endoscopic examination. We review the English and Spanish literatures, focussing on the histological and diagnostic peculiarities. The clinical management and the different available therapeutics, according to symptoms and tumor size, are discussed.

Laparoscopic findings in hereditary haemorrhagic telangiectasia (Osler-Weber-Rendu disease).

The laparoscopic findings observed in eight patients with hereditary haemorrhagic telangiectasia are reported. Clinical signs or laboratory data suggestive of liver involvement were present in all cases and constituted the main indication for laparoscopic examination. Characteristic vascular lesions distributed at random were found in four cases. Numerous oval, round or polygonal areas of 0.5 to 1.5 cm in diameter were observed on the external surface of the liver. They were of a reddish or pink colour, flat or slightly raised, and made up of a dense vascular meshwork. In one patient macronodular cirrhosis was associated with the vascular lesions. In the remaining four cases laparoscopic examination did not show striking vascular changes, although the liver biopsy revealed a fatty liver in three cases and micronodular cirrhosis with intense inflammatory activity, steatosis and Mallory bodies in one case. In these cases the accompanying hepatic lesions could probably not be aetiopathogenically related to Osler's disease.