[Intermediate gastric cancer]. / Cáncer gástrico intermedio.

It is presented a case of gastric cancer that penetrates the stomach wall up to the muscular layer (C.G.P.M.). In a 53 years old patient, who consulted for abdominal pain and weight lost, and who has at the present a survival of 2 1/2 years, symptom free, the radiology, endoscopic and anato-pathologic features of this disease, are analyzed. The transcendence in diagnostic of gastric cancer in this stage is emphasized.

Cáncer gástrico intermedio. / [Intermediate gastric cancer]

It is presented a case of gastric cancer that penetrates the stomach wall up to the muscular layer (C.G.P.M.). In a 53 years old patient, who consulted for abdominal pain and weight lost, and who has at the present a survival of 2 1/2 years, symptom free, the radiology, endoscopic and anato-pathologic features of this disease, are analyzed. The transcendence in diagnostic of gastric cancer in this stage is emphasized.

[Current significance of polypectomy of the upper gastrointestinal tract]. / Significación actual de la polipectomía del tracto gastrointestinal superior.

Author's experience about 70 endoscopic polipectomy of high gastrointestinal tract, realized on 53 patients during 1978-1983 period was evaluated. Esophaguel polyps incidence was 0.06% among 7.900 endoscopic studies; gastric polyps was 0.8% and duodenal was 0.03%. Diagnosis was radiologically suspected in 58%. Gastric antrum was the predominant localization (45.7%) and macroscopic Yamada types IV (32.8%) and III (30.0%) were found more frequently. Most of patients presented solitary polips (86.7%). 63.2% of pieces were under 10 mm in size and 35.2% between 10 - 20 mm. High frecuency of adenomas (23.5%) and a low one of hyperplasiogenic (7.3%) was the prominent finding; only one case of early gastric cancer was founded (1.5%). Neither adenoms or hyperplasiogenic polyps were founded on gastric fundus, and no direct relation between size and histopatologic type was observed. Only one hemorragic complication (1.4%) was present. Polips incidence on 800 consecutive auptopsy protocols in adults was 0.12%.

Significación actual de la polipectomía del tracto gastrointestinal superior. / [Current significance of polypectomy of the upper gastrointestinal tract]

Authors experience about 70 endoscopic polipectomy of high gastrointestinal tract, realized on 53 patients during 1978-1983 period was evaluated. Esophaguel polyps incidence was 0.06

among 7.900 endoscopic studies; gastric polyps was 0.8

and duodenal was 0.03

. Diagnosis was radiologically suspected in 58

. Gastric antrum was the predominant localization (45.7

) and macroscopic Yamada types IV (32.8

) and III (30.0

) were found more frequently. Most of patients presented solitary polips (86.7

). 63.2

of pieces were under 10 mm in size and 35.2

between 10 - 20 mm. High frecuency of adenomas (23.5

) and a low one of hyperplasiogenic (7.3

) was the prominent finding; only one case of early gastric cancer was founded (1.5

). Neither adenoms or hyperplasiogenic polyps were founded on gastric fundus, and no direct relation between size and histopatologic type was observed. Only one hemorragic complication (1.4

) was present. Polips incidence on 800 consecutive auptopsy protocols in adults was 0.12

.

[Pseudotumor of the bile duct: its diagnosis by fine-needle percutaneous transhepatic cholangiography]. / Pseudotumor de la vía biliar: su diagnóstico a través de la CTPH con aguja fina.

Three patients with jaundice are presented. One was erroneously diagnosed as a biliary tumor because of the image in the percutaneous transhepatic cholangiography. When he was operated upon, it was found a chronic pancreatitis. Two other patients exhibited in the first sequences of the percutaneous transhepatic cholangiography an obstruction of the common hepatic duct; this diagnosis was corrected rotating the patients 360 degrees on the X-ray table. With this procedure the existence of choledocolithiasis was demonstrated. Finally, the author presents the case of a patient in whom some cholangiographic sequences induced a diagnostic error, because of the scant opaque media injected.

Pseudotumor de la vía biliar: su diagnóstico a través de la CTPH con aguja fina. / [Pseudotumor of the bile duct: its diagnosis by fine-needle percutaneous transhepatic cholangiography]

Three patients with jaundice are presented. One was erroneously diagnosed as a biliary tumor because of the image in the percutaneous transhepatic cholangiography. When he was operated upon, it was found a chronic pancreatitis. Two other patients exhibited in the first sequences of the percutaneous transhepatic cholangiography an obstruction of the common hepatic duct; this diagnosis was corrected rotating the patients 360 degrees on the X-ray table. With this procedure the existence of choledocolithiasis was demonstrated. Finally, the author presents the case of a patient in whom some cholangiographic sequences induced a diagnostic error, because of the scant opaque media injected.

Pseudotumor de la via biliar:su diagnostico a traves de la CTPH con aguja fina. / Pseudotumor of the bile duct: its diagnosis by TPHC with sharp needle

Se presentan tres pacientes con ictericia.Uno de ellos fue diagnosticado erroneamente en base a la CTPH - tumor de la confluencia - demostrandose en la intervencion que la obstruccion era producida por una pancreatitis cronica. Otros dos pacientes mostraron en el primer colangiograma una obstruccion alta de la via biliar corrigiendose el diagnostico mediante la rotacion de 360 graus del paciente sobre si mismo en la mesa de rayos y demostrando la existencia de litiasis coledociana.Por ultimo se presenta un caso de una paciente con distintos momentos colangiograficos que pueden conducir a error diagnostico de acuerdo a la cantidad de contraste inyectado

Pseudotumor de la via biliar:su diagnostico a traves de la CTPH con aguja fina. / Pseudotumor of the bile duct: its diagnosis by TPHC with sharp needle

Se presentan tres pacientes con ictericia.Uno de ellos fue diagnosticado erroneamente en base a la CTPH - tumor de la confluencia - demostrandose en la intervencion que la obstruccion era producida por una pancreatitis cronica. Otros dos pacientes mostraron en el primer colangiograma una obstruccion alta de la via biliar corrigiendose el diagnostico mediante la rotacion de 360 graus del paciente sobre si mismo en la mesa de rayos y demostrando la existencia de litiasis coledociana.Por ultimo se presenta un caso de una paciente con distintos momentos colangiograficos que pueden conducir a error diagnostico de acuerdo a la cantidad de contraste inyectado

[Endoscopic polypectomy in the diagnosis and treatment of early colorectal cancer]. / La polipectomía endoscópica en el diagnóstico y tratamiento del cáncer temprano rectocolónico.

The rectocolon cancer (RCC) behavior in La Plata is clearly shown to be similar to the one found in high risk countries, both from the epidemiological and the histopathological point of view. The disagreement among different polyps coming from necropsy, endoscopy or surgery is found and discussed in relation to distribution, size and histopathological type. The evidence of de sequence adenoma-carcinoma is once more found in the cases studied. On the other hand, displastics lesions in non-neoplastic flat mucosa are not found. THe malignant potential of the adenomas is found to increase with the increment of their size, villous component and atipía degree. This evidence come from 100 adenomas considered. It is also found that in this sample that the malignant potential is high in small lesions -4,3%of invasive carcinoma on adenomas smaller than 10 mm. In a sample of 1000 colonoscopies, 122 endoscopic polipectomies where performed without evidence of either morbility or mortality. In this material, 4 rectocolonic early cancer were detected in polyps smaller than 10 mm. This fact strongly support the indication of resection in every rectocolonic elevated lesions. 11.4% of total resected polyps were found to be of the early RCC type this figure increases if the incidence of the polipectomy in children is discarded because in this cases adenomatous polyps do not appear in our experience. The clinic-epidemiologic character of 13 early RCC cases followed for periods until 5 years are described.

La polipectomía endoscópica en el diagnóstico y tratamiento del cáncer temprano rectocolónico. / [Endoscopic polypectomy in the diagnosis and treatment of early colorectal cancer]

The rectocolon cancer (RCC) behavior in La Plata is clearly shown to be similar to the one found in high risk countries, both from the epidemiological and the histopathological point of view. The disagreement among different polyps coming from necropsy, endoscopy or surgery is found and discussed in relation to distribution, size and histopathological type. The evidence of de sequence adenoma-carcinoma is once more found in the cases studied. On the other hand, displastics lesions in non-neoplastic flat mucosa are not found. THe malignant potential of the adenomas is found to increase with the increment of their size, villous component and atipía degree. This evidence come from 100 adenomas considered. It is also found that in this sample that the malignant potential is high in small lesions -4,3

of invasive carcinoma on adenomas smaller than 10 mm. In a sample of 1000 colonoscopies, 122 endoscopic polipectomies where performed without evidence of either morbility or mortality. In this material, 4 rectocolonic early cancer were detected in polyps smaller than 10 mm. This fact strongly support the indication of resection in every rectocolonic elevated lesions. 11.4

of total resected polyps were found to be of the early RCC type this figure increases if the incidence of the polipectomy in children is discarded because in this cases adenomatous polyps do not appear in our experience. The clinic-epidemiologic character of 13 early RCC cases followed for periods until 5 years are described.