Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

A survey is carried out of a personal series of 13 cases of benign esophageal stenosis comprising, 8 diaphragmatic herniations, 1 cardiofundic malformation, 2 aclasias and 1 inferior esophageal membrane .. In 39 cases of hiatal herniations, 7 presented stenosis; in the reversible forms, only Nissen's funduplicature was used, with excellent results, due consideration being given to backflow upon ga,stric herniation. The irreversible forms were treated with cardioplasty of the HeinekeMiculicz type followed by Thal's appositionor funduplicature. Nissen's method is regarded as satisfactory for cardiofundic malformations and stenoses following failule of other procedures, such as Allison's.In cases of acalasia the Heller-Kole methods is advocated, but with angle repain in order to prevent the consequent backflow syndrome. The case of esophageal membrane is dealt with in detail, the writeh advising endoscopy at surgery in order to plot its height, followed by esophagotomy. 

Vagotomy. accompanied by piloroplastia or gastrojejunostomy, may at present be included in the treatment of selected cases of perforated duodenal ulcer . Seven clinical observations are analyzed and the procedures to be followed are indicated. The final eva]uation requires greater experience.

The paper presents three observations of intra-abdominal torsion of the epiploic appendices of the colon. Based on their eperience and its comparison with literature, the authors analyze the different aspects which are of in. terest to the surgeon. The difficulties of establishing a positive diagnosis are described, stressing, however, that the essential point is to have it in mind so that it can be recognized during the operatory exploration. Among the complications it presents, the authors stress the importance of obstructiveprocesses of the intestine, for they can generate the adherences and the secondary fibrous organization of epiploic appendices. The papers describe one observation ofocclusion due to torsion of the right colon, determined by this mechanism.

In 1881, Wolkmann discovered the syndrome of ischemic muscle retraction ...

The problem of machanical obstructions of the small intestine after operations of the biliary tract, is discussed. Once again the authors insist on the profilactic measurestaught by Prof. del Campo. The beginning of the symptoms pain in the right hypochondrium, is stressed Value is attached to the appearence of a gas bubble from the small intestine in the right hypochondrium, above the hepatic opacity. The surgical solution is described, involving primary approach through the large abdominal cavity, and later, cohen necessary,through the right hypochondrium, through the anterior operatory zone.

a 25-year old patient with a history of dysphagic episodes from the age of 4, is reported. A brief survey of this infrequent conditions is made. Distinctive features with ectopic cardiaand stenosis from esophagitis, are dealt with. The case under consideration underwent surgical resection, followed by thorough cure. Endoscopy during surgery, as a useful means of locating the lesion, is advocated. We are concerned with the furst case reported in this country and the third one in the world bibliography, treated through esophagotomy and resection.

Malignant thin lymphomas are less rare tumors than is generally believed. Even if its total frequency is not very high, it is worth noting that it isthey are in relation to other tumors of the thin as all the statistics attest ...

Two clinical observations of serious contusion of the pancreas are analyzed. An evaluation is made of clinical and paraclinical elements which permit its diagnosis. The general therapeutic indications to be followed in the treatment of these traumatisms, is considered.

1) Conditions ansmg as a result of cholecystectomis should be regarded as an important chapter in patholo.gy, comprising every' disease clinically manifest asan involvement of the doudeno-biliary junction. 2} A discussion is carried out of the various designations proposed for the symptoms persisting after the cholecystectomy and of the conceptual confusioncaused by sorne of them. 3) From studies conducted by other authors and by ourselves it may · be inferred that: a) Most of the poor results of cholecystectomies on functioning gallbladders are due solely to the higher frequency of cases where they are erroneously blamed for the involvement. In non-functioning gall-bladders the frequency of such erroris lower. b) Neither does the percentage. of good or poor results depend upon the presence or absence of gallstones but on the percentage of error in the indicationof surgery, which is higher in cholecystopathies without stones. The patient's fate is closely dependant on a thorough understanding of every feature of the disease.4 It has been demonstrated that the true sequelae of cholecystectomies are of rare oc.currence and are confined to three fac. ors namely, immediate post-opera ti vecliarrhea due to atony of Oddi's sphincter, :g)l hypochondrium involvement owing to duodenal bend arising from gallbladder bed adbesions and the affliction originat:ing in an amputation neuroma. 5 A survey is carried out of therapeutic ·errors resulting in the persistence of symptoms following gallbladder surgery, attention being drawn to the important role played by an insufficient understanding of frequent neurotic disorders.

Comparing surgical experience with the data obtained from dne-radiography, seriography and electromanometric recordings, the location of the ampulla of Vater is set in the submucous segment of the oddian canal. Two types of calculus of the oddian canal are described: that of the ampulla and the mural calculus, with their clinical, diagnostic and surgical differences. The difficulties of biliary catheterism are studied, with a description of three types of angulation of the oddian canal, and recommendation for its straighteningby traction to ease the pasage of the catheter. For the extFaction of the calculus of the ampulla of Vater three maneuvres are recommended: retro duodeno pancreaticseparation, controlled catheterism and supported biliary dredging, which, properly carried out, make for greater success in the upper or choledocotomy route and more exceptional the need for duodenopapillotomy.