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

1) A case of arterio-venous fistula of the large hypogastric artery and vein, is reported upon. 2) There was no hemodynamic repercussion and tolerance was good. 3) Arteriography showed the arterial radiologic features corresponding to cases of arterio-venous fistulas. 4) Surgical findings confirmed X-ray findings leading to aneurysmectomy withpreservation of th

A survey oJ our series of surgical cases involves findings in agreement with those reported in the literature, i.e. 1) Absence of mortality. 2) Minimal morbidity and importanceof complications. 3) Low incidence and searce entity of functional sequelae in the long-term postoperative. 4) Effectiveness in obtaining an important reduction in the gastric secretionof HCl.

The finding of a foreign body (compress) left in the abdomen 6 years before an emergency operation, is reported. It become lodged in the intestinal lumen· but did not provoke any passage disturbances owing to the development of multiple jejuno-jejunal fistules which restored the continuity of the small intestine. Pathological evidences is submitted.

The technique of inferior mediastinal sector vaguectomy using the abdominal transdiaphragmatic approach is described. The anatomical surgical foundations are given that allow its easy execution and avoid operative accidents. Its advantages are emphasized: the trunk sector of the vagus, preservation of the esophagohiatus diaphragmatic structures (apparatuscardial), a method that prevents hiatal hernias. Feasible technique despite being abdominal reoperation with peritoneal sequelae and adhesions, also complying withthe gastric drainage procedure.

A report is made of a typical case of calcifying chronic pancreatitis in an alcoholic, involving sharp pain and common duct occlusion. Resection ( cephaic duodeno-pancreatectomy) resulted in clinical remission, there remaining as sequela a shight exocrine and endocrine insufficienc'.

A survey is carried out of papillotomy on the basis of 63 cases treated throughout the last 10 years. A correct operative indication is the basis of satisfactory longtermresults. Inflammatory papillary stenosis is the most common causative factor, frequently wet with in connection with repeated bilé-duct surgery and associated with common duct lithiasis, followed by gallstone impactation in the ampoule ( tactical indication) and, far less frequently, by chronic pancreatitis, Wirsung's exploration and oddian hypertony.

A survey is carried out of the immediate and long-term results of papillotoby, a comparison being made with two series of 71 and 28 cases, respeétively. It is shown that papillotomy increases the rate of complications and fatal out comes in conjunction with hile duct surgery. Duodenal fistula and acute pancreatitis are the most frequent and serious complications, usually resulting from on erroneous operative approach. Long-term results are excellent, the cause of failures being imputable to undue indications for papillotomy.

The paper presents sone experimental work on the study of miocardial revascularization as per Vineberg's technique, and the results thereof are analyzed.

Nine cases of inferior vena cava wounds with a mortality under 55 % , are dealt with. All of the patients undergoing tamponade died. Systemati; operative exploration inevery instance ·of retroperitoneal hematoma is advocated.  Attention is drawn to the need for preventive measures et surgery before dealing with the retroperitoneal hematoma.In cases where suture is not feasible, ligature with lesion underneath the renal veins is regarded as the procedure of choice ( case 9) . The cause of death is due to hemorrahgicshock in 90 % of cases and as a result there should be no delay in dealing with continnous bleeding and in operating prior to build-up measures since surgery is an essential p,rt of reanimation.

A special type of non obstructive primary lymphoedema of the lower extremities is analysed. In this form, unilateral or bilateral varicose main lymphatic trunks of the lower extremities and abdomen below the cisterne chyli are present. There is also agenesia of the inguinal, iliac, lumbar and aortic ganglions and drainage is performed by non valvuletdcollectors. The important role of the cisterne chyliand the lymphatic ganglions of the system, which prevent backflow of lymph is emphatized. In case the ganglions areabsent and valvless channels are present, backflow syndrome of lymph in the lower extremities develops. Accoding this ethiology and phisiopathologie, the operation proposed by E. Tosatti, consisting in the excision of the suprainguinal coUectors seems logical. The first case of a lymph backflow syndrome in our country is presented. Diagnosis was made by lymphangiography, and Tosatti's operation performed by Dr. J. Mañana. The patient, male, ayed 15 years, developed a 2nd. degree lymphoedema of the right limb when he was 12 years old. The presence of inguinal ganglions on the left side prevented backflow and lymphoedema of the other limb. Post-operative evolution was excellent.