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

Three observations of single isolated hydatid cysts of the pelvis are presented, one of which spontaneously opened into the vagina. The national as well as the foreign literature relating to this subject is reviewed,and the observations on peritoneal and pelvian echinococcosis to be found in the files at the Hospital de Clínicas, and in the Surgical Clinic of Prof. Piquinela at the Pasteur Hospital ( both Montevideo) are studied as a whole. On these bases the thesis is advanced that pathogenically these cysts correspond to the homotopic primitive echinócoccosis. They may be recognized and distinguished from the secondary cysts of · peritonealsowing by the surgeon through adequated exploration enabling him to uncover multiple differential  characteristics in both forms. The autopsy facts as revealed by the statistics of the Telémaco Susini Instituteof Buenos Aires, Argentina ( 18) are analyzed, to the effect of demonstrating overlapping with the surgical findings and the subsequent confirmation involved therein for the thesis set forth here, Also, the  undamental characteristics o heterotopic primitive peritoneal echinococcosis seen in these pa¡fers are studied and a large group of facts emphasized which distinguish it sharply from the homotopic primitive pelvian cysts. Finally, the doctrinarian value of tlüs study is stqted, as also the practical use to be ma9-e of it for diagnosis, on the clinical side as also in the surgical exploration, for surgical tactics as well as forprognosis of the disease. 

Introduction: Laparoscopy is currently the approach of choice for oncological resections of the colon and rectum, since it does not compromise their quality and offers the advantages of minimally invasive surgery. Description of contents: The main tactical aspects of the anterior resection of the rectum are described: patient positioning and surgical equipment, positioning of the trocars and technical steps. Medial dissection of the mesocolon identifying retroperitoneal structures, vascular control of the superior rectal artery and inferior mesenteric vein, lateral mobilization of the colon, meso-rectal dissection, distal rectal section, exteriorization and section of the piece, intracorporeal anastomosis, and drains. In all the steps emphasis is placed on the prophylaxis of accidents and / or intraoperative adverse events.  

68-year-old patient, with no surgical history.He was admitted to the Emergency Department with a clinical picture of intestinal occlusion. A simple abdominal radiograph was requested (only obtained in decubitus), observing the presence of Rigler's radiological triad, pathognomonic of the biliary ileum. The 3 elements are indicated: dilated thin handles (black arrow), aerobilia (white arrow) and the ectopic calcified stone in the right iliac fossa (yellow arrow). Gallstone ileus is intestinal occlusion as a consequence of the migration of a gallstone through a bilio-digestive fistula and its impaction, frequently at the level of the ileo-cecal valve. Usually it is a cholecysto-duodenal fistula, although it can also be a cholecysto-colonic fistula. The classically described clinical picture is that of intermittent occlusion, being more frequent in elderly patients, with a long history of symptomatic biliary lithiasis.  

We indicate the cases of inguinal hernias, direct or oblique, recurrences, or any big herniason weak abdominal walls on which metalic implants should be used. 

Tribute of leading figure of surgery in the country

The use of antitumoral chemical agents is discussed, and their classification as well as the commercial name of the products available in Uruguay is given. 

A therapeutic procedure for treating umbilical hernia not showing important unusual elements in considered, and an eclectic summary of the diffeterent techniques hither to published is presented. 

Two cases of post-operative necrotizing enteritis, of the peritonitic type, treated surgically and with a favorable course, are reported upon. A number of features underlying thesurgical technique used in these cases, are considered. The following conclusions are reached: 1) The greater extension of the mucous tissue lesions requires a careful examinationin order to determine the safety level for consecutive resection and anastomosis. 2) Simple closure with re-inforcement intestinal folding according to the technique advocated by Noble for perforated cases, has proved of great usefulness and ready application.

We submit a case of bile peritonitis with acute renal failure, in the evolution of an acute litiasic colecistitis and supurative litiasic coledocitis with peritoneal síndrome.The patient was admitted with coledocian icteric síndrome. The correct diagnosis was done and the patient was operated on after a short reanimating period. We tried the primary causing lesion and the actual bile peritonitis. We have used for the post-operative therapy the osmotic diuretic "Manitol". Recovery was satisfactory. We present a brief analysis of the biochemical síndrome and tried a sinthetic commentary of the problem. The operation was done during the acute renal failure itself with simultaneous treatment of the metabolic problem.

In cancer of the common bile duct, resection must include cistic duct and the head of the pancreas. Leaking of the jejunal loop after pancreatectomy is prevented by means ofa tube in the common bile duct or the cistic duct. When the hile duct stump is nor available, a transhepatic drainage is placed. This technic was used successfully in three cases.