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

A report is made of 8 cases with abdominal visceral lesions in conjuntion with multiple injuries, of which 6 with hemoperitoneum and 2 with peritonitis following injury to hollow viscera. Attention is drawn to diagnostic difficulties in this type of patients, particularly in cases of disaster. Delayed detection of actual conditions is one of primary causesof poor diagnosis. The gratifying results of diagnostic paracentesis are described. The procedure was found harmless, readily available and throroughly safe when positive.

The long term post-operative course in the operation of Noble, as performed at the University Hospital of Montevideo, is discussed. 1) Of the 16 patients operated on, 12 have developed no new oclussions. 2) Of the 4 cases operated on for clinical oclussion, mechanical block has been observed only in l. 3) The course of total and partial Noble surgery is studied separately. 4) Attention is drawn to the pathological nature of the massive viscero-parietal adhesion and to the fact that it gives rise to intestinal symptoms, the condition being prevented by interposing the uninvolved greater omentum. 5) The salient features of an operative technique conducive to satisfactory results are discussed. 6) Adequate approach to occlusion from curling is dealt with.

Six cases of cordonal phlebitis following superficial inflammatory processes of the axila and thoraco-abdominal wall are reporte d. Clinical and diagnostic features are discussed, attention being drawn to the fact that it.s rareness is partly due to the lack of detention. It is a benign process often mistaken for carcinomatous lymphangitis. Pathologically it is mainly marked by an interstitial sub-acute inflamatory process giving rise to a superficial phlebitis with narrowing of the venous lumen. Thrombosis was present in one case. The important etiopathogenetic role of the infection in the available series of cases is pointed out.

The ligature of the hypogastric artery, a technique already applied in various countries is a simple, probably life-saving measure in severe pelvic injuries, as it enables the checking of the overpowering hemorrhages underlying their severity. It has been contended that shock cases slould not be operated on, but in the light . of present-day knowledge persistent shock  may be the foremost indication for emergency surgery.

40-year-old patient (IRV) who, due to a polio sequela, has supported a crutch in his left armpit since childhood (4 years), which never caused him disorders until a few days ago, when he began to feel paresthesia in his fingers hand (tingling, coldness) which he relieves by lying down and putting his hand on the decline ...

A case of severe sigmoí vol ulus is reported upon. Treatment in volved: devol ation, intestinal resection and anas omosis without decompressive anus. The po operativecourse was satisfactory.

Two new cases of íleo-cecal invagination in the adult are reported upon. Following a discussion of their clinical features, a brief survey of keys to diagnosis and treatement is presented.

Reflux esophagitis is a serious complication that requires the greatest preoccupation of the surgeon for prophilaxis and surgical treatment. 

A study is carried out of the early post-operative of 34 patients operated upon at the Surgical Clinic "B" ( University Hospital, Montevideo), for a complicated or medically intractable duodenal ulcer. The operation consisted of non-selective vagotomy associated with pyloroplastic ( 27 cases), gastrojejunostomy ( 6 cases), and antrectomy with gastrojejunostomy( 1 case). The series includes 2 perforated ulcers, 1 bleeding ulcer and 3 cases of postpy loric stenosis of ulcerous origin. The following conclusions were inferable:1) Absence of operative and post-operative mortality.2) Absence of post-vagotomy gastric retencion ( gastric atony) beyond the 5th. day.3) Absence of failures in the pyloroplasty.4) Absence of post-operative gastroduodenal hemorrage.5) Subsidance of the pre-operative clinical symptomatology.6) Occurrence of diarrhea in 35 % of cases and infectious complications ( wound suppuration, acute pne umopaty) in 38,2 % 0f cases.  7) Clinical and X-ray evidence bears out the existence of a gastroduodena! dysfuntion during the first 2-4 post-operative days, marked by insufficient gastric drainage to the duodenum, ich renders necessary  gastric aspiration and support feeding by the parenteral or duodenal route. In case of preoperative suspi:cion of important gastric retencion ( large hydric  ypersecretories), a temporary degravitation gastrostomy is advised.

A case of digestive hemorrage traced to a gastric polypus is reported upon. Its presentation is prompted by the fact that its occurrence gave rise to differing pathological reports, with no agreement on definite histological identification. The case was eventually laJelled as a "rare gastric tumor". The procedure involved an extensive resection of the implanta,cion site and a long term follow -up of the patient, whose recovery was complete- by the 8th postoperative month. A survey of 250.700 cases of benign gastric tumors shows that the inci odence for the foregoing tumors i s very low ( 8 cases per 100.000). A general discussion of gastric polypus is finally carried out.