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Nuevo Consejo de Administración.Cita en Quito

-The authors present a hundred cases oi acute cholecystitis. I'hey develop the pathological concept about che e.O.A, and establish the judgments of convenient operation according ti two concepts: a) Concept of time wich allows us to distinguish three surgical peeriods: 1st. Early or opportune peeriod; before the 5th.day; 2nd. intermediate period, between the 5th. and 12th day; 3rd. late period, after the 12 days. b) Concept of evolution, time clinics and paraclinics indexes are enumerated, wich lead to the surgical suggestion. -The importance of the balance and treatment preoperative of the patient is remarked.  -The principal lineaments of the complete operation to make in the e.O.A. are noted. -Cholecystectomy from fundus to neck, subserous, cystic cathe terism, drainage transcystic of choledochus simple manometda, cholangiography and aspirated subhepatic drainage. This is the op!ration to perform, when the general and local conditions are allowed, which is almost always possible before the 5th day of evolution of the_ e.O.A.-It is noted the circunstances in which the complete operative plan must be limited to avoid risks to the patient. -The analysis of the results let us take as consequences that the e.O.A. has not mortality before the 5th. day of evolution and the cholecystectomy is the correct operation in that period,

The authors relate the first two oases found in Uruguay of primary sclerosing cholangitis proved histologically, and complying with characteristics set inliterature for this disease. One of the patients was treated by simple drainage of common bile duct and the other by transhepatic intubation of the bile duct through an old permeablecholedocoduodenostomy. We do not believe that transhepatic intubati'On techniques ever been used in treatment of this disease. In this particular case a transhepatic, transgastric tubein seton was placed, so that it could later be changerl 

Gastrectomies performed totalled i350 cases; there were 6 cases of high jejunal postoperatory occlusions and only one patient died ( death rate: 16 % ) .Occlusions were due to adhesions and kinks of the efferent loop in 4 cases and of the afferent loop in another. The sixth case was caused by retrogradeinvagination of efferent- tip through jejuno-jejunal anastomosis in the lower part at 'the foot of gastrectomy.

The authors refer their experience in symptomatic treatment of malign discharge of serosas. In 1953 they performed a derivation (shunt) through a skin tube,communicating the peritoneum with the cell tissue (subcutaneous tissue). La ter this tube was substituted by vinyl polichloride tubes. Their technique is simple applicablenot only in the peritoneal but also in the pleural cavity. They believe that the. liquid probably has inmunological effect which yould add to the positive mechanical effect. Liquid is also extracted by the venous path. In both casse the_ patients are spared spoiiation resulting from repeated punctures. This method may also be applied in certain cases of peritonealeffusion due to portal hypertension.

In children between the ages of eight and fourteen, in whom arch supports have failed, a surgical therapy is suggested. It is important to restore heel alignment,correcting its va!gus and pronation (interna! rotation), is well to correct the longitudinal arch. The operation is performed on tendons and capsular structures, without any arthrodesis. The lengthening of the tendo calcaneous is a preliminary procedure aimed at freeing the heel for its rea!ignment. The anterior tibial tendon is transferred, rerouting it without disinsertion and passing it through an osteotomy and a slot in the navicular end; the posterior tibia! tendon which had previously been dissected from its insertion, is reattached.For eight weeks a cast is applied. Walking is not permitted until then. 

This is the presentation of one case of a live.r subcapsular traumatic hematome. The authors remark the peculiar anatomic and clinic aspects of this liver traumatismand make patologic and clinical considerations about this case. They study a radiologic aspect (falling of the right colon angle) which has not been shown inthe bibliography making conslderations from surgery point of view.

In Japan great progress has been achieved in the early diagnosis of gastric cancer. The procedure employed is Endoscopy performedby fiberscope, which permits vi,sualization of complete gastric mucosa, biopsies and citologic lavage or study by smear of biopsed piece. The method most employed is the latter.