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

Hydatid disease is particularly serious in thigh loction. Latency stage extends over a prolonged period and diagnosis is not made at a sufficiently early stage.Disease is progressive and invading, with destruction of bone tissue. Bone has no defense, is destroyed and passive. to parasite injury. Diagnosis is based onbiolo;ical reactions. When X-rayed, lesions appear as areas of bone destruction, fil!ing defects or geodic images or "motheaten bone". This geodic osteosis process varies inextent and has no precise limits; there is no limiting reactional osteogenesis. Shape of bone is generally preserved. In exceptional cases bone may have a "deep fissure".There is bipolar geodic osteosis not affecting the joint and hydatid osteoarthritis in advanced forms. Eleven cases were studied: 8 men and 3 women. Lesions were locally malign and demanded early and radical treatment. This comprises two basic aspects: biological and surgical. Use of 33 o sodium chloride saturated solution, as proposed by Velarde Pérez, has become general and complements surgery. If located in cervical epiphysis of femur, Girlsdestone's operation makes total resection of lesion possible. Pelvian sector topography, involving cotyloid cavity (acetabulum). requires hemipelvectomy with partial resection of ilio-ischio-pubic sector; Limb may be preserved or not. This technique has been described byDr. Guglielmone.

Compression of main biliary tract by non-ruptured hydatid cysts, may cause obstructive jaundice with characteristics similar to those caused by biliary or pancreatic cancers.This rare cases may occur in cysts of the quadrate or Spigelian lobe which displace the. hepatic duct in the portal fissure, as well as in sone retropodicularor interportocoledochal cysts which occlude or laminate the coledochus. The latter may be accompanied by compressión or thrombosis of the vena porta, as was the case in twoof the five patients. Treatment consisted of drainage of cysts and main biliary tract, except in cases when the latter's calibre was small, as was the case in one of the patisntson whom colecystostomy was performed. Evolution of three of the patients was good, but those with portal thrombosis died. 

This report is based on 129 cases of liver echinococosis. Pre and post-operatory study has not enabled us to establish a clearly marked delimitation beaweencomplicated and non .complicated hydatid cyst. The term deemed most correct is "repercussion" on the different structures. There was repercussion on the biliarytract in 38.7 % of cases. 'Ibere is no hydatid cirrhosis but rather it should be considered as fibrosis. Surgical treatment consists of cystostomy.In supurated cases drainage should be rapid. This also applies to jaundieed forms of cholansitis. Repercussion of hydatid cyst on vascular system appears as compressionor thrombosis of portal or suprahepatic veins. Hepatobiliary complications are defined as direct or indirect aggression of liver parenchima and it becomes necessaryto prescribe surgical treatment directed fundamentally towards the. hepatobiliary sector in its broadest sense.

All cases of hepatic hydatidosis are related to the biliary tract and appear in two forms: a) cystobiliary communication or fisurisation and b) open, evacuatedor fistulized cyst . of biliary tract. Two surgical situations arise, according to the degree of biliary involvement: A) In the case. of communicated or fisurized cyst,it becomes necessary to evacuate the parasite and drain the cavity; B) In open, evacuated or fistulized cysts, three surgical procedures are applicable:i) Cystostomy;. which is the fundamental operation. ii) Cystostomy and drainage of biliary tract:' this is the complete surgical procedure. iii) Choledochostomy. This procedure is generally incomplete as sole conduct, but it may also be complementary to prior cystostomy. Experience is documented by the two statistics on which this paper is based. 

The authors refer to total prothetic replacement of thigs. The four fundamental principles in prothetic replacements of any joint, and thigh in particular, arediscussed. They are: 1) use of inert materials; 2) satisfactory mechanic design of prothesis; 3) attachment of prothesis to live bone, 4) surgical technique employed.Reference is made to postoperatory period -mediate and immediate- listing sone principles for rehabilitation of patients thus treated.

In hepatic hydatidosis, angiography of celiac trunk •is of value since through it possible to establish the cystic nature of the process, with its dense pericystichalo in a high percentage of cases; it is possible to make a differential diagnosis with respect to other avascular and vascularized processes. The paper ennumerates sone of the characteristic elements of hydatid cyst and its vascular semiology. ·It is important to take due note of semiological value of splenoportal venous return determining hemodynamicalterations. It also serves to localize hemobiliae in recently operated patients and in removed post-operatory cases serves to evaluate hepatic atrophies or hyperatrophies.

Among hepatic lesions caused by hydatidosis we find diffuse fibrosis which should be differenciated from cirrhosis. We also find inespecific reactive hepatitis,supurated angiocholitis and cystobilary communcations. These are described in the paper. We also find a detailed account of alterations of vascularsystem both near to and removed from parasite syst and an account of the role of diffusion of pariadventitial inflamatory process in lesions of vessels.

Se insiste en la necesidad de un conocimiento cabal de la anatomía quirúrgica del cotilo, concebido como una cavidad articular. formada por tres columnas. Se detallan los elementos a interpretar en los tres enfoques radiográficos que se consideran imprescindibles.S e establece una clasificación patogénica agrupando las lesiones e nlos tres sectores del cotilo. Se dan lineamientos generales de orientación terapéutica.

Tribute to uruguayan surgeon

A case of ateromatous obstruction of both internal carotids was successfully treated through revascularization of externa! carotids by venous graft from subclavianon one side and thromboendarteriectomy on the other.