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

A hundred and seventy-five cases of gall baldder cancers treated at the University Hospital (Hospital de Clínicas) in the period 1954-1971, are analyzed. Gall bladder cancer is discussed, including clinical aspects, diagnosis and treatment. The paper includes a summary of literature on this subject. Recent advances in its ireatment and the opinionof severa! authors on controversia! aspects are included. In the light of present knowledge and results obtained, the author indicates radical surgical treai;mentin cases of gall bladder cancer.

Two aspects of gastrectomy due to "gigantic", high. posterior gastric ulcus, exteriorized in retrocavity, are brought up for consideration. The first refers to surgicaltactics in gastric abscission and its management; the second to the use of temporary transgastric intubation of efferent loop ( utilizing plastic tube) for postoperatorycontrol and eventual solution of possible complications. The latter might consist of suture failures, llakege, etc. It is easy to perform, simple, well-tollerated and has practically no morbility.

A patient had repeated biliary-tract operations and during the cours e of supurated choliangitis due to riOsidual lithiasis of choledocus, was found to have frornhemobile. This is a rare consequence of a· hepatic abscesses, pathogeny resulted in septic necrosis of hepatic walL Its origin may lie not only in erosion of a largevessel but also in bleeding of granulation tissue. Adequate treatment of inicial disease is deemed important. However, exact topographic diagnosis is difficult.

The paper covers a case material of 10 carcinoid tumors of the digestive tract and discusses their clinical aspects and therapy. Two were rare, being located in the. cystic duct ( the only case in world literature available) and in the duodenum (having started as a perforation in the free peritoneum). National bibliography was increased by two cases of carcinoidtumor accompanied by carcinoid syndrome.

A case of cystadenome of the pancreas is reported, a rare tumor especially when located in the head of the visu. On examination this tumor, aswell as the. great majorityof the cases quoted from the literature, was very large. Surgical treatment employed was cephalic duodenopancreatectomy. Histological and oncological basis of this procedureare considered. Bibliography was reviewed. Technical hazards are outlined. The histological data are presented.

A patient underwent colostomy with extraperitoneal closure and in the immediate postoperatory period suffered intestinal invagination. The author attributesit to the reduced space left to the colon after replacing it in the abdomen.

Consideration of one case of isolated caecal diverticulitis includes discussion of peroperatory semiological. manouvres for the purpose of diagnosis and adequatetreatment of this benign disease.

Normal hip development follows a pre-established schedule imprinted into its genes. During fetal development the muscles which participatein skeleton remodellation, appear. If muscle structure is altered due to any genetic or acquired factor, its function becomes etiogenic and produces skeleton alterations which affect the joints in particular. Myodysplasia alters its normal development by means of severa! mechanisms: 1 . Increase in pressure between joint components.2. Morp).ological alterations of collum ( neck). 3. Malfunction of joints which tend to dislocate. Etiogenic activity of dysplasic muscles acts on movable segment of hip, i. e. upper end of femur. Alterations of cotyloid cavity ( acetabulum) are secondary to femoral alterations. ''here is delay in appearence and growth of epiphysis due to excessive compression which affects its circulation. In extreme cases this results in total ischemia with necrosis of epiphysis. Normal evolution of femur collum stops, re&ulting in valgus and anteversion in variable degree, due to disharmonic acttvi,y- of muscles. By reason of same mechanism, normal relationship of cotyloid cavity (acetabulum) with epiphysis is lost.Morphology of cotyloid cavity (acetabulum) is altered due to abnormal position of head. This abnormal position is due to morphological alterations ofcollum and to dislocating action of dysplasic muscles. Consequently it can be classified as a secondary dysplasia. Sequel!a in mild forms i¡ represented by an apparentlynormal cotyloid cavity ( acetabulum), which however is lacking in depth; this can be detected by increased thickness of cotyloid cavity (acetabulum). lt is called pre-dislocation. In more serious forms the cotyloid roof ceiling ( acetabulum) is altered so that it is vertically broad with slanting roof ( ceiling. insufficiently deep and very thick. This is termed subdislocation.Finally, in congenital dislocation there is dillocated head and altered epiphysis. Cotyloid cavity ( acetabulum) is small in all its diameters and bottom is thin, thus differing from abovementioned cases.

A case of endocraneal hypertension due to malíng glioma resulted in respiratory failure due to lobule tonsil nailing and bulbar compression. The patientreceived urgency treatment consisting of surgical decompression of spinal bulb.

The paper refers to condropathy of joints, its complications and sequella and coxa vara in adolescents. Physiopathological hypothesis of slipping points toaction of adductor and externa] rotating muscles, specially psoas. We base our treatment on above hypothesis;, adductors and psoas are abscissed and action of gravityis avoide.d in cases of non complicated condropathies with chronic slipping; this is followed by adjlstment and immobilization in plaster cast in acute and subacutecases. In the latter, when adjustment is not induced by manouvres, we perform myotomy followed by open field adjustment and immobilization in pelvipaediumplaster cast. Finally, we have treatment of coxa vara sequella through intratrochanteric tendimentional osteotomies, correcting varus and epiphyses retroversion, or throughanterosuperior wedge cervical osteotomies following capsule graft on epiphyses to provide greater vascularization and prevent necrosis.