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Glucose 6 phosphate dehydrogenase (G6PD) is an enzyme related to the metabolism of glutation, an antioxidant agent. Its deficiency causes hemolisis, generally well tolerated. However there are some factors including, exercise, infections and oxidants drugs that stimulate the hemolisis of the older red blood cells. We report two patients with G6PD deficiency, that were initially diagnosed as acute viral hepatitis. Although this pathology is not frequent it should be recognized, for the implication of giving profilactic antimalaric drugs in endemic areas. The diagnosis should be suspected in patients with unconjugated jaundice, always investigating the previous ingestion of oxidants drugs.

We studied the association between esophageal varices as the course of upper gastrointestinal bleeding and hepatic cirrhosis. 154 patients were admitted 43 patients in which esophageal varices bleeding was diagnosed were considered "CASES". 111 patients in which the source of bleeding was different (peptic ulcer, duodenitis, gastritis or tumor) were considered "CONTROL". The diagnosis of hepatic cirrhosis was confirmed in 69 patients in this group the main cause of bleeding was varices (62%). The "CASES" and "CONTROL" were crossed in 2 x 2 tables with the cirrhosis variable. Hepatic cirrhosis showed statistic and epidemiological association with variceal bleeding by means of CHi Square (p less .005) and Odds ratio about 138.92 with 95% confidence interval about 18.92 to 2844.8. In the control group this associations was not proved.

During a period of six years, 33.452 histopathological studies were reviewed among which were found 285 cases with malignant neoplasm of the colon. 69% of the patients were between fifty and sixty years of age. The diagnosis of colonic adenocarcinoma was positive in 90.17% of the cases. 58.9% of the tumors were localized in the rectum and sigmoid. The remaining 41.06% of the tumors were not subject to rectosigmoidoscopy. The epidemiological analysis was made. Most of the patients were found with locally advanced cancer with a predominance of poor differentiated tumours, which represents a complex challenge to the surgeon.

We present a case of Cronkhite-Canada Syndrome with gastrointestinal polyposis, which is the first one to be reported in this country. We make a review of the literature and compare the clinical and anatomopathological finding in this case with others described.

Portal Hypertensive Gastropathy (PHG) diagnosed in 42 patients by upper gastrointestinal endoscopy and was correlated with histological findings of gastric biopsies taken from fundus-body and antrum and observed blinded by the pathologist. We found that in the fundus PHG was observed in 97.14% and of these 77.14% were mosaic pattern. Submucosal vessel dilatation was observed in 65.71%, congestion in 60% and chronic gastritis in 62.85%. Histologic and endoscopic correlation was possible in 85.71%. Our results show a histologic and endoscopic correlation.

Viral hepatitis serological markers were analyzed in two groups of pregnant women residing in Caracas from: 1) a maternity unit at the moment of delivery (106 sera, low income population), and 2) a private clinic during the third trimester of pregnancy (105 sera, medium-high economic class population). A higher percent positivity was observed in the maternity unit compared to the private clinic for hepatitis A virus (HAV) as measured by anti-HAV activity (96% vs 48%; p < 0.01%), for hepatitis B virus (HBV) as measured by anti-HBc activity (13% vs 2%; p < 0.01%), but not for HBV carriage, as measured by HBsAg (3.8% vs 0%; p = 0.06 %). These differences appear to correlate with the socio-economic level. All the HBsAg positive sera were HBeAg negative and negative for the presence of DNA by PCR, confirming the low rate of perinatal transmission observed in Venezuela. Two out of 106 sera (1.9%) were positive for HCV antibodies in the maternity unit and 0/105 in the private clinic, although these differences were non significant (N.S.). Two out of 106 sera (1.9%) were positive for HEV antibodies in the maternity unit and 1/80 (1.3%) in the private clinic (N.S.). The anti-HEV seropositivity probably reflects a past infection. The importance of testing these viral markers during pregnancy is discussed.

We present a case of gastrocolic fistula secondary to a benign gastric ulcer. In our Knowledge, this is the first reported case with an endoscopic diagnosis using the video-system; we did a complementary upper radiological series with oral contrast. This patient was treated with a subtotal gastrectomy and primary closure of the colonic defect.

In the hope of finding those patients whose pancreas pseudocyst resolution were spontaneous, we undertook a retrospective review of such cases admitted at the Hospital Central de San Cristobal y Hospital Patrocinio Peñuela Ruiz (from IVSS), with the diagnosis of acute pancreatitis. From 619 patients with pancreatitis, 40 developed a pseudocyst (5.78%). The most frequent ethiology was biliary disease (47.5%) and abdominal pain in 87.5%, the most common symptom. Abdominal ultrasonography was the best diagnostic aid. Spontaneous resolution occur in 24 cases (60%) in juntion with the normalization of seric and urinary amylases values, the size of the cyst in these patients was less than 5 cms. Sixteen patients needed surgery, in 8 of them the seric amylase value remained high and in 3 cases this value was normal but with a cyst size more than five cms. Internal drainage in 11, external in 4 and surgical resection in one. There was no deaths in this review.