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It report three cases of Primary Intestinal Lymphangiectasia that presented the common symptoms of diarrhea, oedema and hipoalbuminaemia in which we could observed the clinics variations that can to present this entity. It demonstrated the importance of the intestinal biopsy to get a correct diagnosis just as the essencial of use of the medium chain triglycerides with the restriction of the common fast, to recuperate these patients.

The intrahepactic lithisis is unusual in the Occidental hemisphere. The prevalence in Venezuela in unknown. We study all the edoscipic retrograde cholangiography carried for lithiasic pathology, in the Servicio de Gastroenterología, Hospital Universitario de Caracas, since January 1993 until April 1995. Over 342 patients, 9 were intrahepatic lithisis (1.16%). Seven cases of Caracas and two refered of the rest of the country. The sex was female in seven patients and males in two. The age range was 15 to 67 years old. The clinic feature much frequent was abdominal pain. The diagnosis was ultrasound and endoscopic retrograde cholangiography. The treatment was endoscopic with sphincterotomy and removal stones and surgical with resection in two cases, and choledocotomy in the other four cases.

The objective of the present study was to compare properties of two associations in the topical treatment of hemorrhoids. They were included 40 patient with diagnosis of internal hemorrhoids grade 1 or 2, which was indicated topic treatment after the realization of an interrogatory and anoscopy. The treatment received according to a randomized and double blind design: A = dobesilate of calcium with acetato of dexamethasone and lidocaine or B = Capronato of Prednisolone with Clorhidrato of dibucaina, applied twice a day. They were carried out controls every 7 days. In each control was carried out interrogatory and respective anoscopy. There was a prevalence of the females, and the age corresponded to the 5t decade of the life. Patients of the treatment. A presented greater number of predisponents factors, but minor percentage of previous treatments. As for the evaluation of the punctuation of symptoms and of the grade of Hemorrhoids, comparing beginning and final, they didn't show significant difference interproduct confirming the effectiveness and similar inocuity. In both products was observed a important improvement concerning to the symptoms and grade of hemorrhoids but the patients of the treatment A precipitated the greater speed. As for the evaluation made by the phisicians, the treatment A (88%) and B (85.7%) the got successful outputs. The opinion of the patients was a 100% of marked goods or moderated beneficial. Both treatments were successful so much in effectiveness like in inocuity although the treatment A were always got the best efectiveness outputs.

To establish the risk factors to hepatitis C virus (HCV) infection, we studied 120 patients divided in 2 groups: A first group of 40 patients with HCV infection, 24 (60%) with past medical history of blood transfusion, 14 (35%) of them also had hemodialysis and 3 Kidney transplant. 10 patients (25%) had mayor surgery without transfusion, 3 had frequent visits to the dentist and 3 month baby whose mother was HCV positive. In 4 patients we found no risk factors. A second group of 80 patients who visit our clinic for the first time, 2 were found positive for HCV (1.6%). 13 of them had blood transfusion, one was HCV+ (OR: 5.5, P = 0.73). 41 had history of mayor surgery, one HCV+ (OR: 0.95, P = 1.000). The risk factors related to HCV infection in our population were blood transfusion, hemodialysis and mayor surgery. The use of EV drugs, tatoos, sexual behavior, interfamiliar or vertical transmission were not risk factor in our population.

We report two cases of Primary small Intestinal Lymphoma (IPSID), in adults. The clinical presentation was, watery diarrhea and weight loss. The histology of this cases was non-Hodgkin's Lymphoma, and the treatment was chemotherapy.

We evaluated the efficiency of polyethylene glycol at low dosage as a treatment for constipation in the puerperium. A prospective, open label and control study was performed in 225 puerpery patients. We observed a 94.7% of study group patients and a 10.7% of a control group patients had a evacuation in the first 48 hours, (p < 0.01). Decreased consistency of the stools was seen in the PEG group (74.3%). According to our findings, low doses of PEG were useful and safe as a treatment for constipation in the puerperium, without side effects.

With the purpose of knowing the spectrum of the disease we studied the outcome of 64 children chronically infected by Hepatitis B Virus (HBV): 38 treated with Interferon (INF) and 26 without treatment. The period of infection was no less than 8 months, the average age was 4.7 years, 39 boys, 25 girls, and the observation period was 5 years, 3 moths (range 6 months-14 years). We divided them in 2 groups: a) 40 patients AgeBH positive from which 26 received treatment. b) 24 patients AgeBH negative from which 12 received treatment. We used 5,000,000 U. of interferon per M2 3 times a week for 16 weeks. The results do not show statistically difference that might favor the use of INF in order to reach seroconversion neither of Age nor Ags. Meanwhile the age is significant in Ags seroconversion. This might lead us to the question if seroconversion is due to the natural course of the disease once the body gets rid of the virus, or to interferon treatment. During the study period only one case turned to cirrhosis (1.7%) and none to Hepato carcinoma.

We report a case of hepatocellular carcinoma associated with fatty degeneration of the liver, which presented as and surgical acute abdomen, and was operated on at "Victorino Santaella" Hospital, being the first case observed at own Institution, and the only one reported in the national and international literature from 1971 to 1995.

Enzyme-linked immunosorbent assays (ELISA) have been developed to diagnose H. pylori infection. However, the methods are not standardized. We therefore evaluated the sensitivity of ELISA developed in our laboratory in a study population comprising 38 patients with dyspeptic symptoms and 41 healthy children under 10 years. The assays for immunoglobulin G used a pool of sonicated isolates of H. pylori from five patients with dyspeptic symptoms. Serum levels IgG antibodies to cell sonicates of H. pylori were significantly higher (p < 0.001) in patients with positive culture than in the control group. Cutoff score of 0.231 for positive results was determined with mean + 3ds of the healthy group analyzed. On the basis of this survey, we conclude that a serum dilution of 1:300 and 5 micrograms/ml of antigen, are the optimal condition for rapid screening with high sensitivity of 92% of symptomatic patients for the presence of H. pylori.

With the purpose of evaluate the Morbi-mortality related with the kind of surgery recommended by the Japanese Research Society for Gastric Cancer (JRSGC), 13 patients treated surgically by the Rules of that Society were reviewed. Eleven patients were males and 2 females, with ages between 24 and 72 years old. Twelve of them were operated at the Hospital "Dr. Luis Gómez López" (MSAS) and one in a private clinic, both centers located in Barquisimeto, Lara State. Twelve (92.3%) of the patients had advanced Gastric Cancer and only one case was an Early Gastric Cancer. Nine patients received a Distal Gastrectomy (69.23%) and 4 a Total Gastrectomy. Eight among the 13 also underwent a combined resection of another organ(s) (Spleen; 4: Transverse Colon: 1; some kind of Pancreatic resection: 3; Gallbladder: 2). Considering the kind of Radicality (= D2: lymph Node Level Dissection, based on the JRSGC), 10 patients (76.9%) received a D2 type (the Radicality recommended by the JRSGC), being also disected another Lymph Groups (ALFA), and the Paraortics one in 6 of them. The Post-operative Stages founded were: Ia: one case; II:2 cases; IIIb: 3 cases; IV a:2 cases and IVb: 5 cases (38.46%). In relation with the Post-operative Morbidity, directly related with this kind of surgery, only one patient with a severe Desnutrion developed a Fistula, but it healed spontaneously, after a conservative treatment. Two patients received a second surgery; one during the immediate Post-operative period because a Mesentery Rotation, and the other at the 20th. Post-operative day due to an eventration plus an abdominal wall abscess. Both patients were discharge in good conditions. None of the 13 cases stayed in an Intensive or Intermediate Care Unit. There was no case of Post-operative Mortality. It is important to reassure the low risk of Post-operative Complications with this kind of Radical surgery, for Gastric Cancer patients, even in those with nutrional deficit and with a minimal hospital conditions.