Revista espanola de las enfermedades del aparato digestivo最新文献

In this report, the possible effects of povidone iodide (PVP-I) on the biliary system are studied in an experimental study using dogs. We used 20 dogs divided in two study groups. Light microscopy and electronic scanning microscopy (SEM) were used. We demonstrated that in the tied choledochus, intermittent washings with PVP-I caused a notable injury pattern on the biliary system.

The intestinal paralysis that follows peritonitis has been classically explained as the result of local inflammation of the overlying serosa (Stokes's law). The main object of this study is to determine if these motor alterations, the most relevant of them being intestinal paralysis, are really due to local factors or to general factors in view of the intense affectation that peritonitis induces in the organism. For this purpose we used animals with an isolated and exteriorized intestinal loop to study loop motility during peritonitis in the absence of direct local contact with the process. To test the operation of the smooth intestinal muscle and intrinsic plexus we used two types of motor stimuli: hormonal (insulin) and pure (prostigmine). We found that the isolated loop presented the normal motor characteristics of the small intestine. When peritonitis was achieved, all motor activity ceased in the intracavitary loops and in the isolated loops exposed to acid, so all the intestinal segments were completely paralyzed. The administration of insulin under these circumstances only had effect on the exteriorized loop, where we recorded motor activity similar to that of normal conditions. The administration of prostigmine caused the appearance of a sharp, synchronic contraction of the three intestinal segments studied. Based on these findings, we conclude that the smooth fiber of the small intestine is not paralyzed during peritonitis and can exhibit intense contraction when the motor plate is stimulated with prostigmine.(ABSTRACT TRUNCATED AT 250 WORDS)

We reviewed 79 patients with a picture of pleural effusion (EP) and ascites, who represented 8% of a total of 982 pleural effusions studied. Liver cirrhosis (CH), 37 cases (47%), disseminated carcinomatosis, 31 cases (39.5%), and congestive heart failure, 6 cases (7%), were the main causes. We made two groups of liver cirrhosis: A) liver cirrhosis with hydropic decompensation, 12 patients (15%), and B) liver cirrhosis with an additional complication added to the above, 25 patients (31.5%), this being infectious in 88% of the cases. In the B group there were cases of left hydrothorax, more features of effusion and a lower survival at 3 months of follow-up than in tha A group. Effusions of neoplastic origin were most frequently seen in tumors of the ovary, digestive system, lymphomas and undetermined origin. In malignant effusions, the cytology was positive in pleura in 60% and in ascites in 55%. Twenty percent of peritoneal fluids and 47% of pleural effusions were serohemorrhagic and 100% and 88%, respectively, were of exudative nature. In liver cirrhosis the ascites was serofibrinous and transudated (100% in group A and 85.5% in B) and the pleural effusion was a serofibrinous transudate except in the cases in which there was an added infection. We confirm the ominous prognosis of the coexistence of pleural effusion and ascites.

We present a case of an infrequent association of colonic carcinoma and hypernephroma. Despite the relative infrequency of this kind of association, they are now commonly reported, so we should not consider multiple primary carcinomas as a sporadic phenomenon, but rather as a frequent phenomenon with important clinical implications.

We present a case of a brucellar liver abscess in a 25-year-old male that was successfully treated by surgery and comment on this unusual form of brucellosis. We detail the complementary exams and how the diagnosis was achieved. We also review the 23 cases reported in the world literature, commenting on them from an etiological, clinical, diagnostic and therapeutic point of view in its two aspects: medical and surgical.

To discover the biochemical alterations occurring in the first 24 hours of acute pancreatitis (PA), we made an experimental study using rats. We used 90 animals in which necrosis and hemorrhage were induced by closing the choledochus. Animals underwent evolutive periods of 1, 2, 3, 4, 5, 6, 12, 18 and 24 hours. They were sacrificed and plasma (to determine amylase, lipase, creatinine and calcium), urine (amylase and creatinine), ascitic and pleural liquid (amylase and lipase) were obtained from 6 animals of each evolutive period. We made a post-mortem study of the pancreas of three animals of each subgroup. There was a significant increase in the amylasemia from the third hour (p less than 0.005) and of plasmatic lipase from the first hour (p less than 0.0001). Creatinine values remained in normal range and calcemia fell after the sixth hour (p less than 0.001). There was an increase in amylase concentration in urine and in ascitic and pleural liquids, and of the lipase in the last two. These changes correlated with the duration of the disease and with the histologic changes of the gland, which consist in edema, acinar necrosis, vasculitis and hemorrhage, which are present from the first hour and increase as time passes.

Cells that produce somatostatin are widely distributed throughout the digestive tube. They are found in the stomach, small bowel, large bowel and pancreas. The authors used 54 Wistar rats, with an approximate weight of 300 gr, to evaluate the possible variations of the D cell population in isolated and functional intestinal segments, using jejuno-ileal bypass as a model. Rats were divided into three groups, a control group and two groups in which simple derivation techniques were performed following the techniques of Payne and DeWind, and Scott. Rats were sacrificed after 7, 30 and 90 days in subgroups of six animals. Macroscopic, microscopic and ultrastructural studies were carried out. Cells were specifically stained using immunocytochemical techniques (PAP). The corresponding values of the mucous areas were obtained using a computerized image analyzer (Quantimet 800) and then the number of D cells per mm2 mucosa was calculated. The results show a decrease in the number of D cells per mm2 of mucosa in the functional intestinal segments and degranulation of these cells, coinciding with the existence of large areas of rough endoplasmic reticulum (sign of cellular hyperactivity).