[Portal blood flow studied in children with portal hypertension using Doppler duplex echocardiography]. / Estudio del flujo sanguíneo portal, en niños con hipertensión portal, mediante ecografía Doppler dúplex.

UNLABELLED: The study of portal morphology and hemodynamics is due the fact that the principle symptoms of portal hypertension are due primarily to alterations in the circulation of the venous portal system. The Doppler duplex echography (bidimensional echography in real time plus pulsatile Doppler) allows one to study these circulatory alterations in a non-invasive manner. MATERIAL AND METHOD: For these studies, an echograph (Toshiba, model Sonolayer SSH-60A) was used to study the morphology and the blood flow of the portal vein and the hepatic artery in 83 children. These children were divided into 4 groups: a) 9 children with atresia of the biliary ducts, b) 11 children with cavernoma of the portal vessel, c) 5 children with neonatal hepatitis and d) 58 healthy children. The parameters studied included the calibre, cross-sectional area, perimeter, velocity, blood flow volume, index of congestion and fluctuation and the direction of the portal flow, as well as the index of resistance of the hepatic artery. RESULTS: The results obtained in groups a, b and c were compared to healthy children of the same weight. When compared to normal children, it was found that children with portal hypertension had a decrease in the velocity and volume of the blood flow with respiration. There were no differences in the size of the portal vein nor in the index of resistance of the hepatic artery. The values obtained in children with neonatal hepatitis did not differ from those found in healthy children. CONCLUSIONS: We conclude that the Doppler duplex echography is an excellent method for the diagnosis and follow-up of portal hypertension, as well as for the detection of this condition early in asymptomatic patients.

[Evaluation of the portal blood flow in healthy children by Doppler duplex echography]. / Valoración del flujo sanguíneo portal, en niños sanos, mediante ecografía Doppler duplex.

We have measured the dimensions and blood flow of the portal vein, as well as the resistance rate of the hepatic artery in eighty-two healthy children by using Duplex Doppler Echography. From the data obtained, we have observed that the parameters of size and blood flow of the portal vein increase with the age, weight and height of the child, with a greater correlation with weight and height than with age. We did not observed any difference between males and females nor any variation in the resistance rate of the hepatic artery with age, weight or height.

[Galactosemia and cow's milk intolerance (author's transl)]. / Galactosemia e intolerancia a proteínas vacunas. Estudio clínico-bioquímico y anatómico.

The clinical, biochemical and anatomical studies of one case of galactosemia with cow's milk intolerance in a one month old infant are reported. Diagnosis was ascertained measuring the enzyme (Gal-1-P-Uridyl-transferase) deficiency with the methods of Anderson, Kalckar and Isselbacher. Overload and enzymatic studies were also carried out in relatives. The interest of this association of galactosemia with cow's milk intolerance, and its clinical and therapeutic implications are pointed out in the discussion.

[Idiopathic intestinal lymphangiectasis. Evolution with M.C.T. (author's transl)]. / Linfangiectasia intestinal idiopática. Evolución con triglicéridos de cadena media

A case of idiopathic intestinal lymphangiectasis is reported in a three month old child. Clinical course and laboratory findings are given in relation to administration of three diets containing different concentrations and types of fat. Short term improvement was only noticed with diets containing low concentrations of long chain triglycerides supplement with medium chain triglycerides. Clinical manifestations related to fat malabsortion improved greatly but there was no relationship with serum protein level. No effect on low level of gamma-globulins and lymphatic displasia was found as sawn in an intestinal biopsy performed after three months of treatment. Nevertheless, long-term results were poor and only were evident in a diminution of steatorrhea and normalization of stools.