[Treatment of choledocholithiasis at the General Hospital of Mexico, S.S]. / Tratamiento de la coledocolitiasis en el Hospital General de México, S.S.

We present two years of our surgical experience in the Gastroenterologic department of General Hospital of Mexico city; we studied prospectively 23 patients with choledocholithiasis diagnosed preoperatively and postoperatively, 18 females (78%) and 5 males (22%). Diagnosis were performed preoperatively by sonogram, intravenous cholangiography and/or endoscopic retrograde pancreatocholangiography in 19 cases, and postoperatively in four cases. In 22 cases we performed colecistectomy with choledocotomy, extraction of calculi and placement of a "T" biliary catheter. In only one case was necessary a choledoco-duodenal anastomosis. We observed morbility in 3 cases (13%), and a patient died postoperatively (4%). The postoperative follow up was satisfactory in 83% of these cases.

[A comparative study of 2 methods of preparation for colonoscopic procedure]. / Estudio comparativo de dos esquemas de preparación para procedimiento colonoscópico.

BACKGROUND: Although ingestion of polyethylene glycol solution has become the standard preparation for colonoscopy since 1980, there is investigation of new safe, comfortable and cheap methods. OBJECTIVE: We carried out a prospective study in order to compare the utility and tolerance related to the preparation of the colon for colonoscopy, using a dioctyl sodium sulfosuccinate enema (SD) versus our conventional preparation. METHOD: Group A was prepared the day previous to the study with liquid diet, oral laxative and application of an SD, prior to the endoscopy received another SD. Group B was prepared three days with liquid diet, the day previous to the colonoscopy they ingested oral laxative and used a water enema (W(e)), and they used another W(e) the day of the procedure. The patients' tolerance in each case was compared using a scale assigned as good, fair and poor. The cleaning obtained in the colon was also evaluated in a scale of good, regular and bad, considering three colon segments. RESULTS: Forty-four patients had been studied, 19 men and 25 women; each group with 22 patients. In group A: the preparation tolerance was good in 14 cases (63.6%), fair in seven (31.8%) and poor in one (4.5%); also, the obtained cleaning up to the cecum was good in nine cases (40.9%) and fair in 13 (59%). In group B: the tolerance was good in five cases (22.7%) fair in 12 (54.5%) and poor in five (22.7%); the obtained cleaning in this group up to the cecum was good in two cases (9%), fair in 19 (86.3%) and poor in one (4.5%). CONCLUSIONS: The SD preparation was better tolerated and more effective in order to achieve the cleaning of the colon than the conventional one.

[Crohn disease. Medico-surgical experience. A 10-year retrospective study]. / Enfermedad de Crohn. Experiencia médico-quirúrgica. Estudio retrospectivo de 10 años.

Crohn's disease is rare in Mexico. The regarding of this pathology at Gastrointestinal Unit of the General Hospital of Mexico city, between january 1980 and december 1989, is presented. There were six cases of Crohn's disease, two women (33%) and four men (66%). The definitive diagnosis was done preoperatively only in one case, the other were diagnosed postoperatively. In all, intestinal obstruction was the surgical indication. A patient died (16.6%), three cases were followed for 12 months, only two patients are still under surveillance after 15 months.

[Gastric leiomyosarcomas and leiomyoblastomas]. / Leiomiosarcomas y leiomioblastomas gástricos.

The authors review the cases with smooth muscle tumors of the stomach (SMTS), excluding the leiomyomas, at the Mexico's General Hospital in a period of 5 years. They found 8 cases in women and 3 in men, with 51.3 years average. The average of evolution of symptoms was 5 months, prevailing: anaemia, digestive bleeding and abdominal pain. Barium radiology and endoscopy guided to the diagnosis. The tumors were located 7 at the fundus, 3 at the body and one at the gastric antrum. The size oscillated between 1.5-28 cm., average 8 cm. Endoscopic specimens were positive in 2/7 cases and cytologic samples were negative in all cases. Eight tumors were leiomyosarcomas (LMS) and 3 were leiomyoblastomas (LMB); the histologic criteria in order to differentiate them was based on the number of mitosis for 50 fields (50 csf), the size and their hypercellularity. A patient died before being operated. Two cases were subjected to emergency surgery, and died after that. In the cases treated with elective surgery the authors performed subtotal gastrectomy with major omentectomy in 4 and surgical resection of the tumor in the remaining 4 patients. The mortality rate for surgery was 27.2%.