[Ultrasound-guided biopsy of the pancreas: a multicenter study]. / Punción pancreática ecodirigida: estudio multicéntrico.

OBJECTIVE: Members of "Asociación de Ecografía Digestiva" decided to carry out a multicenter retrospective study on fine-needle aspiration biopsy for pancreatic space-occupying lesions under ultrasonographic guidance and via the percutaneous route in order to assess this technique s performance versus endoscopic ultrasound-guided biopsy. SUBJECTS: 10 hospitals for a total of 222 patients with suspiciously malignant, 8-120-mm pancreatic lesions were included in the study. RESULTS: The analysis of results shows a sensitivity of 89%, a specificity of 98%, a positive predictive value of 99%, and a negative predictive value of 74%, for an overall diagnostic accuracy of 91%. No major complications occurred. CONCLUSION: Percutaneous fine-needle aspiration for pancreatic lesions is highly cost-effective and has few and mild complications.

[Treatment of non-parasitic splenic cyst with percutaneous injection of alcohol]. / Tratamiento del quiste esplénico no parasitario con inyección percutánea de alcohol.

We report a case of a 12-years-old girl treated by percuta-neous injection of a splenic epithelial cyst. Indication was due to the gradual cyst's growth and pain in left hypocondrium. A percutaneous drainage under ultrasonographic view was performed with direct puncture technique, inserting a pigtail catheter into the cyst. After the total aspiration of the contrast, we injected sterile absolute alcohol for 20 minutes. Subsecuently, it was aspirated and the catheter was pulled-out. After a follow up period of more than 4 years, the cyst remains collapsed. There were no complications.

[Ultrasound guided percutaneous drainage of splenic abscesses]. / Drenaje percutáneo de abscesos esplénicos guiado por ecografía.

We present our experience of ultrasound-guided percutaneous drainage with a catheter in 5 splenic abscesses. All the cases were resolved and there was only one relevant complication. The advantages of this treatment compared with surgery and isolated medical treatment are discussed and this technique is proposed as the treatment of choice.

[Focal nodular hyperplasia: characterization with Doppler ultrasonography]. / Hiperplasia nodular focal: caracterización con ultrasonografía Doppler.

Focal nodular hyperplasia (FNH) is an hepatic pseudotumoral lesion which is usually detected accidentally in subjects of any age. Definitive diagnosis requires histologic study, prior to analysis with imaging techniques. Three casos of FHN are presented characterized with Doppler ultrasonography in whom high frequency and low resistance central pulse flow were observed in contrast with the findings obtained in other benign hepatic lesions.

[Analysis of the Doppler signal (color and pulsed) in hepatocarcinoma]. / Análisis de la señal Doppler (color y pulsado) en el hepatocarcinoma.

Real time echocardiography associated with pulsed Doppler (duplex) and color (triplex) provide a non invasive technique to determine the vascular morphology of a lesion. The duplex and triplex signal of 35 liver tumors, 23 hepatocarcinomas and 12 angiomas found in the first high frequency signals greater than 1.81 kHz and traced with pulsatile or mixed morphology (pulsed and continuous) were analyzed. The second signals were of low frequency, less than 1 kHz and continuous tracing. It may be concluded than echo-Doppler is a complementary technique to conventional echography and is useful in the diagnosis of hepatocellular carcinoma.

[Menetrier's disease suspected by ultrasonography]. / Enfermedad de Menetrier sospechada por ecografía.

Menetrier's disease was suspected in a patient during transcutaneous ultrasound by the finding of an important thickening of the mucosa with normality of submucosal, muscular and serous layers. The description of the ultrasound aspect of this disease is very uncommon, specially in adults.

[Gastric lipoma diagnosed using transcutaneous echography with a fluid-filled stomach]. / Lipoma gástrico diagnosticado mediante ecografía transcutáneá con llenado líquido del estómago.

A patient with a lipoma of the stomach was diagnosed preoperatively by transcutaneous ultrasound and replenishment of the stomach with fluid, obtaining in this way specific ultrasound diagnostic criteria. This technique might be considered as complementary to endoscopy in the diagnosis of submucous tumours and as an alternative to other expensive examinations such as endoscopic echography.

[Percutaneous cholecystostomy guided by ultrasonography. A preliminary experience]. / Colecistostomía percutánea guiada por ecografía. Experiencia inicial.

Surgical cholecystostomy is a palliative treatment for cholecystitis and distal biliary obstructions when the general condition of the patient does not allow complex techniques. Percutaneous cholecystostomy (PC) guided by ultrasonography is an alternative to that procedure as well as a method of direct access to the biliary tract for diagnostic examinations (bacteriologic study of bile and percutaneous cholangiography). During one year, 9 female patients, mean age 74 (49 to 90) underwent this approach; 5 patients had cholecystitis, 2 were suspicious of biliary sepsis and 2 had angiocholitis. Because of poor general condition, no other approach was possible in any of the cases. There were no relevant complications. All 5 cases of cholecystitis improved after the procedure although 3 patients died within 30 days of causes unrelated to PC. In two cases biliary sepsis was ruled, and the probe was withdrawn, without complications. The two patients with angiocholitis improved significantly; in both cases it was shown that the cause was cholelithiasis: later on, they were treated by different methods (endoscopic sphincterotomy in one case and surgery in the third case). These preliminary results suggest that PC guided by echography should be included as a routine therapeutic and diagnostic method in the management of digestive diseases.