[Functional recovery of Oddi's sphincter after balloon dilatation of the papilla of Vater. An experimental study in rabbits]. / Recuperación funcional del esfínter de Oddi tras dilatación con balón de la papila de Vater. Estudio experimental en conejos.

INTRODUCTION: Balloon dilatation of the papilla of Vater is used to treat biliary lithiasis. The results and complications rate of this technique are excellent. Published data indicate that this procedure does not significantly alter the physiology of the sphincter of Oddi and that normal function is maintained. Papillary balloon dilatation would therefore provide an advantage over other techniques in which sphincteric function is abolished. The objective of this study was to evaluate the functional status of the sphincter of Oddi after balloon dilatation of the papilla of Vater. MATERIAL AND METHODS: Twenty-four New Zealand albino rabbits were used. All animals underwent laparotomy and duodenotomy with balloon dilatation of the papilla of Vater. Manometric study of the biliary tract and of the sphincter of Oddi was also performed before, shortly after, and 21 days after dilatation. Biliary and sphincter of Oddi pressures and phasic activity of the sphincter (frequency, amplitude and duration of waves) were used as measuring variables for each of the stages of the experiment. RESULTS: Papillary balloon dilatation immediately provoked substantial sphincter relaxation. Comparison of the values of basal biliary and sphincter of Oddi pressures with those found 21 days after dilatation showed no statistically significant differences. No significant differences were found when the variables related to phasic activity of the sphincter (frequency, amplitude and duration) were compared between the distinct phases of the experiment. CONCLUSIONS: The results of the present study suggest complete recovery of sphincter function 21 days after balloon dilatation.

Recuperación funcional del esfínter de Oddi tras dilatación con balón de la papila de Vater. Estudio experimental en conejos / Functional recovery of Oddi’s sphincter after balloon dilatation of the papilla of Vater. An experimental study in rabbits

Introducción. La dilatación con balón de la papila de Vater es utilizada para el tratamiento de la ocupación litiásica de la vía biliar con resultados e índice de complicaciones buenos. Los datos publicados apuntan a que tras esta técnica la fisiología del esfínter de Oddi podría verse poco alterada tendiendo a una función normal. Este hecho aportaría una ventaja en relación con otras técnicas utilizadas en las que el mecanismo esfinteriano queda destruido y su función, abolida. El objetivo del estudio es valorar el estado funcional del esfínter tras realizar la técnica de dilatación con balón de la papila de Vater. Material y métodos. Se usaron 24 conejos de raza neozelandés albino que fueron sometidos, tras laparotomía y duodenotomía, a una dilatación con balón de la papila de Vater. Se realizó un estudio manométrico biliar y del esfínter de Oddi previo a la dilatación, inmediatamente después de ésta y a los 21 días. Se analizaron como variables los valores de presión de la vía biliar y el esfínter, así como los valores de las variables de actividad fásica del esfínter (frecuencia, duración y amplitud de las ondas de presión). Resultados. La dilatación con balón de la papila produjo de forma inmediata una relajación importante del esfínter. La comparación de los valores de presión intrabiliar y del esfínter de Oddi basales con los encontrados a los 21 días posdilatación no ha mostrado diferencias significativas. Tampoco se han encontrado diferencias al comparar las variables de actividad fásica del esfínter (frecuencia, duración y amplitud de ondas) entre una y otra fase del experimento. Conclusiones. Los resultados de nuestro trabajo sugieren la recuperación total de la función del esfínter tras ser sometido a una dilatación con balón después de un período de 21 días (AU)

Introduction. Balloon dilatation of the papilla of Vater is used to treat biliary lithiasis. The results and complications rate of this technique are excellent. Published data indicate that this procedure does not significantly alter the physiology of the sphincter of Oddi and that normal function is maintained. Papillary balloon dilatation would therefore provide an advantage over other techniques in which sphincteric function is abolished. The objective of this study was to evaluate the functional status of the sphincter of Oddi after balloon dilatation of the papilla of Vater. Material and methods. Twenty-four New Zealand albino rabbits were used. All animals underwent laparotomy and duodenotomy with balloon dilatation of the papilla of Vater. Manometric study of the biliary tract and of the sphincter of Oddi was also performed before, shortly after, and 21 days after dilatation. Biliary and sphincter of Oddi pressures and phasic activity of the sphincter (frequency, amplitude and duration of waves) were used as measuring variables for each of the stages of the experiment. Results. Papillary balloon dilatation immediately provoked substantial sphincter relaxation. Comparison of the values of basal biliary and sphincter of Oddi pressures with those found 21 days after dilatation showed no statistically significant differences. No significant differences were found when the variables related to phasic activity of the sphincter (frequency, amplitude and duration) were compared between the distinct phases of the experiment. Conclusions. The results of the present study suggest complete recovery of sphincter function 21 days after balloon dilatation (AU)

Heridas por asta de toro en el Hospital General de Castellón. Estudio de 387 pacientes / Bull horn wounds in Castellon General Hospital. A study of 387 patients

Las heridas por asta de toro son frecuentes en el mundo iberoamericano, donde los espectáculos con estos animales son algo habitual. Dichas heridas presentan unas características especiales que las diferencian de cualquier otro tipo de heridas. Material y método: Se realizó un estudio retrospectivo con revisión de las historias clínicas de los pacientes ingresados en nuestro servicio con el diagnóstico de herida por asta de toro entre enero de 1978 y octubre de 2005. Resultados: Se estudiaron 387 ingresos. En 12 ocasiones se trató de reingresos por nuevas cogidas en un mismo paciente. En 27 enfermos se presentaron múltiples heridas. La localización de las heridas principales fue: cabeza y cuello 12 (3,1%), tórax 21 (5,4%), extremidades superiores 19 (4,9%), abdomen 44 (11,3%), periné 41 (10,5%), región lumbar-espalda 6 (1,5%) y extremidades inferiores 244 (63%). Fueron necesarias 31 laparotomías con 23 lesiones viscerales. Aparte del tratamiento específico, se realizó lavado con solución antiséptica, Friedreich y sutura de piel sobre drenajes, tratamiento antibiótico y vacunación antitetánica. Las complicaciones inmediatas más frecuentes fueron la desvitalización de la herida y la infección, con 7 y 6 casos, respectivamente. La complicación tardía más frecuente fue la eventración con 6 casos. Hubo 3 muertes por shock hipovolémico, por shock séptico y por gangrena gaseosa. Conclusión: Las heridas por asta de toro tienen unas características propias que es necesario conocer especialmente en regiones con afición al toreo. Aunque son lesiones graves, su pronóstico es bueno, con escasas complicaciones y una mortalidad menor del 1% (AU)

Bull horn lesions are frequent in the Latin world due to spectacles involving these animals. These wounds have special characteristics that distinguish them from all other lesions. Material and method: A retrospective analysis of the medical records of patients with bull horn lesions admitted to our service between January 1978 and October 2005 was performed. Results: A total of 387 patients with bull horn lesions were admitted to our service. There were 12 readmissions due to a new wound in a previously treated patient. Twenty-seven patients had two or more lesions. The location of the wounds was: head and neck in 12 (3.1%), thorax in 21 (5.4%), upper extremities in 19 (4.9%), abdomen in 44 (11.3%), perineum in 41 (10.5%), back and lumbar region in 6 (1.5%), and lower extremities in 244 (63%). Thirty-one laparotomies were performed and there were 23 visceral lesions. Surgical treatment in addition to specific procedures consisted of irrigation with antiseptic solution, Friedreich, and primary closure over drains. Antibiotic and antitetanus vaccinations were administered in all patients. The most frequent early complications were: wound devitalization (7 patients) and infection (6 patients). The most frequent late complication was incisional hernia. Three patients died as a result of hypovolemic shock, septic shock and gas gangrene. Conclusion: Bull horn wounds have special characteristics. Familiarity with these lesions is important in areas where bullfighting is practiced. Although bull horn wounds are severe, their prognosis is good, with few complications and a mortality rate of less than 1% (AU)

[Bull horn wounds in Castellon General Hospital. A study of 387 patients]. / Heridas por asta de toro en el Hospital General de Castellón. Estudio de 387 pacientes.

UNLABELLED: Bull horn lesions are frequent in the Latin world due to spectacles involving these animals. These wounds have special characteristics that distinguish them from all other lesions. MATERIAL AND METHOD: A retrospective analysis of the medical records of patients with bull horn lesions admitted to our service between January 1978 and October 2005 was performed. RESULTS: A total of 387 patients with bull horn lesions were admitted to our service. There were 12 readmissions due to a new wound in a previously treated patient. Twenty-seven patients had two or more lesions. The location of the wounds was: head and neck in 12 (3.1%), thorax in 21 (5.4%), upper extremities in 19 (4.9%), abdomen in 44 (11.3%), perineum in 41 (10.5%), back and lumbar region in 6 (1.5%), and lower extremities in 244 (63%). Thirty-one laparotomies were performed and there were 23 visceral lesions. Surgical treatment in addition to specific procedures consisted of irrigation with antiseptic solution, Friedreich, and primary closure over drains. Antibiotic and antitetanus vaccinations were administered in all patients. The most frequent early complications were: wound devitalization (7 patients) and infection (6 patients). The most frequent late complication was incisional hernia. Three patients died as a result of hypovolemic shock, septic shock and gas gangrene. CONCLUSION: Bull horn wounds have special characteristics. Familiarity with these lesions is important in areas where bullfighting is practiced. Although bull horn wounds are severe, their prognosis is good, with few complications and a mortality rate of less than 1%.