[Resolution of Ménétrier's disease after eradication of Helicobacter pylori infection]. / Resolución de la enfermedad de Ménétrier tras la erradicación de la infección por Helicobacter pylori.

Ménétrier's disease is an infrequent clinical entity characterized by thickening of the gastric folds secondary to hyperplasia of the foveolar mucosa cells, frequently associated with loss of enteric proteins and hypoalbuminemia. Its etiology is unknown, although in the last few years it has been related to Helicobacter pylori infection. We present the case of a 38-year-old man with protein-losing gastroenteropathy caused by Ménétrier's disease, in whom eradication of H. pylori infection was followed by symptom improvement and resolution of hypoalbuminemia. In agreement with the criteria of other authors, we investigate the presence of H. pylori infection in all patients with Ménétrier's disease. When positive, the first-line treatment consists of eradication therapy.

Tratamiento del síndrome de intestino irritable

El síndrome de intestino irritable es un trastorno funcional digestivo de etiología desconocida definido por molestias continuas o recidivantes de más de tres meses de evolución, que consisten en cambios en el hábito intestinal que se acompañan o no de dolor abdominal, meteorismo o distensión abdominal, no explicables por una causa orgánica, infecciosa o metabólica. Para establecer unas guías terapéuticas lógicas y adecuadas revisaremos los aspectos patogénicos sobre los que se basará el tratamiento, así como las características de los síntomas a tratar (AU)

[The clinical efficacy and complications of the transjugular intrahepatic portosystemic shunt-stent]. / Eficacia clínica y complicaciones del shunt-stent portosistémico intrahepático transyugular.

TIPSS is a new therapeutic modality for decompressing the portal tree and its use has broadened in the last five years. From February 1993 to August 1994 a prospective study was performed to evaluate its efficacy and safety. Nineteen cirrhotic patients (Child A-5, B-10, and C-4) with a TIPSS placed were included. The mean follow-up was 7.2 months. The indication was therapy of esophageal variceal bleeding in 18 patients (acutely in 8 and elective in 10 patients) and refractory ascites in one. In all cases could the "stent" be placed and the portocaval gradient decreased from 22.8 +/- 3.71 to 9.3 +/- 2.27 mmHg. In the first thirty days the mortality rate was 10.5%, with the following complications: two portal thromboses, two acute non-lithiasic cholecystitis, one hemoperitoneum, one spontaneous bacterial peritonitis, and one hepatic encephalopathy. During the follow-up period two patients developed hemorrhagic relapses and two additional patients subclinical encephalopathy. TIPSS dysfunction was observed in 57.8%.