[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.

Paciente con esclerosis tuberosa y angiomiolipomas renales bilaterales gigantes / Patient with tuberous sclerosis and giant renal angiomyolipomas

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Ultrasound-guided fine-needle aspiration biopsy. Study of the cost per patient and comparison with computed tomography-guided biopsy.

Between February 1992 and July 1995, we performed 222 ultrasound-guided fine-needle aspiration biopsies (FNAB) in abdominal space-occupying lesions. The sensitivity was 90% and the specificity, 100%, with an overall diagnostic precision of 93%. We also determined the cost of each procedure (2,550 pesetas) and compared it with the cost of computerized tomography (CT)-guided biopsy (22,500 pesetas). These results and those reported in the literature indicate that there is no significant difference with respect to diagnostic yield, but that the difference in terms of expense is considerable. We believe that, in the assessment of abdominal lesions. CT-guided FNAB should be reserved for those lesions that prove inaccessible to ultrasound.

[Splenic rupture in acute pancreatitis]. / Rotura esplénica en una pancreatitis aguda.

The case of a 42-years-old male with acute pancreatitis of ethanol origin and formation of pseudocysts in the tail of the pancreas is presented. The patient suddenly presented a picture of hypovolemic shock caused by rupture of the spleen. Emergency splenectomy with resection of necrotic tissue was performed and thrombosis of the splenic vein was observed. The patient evolved satisfactorily following surgery.

[Ultrasonographic diagnosis of intestinal fistulae associated with Crohn disease]. / Diagnóstico ultrasonográfico de fístulas intestinales asociadas a enfermedad de Crohn.

In two patients with Crohn's disease, abdominal mass and fever, abdominal ultrasound disclosed enteroenteric fistula in one, and intestinal fistula associated to subcutaneous abscess in the second. We emphasize the role of ultrasound in the diagnosis of active Crohn's disease, especially as a complementary method for the detection of intraabdominal complications.

[A case of dextrogastria associated with eventration of the right hemidiaphragm]. / Un caso de dextrogastria asociado a eventración de hemidiafragma derecho.

A rare case is reported of dextrogastria associated with congenital elevation of the right hemidiaphragm and partial inclusion of the subdiaphragmatic right colon. The main embryological, epidemiological and clinical characteristics are commented.