[Esophageal stenosis due to a dissecting intramural hematoma following the endoscopic sclerotherapy of esophageal varices]. / Estenosis esofágica por hematoma intramural disecante tras escleroterapia endoscópica de varices esofágicas.

The dissecting intramural hematoma of the esophagus (DEH) is a rare complication of endoscopic variceal sclerotherapy (EVS). We present a 37 years male with Laennec's cirrhosis who developed a submucosal hematoma with complete obstruction of the esophagus 24 h. after the second session of EVS diagnosed by endoscopy. After conservative treatment the patient recovered well with complete resolution of the lesion. The review of the literature shows no correlation between DEH and type or volume of sclerosant, site of injection or previous number of sessions. Unknown in children. Most of these patients had abnormal hemostasis. We have performed EVS in 227 patients (879 sessions), with only a case of DEH (rate 0.13%). In this case the bad tolerance and movements during of EVS were very important.

[Retrospective study of ulcerative colitis at an Andalusian hospital]. / Estudio retrospectivo de la colitis ulcerosa en un hospital andaluz.

We reviewed 96 cases of ulcerative colitis diagnosed during the period between 1970 and 1988, with the intention of analysing the presentation, complications, evolution and diagnosis aspects. The most frequent presentation symptoms were mucoid and bloody diarrhea (91.3%) and abdominal pain (84%), isolated rectal bleeding being predominated in distal type. The frequency of complications were 17.14%. X-ray findings were the lack of haustration and ulcers, the rate of normal barium enema being of 27.27% (without double contrast). Rectum was not affected in 6.8%. The endoscopy showed an edematous and congestive mucosa, ulcer with normal barium enema. The most significant anatomopathological findings were the lymphoplasmocyte and polynuclear infiltration of the proper lamina and epithelial ulcer, with a lack of cripta and absence of metaplasia of Paneth's cells. In our area, we have to use colonoscopy to diagnose the disease, because the double contrast barium enema is not performed as a routine. Only a few (5) of our patients needed surgical treatment.

[Esophageal pseudomotor]. / Pseudomotor esofágico.

A patient was referred by Zone Cardiology due to the absence of heart disease in spite of a history suggestive of coronary ischemia and occasional dysphagia. We performed EDA and encountered a submucous mass that was depressible by the endoscope and pulsatile. Biopsy was not performed, but PA-lateral X-ray disclosed a large aortic aneurysm that was later confirmed by CAT.