Signos radiológicos: esófago felino / Radiological signs: feline esophagus

Feline esophagus is the benign transient fine circumferential transverse folds that arise during double-contrast esophagography. Accurate discrimination of this entity is relevant due to its association with gastroesophageal reflux and hiatal hernia. Among the differential diagnoses, fixed folds secondary to reflux esophagitis and eosinophilic esophagitis have to be considered.

El signo del esófago felino corresponde a múltiple pliegues finos, dispuestos transversalmente, muy cercanos y generalmente transitorios, detectados en el estudio con doble contraste del esófago. Su reconocimiento es importante por su asociación con reflujo gastroesofágico y hernia hiatal. Dentro de los diagnósticos diferenciales a considerar se encuentran los pliegues fijos secundarios a esofagitis por reflujo y la esofagitis eosinofílica.

Interconsultas al servicio de otorrinolaringología en el Hospital Clínico Universidad de Chile / Referrals to otolaryngology service in Hospital Clínico Universidad de Chile

The objective of this paper is to analyze the consultations performed by the Ear, Nose and Throat service from Hospital Clínico Universidad de Chile (HCUCH) in other services of the hospital during the year 2006. Using a random sample of 80 consultations we find that theservices most consulted were: internal medicine (37,5 percent), surgery (13,8 percent), and pediatrics (13,5 percent). The leading causes were swallowing disorders (30 percent), prolonged mechanic ventilation(12,5 percent), and hypoacusia (11,3 percent). The average answer time was 1,28 days (with standard deviation of 2.5 days), 41,3 percent were followed with a median of 2 controls by patient (interquartilerange 2-4). Furthermore 35 percent of the sample was intubated. The mean time of intubation versus the accepted recommendation was 15,7 vs 10 days (t-test p< 0,0005). 13,3 percent of tracheostomy where performed by ORL. High answer time, in the case of swalling disorder, is due to lack ofmaterials. Complications of tracheostomy are less frequent and severe.

Signo radiológico: las valiosas perlas del intestino delgado / The valuable pearls of the small intestine

The string of pearls sign can be seen in simple abdominal radiography and computed tomography as well. It consists of a row of small air bubbles longitudinally oriented in the abdomen. They represent small amounts of air trapped between valvulae conniventes along the non dependent wall of predominantly fluid-filled, dilated small bowel loops. This sign is considered virtually diagnostic of small bowel obstruction, which occurs whenever there is an intrinsic or extrinsic blockage of the normal flow of bowel contentand manifests as abdominal pain, distention, vomiting, and increased high-pitched bowel sounds. It is a potentially life threatening disease that requires urgent treatment. Duration of obstruction, vomiting frequency and gastric or enteric suction may affect radiographic appearance. It continues being hard to diagnose only based on simple radiography. Despite its low frequency, the string of pearls sign could be very valuable for radiologist, clinical physician and patient.

El signo del collar de perlas puede ser visto en radiografía simple de abdomen y en tomografía computada. Consiste en un conjunto de pequeñas burbujas dispuestas en forma longitudinal. Representan pequeños acúmulos de gas atrapados entre las válvulas conniventes de asas de intestino delgado dilatadas y predominantemente rellenas de líquido a lo largo de su pared no dependiente(1). Es considerado virtualmente diagnóstico de obstrucción intestinal, que ocurre cuando existe un bloqueo intrínseco o extrínseco al flujo normal del contenido intestinal que se manifiesta con dolor abdominal, distensión, vómitos, borborigmos y bazuqueo. Es una enfermedad potencialmente letal que requiere ser resuelta en forma urgente. La duración de la obstrucción, la frecuencia de los vómitos, y la aspiración del contenido gástrico o enteral pueden afectar la apariencia radiográfica. Continúa siendo difícil de diagnosticar solamente con radiografía simple de abdomen. Aunque es poco frecuente, el signo del collar de perlas es muy valioso para el radiólogo, el clínico y el paciente.