[Idiopathic portal hypertension, multiple focal nodular hepatic hyperplasia, the CREST syndrome and protein S deficiency]. / Hipertensión portal idiopática, hiperplasia nodular focal hepática múltiple, síndrome de CREST y déficit de proteína "S".

A 54 year old woman with idiopathic portal hypertension, CREST syndrome, protein "S" deficiency and multiple focal nodular hyperplasia is reported. The patient presented several episodes of upper digestive bleeding due to portal hypertension gastropathy and to esophageal varices. Treatment with propanolol and isosorbide 5-mononitrate failed to control recurrent bleeding and a portacaval shunt was performed. At operation, ten hepatic nodes were found, being diagnosed as focal nodular hyperplasia in the pathologic study. Congestive gastropathy, esophageal varices and splenomegaly disappeared after portacaval shunt and bleeding did not recur after a follow-up of twelve months. This results support the role of portal decompressive surgery in the bleeding due to portal hypertension gastropathy.

[Undifferentiated small cell (oat cell) carcinoma of the esophagus]. / Carcinoma indiferenciado de células pequeñas (oat cell) de esófago.

A case of small cell carcinoma (oat cell) of the esophagus is presented. Esophagectomy and gastroplasty were performed followed by six cycles of combination chemotherapy and radiotherapy. Recovery was uneventful. The patient died nine months later with widespread disease. Literature is reviewed. To date, about 100 cases of this rare tumor have been reported. The aggressive behavior of the tumor is stressed and the different therapeutic modalities are discussed.