Utilidad del octreotide en la prevención de la hemorragia digestiva no variceal en cirrosis hepática: descripción de 2 casos / Usefulness of octreotride in preventing non-variceal gastroinetestinal bleeding in liver cirrhosis: A report of two cases

No disponible

[Acute recurrent pancreatitis in a patient with Oddi's sphincter dysfunction]. / Pancreatitis aguda recurrente en un paciente con disfunción del esfínter de Oddi.

Alcohol consumption and gallstones are the most common causes of acute pancreatitis in developed countries. However, some episodes of acute pancreatitis have being regarded "idiopathic" once blood samples have been analyzed and diagnostic procedures (abdominal ultrasonography, CT and ERCP) have been performed. Sphincter of Oddi (SO) dysfunction is a rare entity that may be involved in the development of recurrent acute pancreatitis. SO manometry is the first option to investigate SO dysfunction. A recurrent idiopathic pancreatitis case in a young patient is presented. The manometric study revealed SO dysfunction, and oral nidefipine 10 mg was started. After a 12-months follow-up undergoing this therapy, the patient remains asymptomatic.

In vitro and in vivo evaluation of a reusable double-channel sphincterotome.

BACKGROUND: To date, one reusable, double-channel sphincterotome has been approved by the Food and Drug Administration in the United States. Whether this device can be reprocessed easily and whether it is more durable than currently manufactured disposable sphincterotomes are uncertain. METHODS: Thirty double-channel, 20 mm, braided-wire sphincterotomes approved for multiple uses were studied in vitro/in vivo with regard to durability and sterilization. A cost analysis of reusable, disposable, and reprocessed disposable sphincterotomes was also carried out. RESULTS: Three of 10 sphincterotomes evaluated in vitro broke after 3, 4, and 8 uses. Electrical integrity was preserved after 10 uses in the remaining sphincterotomes. Nine sphincterotomes remained functional for at least 3 uses, five for 6 uses, and one for 10 uses. Culture results after inoculation demonstrated contamination with surviving organisms after manual cleaning and no growth after ethylene oxide sterilization. Sixty-one procedures were performed in vivo using 20 sphincterotomes (mean number of uses 3.1). No evidence of procedurally related infection occurred with reuse. Cost per use of this reusable sphincterotome was calculated to be $62.98; it became cost effective after 2.2 and 7.9 uses when compared with disposable and reprocessed, disposable sphincterotomes, respectively. CONCLUSIONS: This reusable sphincterotome proved to be safe, easily sterilized, and electrically intact after repeated use. In vivo, however, a progressive loss of function limited the mean number of uses to 3.1. In settings that preclude reuse of reprocessed disposable accessories, this reusable sphincterotome may provide a means to decrease costs associated with endoscopic retrograde cholangiopancreatography.

Expandable metallic prostheses for malignant obstructions of gastric outlet and proximal small bowel.

BACKGROUND: Data are limited on use of expandable metal stents for treatment of malignant gastric outlet obstruction. Accordingly, we report our experience using these stents to palliate malignant obstructions of the gastric outlet, duodenum, and proximal jejunum. METHODS: Eight patients with malignant strictures causing gastric obstruction underwent endoscopy with fluoroscopic guidance to delineate tumor borders and length followed by expandable metallic prosthesis placement (Wallstent, Z-Stent, Ultraflex, and Endocoil). RESULTS: Symptoms were relieved in seven patients, five of whom had previous surgeries (Whipple, Billroth II, esophagojejunostomy, and gastrojejunostomy) for malignancy. One patient underwent surgical resection of a presumed malignant stricture containing a previously placed Wallstent after a 45-pound weight gain. CONCLUSIONS: Expandable metallic prostheses placed in patients with malignant obstruction of the gastric outlet, duodenum, or proximal jejunum, before or after surgery, effectively palliate obstructive symptoms and may also serve to improve nutrition.

Occupation and gastric cancer in Spain.

The association between occupational exposure and stomach cancer was investigated in a multicenter case-referent study conducted in Spain on 354 histologically confirmed cases and 354 hospital referents, matched by age, gender, and residence. An increased risk of gastric cancer was found for coal mining workers [odds ratio (OR) 11.8], but the number of workers was small, and therefore the 95% confidence interval (95% CI) was wide (95% CI 1.36-103). An increased risk was observed for wood and furniture workers (OR 1.76), construction workers (OR 1.68), and glass and ceramic workers (OR 2.18), but none of these risks were statistically significant. According to an occupation-exposure linkage system an increased risk was found for occupations associated with exposure to silica and mineral dust (OR 1.80, 95% CI 0.90-3.59). All of the OR estimates were adjusted for the confounding factors socioprofessional status and dietary habits. The possibility of a causal association between stomach cancer and coal and mineral dust is supported by the results.

Fiberendoscopy in the diagnosis of the pathology of the ileal conduit.

The advantages of the exploration with flexible fiberendoscopy in the pathologies of the ileal conduit, as in hematuria, are commented. The method to be followed, as well as the results of the explorations in 2 patients are evaluated. This method has proved to be highly advantageous compared with the standard methods.