[Hepatic angiosarcoma: report of 4 cases]. / Angiosarcoma hepático: comunicación de 4 casos.

Hepatic angiosarcoma is an infrequent vascular liver tumor of high malignancy. Four patients (two males) are presented, in whom a histopathological study was performed. All patients died and in three a necropsy was executed.

[A submucosal hematoma of the esophagus. A clinical case]. / Hematoma submucoso del esofago. Caso clinico.

Spontaneous intramural hematoma of the esophagus (SIHE) is a rare condition usually affecting middle-aged or elderly women. It presents as acute substernal or epigastric pain, typically accompanied by dysphagia or hematemesis. SIHE is not usually associated with vomiting, and is therefore clearly distinguishable from hematogenic esophageal disorders, such as the Mallory Weiss lesion and the Boerhaave syndrome. The pathogenesis is in dispute. We present a case of SIHE without a discernible mucosal breach, suggesting a primary intramural bleed as the initiating event. Its diagnosis relies on the history and a barium swallow. Instrumentation can result in further damage to the esophagus. Treatment is conservative and results in resolution of the hematoma and return to normal swallowing. A favorable prognosis is the rule.

[Cutaneous metastasis in gastric cancer]. / Metástasis cutáneas en cáncer gástrico.

We report 3 patients operated on for gastric cancer who developed skin metastasis proven by biopsy. Within a year of this complication 2 patients had died, confirming the bad prognosis associated to this finding. No estimates of the frequency of this complication are available in Chile.

[Paracentesis combined with albumin infusion in the treatment of tense ascites in cirrhotic patients]. / Paracentesis con infusión de albumina en el tratamiento de la ascitis a tensión en pacientes cirróticos.

We randomized 31 cirrhotic patients with tense ascites to a Group A receiving only diuretic therapy (spironolactone, furosemide, n = 14) or a Group B treated with paracentesis and intravenous albumin infusion (n = 17). Ascites was eliminated in 88% of patients in Group B compared to 57% of patients in Group A (p < 0.05). Complications developed in 4 patients in Group A and 2 patients in Group B. Paracentesis was associated to a mild and transient reduction in mean arterial pressure and a significant rise in urinary output. Duration of hospital stay was 5 +/- 3 days in Group B and 22 +/- 6 in Group A (p < 0.001). Survival and likelihood of readmission for ascites was similar in both groups. Our results suggest that paracentesis plus intravenous albumin infusion is a fast, safe and effective therapy for tense ascites in cirrhotic patients.