Paula Csendes G

Resultados premilinares de la gastroplastia horizontal con anastomosis en Y de Roux como cirugía bariática en pacientes con obesidad severa y mórbida

Background: Morbidly obese subjects have a high incidence of complications. The poor results of dietary treatments, has prompted the search of new therapies for obesity and among these, surgical procedures. Aim: To report the long term results of horizontal gastroplasty with Roux en Y anastomosis in morbidly obese subjects. Patients and methods: Fifty patients with an initial body mass index of 41.3 ± 6 kg/m2 have been subjected to a horizontal gastroplasty with Roux en Y anastomosis. During the study period, surgical techniques were modified, reducing the gastric pouch size, adding a truncal vagotomy, cholecystectomy, and increasing the length of the Roux en Y loop from 70 to 100 cm. Twenty five patients have been followed for two years. Results: There was no operative mortality and one patient had an anastomotic leak that required 35 days of hospitalization. During follow up, in one patient, the stapled suture line loosened. After two years of follow up, weight decreased from 112 ± 19 to 77.2 ± 14 kg. Conclusions: Horizontal gastroplasty with Roux en Y anastomosis achieved an adequate weight loss with a low rate of complications in this group of morbidly obese subjects.

Características clínicas y de laboratorio de pacientes con reflujo gastroesofágico crónico patológico

Background: Sixty percent of adults has typical symptoms of gastroesophageal reflux in Chile. Aim: To report the clinical and laboratory features of patients with gastroesophageal reflux. Patients and methods: Five hundred thirty four patients (255 male) with gastroesophageal reflux were included in a prospective protocol that included clinical analysis, manometry and endoscopy in all patients, barium swallow in 427, scintigraphy in 195, acid reflux test in 359, 24 h pH in 175, and differential potential of gastroesophageal mucosa in 73 patients. Results: There was no correlation between the severity of symptoms and the endoscopical severity. Patients with Barret esophagus were 12 years older, were male in a greater proportion and had a higher proportion of manometrically incompetent sphincters than patients with esophageal reflux but without esophagitis or with erosive esophagitis. Severity of acid reflux, measured with 24 h pH monitoring was proportional to the endoscopical damage of the mucosa. There was a close relationship between the mucosal change limit determined with differential potentials and with endoscopy. No short esophagi were found. Conclusions: Patients with symptoms of gastroesophageal reflux must be assessed using several objective measures to determine the severity of their pathological alterations.

Utilidad clínica de la fusión SPECT/CT con marcadores externos en patología oncológica

Interpretation of abnormal foci with high traceruptake may require morphological correlation. Fusion of functional images obtained by singlephoton emission computed tomography (SPECT) and anatomical images obtained by computedtomography (CT) or magnetic resonance (RM) allows an integrated comprehension ofcomplementary information.

HIGADO GRASO: ULTRASONIDO Y CORRELACION ANATOMOPATOLOGICA

Fatty liver is a pathology characterized for accumulation of triglycerides within the hepatocytes. Today is diagnosed frequently by ultrasound and is important to know the ultrasonographic findings for the diagnosis. Our purpose was to correlate ultrasound and pathologic findings in the diagnosis of steatosis and propose grades of severity. This study demonstrated moderate concor- dance between ultrasound and biopsy findings.

Estudio prospectivo del diámetro de la vía biliar principal antes y 12 años después de colecistectomía

tiempo. Hay una opinion generalizada entre ciru-janos y radiologos, que la via biliar principal sedilata despues de una colecistectomia, debido a laperdida de la funcion absorptiva de la vesiculabiliar y al aumento de la presion intraluminaldentro del sistema ductal biliar. Esta dilatacion«fisiologica» fue enunciada por primera vez porOpie en 1887

EVALUACION DEL CANCER GASTRICO POR TOMOGRAFIA COMPUTADA

El desarrollo de la tomografia computada multidetector ha permitido estudiar de mejor manera la patologia del tubo digestivo, siendo de especial utilidad en el diagnostico y la etapificacion de las neoplasias malignas. Se discuten las caracteristicas epidemiologicas y en examenes de imagen del adenocarcinoma gastrico, la principal neoplasia gastrica maligna, de alta incidencia en Chile, con enfasis en la tecnica del estudio y los hallazgos tomograficos pre y postoperatorios

Quiste hidatídico pancreático: Reporte de un caso

Se presenta el caso de un paciente con dolor epigastrico de intensidad progresiva, cuyos estudios de imagenes revelaron la presencia de una lesion quistica de la cabeza de pancreas. Se realizo una pancreato-duodenectomia. El estudio anatomopatologico revelo un quiste hidatidico de la cabeza de pancreas, siendo el primer caso publicado en nuestra literatura nacional

Semiología del intestino en Tomografía Computada: del blanco al negro

En este articulo, basado en el analisis retrospectivo de 67 tomografias computadas de abdomen-pelvis de los ultimos tres anos, presentaremos las caracteristicas de la pared intestinal, en particular su coeficiente de atenuacion, como metodologia para orientar el diagnostico diferencial de engrasamientos de la pared intestinal

CARACTERIZACION DE APENDICE NORMAL EN TOMOGRAFIA COMPUTADA HELICOIDAL SIN CONTRASTE: RESULTADOS PRELIMINARES

El desarrollo del ultrasonido (US) y tomografia computada (TC) ha aumentado la solicitud de examenes para confirmar o descartar el diagnostico de abdomen agudo de origen apendicular. El objetivo del trabajo es caracterizar los hallazgos del apendice normal en TC helicoidales efectuadas sin contraste. Se revisaron 235 TC. El diametro promedio del apendice fue de 6.18 mm con una desviacion estandar de 1.29 mm; el 76% de ellos presentaban aire en su interior. En el 98.9% de los pacientes, el tejido adiposo periapendicular fue normal

INTESTINO DELGADO PATOLOGICO: RESONANCIA MAGNETICA CON CONTRASTE ORAL VERSUS TRANSITO INTESTINAL CON BARIO (RESULTADOS PRELIMINARES

Small bowel transit with barium sulphate allows adequate visualization of endoluminal alterations, but with drawbacks such as limited usefulness for wall compromise and extra parietal extension. Magnetic resonance appears to be an alternative, given its benefits avoiding radiation and allowing evaluation of anatomic details of the small bowel and adjacent structures. Eleven patients with abnormal result of intestinal transit with barium underwent magnetic resonance with water 1500 cc p.o in brief period, with images achieved in a 1.5 Tesla resonator, with 25 mT/m gradient, using optimized sequences. Comparison in regards of time of transit, distension, and characterization of pathology was made. An adequate correlation of the pathologic small bowel and its adjacent structures is achieved with magnetic resonance compared with transit with barium, achieving 90.9% of simple correlation and 0.82 Kappa value (excellent correlation), making this technique a valid and effective alternative to the conventional study of the small bowel with barium in our experience. Larger series are required to confirm this.