Biomedical subjects
Publications and source records attributed to J Ruiz del Castillo.
A male, 52 years old, presenting acute abdominal pain and hypovolemic shock, was diagnosed by ultrasound and CAT of fissured aneurysm of the splenic artery. Emergency laparotomy confirmed that the aneurysm had ruptured into the peritoneal cavity.
We present our experience in the surgical treatment of 14 cases of Zenker's diverticulum, diagnosed from January, 1969 to December, 1988. In 11 cases we performed one stage diverticulectomy; in 4 cases, manometric findings required cricopharyngeal myotomy. In 3 cases surgical treatment was not indicated; 2 patients had liver cirrhosis and high surgical risk and the third patient declined the treatment. Current treatment is discussed.
All the previous studies which have associated arteriovenous malformations of the colon with chronic inflammatory disease have always been performed on a diseased intestine. This study, which uses the intravascular injection of resin, shows morphological evidence that angiodysplasia of the colon and intestinal inflammatory disease can coexist independently. This fact suggests that in cases of severe hemorrhage in a patient with inflammatory disease of the small intestine, it cannot simply be assumed that it originates in the macroscopically abnormal intestine, and that angiographic examination is a wise measure to rule out the possibility of arteriovenous malformations in the "normal" intestine.
The authors present a series of 32 cases of reflux peptic strictures of the esophagus. The mean age of the patients is 54 years, with a 3/1 predominance of males. The etiologic antecedent was hiatal hernia in every case, with a clinical time of evolution of 29 months, dysphagia being the most frequent symptom (100%). Complementary diagnosis was based fundamentally on endoscopy and barium transit, explorations that also allow exclusion of other pathologies. All the patients underwent medical treatment, this being the only treatment in 4 cases. The other 28 cases were treated surgically. The technique used was, in the cases in which the esophagus could be dilated, dilatation associated with an antireflux technique, and when not dilatable, resection with reconstruction using stomach (Sweet) or colonoplasty. The global mortality was two patients (5.2%). Patients were followed-up for a minimum of 2 years and the global results have been good, with recurrence in 3 cases (7.7%). Postoperative dysphagia appeared in 17 cases (44.7%), in all of the transitory.
Cystadenocarcinomas represent approximately 1% of the pancreatic tumors and are difficult to diagnose clinically and by pathology. Due to their rarity, published series are small. We present 6 cases of pancreatic cystadenocarcinoma collected over a period of 15 years at the Visceral Surgery Service of the Valencia University Hospital. The better evolution and prognosis of these tumors in comparison with pancreatic adenocarcinomas is noteworthy.
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A clinical review about the subjects is made. Percentages and comparisons between lower and upper limbs were established. Correlation with statistics from other authors are presented.
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