[Epidemiologic aspects of peptic ulcer in Chile (author's transl)].
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Biomedical subjects
Publications and source records attributed to A Csendes.
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Eight adult patients with visceral Chagas' disease were studied twice within an interval of 64 months. In each case the esophagus was evaluated radiologically and manometrically. None of the patients had esophageal symptoms and no significant change in resting gastroesophageal sphincter pressure was observed during the study. However in 3 patients incomplete sphincteric relaxation was noted. Normal progressive contractions did not change. The importance of these findings are discussed.
A bacteriologic analysis of the gallbladder bile in eighty patients who underwent operation was performed in a prospective study. In all twenty patients with a normal gallbladder as assessed by oral cholecystography and intraoperative palpation, cultured were negative. Among patients with chronic cholecystitis only 30 per cent had positive bile cultures and this rose to 47 per cent among patients with acute cholecystitis.
Twenty adult patients with achalasia of the esophagus were treated with an anterior esophagomyotomy and fundic patch. A significant decrease in resting gastroesophageal sphincter pressure was obtained immediately after surgery (p less than 0.001). One case was lost and the rest were followed up for 34 months. Patients had no esophageal symptoms and resting gastroesophageal sphincter pressure remained in low values. Surgical procedure is an adequate and definitive treatment for this disease.
An effective antireflux operation, posterior gastropexy with cardiac calibration, was performed on 24 patients with well established peptic strictures of the esophagus. Without intraoperative or postoperative dilation, the diameter of the strictures went from a mean of 6.3 mm to a postoperative mean diameter of 13.0 mm. Significant increases in sphincter pressure were recorded and endoscopic evaluation showed a return to normal. Preoperative dysphagia was relieved. It is concluded that an adequate antireflux operation will obviate the need for postoperative dilations or more formidable operations such as interposition.
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