RESUMENDamos a conocer una serie de 4 pacientes con rotura hepática, preeclampsia severa y síndrome de HELLP, resuelto su parto y tratada su complicación hepática con taponamiento temporal de compresas, lo que permitió la sobrevida de todas ellas.PALABRAS CLAVES: Rotura hepática, preeclampsia, síndrome de HELLP, taponamiento intraabdominal temporal SUMMARYWe report the results of four patients with spontaneous rupture of the liver during pregnancy, preeclampsia and HELLP syndrome; current therapy and management with temporary packing is discussed, the four patients are alive.

La rotura subcapsular hepática como complicación grave y altamente letal del síndrome de HELLP se presenta en un 2 a 3% de los casos, con una mortalidad reportada de un 33% con diversas técnicas quirúrgicas. En base a 4 casos se presenta la propuesta de una técnica quirúrgica que reporta según nuestra experiencia un 100% de sobrevida.

Colovesical fi stula: laparoscopic surgery Aim: Colovesical fi stula is a severe complication associated to neoplastic or infl ammatory colon disease. Most common procedure is open surgery. We report a case of colovesical fi stula secondary to diverticular disease treated with a laparoscopic approach. Methods: A 64-year-old man was seen with a known colonic diverticular disease, type 2 diabetes mellitus and recurrent urinary tract infection. He complained of lower abdominal pain, dysuria, and pneumaturia. A CT scan revealed a sigmoid diverticular perforation into the bladder (colovesical fi stula). A left hemicolectomy with partial cystectomy was performed by laparoscopy means. Results: There was no morbidity related to the surgical procedure, and the fi nal pathology confi rmed a colonic diverticular disease with bladder compromise. The patient is asymptomatic at 24 months of follow up. Conclusion: The laparoscopic approach is a feasible alternative for the treatment of colovesical fi stula with low morbidity.

IntroducciónCada vez con mayor frecuencia existen patologías que requieren como parte de su terapia el uso de tejidos homólogos para implantes, los que han mejorado el pronóstico de estas enfermedades.Se ha descrito un aumento significativo del número de implantes de tejidos como válvulas Recomendaciones para el estudio microbiológico de tejidos preservados para implantes PATRICIA GARCÍA C., BÉATRICE HERVÉ E., CHRYSTAL JULIET L., EDUARDO TURNER G., CLAUDIO ARRETZ V., JULIO ARRIAGADA V., CLAUDIO RAFOLS DEL C., ALBERTO PÉREZ C., JORGE VILLEGAS C., GLORIA M. GONZÁLEZ G., PAULINA AGUIRRE H., JOSÉ MINGUELL U., MAURICIO OCQUETEAU P., ISABEL PIZARRO A., FRANCISCO ANDRIGUETTI C. y ALONSO RODRÍGUEZ B.Recommendations for the microbiological study of tissues preserved for implantsThe implant of tissues in Medicine has enhanced the prognosis and/or quality of life of several diseases, however its utilization is not free of risks for the receptor. Because of this, a carefully selection of live or cadaveric donors and the microbiological control of tissues before its utilization are very important procedures in securing the quality of the procedure. Contamination of tissues may be intrinsic (because of unnoticed infection in the donor) or extrinsic (after the tissues has been harvested). These recommendations focus into the microbiological control of extrinsic contaminations, through its handling during the tissues harvest or during its processing for preservation. Most frequently used implants in our country (cardiac valves, osseus tissue, skin, hematopoyetic precursor cells and cornea) are analyzed and methodology is described according to existing data in the literature and through a review of procedures employed in foreing centers. As no one of implants is completely sterile it is very important to analyze too the recommendations for handling contaminated cultures. As authors we expect that this document will be useful and in brief, we can exhibit national multicenter figures constructed with comparable methodologies.