Gastrointestinal stromal tumors (GIST) are lesions whose diagnosis and treatment have varied in the last decade. We report a 76 year-old male with a history of eight episodes of upper gastrointestinal bleeding. A duodenography showed an elevated lesion in the third portion of the duodenum with a central ulceration. It was initially managed with tumorectomy and primary closure of the duodenum. The pathological study of the surgical specimen revealed a low grade gastrointestinal stromal tumor. Three years later, the tumor recurred and pancreatoduodenectomy was performed. Due to the high risk of malignant potential, tumor size, number of mitoses and the presence of necrosis, imatinib mesylate was started. The patient had a satisfactory evolution, without evidences of recurrence after 15 months of follow up.

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Laparoscopic gastric plication, a new bariatric procedure: report of one caseBariatric surgery is an effective treatment for morbid obesity. Various techniques have been developed with different outcomes and complications. A new technique with promising results recently described in the literature: the gastric plication, which would not have the complications of using mechanical suture and would imply a reduction of costs. We report the fi rst case in Chile under this technique.Key words: Morbid obesity, bariatric surgery, gastroplasty, gastric plication. ResumenLa cirugía bariátrica es un tratamiento efectivo para la obesidad mórbida. Diversas técnicas se han desarrollado con diferentes resultados y complicaciones. Una nueva técnica con resultados prometedores se ha descrito recientemente en la literatura: la plicatura gástrica, la cual no tendría las complicaciones del uso de sutura mecánica e implicaría una reducción de los costos. Presentamos el caso clínico del primer paciente en Chile sometido a esta técnica.Palabras clave: Obesidad mórbida, cirugía bariátrica, gastroplastía, plicatura gástrica. CASOS CLÍNICOS IntroducciónLa obesidad es la epidemia del siglo XXI. Según la organización mundial de la salud, Arabia Saudita y Estados Unidos tienen 72,5% y 66,9% de su población con un índice de masa corporal (IMC) mayor o igual a 25 kg/mt 2 , respectivamente 1 . En nuestro país este porcentaje aumentó recientemente a un 67% 2 . La obesidad está ligada a comorbilidades tales como hipertensión arterial, diabetes, dislipidemia, apnea del sueño, enfermedad coronaria e infartos cerebrales 3,4 . La cirugía bariátrica reduce la ingesta calórica modifi cando la anatomía del tracto gastrointestinal. Éstas pueden ser cla-