No abstract

Distal intestinal obstruction syndrome. Report of two cases with cystic fibrosis Distal Intestinal Obstruction Syndrome (DIOS) has a 16% incidence among patients with Cystic Fibrosis (CF). It is characterized by an intestinal obstruction secondary to fecal impaction in distal ileum or cecum. We report two adult patients with DIOS. A female with CF and subjected to a lung transplantation at the age of 13 years. Five years later, she consulted for an intestinal obstruction. She was treated conservatively with a good clinical evolution. She had a new episode of DIOS eight months later, that was also treated conservatively. A 31 year-old male, subjected to bilateral lung transplantation nine years before, that was admitted to the hospital for a bronchiolitis. Three days after admission he started with a intestinal obstruction, that was diagnosed as a DIOS. He was managed conservatively with a good clinical response.

The diagnosis of hepatocellular carcinoma in cirrhotic patients has increased, mainly due to early detection using newer imaging techniques. The therapeutic approach depends on the tumor staging and the liver function. Cardiac involvement has a very (Rev Méd Chile 2004; 132: 1517-22E l carcinoma hepatocelular (CHC) representa más de 5% de todos los cánceres en el mundo y las muertes relacionadas con éste se estiman en 500 mil por año 1 . Este tumor puede debutar sintomáticamente con descompensación de la cirrosis de base, o ser de sospecha en pacientes asintomáticos por estudio de imágenes o medición de alfafetoproteína (AFP). En los países desarrollados se ha visto un aumento de su incidencia en el último tiempo, probablemente relacionado con la mejoría de exámenes diagnós-ticos y por la inmigración proveniente de zonas de alta prevalencia. Por otro lado, el mejor manejo de los pacientes cirróticos y la consiguiente mayor expectativa de vida de éstos, favorece su aparición, con una sobrevida que en casos avanzados suele ser inferior a 3 meses 2,4 .El diagnóstico de CHC en pacientes cirróticos se basa actualmente en los criterios establecidos en Barcelona 3 , que consideran la presencia de al menos dos técnicas de imagen que muestren un nódulo de 2 o más centímetros con hipervascularización, o por una sola imagen asociada a AFP >400 ng/ml. Se han desarrollado varias clasificaciones para determinar el estadio tumoral y la función

The rectal cancer has a different therapeutic approach due to its special anatomical location. Therefore, the surgical technique today it has been standardized and implay the total resection of the mesorectum to remove not just the rectal wall and the cancer but also all the fat around it and then the surgical plane is given by the MRF. To apply this technique and to know the use of co adjuvant pre surgical treatment the role of the MRI is essential because it is necessary to the exact extension of the tumor between the mesorectum and beyond the MRF. This excellence in the imaging quality it has been achieved with the use of the endorectal coil, which allows defining the all mesorectum, including the MRF, which will give the surgical plane, the preservation of the anal sphincter and the need of pre surgical treatment. From the information given by MRI the survival and recurrence rate of the rectal cancer, could be established.

No abstract