Background: Primary biliary cirrhosis (PBC) is a chronic cholestatic (Rev Méd Chile 2006; 134: 469-74).

Small bowel transplantation. Report of a single case Small bowel transplantation is associated with a patient survival at one and five years, of 80% and 63%, respectively. We report a 36 year-old female with short bowel syndrome, subjected to the first small bowel transplantation performed in Chile. A cadaveric graft was used. Immunosuppression was achieved by means of alemtuzumab, tacrolimus, sirolimus, micofenolate mofetil and steroids. Serial endoscopies and biopsies were performed during seven months after transplantation. The most important late complications were a drug induced renal failure, infections caused by opportunistic agents and a gastrointestinal bleeding probably induced by drugs.

Cytomegalovirus infection and disease in pediatric solid organ transplantation. Experience in a Chilean multiorganic transplantation center Cytomegalovirus (CMV) infection and disease in transplant (Tx) recipients may severely complicate the patients outcome. Aim: To determine the incidence, clinical characteristics and risk factors for CMV infection and disease in liver and kidney transplant recipients in a tertiary care children's hospital. Method: A clinical and laboratory evaluation was prospectively performed in 44 and 20 children receiving a renal and liver Tx respectively in the Hospital Luis Calvo Mackenna between 2004 and 2006. Results: At the time of the organ Tx 20.3% (13/64) children were seronegative for CMV. Thirty six per cent (23/64) patients were infected with CMV, of whom 32% (14/44) received kidney Tx and 9/20 (45%) received liver Tx. CMV disease occurred in 52% (12/23) of infected patients. CMV disease was characterized by fever (100%), anemia (50%), leucopenia (16.6%) and specific organ involvement (renal graft 60% liver graft 57.1%, lung 25%, intestine 16.6%). Variables significantly associated with infection were a CMV seronegative status (p = 0.035) and lower age 5.5 + 3.7 years old vs 8.3 + 4.4 years old (p = 0.01). Conclusions: Incidence of CMV infection was high in children receiving a solid organ transplant in our institution and near half of infected children developed CMV-associated disease.

Mujer de 38 años de edad se presenta en servicio de urgencia por dolor abdominal intenso. Al examen físico destaca Blumberg difuso y abdomen en tabla, sin compromiso hemodinámico.TC de Abdomen informa imagen compatible con cuerpo extraño de 19 cm de longitud, en lumen duodenal, perforando la pared de la tercera porción, quedando su extremo distal en situación retroperitoneal, peri renal (Figuras 1A y 1B). A pesar de reinterrogarla la paciente niega su ingestión.Figura 1A y 1B. TAC de Abdomen mostrando el cuerpo extraño (flechas) que se extiende desde el píloro (a) hasta llegar a la inmediación del riñón derecho (b).

We report a girl with a chronic hepatitis caused by C virus diagnosed at the age of nine, unsuccessfully treated with interferon and ribavirine. Two years later, she was subjected to a liver transplantation. She maintained elevated viral loads with a normal pathological study of the liver until 22 months after transplantation. She was treated again with combined antiviral therapy, for 6 months, without response and experienced a progressive deterioration liver function, dying three years after transplantation.