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This study was conducted to analyze the effect of genotype and climate on the resistance of honey bee (Apis mellifera) colonies to parasitic and viral diseases. The prevalence and intensity of parasitism by Varroa destructor, or infection by Nosema spp., and four honey bee viruses were determined in 365 colonies of predominantly European or African ancestry (descendants of A. m. scutellata) in subtropical and temperate regions of Mexico. Varroa destructor was the most prevalent parasite (95%), whilst N. ceranae was the least prevalent parasite (15%). Deformed wing virus (DWV) and black queen cell virus (BQCV) were the only viruses detected, at frequencies of 38% and 66%, respectively. Varroa destructor was significantly more prevalent in colonies of European ancestry (p < 0.05), and the intensity of parasitism by V. destructor or infection by DWV and BQCV was also significantly higher in colonies of European descent than in African descent colonies (p < 0.01), although no genotype−parasite associations were found for N. ceranae. Additionally, significant and positive correlations were found between V. destructor and DWV levels, and the abundance of these pathogens was negatively correlated with the African ancestry of colonies (p < 0.01). However, there were no significant effects of environment on parasitism or infection intensity for the colonies of both genotypes. Therefore, it is concluded that the genotype of honey bee colonies, but not climate, influences their resistance to DWV, BQCV, and V. destructor.

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Hemophagocytic lymphohistiocytosis is a rare complication in Rickettsia typhi infections. We report the case of a 2-year-old boy with sudden night-onset fever, pallor, neck adenopathy and erythematous macular rash on the thorax, thighs and buttocks. During admission, he developed hyponatremia, hypoalbuminemia, anemia, thrombocytopenia, leukopenia, neutropenia, liver damage, hemorrhages and persistent fever. No hematological improvement was observed after the initial management, neoplastic diseases were discarded by bone marrow aspiration and lymph node biopsy; hemophagocytic lymphohistiocytosis was diagnosed. By immunohistochemistry and indirect immunofluorescence, murine typhus was also diagnosed and doxycycline was started with transitory recovery. Later, the child developed kidney failure and distributive shock that evolved to cardiac arrest and death. This is the first case report in Mexico on a fatal murine typhus associated with hemophagocytic lymphohistiocytosis in which the etiology was evidenced by histopathology.

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BACKGROUND: The incidence of papillary thyroid microcarcinoma (PTMC) is increasing. OBJECTIVE: To analyze the long-term prognosis of PTMC. METHOD: Study population: patients with a histopathological diagnosis of PTMC (size ≤ 1 cm) treated according to the risk of recurrence of the Latin American Thyroid Society. Inclusion criteria: minimum follow-up of 2 years, availability of histopathological samples, and treatment compliance. Exclusion criteria: previous thyroid surgery, other synchronous malignancies or ectopic location of the PTMC. Study variables: persistences, recurrences and mortality. RESULTS: Based on the risk of recurrence, PTMC has very low risk in 65.2% (n = 105), low risk in 17.4% (n = 28) and high risk in 17.4% (n = 28). In high risk patients, total thyroidectomy was performed in all cases, cervical lymphadenectomy in 57,1% (n = 16) and metabolic therapy with I131 in all cases. During a mean follow-up of 119,8 ± 65 months, 0.6% (n = 1) of recurrences took place. Risk factors associated to recurrence were not identified. No patient died due to MCPT. CONCLUSIONS: PTMC treated based on its risk of recurrence has a good long-term prognosis, without persistences, with a low number of recurrences and absence of disease-associated mortality.

ANTECEDENTES: La incidencia del microcarcinoma papilar de tiroides (MCPT) está aumentado. OBJETIVO: Analizar el pronóstico a largo plazo del MCPT. MÉTODO: Población a estudio: pacientes con diagnóstico histopatológico de MCPT (tamaño ≤ 1 cm) tratados según el riesgo de recurrencia de la Sociedad Latinoamericana de Tiroides. Criterios de inclusión: seguimiento mínimo de 2 años, disponibilidad de las muestras histopatológicas y cumplimiento del tratamiento. Criterios de exclusión: cirugía tiroidea previa, otras patologías malignas sincrónicas o localización ectópica del MCPT. Variables a estudio: persistencias, recidivas y mortalidad. RESULTADOS: Según el riesgo de recurrencia, el 65.2% (n = 105) tuvo muy bajo riesgo, el 17.4% (n = 28) bajo riesgo y el 17,4% (n = 28) alto riesgo. En los pacientes de alto riesgo se realizó tiroidectomía total en todos los casos, linfadenectomía cervical en el 57,1% (n = 16) y terapia metabólica con I131 en todos los casos. Durante un seguimiento medio de 119,8 ± 65 meses hubo un 0,6% (n = 1) de recurrencias. No se evidenciaron factores de riesgo asociados a recidiva de la enfermedad. Ningún paciente falleció debido al MCPT. CONCLUSIONES: El MCPT tratado en función del riesgo de recurrencia tiene un buen pronóstico a largo plazo, sin persistencias, con una baja cifra de recurrencias y ausencia de mortalidad debida a la enfermedad.

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The microsporidian parasite Nosema ceranae and neonicotinoid insecticides affect the health of honey bees (Apis mellifera). However, there is limited information about the effect of these stressors on other pollinators such as stingless bees (Hymenoptera: Meliponini). We examined the separate and combined effects of N. ceranae and the neonicotinoid thiamethoxam at field-exposure levels on the survivorship and cellular immunity (hemocyte concentration) of the stingless bee Melipona colimana. Newly-emerged bees were subjected to four treatments provided in sucrose syrup: N. ceranae spores, thiamethoxam, thiamethoxam and N. ceranae, and control (bees receiving only syrup). N. ceranae developed infections of > 467,000 spores/bee in the group treated with spores only. However, in the bees subjected to both stressors, infections were < 143,000 spores/bee, likely due to an inhibitory effect of thiamethoxam on the microsporidium. N. ceranae infections did not affect bee survivorship, but thiamethoxam plus N. ceranae significantly increased mortality. Hemocyte counts were significantly lower in N. ceranae infected-bees than in the other treatments. These results suggest that N. ceranae may infect, proliferate and cause cellular immunosuppression in stingless bees, that exposure to sublethal thiamethoxam concentrations is toxic to M. colimana when infected with N. ceranae, and that thiamethoxam restrains N. ceranae proliferation. These findings have implications on pollinators' conservation.

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BACKGROUND: Many neglected tropical diseases (NTDs) are not fatal, but they are disabling, disfiguring and stigmatizing. More accurate data on these aspects would benefit planning, monitoring and evaluation of interventions, as well as provision of appropriate services for the often life-long consequences. In 2015, a cross-NTD toolkit was developed, consisting of a variety of existing questionnaires to measure morbidity, disability and health-related quality of life. The toolkit covers the domains of the International Classification of Functioning, Disability and Health (ICF) framework. These tools have been developed in a source country, however, it was intended for the cross-NTD toolkit to be applicable across NTDs in many countries with different cultures and languages in order to generate universally comparative data. Therefore; the present study aimed to validate several tools of the toolkit among people affected by leprosy or leishmaniasis in the cultural settings of Cartagena and Cúcuta, Colombia. METHODOLOGY: This study aimed to validate the following tools among 55 participants between 18-85 years old, affected by leprosy and leishmaniasis: (I) Clinical Profile, (II) Self-Reporting Questionnaire (SRQ), (III) WHO Quality of Life assessment-abbreviated version (WHOQOL-BREF), and (IV) WHO Quality of Life assessment-Disability (WHOQOL-DIS). The tools were administered during face-to-face interviews and were followed by open questions about the respondents' thoughts on format of the tool and the understanding, relevance and acceptability of the items. The tools were validated using a qualitative method approach based on the framework for cultural equivalence, measured by the cultural, item, semantic and operational equivalences. RESULTS: The Clinical Profile was seen as acceptable and relevant, only the semantic equivalence was not as satisfying and needs a few adaptations. The SRQ was very well understood and shows to reach the equivalences for the population of Colombia without any additional changes. Several items of the WHOQOL-BREF and the WHOQOL-DIS were not well understood and changes are recommended due to semantic difficulties. Operational equivalence of both questionnaires was not as desired in relation to the used response scales. The participants shared that the tools are relevant and important for their particular situation. CONCLUSIONS/SIGNIFICANCE: The SRQ is found to be a valid tool for Colombia and can be included in the cross-NTD toolkit. The Clinical Profile, WHOQOL-BREF & WHOQOL-DIS need changes and retesting among Colombian people affected by an NTD. The toolkit as a whole is seen as useful to show the effects leprosy and leishmaniasis have on the participants. This cultural validation will contribute to a universally applicable cross-NTD toolkit.

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The purpose of this review is to present information about the role of activation of aflatoxins and other mycotoxins, of the aryl hydrocarbon receptor (AhR) pathway. Aflatoxins and other mycotoxins are a diverse group of secondary metabolites that can be contaminants in a broad range of agricultural products and feeds. Some species of Aspergillus, Alternaria, Penicilium, and Fusarium are major producers of mycotoxins, some of which are toxic and carcinogenic. Several aflatoxins are planar molecules that can activate the AhR. AhR participates in the detoxification of several xenobiotic substances and activates phase I and phase II detoxification pathways. But it is important to recognize that AhR activation also affects differentiation, cell adhesion, proliferation, and immune response among others. Any examination of the effects of aflatoxins and other toxins that act as activators to AhR must consider the potential of the disruption of several cellular functions in order to extend the perception thus far about the toxic and carcinogenic effects of these toxins. There have been no Reviews of existing data between the relation of AhR and aflatoxins and this one attempts to give information precisely about this dichotomy.

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We determined the presence of six viruses in different bee species collected in subtropical environments. Deformed wing virus (DWV) and black queen cell virus (BQCV) were detected in >90% of honey bee samples and in 50-100% of four stingless bee, two bumble bee and one solitary bee species. Additionally, minus DWV and BQCV RNA strands were detected, indicating that the viruses replicate in several hosts. This is the first report of honey bee viruses replicating in six wild bee species in the tropics. If pathogenic to them, viral infections could result in negative impacts in agricultural and unmanaged ecosystems.

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PURPOSE: To report the therapeutic efficacy and safety of topical 0.1% lodoxamide in the long-term treatment of superior limbic keratoconjunctivitis. METHODS: Sixty-seven eyes of 34 patients with active SLK were studied. Therapeutic response was analyzed according to modified-Ohashi parameters. All eyes were treated with 0.1% lodoxamide twice daily, and those with moderate or severe inflammation received a short course (7-14 days) of 0.1% fluorometholone acetate at presentation and during a relapse. Patients were evaluated at regular intervals and followed up for ≥3 months on continuous therapy. Primary endpoints included inflammatory response; rates of inflammatory control and remission; relapses while on therapy or on remission; and therapeutic failure rate. RESULTS: The mean follow-up time on lodoxamide therapy was 15.3 months. The majority of eyes (82.0%) achieved control of inflammation in a mean time of 2.2 months. Of these, 42 (76.3%) eyes remained under control while on therapy for 13.8 months. There was a significant improvement of SLK-related signs by the third month on therapy (p < 0.05). A total of 24 (35.8%) eyes achieved remission. Relapses presented in 12 (18.0%) treated eyes and in 4 (16.6%) eyes on remission. Only 5 (7.4%) eyes failed to respond to therapy. In the majority of cases (95.3%), lodoxamide 0.1% was well tolerated and minor adverse effects not requiring stopping the medication were reported in only 4.7% of patients. CONCLUSIONS: Lodoxamide 0.1% is an efficacious therapeutic alternative for the treatment of active and chronic SLK. This medication has proved to be safe and well tolerated.

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BACKGROUND: Scalp involvement is not directly evaluated in patients with dermatomyositis (DM). Therefore, the exact frequency of scalp dermatomyositis (SDM) and its clinical and trichoscopic characteristics have been poorly described. OBJECTIVE: The aim of this study was to determine the frequency and clinical and dermoscopic features of SDM in patients diagnosed with DM. METHODS: We performed a descriptive prospective, cross-sectional observational study that included all patients diagnosed with DM at a Mexican academic institute over the course of a year. RESULTS: Twenty-four out of 31 patients with DM had scalp involvement at clinical examination, with a prevalence of 77.4%. SDM was clinically characterized by erythema in all cases, scales in 20 (83.3%) patients, nonscarring alopecia in 21 (87.5%) patients, pruritus in 17 (70.8%) patients, and poikiloderma of the scalp in 16 (51.6%) patients. Twenty-eight patients were evaluated by trichoscopy. The most consistent finding was the presence of enlarged capillaries, found in 20 (71.4%) cases, followed by peripilar casts (57.1%) and tufting and interfollicular scales in 14 (50%) cases. Twenty-two patients also had positive nail fold capillaroscopic features similar to those observed by trichoscopy. LIMITATIONS: The simple size was limited. CONCLUSIONS: Scalp involvement and alopecia are common in patients with DM, and trichoscopy shows features similar to those found at capillaroscopy. Trichoscopy is a very important tool for diagnosis of scalp involvement in patients with DM.

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El objetivo de este estudio fue conocer el contenido de las representaciones sociales acerca del consumo de drogas en adolescentes y adultos jóvenes, y si tales representaciones favorecían y, por lo tanto, predecían el consumo de las mismas. Para esto, se seleccionaron seis creencias acerca del uso social de las drogas -tales como tomar alguna droga es normal-, considerándolas como indicadores de dichas representaciones sociales. La muestra estuvo compuesta por 417 alumnos del Ciclo Formativo de Grado Medio y Programa de Garantía Social pertenecientes a distintos centros educativos de la ciudad de Granada, considerados de alto riesgo para el consumo. Los resultados mostraron que las creencias evaluadas estaban presentes entre los participantes, que predecían el consumo de drogas legales e ilegales y que estaban asociadas sobre todo al consumo de cannabis. En conclusión, en los programas preventivos sería de gran utilidad tener en cuenta las representaciones sociales sobre el uso de drogas.

The objective of the study was to know the content of social representations about the consumption of drugs and also if those representations contributed and predicted the consumption of drugs among young people. Six beliefs about the social use of drugs were selected, such as whether it is common to take drugs. These beliefs were considered indicators of those social representations. The study was carried out among 417 students of Associate Degree and Social Guarantee Program from different Educational Centres of Granada, who were considered high risk drug users. Results showed that evaluated beliefs were present among young people, these beliefs predicted the consumption of legal and illegal drugs and were specially associated with the consumption of cannabis. Thus, social representations about the consumption of drugs should be considered for prevention programs.

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De los quistes odontogénicos el quiste dentígero (QD) ocupa el segundo lugar en frecuencia, siempre asociado a la corona de un diente retenido, tiene predilección por el género masculino en la segunda y tercera década de la vida. En algunas ocasiones se puede observar deformidad facial por expansión de las corticales óseas del hueso comprometido. Radiográficamente se aprecia imagen radiolúcida circunscrita relacionada a la corona de un diente no erupcionado o en desarrollo. Se presentan dos casos pediátricos del sexo femenino de 6 y 15 años de edad. La niña de 6 años llega a consulta por preocupación de la madre al observarse un aumento de volumen en el maxilar superior del lado derecho, el examen clínico mostró expansión cortical de la tabla vestibular de la zona del primer molar primario superior derecho, el examen radiográfico revela imagen radiolúcida rodeando la corona de un diente retenido que corresponde al primer premolar permanente. La otra paciente acude a consulta por deformidad facial y al examen clínico se observa expansión de la cortical ósea vestibular mandibular del lado izquierdo ocasionando asimetría facial, al estudio radiográfico se observa imagen radiolúcida circunscrita que se extiende desde el segundo molar hasta la rama mandibular asociada a un tercer molar retenido. En ambos casos se planificó extirpación quirúrgica previa punción de las mismas para descartar su naturaleza quística, resultando como diagnóstico definitivo: Quiste Dentígero. Se resalta el hecho de que estos dos casos difieren en cuanto al comportamiento epidemiológico clásico, frecuente en el género masculino y entre segunda y tercera década de la vida

Of odontogenic cysts the cyst is second in frequency, always associated with the crown of an impacted tooth, has a predilection for the male gender in the second and third decade of life. Sometimes you can see facial deformity expansion of cortical bone. Radiographically circumscribed radiolucency is seen related to the crown of an unerupted tooth or developing. There are two female pediatric cases of 6 and 15 years of age. The 6 year old girl comes to consultation by the mother's concern to see an increase of volume in the right upper jaw, clinical examination showed cortical expansion of the buccal plate of the primary molar region of the first upper right, the radiographic examination reveals radiolucency surrounding the crown of an impacted tooth that corresponds to the first premolar. The other patient comes for consultation facial deformity and the clinical examination shows expansion of the cortical bone of the left mandibular buccal causing facial asymmetry, the radiographic study lucid radio image shows circumscribed extending from the second molar to the ramus associated a third molar. In both cases, surgical removal was planned after the same puncture to rule out cystic nature, resulting as definitive diagnosis: dentigerous cyst. It highlights the fact that these two cases differ in the classic epidemiological pattern, common in the male, and between second and third decades of life

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RESUMEN Las explosiones nucleares de gran potencia a cielo abierto, debido a las pruebas de armas nucleares o como consecuencia de accidentes que han tenido lugar, son las principales causas de que gran número de radionúclidos se haya dispersado en todo el globo terráqueo. Entre estos se encuentra el cesio-137, que al llegar al suelo se adhiere fuertemente a sus partículas más finas. Ello, junto a su período de semidesintegración de 30 años y su fácil detección por gamma espectrometría hacen que se use como radiotrazador de los movimientos del suelo. Esta técnica, ampliamente usada y validada en diferentes entornos en todo el mundo, también fue previamente validada y se demostró su eficacia en la provincia de Cienfuegos. El objetivo de esta investigación fue estudiar mediante el uso del cesio 137, la redistribución del suelo y cuantificar la erosión en áreas protegidas de la provincia, donde las pérdidas de suelo y el arrastre de sedimentos son las principales causas del deterioro de estos ecosistemas con las consiguientes pérdidas económicas y ambientales. Los resultados obtenidos se interpolaron, empleando el método kriging mediante el software gvSIG, obteniendo un mapa de la distribución del suelo en las parcelas estudiadas, y garantizando una mejor visibilidad al respecto. El método se puede aplicar en otros lugares donde sea necesario conocer la magnitud de los problemas de erosión y la redistribución del suelo en el paisaje, lo cual puede ser muy útil para trazar los planes de reordenamiento de los usos del suelo.

ABSTRACT The large-scale nuclear explosions as a result of nuclear weapons tests or nuclear accidents are the main causes of/for the great dispersion of artificial radionuclides all over the world. One of these radionuclides is cesium-137, which is strongly fixed to the fine soils particles. This fact, together with its half-life of 30 years and its easy detection by gamma spectrometry have turned cesium 137, in a good radiotracer of soil movement. This technique has been widely used and validated in different landscapes throughout the world. Its effectiveness was also previously validated and proved in Cienfuegos province as well. This research was aimed at using the cesium-137 technique to study soil redistribution and quantify erosion in the so called Protected Areas in Cienfuegos province, where soil loss and sediment transport are the main causes of deterioration of these ecosystems with the consequent economic and / or environmental losses. The results were represented in a map using the gvSIG software by kriging, thus achieving greater visibility of the soil redistribution in the studied plot. The methodology used in this study could be used in other places wherever the magnitude of erosion problemsas well as knowing the soil redistribution plot pattern in the landscape are necessary and very useful to elaborate plans for rearrangement in land use management.

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Se realizó un estudio retrospectivo con el objetivo de determinar las complicaciones quirúrgicas en 60 pacientes consecutivos a los que se implantaron sistemas de accesos subcutáneos venosos centrales en nuestra institución (Port-a-Cath®), teniendo en cuenta edad, sexo, enfermedad oncológica y vasos abordados. Se registró 8,33 por ciento de complicaciones atribuibles a cirugía: hematomas posoperatorios, necrosis del bolsillo quirúrgico, mala posición del catéter en el vaso venoso y pérdida de derecho a domicilio del bolsillo quirúrgico. Nuestro estudio muestra que la mortalidad en el procedimiento quirúrgico para colocar sistemas de accesos subcutáneos vasculares centrales es nula y que las complicaciones quirúrgicas son pocas(AU)

A retrospective study was made to determine surgical complications in 60 consecutive patients in whom central subcutaneous venous access devices were implanted in our institution (Port–a-Carth®), taking age, sex, oncological disease and approached vessels into consideration. Surgery-attributable complications amounted to 8,33 per cent: postoperative hematomes, surgical pocket necrosis, wrong placement of catheter in the vein and loss of place of the surgical pocket. Our study showed that mortality in this surgical procedure for placing central venous access devices was nule and that surgical complications were few(AU)

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Se realizó un estudio retrospectivo con el objetivo de determinar las complicaciones quirúrgicas en 60 pacientes consecutivos a los que se implantaron sistemas de accesos subcutáneos venosos centrales en nuestra institución (Port-a-Cath®), teniendo en cuenta edad, sexo, enfermedad oncológica y vasos abordados. Se registró 8,33 por ciento de complicaciones atribuibles a cirugía: hematomas posoperatorios, necrosis del bolsillo quirúrgico, mala posición del catéter en el vaso venoso y pérdida de derecho a domicilio del bolsillo quirúrgico. Nuestro estudio muestra que la mortalidad en el procedimiento quirúrgico para colocar sistemas de accesos subcutáneos vasculares centrales es nula y que las complicaciones quirúrgicas son pocas(AU)

A retrospective study was made to determine surgical complications in 60 consecutive patients in whom central subcutaneous venous access devices were implanted in our institution (Port­a-Carth®), taking age, sex, oncological disease and approached vessels into consideration. Surgery-attributable complications amounted to 8,33 per cent: postoperative hematomes, surgical pocket necrosis, wrong placement of catheter in the vein and loss of place of the surgical pocket. Our study showed that mortality in this surgical procedure for placing central venous access devices was nule and that surgical complications were few(AU)

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Los autores presentan tres casos de necrosis isquémica de vesícula biliar, dos como complicación por gastrectomía y uno como cuadro agudo de abdomen en un paciente con patología vascular de fondo evolucionada. Los pacientes gastrectomizados tenían como factor común haber sido sometidos a procedimientos sobre los vasos del pedículo hepático: vaciamiento ganglionar en un caso y ligadura incidental de la gastroduodenal en el otro. Estos casos pueden considerarse como colecistitis alitiásicas necrotizantes. El diagnóstico de cuadro agudo abdominal postoperatorio es siempre dificultoso lo que lleva una apreciable morbimortalidad, como sucedió en estos casos. La infrecuencia de este cuadro clinicopatológico, los resultados obtenidos y la morbimortalidad justifican la comunicación de estos casos. La infrecuencia de este cuadro clinicopatológico, los resultados obtenidos y la morbimortalidad justifican la comunicación de estos casos

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Los autores presentan tres casos de necrosis isquémica de vesícula biliar, dos como complicación por gastrectomía y uno como cuadro agudo de abdomen en un paciente con patología vascular de fondo evolucionada. Los pacientes gastrectomizados tenían como factor común haber sido sometidos a procedimientos sobre los vasos del pedículo hepático: vaciamiento ganglionar en un caso y ligadura incidental de la gastroduodenal en el otro. Estos casos pueden considerarse como colecistitis alitiásicas necrotizantes. El diagnóstico de cuadro agudo abdominal postoperatorio es siempre dificultoso lo que lleva una apreciable morbimortalidad, como sucedió en estos casos. La infrecuencia de este cuadro clinicopatológico, los resultados obtenidos y la morbimortalidad justifican la comunicación de estos casos. La infrecuencia de este cuadro clinicopatológico, los resultados obtenidos y la morbimortalidad justifican la comunicación de estos casos(AU)

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Los autores aportan un nuevo caso de traumatismo grave de pancreas, por trauma cerrado abdominal que requirió cirugía resectiva de urgencia. Se presenta el caso clínico, los hallazgos operatorios y el tratamiento quirúrgico realizado, que consistió en duodenopancreatectomía atípica de urgencia. La discusión se centra en el tipo lesional de trauma pancreatico y sus alternativas terapéuticas. Se destaca la buena evolución postoperatoria, la baja frecuencia de este tipo de traumatismo explica la escasa casuistica nacional e internacional. Presentamos series comparativas de frecuencia y morbimortalidad

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Los autores aportan un nuevo caso de traumatismo grave de pancreas, por trauma cerrado abdominal que requirió cirugía resectiva de urgencia. Se presenta el caso clínico, los hallazgos operatorios y el tratamiento quirúrgico realizado, que consistió en duodenopancreatectomía atípica de urgencia. La discusión se centra en el tipo lesional de trauma pancreatico y sus alternativas terapéuticas. Se destaca la buena evolución postoperatoria, la baja frecuencia de este tipo de traumatismo explica la escasa casuistica nacional e internacional. Presentamos series comparativas de frecuencia y morbimortalidad(AU)

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Los autores presentan tres casos de necrosis isquémica de vesícula biliar, dos como complicación posgastrectomía y uno como cuadro agudo de abdomen en un paciente con patología vascular de fondo evolucionada. Los pacientes gastrectomizados tenían como factor común haber sido sometidos a procedimientos sobre los vasos del pedículo hepático; vaciamiento ganglionar en un caso y ligadura incidental de la arteria gastroduodenal en el otro. Estos casos pueden considerarse como colecistitis alitiásicas. El diagnóstico de cuadro agudo abdominal posoperatorio es siempre dificultoso, lo que lleva una apreciable morbimortalidad, como sucedió en estos casos. La infrecuencia de este cuadro clinicopatológico, los resultados obtenidos y la morbimortalidad justifican la comunicación de estos casos

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