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We report the case of a young female patient with a gastric duplication communicating with the pancreas, which manifested clinically as episodes of acute relapsing pancreatitis. We analyze the diagnostic procedures and treatment methods, and review similar cases reported in the literature.

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Serum concentrations of C-Reactive protein (CRP) were measured in 40 patients with inflammatory bowel disease (22 with ulcerative colitis and 18 with Crohn's disease). In the evaluation of disease activity, CRP was a more sensitive (98.6% vs 71.4%) and specific (95% vs 84.6%) activity index in Crohn's disease than in ulcerative colitis. The CRP concentrations were significantly higher in Crohn's disease (57.7 +/- 55.7 mg/dl) than in ulcerative colitis (16.3 +/- 18.8 mg/dl), particularly in severely affected patients (104.8 +/- 54.3 vs 29 +/- 24.2 mg/dl). The CRP levels correlated significantly with clinical activity indices. There was poor or no correlation between CRP levels and the endoscopic activity indices, the extent of inflammatory bowel disease, and the days of hospitalization. We conclude that the determination of CRP levels provide a simple objective index of inflammatory activity with may be useful in the assessment, management and study of inflammatory bowel disease.

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We have studied by means of flexible endoscopy 298 patients with a suspicion of esophageal foreign body. Only a third of them were proven, prevailing in women older than 60 years. We verify the meaning of some symptoms (dysphagia, odynophagia, retrosternal pain, and pharyngeal parestesias) according to the presence or not of the foreign body, and we confirm its general tendency to locate in the proximal esophagus and Killian's ring becoming nailed or impacted in a high percentage (73.8%) of cases. The lesions caused by such foreign bodies were slight in general, and no special treatment was required. The incidence of serious complications was very low (0.97%). The success of treatment by flexible endoscopy was 92.3%, making this the best method for extracting the foreign bodies of the upper digestive tract.

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We report a case of Crohn's disease diagnosed 13 years ago, complicated by a psoas abscess. The main symptoms were flexion deformity of the hip, pain and fever. Diagnosis was made by CT-scan. Surgical and CT-guided percutaneous drainage was ineffective and the abscess relapsed. Surgical resection of the affected bowel with abscess drainage, provided patient's healing.

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The aim of the present prospective trial was to study the disorders of blood coagulation in 31 patients diagnosed of inflammatory bowel disease (18 with ulcerative colitis and 13 with Crohn's disease) for assessing the possibility of hypercoagulability state in relation to the grade of activity of the disease. During the acute recurrences we observed an increase of factor VIIIC (65.3%), fibrinogen (57.7%), factor VIIIAg (50%), platelet (30.7%) and factor V (19.2%). In two (7.7%) patients a moderate decrease of antithrombin III was detected during a severe episode of activity. During the periods of inactivity the laboratory values concerning the coagulation were normal. There was a correlation between the blood coagulation alterations and the grade of activity of the inflammatory bowel disease.

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We appraise the efficacy of endoscopic injection treatment in 112 patients with gastroduodenal bleeding lesion versus 78 control patients (historical group), employing adrenaline (29 patients), absolute ethanol (52 patients) o adrenaline and ethanol (31 patients) as sclerosants. We observe in the treated group a diminution in rebleeding, lower transfusional blood needs and shorter hospital staying, with high stadistic significance versus the control group (p less than 0,001). Among treated patients the larger relapsing index (29.6%) was in patients treated with adrenaline injection only, against the group treated with ethanol or adrenaline and ethanol (10.2%) (p less than 0.05). The demand of surgical treatment was not significant between both groups, except in patients with actively jet bleeding, because urgent treatment was necessary in 37.5% of endoscopically treated patients versus 88.8% in not endoscopically treated. The mortality was similar in both groups.

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Twenty-two patients with variceal bleeding were treated with somatostatin, receiving a bolus of 250 mcg followed by an infusion at a rate of 250 mcg/hour. Bleeding stopped in sixteen patients (72.7%). Definitive control was attained in 13 patients (59.2%). Mortality was 31.8%. Somatostatin was not effective in patients with large varices, jet bleeding and hepatic insufficiency. Only minor side effects were recorded in four patients (18.2%).

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