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It is very important in the clinical practice to identify the individuals with Barrett's esophagus, because they are at risk to develop adenocarcinoma in the columnar epithelium. The objective of this research is to verify the incidence of this specific kind of epithelium at the "Gastrocentro", at State University of Campinas-UNICAMP, Campinas, SP, Brazil, among the total of 15,976 upper digestive endoscopies, performed from january of 1992 to December of 1995. From the total examinations performed were identified 2,381 patients (14.9%) presenting reflux esophagitis (grades I-IV, Savary-Miller). Among this group of patients, the endoscopist suspected of Barrett's esophagus in 110 cases (4.6%) and biopsed the distal esophagus. However, only in 85 cases (77.3%) the pathologist confirmed the diagnosis of Barrett's epithelium. The patients with Barrett's esophagus were 53 males (62.3%), presenting the mean age of 52.2 years and the following grades of esophagitis: grade I-33 cases (38.8%); grade II-15 cases (17.7%); grade III-15 cases (17.7%), grade IV-12 cases (14.1%) and without esophagitis-10 cases (11.7%). The incidence of Barrett's esophagus among the patients with reflux esophagitis was 3.57%, and among the total of examinations performed at the "Gastrocentro" during the period of four years was 0.53%, totalizing 22,4 cases/100,000 habitants.

During the period from August 1st, 1990 to June 15, 1992, 117 patients with portal hypertension and upper gastrointestinal bleeding were examined at the "GASTROCENTRO"--State University of Campinas--UNICAMP, Campinas, SP, Brazil few hours after hospital admission. The objectives were to study the association of gastroduodenal acute lesions and esophageal varices. The predominant ages were thirties and sixties years (83.76%), being 70.08% of males. The hematemesis occurred in 94.02% of the cases. The etiologies of the bleeding were: esophageal varices, 47.87%; gastroduodenal acute mucosal lesions, 34.19%; gastric varices, 9.4%; gastric ulcers, 5.98% and duodenal ulcers, 2.56%. The authors concluded that exists a significant association of acute gastroduodenal lesions and esophageal varices causing upper gastrointestinal bleeding. It is essential to examine early and in detail the gastroduodenal mucosa during upper digestive endoscopy in the patient with portal hypertension and esophageal varices to diagnose the etiology of the bleeding. It is advisable to perform endoscopic examination twice a year when the dyspeptic symptoms are constant, with previous treatment for gastroduodenal acute mucosal lesions or peptic ulcers, and annual in the others.

A case of mesenteric panniculitis is presented in which the main signal was an abdominal pulsable mass and severe obstruction of the lymphatic vessels of the mesentery. A review of the literature was done.

Benign neoplasms are rare events in the extrahepatic biliary ducts, and scanty literary references on the subject are available. Four cases of obstructive jaundice caused by benign tumours of the extrahepatic biliary ducts have been reviewed. Two of them have also displayed lithiasis of the gallbladder and common bile duct. In three cases histopathologic confirmation was obtained, in contrast to the remaining case in which only a gross pathologic presumptive diagnosis was possible. Three patients underwent surgical resection, and in one of them hepatojejunostomy was performed. The patient with a presumptive diagnosis of "inflammatory polyp" was not submitted to surgery, due to the special circumstances of the case. The undisturbed follow-up of the four cases attested to the worthiness of the surgical procedures.