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Hyperhidrosis is a disorder consisting of excessive sweating through the different body sweat glands, which produces a negative impact socially and in work-related activities in those that suffer this condition. There are primary and secondary forms. The primary form is a benign condition with excessive sweating mainly in palms, soles of feet, axillae and face. It affects a 1% of the population, and its cause is unknown. Most medical treatments are unsuccessful, and at best, transitory. In patients who are very troubled by the condition, videoassisted bilateral thoracic sympathicotomy has become the elective treatment. In the period ranging from 1998 to 2018, 174 procedures were undertaken for primary hyperhidrosis, of which 102 satisfied the inclusion criteria. 72 patients were excluded. A 20.5% were males, and 79.5% were females, with an average age of 29.22 years at surgery. As to localization of sweating, a 50.9% was palmar-plantar-axillary, 23.5% axillary, 10.7% palmarplantar, 7.8% palmar, 6.8% palmar-axillary, and a 5.8% facial. Those patients with palmar sweating showed a 94.9% improvement, those with axillary sweating a 88.51%, with plantar a 46.25% and those with facial sweating a 84% improvement. The average admission time was 1.1 days. As an undesired effect, compensatory sweating occurred in 53 cases and postoperative complications in 18 cases. We conclude this is a safe technique, that diminishes sweating significantly, improving patient's quality of life.

Whipple's disease is a chronic mutisystem disease caused by the bacteria Tropherima whipplei. Approximately 1200 cases have been described in the literature. The worldwide incidence is estimated at 9.8 cases per million people. Data from South America and Europe show that it affects middle-aged males. It is believed that host immunological factors rather than agent genotypic traits influence the course of the infection. Since the clinical characteristics are usually nonspecific and the wide spectrum of manifestations in individual organs may be underestimated, the diagnosis remains challenging. We present a case with multisystem compromise confirmed by histopathology. We consider its publication important given the few cases documented in South America and the relevance of bearing in mind the importance of an early diagnosis for a prompt treatment that improves the prognosis of this rare disease.

Cough may be associated with complications such as syncope, urinary incontinence, pneumothorax, and less frequently, pulmonary hernia and costal fractures. Chronic cough is a cause of rib fractures and when they occur it is likely to affect more than one rib. We report a 53 year-old obese male in treatment with enalapril 10 mg for hypertension with a dry cough lasting five months. He consulted for bilateral chest pain and a Chest X ray examination showed symmetrical fractures in the seventh left and right ribs. Enalapril was discontinued, cough and pain subsided in two weeks.

Deep vein thrombosis (DVT) of the upper limb is a rare entity, estimated to account for 10% of all cases of DVT. Classically, they are classified into primary (idiopathic, due to subclavian vein compression or exercise related) and secondary (cancer, thrombophilia, trauma, shoulder surgery, associated to venous catheters or due to hormonal causes). The Paget- Schrötter syndrome is a primary thrombosis of the subclavian vein in the subclavian-axillary junction, related either to repetitive movements or to exercise; leading to microtrauma in the endothelium with consequent activation of the coagulation cascade. Clinically, it presents abruptly with pain, edema and feeling of heaviness in the affected limb. The treatment varies from thrombolytics and anticoagulation to surgical intervention, depending on the time of evolution. We present four cases of exercise-related subclavian vein thrombosis.

Vertigo is defined as an abnormal sensation of body motion or of its surrounding objects. It is a common chief complaint in emergency departments comprising 2 to 3% of these consultations worldwide. Vertigo is classified as peripheral or central, according to its origin, and can also be occasionally mixed, the most common cause of peripheral involvement being benign paroxysmal positional vertigo. The initial findings on clinical evaluation of patients are the clues for making a correct diagnosis. The differentiation between central and peripheral vertigo can be optimized by analysing nystagmus, by using the skew test and the head impulse test (HINTS), as also by performing the appropriate tests to evaluate the integrity of the vestibular-cerebellar pathway. In addition, tonal threshold audiometry could raise the diagnostic sensibility from 71 to 89% on initial approach. Appropriate diagnosis is the principal key for managing this clinical condition.

In the political and social context of World War periods and unstoppable technological advances, health professionals in the early twentieth century tried to orientate the practice of medicine towards a modern anthropological concept close to the biomedical perspective, which defends the dignity of a person. Threatened by the risks represented by collectivism and the meanness of the prevailing repressive governments, a personal struggle for the defense of life aroused, which was socially expressed by the advent of bioethics, psychoanalytic theories and the concept that environment has an important role in people’s health and welfare. And above all, the appearance of a paradoxical claim of religious ideals as support of science in times of overall crisis.

Intravascular lymphoma is a rare subtype of extranodal diffuse large B-cell lymphoma characterized by clonal proliferation of lymphocytes inside of small and medium caliber vessels. Its incidence is estimated at one case per million. The clinical picture is very variable, but frequently has skin and central nervous system involvement. It is diagnosed by demonstrating pathological blood vessel infiltration by lymphoma cells. We report a 44 years old male presenting with fever, malaise and erythematous lesions in the abdominal wall. An abdominal wall biopsy showed dilated vascular vessels with atypical cells in their lumen, compatible with large B-cell intravascular lymphoma. He was treated with rituximab, cyclophosphamide, adriamycin, vincristine and prednisone and an autologous hematopoietic stem cell transplantation, achieving a complete remission that has lasted two years.

Sensory neuronopathies or ganglionopathies, or dorsal root ganglion disorders, represent a subgroup of peripheral nervous system diseases, frequently associated with dysinmune or neoplastic disorders and with toxic agents. A degeneration of both central and peripheral sensory proyections is present. Patients typically show early ataxia, loss of deep tendon reflexes and positive sensory symptoms present both in proximal and distal sites of the body. We retrospectively studied 10 cases with a final diagnosis of sensory neuronopathy. Sensory neuropathy was the presenting symptom and the course was subacute in all cases. Paresthesias in upper limbs were a predominant manifestation (100%). Other manifestations included: hypoesthesia (10/10), gait ataxia (8/10), autonomic symptoms (3/10) and perioral paresthesias (3/10). Electrophysiology showed sensory axonal neuronal pattern, with normal motor responses. Final diagnosis was acquired sensory neuronopathy in all patients, associated with Sjögren's syndrome in 2, with lupus erythematosus in 1, with rheumatoid arthritis in 1, with a cancer in 2 (paraneoplastic) and idiopathic in 4. In paraneoplastic cases, the tumor was small cell lung cancer in 1 (with positive anti-Hu antibodies), and epidermoid lung cancer in the other. Eight patients were treated with immunotherapy, high dose intravenous methylprednisolone and/or intravenous immunoglobulin; with poor response in 4 cases, neurologic improvement in 5, and without any change in 1 patient. The present work shows the typical clinical and electrophysiological pattern of subacute sensory neuronopathy, and the relevance of early treatment.

Armand Trousseau (1801-1867) was born in Tours, France on October 14, 1801. He graduated as a physician in the same city under the direction of Pierre Bretonneau and received his doctorate in 1825 in Paris. He was the first physician to practice tracheotomy in diphtheria and perform thoracenteses to remove air or fluid from the pleural space. He recommended tracheal intubation in different scenarios. He described the first cases of laryngeal tuberculosis and the presence of carpopedal spasm in hypocalcemia, a sign that has his name. He also described the association between migratory thrombophlebitis and neoplasia, which is known as Trousseau's syndrome. Ironically, on January 1, 1867 he diagnosed in himself a deep vein thrombosis of the left upper limb and told one of his disciples "I am lost; I have no doubt about the nature of my disease". He died of gastric cancer at the age of 66 years on June 23, 1867. He carried out an educational and medical work. He instructed his students about the rather instantaneous thought process in clinical medicine. He always conducted his clinical work with the certainty of a sound scientific background. Contemporary physicians should take advantage of the example and lessons of Armand Trousseau.

Frédéric Chopin - a great Polish composer and pianist-suffered from a chronic disease. Both during his life and after his death, physicians disagreed on Chopin's diagnosis. His contemporaries accepted the diagnosis of tuberculosis, a common disease in the 18th century. Description of new clinical entities provoked new dilemmas in the 21th century. Although other alternative diagnoses to tuberculosis have emerged, such as cystic fibrosis or alpha-1 antitrypsin deficiency, we still sustain that the first diagnosis is the most probable. In this paper we report F. Chopin's case history and discuss cons and pros for different diseases as the cause of F. Chopin's suffering and death.

Granulomatosis with polyangiitis (GPA) or Wegener's disease is characterized by a granulomatous vasculitis of the upper and lower airways and kidney. It involves the lower respiratory tract causing subglottic tracheal stenosis, which occurs in approximately 22% of patients. We report two females aged 40 and 52 years, admitted to the hospital with a subglottic tracheal stenosis. Their symptoms and management are reviewed. The first patient responded to rituximab. The second patient required a tracheostomy.

Hiccup is a spasmodic involuntary contraction of the diaphragm which triggers a sudden inspiration and an abrupt closure of the glottis with a characteristic sound. Regarding its duration, it is classified as hiccup attack, persistent hiccup or rebellious or intractable hiccup. We present the case of a 75 old male with rebellious hiccup which prevented him to fall asleep by day or by night, associated with belches lasting for three years, refractory to chlorpromazine. An extensive evaluation led to the diagnosis of right ethmoid sinus tumor. The tumor resection was performed and after subsequent local radiotherapy the hiccup disappeared. We consider this a rare cause of rebellious hiccup that generated a diagnostic and therapeutic challenge.

Gustav Klimt was an Austrian Symbolist painter and one of the most important representatives of the modernist movement of the Viennese Secession. The most notable works carried out at his golden age were the "Portrait of Adele Bloch-Bauer I" and "The kiss". In 1901 he paints "Medicine" where he returns to the entanglement of floating bodies -the lifetime- among which appears the skeleton of death; a female figure stands out from the column to represent freedom from pain. The figure of Hygeia or Hygieia, daughter of Aesculapius, who personifies medicine, is shown in the foreground. In 1911, thanks to "The life and death", a picture related to medicine, he was awarded the first prize at the Universal Exhibition of Rome. A number of his artworks were confiscated by the Nazi dictatorship. During the advance of enemy troops, and fearing that these works would become spoils of war, it was decided to burn the castle where they remained confiscated. Therefore, countless artworks were lost. The progressive development of symbolic or abstract motifs already emphasized the freedom of spirit that permeated all the avant-garde of early twentieth century.

Symbolism is one of the most archaic forms of human thoughts. Symbol derives from the Latin word symbolum, and the latter from the Greek symbolon or symballo, which means "I coincide, I make matches". The Medicine symbol represents a whole series of historical and ethical values. Asclepius Rod with one serpent entwined, has traditionally been the symbol of scientific medicine. In a misconception that has lasted 500 years, the Caduceus of Hermes, entwined by two serpents and with two wings, has been considered the symbol of Medicine. However, the Caduceus is the current symbol of Commerce. Asclepius Rod and the Caduceus of Hermes represent two professions, Medicine and Commerce that, in ethical practice, should not be mixed. Physicians should be aware of their real emblem, its historical origin and meaning.

Lethargic encephalitis (LE) is a Central Nervous System disorder following an upper respiratory tract infection, characterized by sleep disturbances, clinical symptoms corresponding to basal ganglia involvement and in some cases, neuropsychiatric sequelae. We report a 18-year-old mole with a history of sinusitis treated with azithromycin, two weeks before, presenting with fever, headache, confusion and myoclonus. Urine analysis was positive for cannabis. Cerebro spinal fluid analysis showed mononuclear pleiocytosis (109xmm³) and an increase in protein concentration of l.6 g/dl. Forty eight hours after admission, the patient required mechanical ventilation and subsequently a status epilepticus appeared. Ten days later, fever, rigidity and resting tremor appeared. A magnetic resonance imaging showed hyperintensities in FLALR sequence in the right insular cortex. The patient continued with extreme rigidity, catatonia and mutism. Considering the possibility ofa LE, methyl prednisolone 1 g/day was administered for five consecutive days followed by prednisone 40 mg l day, observing a dramatic improvement of rigidity and tremors.

Ergotism is a complication of acute intoxication and/or chronic abuse of ergot derivatives. It expresses itself through a vasomotor syndrome with peripheral vascular disease which frequently involves extremities. We report four cases of HIV-1 infected patients treated with antiretroviral drugs including boosted-protease inhibitors who had self-treated themselves with ergotamine. They developed peripheral vascular disease symptoms and their pulses where diminished or absent in the physical examination. Arterial Doppler confirmed diffused arterial spasm in two of them. Ergotism following ergotamine-protease inhibitors association was diagnosed. Patients were treated through the discontinuity of involved drugs (protease inhibitors and ergotamine), calcium blockers; antithrombotic prophylaxis with enoxaparine, antiaggregant therapy with acetylsalicylic acid, and one of them received pentoxifylline and vasodilator prostaglandins infusion, with amelioration of the symptoms. We discuss the clinical presentation of this drug interaction, difficult to diagnose properly without a strong suspicion of its existence.

Background: William Osler was generally regarded as the greatest and most respected physician of his time. This paper describes Osler's life, his philosophy and views. He was an outstanding clinician who emphasized bedside teaching and observation. He possessed an extraordinary charm that inspired many others. As Professor of Medicine at four institutions in three countries, he was a great influence on medical education. He was a prolific writer, and his textbook became the most popular and widely read treatise on medicine in the world. He also was a medical historian, a classical scholar, and an avid bibliophile. He emphasized the value of hard work and ongoing education. His compassion and concern for patients and colleagues reflected his personality. We summarize Osler's descriptions, and some of his aphorisms. His wisdom is as relevant now, as it was in his time. Osler blended the art and science of Medicine perhaps better than anyone else, and remains a valuable role model for students and physicians more than ninety two years after his death.

Background: Adolf Kussmaul was born in Graben, close to Karlsruhe, Germany, on February 22,1822. He graduated at Heidelberg University in 1845 and he received his medical degree in 1855. He made original descriptions, such as the ophthalmoscope, the gastroscope or endoscope, and Kussmaul signs, besides the respiration named after him. He was the first to perform a thoracocenteses, peritoneal and gastric lavages. He rediscovered progressive bulbar paralysis (previously described by Guillaume Duchenne in 1861), polyarteritis nodosa (which was described by Karl von Rokitansky en 1852), dyslexia, (described by Thomas Willis in 1672) and pulsus paradoxus named after him, but that was reported by Richard Lower in 1669. During his 80 years of life, he wrote about different issues and topics (cardiology, rheumatology, endocrinology, gastroenterology, psychiatry, and neurology). Kussmaul was a student and professional without limits in his observation capacity. He preached with his own example in pursuit of science: observation, hypothesis, experimentation and analysis.

Cellulitis is an acute inflammation of dermis and subcutaneous tissue, usually complicating wounds, ulcers, or dermatosis. Even though in these cases it is recommended to perform culture from skin and soft tissue samples, the utility of blood cultures remains controversial due to the low frequency of positive results. Here we report the prevalence of bacteremia in patients with cellulitis admitted in our Hospital, and evaluate the presence of risk factors associated with the occurrence of this event. Clinical records of patients with diagnosis of cellulitis admitted between June 2007 and March 2010 were retrospectively reviewed. Patients without skin and soft tissue culture and/or blood cultures were excluded. Demographic data, presence of comorbidities, and culture results were analyzed. In this period, 140 patients were admitted with this diagnosis. Fifty six (40%) of them had positive skin and soft tissue cultures; where methicillin resistant Staphylococcus aureus (MRSA) was the most frequently isolated bacterium species (35.7%). Bacteremia was detected in 8.6% of these cases, where the most frequently isolated bacteria were Group G Beta haemolytic Streptococcus (33%). Bacteremia was significantly associated with longer hospital stay (10.5 ± 8.98 vs. 4.9 ± 6, p = 0.004). The following variables were significantly associated with the occurrence of positive blood cultures: diabetes (41.7% vs. 14.1%; p = 0.02; OR 4.4), positive skin and soft tissue culture (75% vs. 35.2%; p = 0.01; OR 5.5), alcoholism (16.7% vs. 3.9%; p = 0.01; OR 4.9), and chronic obstructive pulmonary disease (16.7% vs. 0.78%; p = 0.01; OR 25.4).

Septic arthritis of the pubic symphysis, so called osteomyelitis pubis is the infection which involves pubic symphysis and its joint. It is a rare condition, representing less than one percent of all cases of osteomyelitis. It affects most frequently young athletes and women undergoing gynecologic or urologic surgery. It presents itself with fever and pubic pain which irradiates to the genitals and increases when hip is mobilized, and this fact produces gait claudication. Differential diagnosis should be made with pubic osteitis, which is a sterile inflammatory condition. Diagnosis is based on clinic supported by microbiologic culture results, image methods, and proteins augment during acute phase. Image guided puncture is often necessary for the differential diagnosis with pubic osteitis. The etiologic agents most commonly found are Staphylococcus aureus, followed by gram-negative bacilli, and polymicrobial infection in recent pelvis surgery. The antibiotic treatment is adjusted depending on the microbiological diagnosis, adding NSAIDs, and bed rest. Surgical debridement is required up to 55% of the cases. Two cases of osteomyelitis of the pubis by S. aureus, with good outcome to treatment with antibiotics, NSAIDs and rest are here described. Both patients were healthy relevant athletes.

We herein describe Florence Nightingale's life and work. She is considered one of the pioneers in nursing practice. Her greatest success was during the Crimean war when, along with 38 voluntary nurses, she cleaned and refurbished the hospital in Scutari and reduced the mortality rate from 40 to 2%. She used to make rounds at night in the wards under the light of a lamp, and therefore she was named "The Lady with the Lamp". Queen Victory gave her the Royal Red Cross and she was the first woman who was honored with the Order of Merit in 1907. She had solid knowledge on Statistics and Mathematics which were useful for her nursing job.

Hemophagocytic syndrome (HS) is a severe hyper inflammatory condition whose cardinal symptoms are prolonged fever, cytopenia, hepatosplenomegaly, and hemophagocytosis by activated, morphologically benign macrophages. The clinical course resembles sepsis, sharing similar physiopathological features. We report four patients with the syndrome. A 61-year-old female presenting with fever and pleuritic pain. During the course of the disease, a pancytopenia was detected and a bone marrow aspiration was suggestive of HS. The patient was treated with cyclosporine and steroids with a good response. A 61-year-old male with fever and pancytopenia and a bone marrow aspirate suggestive of HS. The patient did not respond to treatment and died. A 23-year-old male with fever, pancytopenia and positive Hanta virus antibodies. A bone marrow aspirate was suggestive of HS. The patient recovered without any treatment. A 72-year-old male admitted with the diagnosis of pneumonia, that developed a progressive pancytopenia and bone marrow aspirate was suggestive of HS. A bronchoalveolar lavage showed the presence of Acinetobacter baumanii. Despite treatment with methylprednisolone and gammaglobulin, the patient died. Awareness of the clinical symptoms and of the diagnostic criteria of HS is important to start life-saving therapy in time.

Protein-energy wasting (PEW) and inflammation are usually common and concurrent conditions in maintenance dialysis patients and associated with poor prognosis. Low appetite and hypercatabolic states are common features. In dialysis patients, the former has been suggested to be secondary to inflammation; however, the evidence is not conclusive. Hence, the term malnutrition-inflammation complex syndrome (MICS) was coined to include this clinical entity, regardless the original causes. Possible causes of MICS include comorbid illnesses, oxidative stress, nutrient loss through dialysis, hyporexia, uremic toxins, decreased clearance of inflammatory cytokines, volume overload, increased blood phosphate and dialysis-related factors. MICS is believed to be the main cause of erythropoietin hypo-responsiveness, cardiovascular atherosclerotic disease, decreased quality of life, hospitalization and increased mortality in dialysis patients. Because MICS leads to a low body mass index, hypocholesterolemia, decrease in muscle mass, hypocreatininemia and hypohomocysteinemia, a "reverse epidemiology" phenomenon of cardiovascular risk factors can occur in dialysis patients. Therefore, obesity, hypercholesterolemia, and increased blood levels of creatinine and homocysteine, within certain limits, appear to be protective and paradoxically associated with a better outcome. There is no consensus about how to determine the degree of severity of MICS or how to manage it. Several diagnostic tools and treatment modalities are discussed in this paper. The correct management of MICS may diminish the cardiovascular disease, main cause of death in this population.

Palindromic rheumatism is characterized by multiple recurrent episodes of arthritis and periarthritis (mono or oligoarticular) that may last hours or days, disappearing without sequels. We report a 69-year-old male with a history of hypertension and a presumptive diagnosis of gout due to recurrent episodes of arthritis and periarthritis in the last thirty years. They involved at least two joints, lasted few days and were self limited. The patient was admitted due to arthritis and periarthritis of both wrists, knees, ankles, elbows and hands. He presented with fever (38-39 degrees C), intense articular pain and anorexia. With a presumptive diagnosis of palindromic rheumatism and the lack of response to non steroidal anti inflammatory drugs, methylprednisolone 20 mg/od per os was started, with an excellent response.

The prolific life of Jonathan Hutchinson is reviewed. The importance of triads, a set of signs and symptoms that lead to the suspicion of the presence of one or more clinical entities, that are a demonstration of associative thinking, is also discussed. Nowadays, when technology plays a very important role in medicine, we would like to underscore the value of history taking and physical examination as useful clinical tools.

The term asthenia comes from the Greek (centsqsneia, a: privation, without; esthénos: vigor, force), it means absence of strength, vigor or force. It is a symptom, difficult to define, with a set of vague sensations, different for each patient. It is a frequent cause of consult, almost 30% in ambulatory settings. The chronic fatigue represents up to 10% of these cases, and the 0.2-0.7% belongs to the chronic fatigue syndrome. It is very important to differentiate asthenia from weakness, dizziness or dyspnoea, since patients may confuse them. The factor time in asthenia is very useful for its characterization, it was defined to the prolonged fatigue when it lasts for more than a month and chronic when the duration is greater than 6 months. The depression is the commonest fatigue cause, representing approximately half of the cases. The most effective treatment of the asthenia is to solve the underlying cause, although up to 20% of the patients remain without diagnosis. The diagnosis of the chronic fatigue syndrome is of exclusion and the criteria of the international consensus of year 1994 are due to use. The high frequency of the symptom entails an enormous social and economic cost and it is for that reason so important for physicians to have a correct manage of this symptom.

Interstitial cystitis is characterized by over 6 months of chronic pain, pressure and discomfort felt in the lower pelvis or bladder. It is often relieved with voiding, along with daytime frequency and nocturia in the absence of an urinary tract infection. The disorder can be divided clinically into two groups -ulcerative and non-ulcerative- based on cystoscopic findings and response to treatment. Management follows an approach of applying the least invasive therapy that affords sufficient relief of symptoms. We report a case of a patient with interstitial cystitis. The diagnosis was performed by symptoms and lesion in the cystoscopy and excellent response to amitriptyline.

Acute esophageal necrosis, which presents as a black esophagus on endoscope, is an uncommon occurrence. It is defined as a dark pigmentation of the esophagus associated with histological mucosal necrosis. We report a 75-year-old man who developed black esophagus due to acute esophageal necrosis caused by septicemia. The patient had a favorable evolution.

Systemic lymphoma that involves the aorta is called periaortic lymphoma, and may be misdiagnosed clinically or in CT sean, mimicking a thoracic aortic aneurysm, dissection, penetrating ulcer or an intramural hematoma. We report a 70 year-old woman in whom a systemic non-Hodgkin 's lymphoma ivas diagnosed after she presented with the clinical features of an acute aortic syndrome. A CT sean showed the presence of a large thoracoabdominal periaortic soft tissue mass without aneurism or dissection. Later, a biopsy of the mass ivasperformed which showed a non-Hodgkin's lymphoma. Chemotherapy with CHOP-R was effective, with complete initial resolution of the mass, developing in the follow up chylothorax, malnutrition and death.

Acute pancreatitis (AP) is a disease with several causes and diverse clinical course. In our environment there are not many papers on this entity and they approach punctual features inside the broad spectrum picture. The aim of this study is to determinate clinical features, etiology, handling and evolution of patients diagnosed with AP admitted in our Hospital during a three years period. The clinical records of patients with AP admitted at the British Hospital of Buenos Aires between April 2004 and April 2007 were retrospectively analyzed. Demographic data, etiology, treatment, severity of the illness, morbidity and mortality were evaluated. Ninety seven patients were diagnosed with AP during the analyzed period. Forty nine were male (50.5%). The average age was 58.5 +/- 1.6 years (range 21-93). Ninety two patients presented only one episode of AP and five patients suffered two or more (recurrent pancreatitis). According to the etiology, 48 had a biliary origin, 23 were idiopathic, 11 post biliary tract procedures, 2 recognized an alcoholic origin and 13 other causes. The median hospital stay was 7 days. Twenty five percent required admission in Intensive Care Unit. Most of the patients (n: 66; 72%) presented mild episodes according to the Ranson Score. The median of beginning oral feeding was 3 days. Regarding to complications, 13% have multiple organ failure, 8% pancreatic necrosis (4 infected), only one patient had a pseudocist and another patient a peripancreatic abscess. Mortality rate was 7.2% (7 cases, all with Ranson = 3). Although this is a short series, the biliar origin is still the most prevalent etiology in our population. The low number of alcoholic origin caught our attention. Mortality was similar to that described in other series, but the number of local complications was lower. Our data are consistent with other papers regarding management and prognosis, and update the Argentine casuistic.