Synchronous colorectal cancer and abdominal aortic aneurysm treated simultaneously. Is a one-stage surgery a feasible treatment?

The finding of synchronous abdominal aortic aneurysm and colorectal cancer is rare. There is no consensus on which is the best surgical approach, so its management remains uncertain. A 64-year-old man was diagnosed with synchronous abdominal aortic aneurysm and rectal cancer. One-stage treatment was performed: He underwent endovascular aortic repair followed by simultaneous laparoscopic tumor resection. In our experience, one-stage minimally invasive surgery could be a safe and feasible treatment for concomitant abdominal aortic aneurysm and colorectal cancer.

Early and late results of open surgical and endovascular treatment of infrarenal abdominal aortic aneurysms, selected according to surgical risk.

BACKGROUND: Open surgical repair (OSR) and endovascular aneurysm repair (EVAR) surgery are alternative treatments for infrarenal abdominal aortic aneurysm (IRAAA). OBJECTIVES: To compare OSR and EVAR for the treatment of IRAAA. METHODS: 119 patients with IRAAA were electively operated by the same surgeon between January 1, 2006 and December 31, 2015, following selection for OSR or EVAR according to surgical risk. Complications, reinterventions, failures, and early and late mortality were analyzed. RESULTS: 63 OSR and 56 EVAR patients were analyzed. They were similar in terms of age (70 years), gender (92% men), and average diameter of IRAAA (6.5 cm), but with different comorbidities, surgical risk, and anatomy. EVAR was better than OSR regarding time in the operating theatre (177.5 vs. 233.3 minutes), need for transfusion (25 vs. 73%), and length of stay in ICU (1.3 vs. 3.3 days) and hospital (8.1 vs. 11.1 days). OSR allowed more associated procedures to be conducted simultaneously (19.0 vs. 1.8%). There were no significant differences between the groups with respect to complications (25.4 vs. 25.1%), reinterventions (3.2 vs. 5.2%), or early mortality (1.6 vs. 0%). During follow-up, OSR was associated with fewer revisions (3.13 vs. 4.21), angio-CTs (0.22 vs. 3.23), complications (6.4 vs. 37.5%), reinterventions (3.2 vs. 23.2%), and failures (1.6 vs. 10.7%), and had better survival (78.2 vs. 63.2%). CONCLUSIONS: Correct selection of patients achieves excellent results because it avoids OSR in patients at high risk and avoids EVAR in patients with high anatomical complexity, achieving similar results in the perioperative period, but better results for OSR over the course of follow-up.

CONTEXTO: A cirurgia aberta (CA) e o reparo endovascular de aneurisma (REVA) são tratamentos alternativos para o aneurisma da aorta abdominal infrarrenal (AAAIR). OBJETIVOS: Comparar CA e REVA no tratamento do AAAIR. MÉTODOS: Foram incluídos 119 pacientes com AAAIR, operados eletivamente pelo mesmo cirurgião entre 1 de janeiro de 2006 e 31 de dezembro de 2015, após seleção para CA ou REVA de acordo com o risco cirúrgico. Complicações, reintervenções, falhas e mortalidade precoce e tardia foram analisadas. RESULTADOS: Foram analisados 63 pacientes de CA e 56 de REVA, com semelhanças de idade (70 anos), sexo (92% homens) e diâmetro médio do AAAIR (6,5 cm), mas com diferentes comorbidades, riscos cirúrgicos e anatomias. O REVA foi melhor que a CA em relação ao tempo na sala de cirurgia (177,5 vs. 233,3 minutos), necessidade de transfusão (25 vs. 73%) e tempo de permanência na unidade de terapia intensiva (1,3 vs. 3,3 dias) e no hospital (8,1 vs. 11,1 dias). A CA permitiu que mais procedimentos associados fossem realizados simultaneamente (19,0 vs. 1,8%). Não houve diferenças significativas entre os grupos em relação a complicações (25,4 vs. 25,1%), reintervenções (3,2 vs. 5,2%) e mortalidade precoce (1,6 vs. 0%). Durante o acompanhamento, a CA apresentou menos revisões (3,13 vs. 4,21), angiotomografias (0,22 vs. 3,23), complicações (6,4 vs. 37,5%), reintervenções (3,2 vs. 23,2%) e falhas (1,6 vs. 10,7%), além de ter melhor sobrevida (78,2 vs. 63,2%). CONCLUSÕES: A seleção correta dos pacientes proporciona excelentes resultados porque evita pacientes com alto risco para CA e com complexidade anatômica para REVA. Os resultados são semelhantes no período perioperatório, mas melhores para CA durante o acompanhamento.

Decision-making and therapeutic options in intact splenic artery aneurysms: single-center experience and literature review.

BACKGROUND: Splenic artery aneurysms are rare, potentially serious, and usually asymptomatic. Several methods are currently available to treat them, each with their own advantages and drawbacks. Therefore, its therapeutic paradigm has changed. METHODS: We review our database of splenic aneurysms (2009-2019) and undertake an exhaustive literature review. Demographic, clinical, diagnostic, therapeutic, early and follow-up outcome data were examined. Our experience comprised: 15 patients with 19 splenic aneurysms. 11 women (average age, 59.4 years) and 4 men (average age, 61.7 years). All asymptomatic. RESULTS: At diagnosis, aneurysms had a mean cross-sectional diameter of 3.4 cm (3.2 and 3.9 for women and men, respectively), the largest measuring 8.5 cm. Two independent aneurysms were detected in four patients. Diagnoses were always incidental to a CT scan. Treatments consisted of open surgery (2 patients), endovascular surgery (10 patients: 7 embolizations, 3 covered stent) and observation/follow-up (3 patients). The cases of open surgery (with splenectomy) were carried out without postoperative morbidity. One embolization failed (requiring subsequent open surgery) and two suffered localized splenic infarction, but without further complications. In patients treated with a covered stent, the aneurysm was always excluded, without complications. There was no 30-day or follow-up (average 26.2 months) mortality. Splenic aneurysms are diagnosed more frequently and earlier (in the asymptomatic phase), albeit incidentally, than in the past. CONCLUSIONS: The correct indication (identifying patients at risk) and individualization of treatment, in which endovascular techniques are the first-line option, have significantly improved morbidity and mortality outcomes in our hospital.

Executive Summary of the Consensus Statement of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), the Spanish Society of Tropical Medicine and International Health (SEMTSI), the Spanish Association of Surgeons (AEC), the Spanish Society of Pneumology and Thoracic Surgery (SEPAR), the Spanish Society of Thoracic Surgery (SECT), the Spanish Society of Vascular and Interventional Radiology (SERVEI), and the Spanish Society of Paediatric Infectious Diseases (SEIP), on the Management of Cystic Echinococcosis.

The Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), the Spanish Society of Tropical Medicine and International Health (SEMTSI), the Spanish Association of Surgeons (AEC), the Spanish Society of Pneumology and Thoracic Surgery (SEPAR), the Spanish Society of Thoracic Surgery (SECT), the Spanish Society of Vascular and Interventional Radiology (SERVEI), and the Spanish Society of Paediatric Infectious Diseases (SEIP) considered it pertinent to issue a consensus statement on the management of cystic echinococcosis (CE) to guide healthcare professionals in the care of patients with CE. Specialists from several fields (clinicians, surgeons, radiologists, microbiologists, and parasitologists) identified the most clinically relevant questions and developed this Consensus Statement, evaluating the available evidence-based data to propose a series of recommendations on the management of this disease. This Consensus Statement is accompanied by the corresponding references on which these recommendations are based. Prior to publication, the manuscript was open for comments and suggestions from the members of the SEIMC and the scientific committees and boards of the various societies involved.

[Diagnosis and treatment of head and neck paragangliomas. Uses of angiography and interventional radiology]. / Diagnóstico y control evolutivo de los paragangliomas de cabeza y cuello. Interés de la angiografía y procedimientos neurorradiológicos intervencionistas.

The present article aims to describe the current role of interventional neuroradiology in the diagnosis and treatment of head and neck paragangliomas, based on our experience and a literature review. The cellular polymorphism of head and neck paragangliomas confers these tumors with their characteristics hypervascularization (angioarchitecture) with characteristic arteriographic signs and hemorrhage that justify presurgical embolization. The main indications of digital angiography in head and neck paragangliomas are to confirm diagnosis and identify functional involvement of the large cervical vessels, as well as their possible vascular replacement. Extensive carotid or jugular involvement may require excision of these vessels. Functional tests that allow the patency of the circle of Willis and/or that of the contralateral sigmoid sinus to be identified are required to predict post-treatment neurological complications. Although the treatment of choice of head and neck paragangliomas is complete excision, hypervascularization may complicate surgical resection. Presurgical embolization is used to facilitate treatment by reducing blood loss, shortening operating time and lowering postoperative neurological morbidity. Palliative embolization is indicated in patients with inoperable tumors. Currently, three interventional techniques can be used in the treatment of head and neck paragangliomas: endovascular embolization, direct percutaneous puncture, and placement of vascular stents. Although infrequent, the most severe complications are those related to embolism of the embolizing material. These complications are less frequent in highly specialized centers.

Early and late results of open surgical and endovascular treatment of infrarenal abdominal aortic aneurysms, selected according to surgical risk / Resultados precoces e tardios dos tratamentos aberto e endovascular de aneurismas da aorta abdominal infrarrenal, selecionados de acordo com o risco cirúrgico

Abstract Background Open surgical repair (OSR) and endovascular aneurysm repair (EVAR) surgery are alternative treatments for infrarenal abdominal aortic aneurysm (IRAAA). Objectives To compare OSR and EVAR for the treatment of IRAAA. Methods 119 patients with IRAAA were electively operated by the same surgeon between January 1, 2006 and December 31, 2015, following selection for OSR or EVAR according to surgical risk. Complications, reinterventions, failures, and early and late mortality were analyzed. Results 63 OSR and 56 EVAR patients were analyzed. They were similar in terms of age (70 years), gender (92% men), and average diameter of IRAAA (6.5 cm), but with different comorbidities, surgical risk, and anatomy. EVAR was better than OSR regarding time in the operating theatre (177.5 vs. 233.3 minutes), need for transfusion (25 vs. 73%), and length of stay in ICU (1.3 vs. 3.3 days) and hospital (8.1 vs. 11.1 days). OSR allowed more associated procedures to be conducted simultaneously (19.0 vs. 1.8%). There were no significant differences between the groups with respect to complications (25.4 vs. 25.1%), reinterventions (3.2 vs. 5.2%), or early mortality (1.6 vs. 0%). During follow-up, OSR was associated with fewer revisions (3.13 vs. 4.21), angio-CTs (0.22 vs. 3.23), complications (6.4 vs. 37.5%), reinterventions (3.2 vs. 23.2%), and failures (1.6 vs. 10.7%), and had better survival (78.2 vs. 63.2%). Conclusions Correct selection of patients achieves excellent results because it avoids OSR in patients at high risk and avoids EVAR in patients with high anatomical complexity, achieving similar results in the perioperative period, but better results for OSR over the course of follow-up.

Resumo Contexto A cirurgia aberta (CA) e o reparo endovascular de aneurisma (REVA) são tratamentos alternativos para o aneurisma da aorta abdominal infrarrenal (AAAIR). Objetivos Comparar CA e REVA no tratamento do AAAIR. Métodos Foram incluídos 119 pacientes com AAAIR, operados eletivamente pelo mesmo cirurgião entre 1 de janeiro de 2006 e 31 de dezembro de 2015, após seleção para CA ou REVA de acordo com o risco cirúrgico. Complicações, reintervenções, falhas e mortalidade precoce e tardia foram analisadas. Resultados Foram analisados 63 pacientes de CA e 56 de REVA, com semelhanças de idade (70 anos), sexo (92% homens) e diâmetro médio do AAAIR (6,5 cm), mas com diferentes comorbidades, riscos cirúrgicos e anatomias. O REVA foi melhor que a CA em relação ao tempo na sala de cirurgia (177,5 vs. 233,3 minutos), necessidade de transfusão (25 vs. 73%) e tempo de permanência na unidade de terapia intensiva (1,3 vs. 3,3 dias) e no hospital (8,1 vs. 11,1 dias). A CA permitiu que mais procedimentos associados fossem realizados simultaneamente (19,0 vs. 1,8%). Não houve diferenças significativas entre os grupos em relação a complicações (25,4 vs. 25,1%), reintervenções (3,2 vs. 5,2%) e mortalidade precoce (1,6 vs. 0%). Durante o acompanhamento, a CA apresentou menos revisões (3,13 vs. 4,21), angiotomografias (0,22 vs. 3,23), complicações (6,4 vs. 37,5%), reintervenções (3,2 vs. 23,2%) e falhas (1,6 vs. 10,7%), além de ter melhor sobrevida (78,2 vs. 63,2%). Conclusões A seleção correta dos pacientes proporciona excelentes resultados porque evita pacientes com alto risco para CA e com complexidade anatômica para REVA. Os resultados são semelhantes no período perioperatório, mas melhores para CA durante o acompanhamento.

Idiopathic calcinosis cutis of the penis.

Calcification of the skin occurs in three main forms: dystrophic; metastatic; and idiopathic. Idiopathic calcinosis cutis of the penis is a rare event and only 4 cases have been reported. Herein we present another case in a 19-year-old man and discuss its probable pathogenic origin.

[Segmentary testicular infarction]. / Infarto segmentario de testículo.

OBJECTIVE: A new case of segmental testicular infarction is reported. METHODS: A 52-year-old man presented to the emergency department with severe pain in the left testicle over a few days period. Physical examination revealed a tender induration in the upper pole of the left testicle. Beta-human chorionic gonadotropin and alpha-fetoprotein were normal. Sonography demonstrated a poorly-defined, hypoechoic, 13 mm lesion. On power Doppler sonography, the hypoechoic area appeared completely avascular in contrast to the rest of the testicle. RESULTS: Since testicular tumor was the initial diagnosis, the patient underwent a left radical orchiectomy. Pathological study revealed a focal testicular infarction, without signs of malignancy or vasculitis. CONCLUSIONS: Segmental testicular infarction is usually diagnosed after radical orchiectomy, performed when testicular tumor is suspected. On certain occasions Doppler ultrasound and magnetic resonance imaging findings suggested a segmental testicular infarction. However, if tumor cannot be entirely excluded, exploratory surgery is necessary.

[Evolution of Escherichia coli antibiotic resistances in urine samples from the community]. / Evolución de la resistencia a antibióticos de Escherichia coli en muestras de orina procedentes de la comunidad.

OBJECTIVES: The objectives of this work are two: first, to evaluate the resistance of Escherichia coli to several antibiotics and their trends over a six-year period in strands isolated in urine samples from patients receiving health-care in general practitioner offices in our environment; and second, to evaluate if empirical treatment regimens commonly accepted in our country would be applicable in our environment depending on the results of this study. METHODS: We analyzed the urine cultures positive for Escherichia coli obtained from samples collected at the 10 primary health care centers of the health-care area of El Bierzo and Laciana (Leon, Spain) between the years 2002 and 2007. In vitro resistances of these germs to several common use antibiotics were determined: fosfomycin, nitrofurantoin, tobramycin, cefuroxime, cefixime, amoxicillin-clavulanic acid, cotrimoxazole, ciprofloxacin, norfloxacin, and ampicillin. The existence of statistically significant (p < 0.05) differences in sensitivity comparing the years 2002 and 2007, including all antimicrobials except cefixime, was analyzed by the chi-square test. For cefixime we compared the results between 2002 and 2005. RESULTS: An increase of the resistance of Escherichia coli isolated in urine to all antimicrobials under study has occurred, except for nitrofurantoin, being the differences statistically significant in most cases. Nevertheless, resistances to fosfomycin and nitrofurantoin have remained below 6% throughout the study period. Resistances to tobramycin and cefuroxime were slightly over 10% and cefixime below 3.4%, although in the last one we only have data until 2005. Resistances to amoxicillin-clavulanic acid, initially low, have progressively increase reaching 20.6% in 2007. The same has happened for cotrimoxazole, ciprofloxacin, norfloxacin and ampicillin, passing 32% in 2007 in the first three cases and 62% in the last one. CONCLUSIONS: Variations in bacterial resistance patterns for Escherichia coli obliges to have an updated knowledge of them to adapt general empirical treatment uses to each specific health-care area.

[The treatment of bladder endometriosis. Spanish literature review]. / Tratamiento de la endometriosis vesical. Revisión de la literatura española.

OBJECTIVES: To perform a comprehensive, up-to-date review of the treatment of all cases of bladder endometriosis published in Spanish language journals in our country, including those published in non-urological scientific journals. METHODS: We identified 28 cases of bladder endometriosis published in the Spanish literature. The treatment performed in each case has been studied, as well as the treatment of relapses and follow-up after definitive treatment. Age and history of caesarean section were registered. RESULTS: Mean patient age was 35 years, with a median of 34 years and limits of 27 and 48. The history of caesarean section is present in 11 cases (39%). Several therapeutic regiments have been followed. Watchful waiting was only undertaken in one case due to the absence of urinary symptoms. Three patients received medical therapy initially. Only one of them had a favourable response. The other two underwent partial cystectomy and transurethral resection (TUR) respectively due to negative response. Transurethral resection was the most frequently used therapeutic modality; it was performed in 19 patients in addition to the aforementioned case. Bladder endometriosis recurred in 7 cases after TUR. Four of these cases underwent partial cystectomy, one of them laparoscopic, and three a second transurethral resection. Partial cystectomy was the initial therapeutic option in 5 cases. 4 of them were open and 1 laparoscopic. No recurrences have been described after partial cystectomy, including those performed for TUR failures. Mean follow-up was 37 months and median follow-up 12 months, being the limits 3 and 192 months. CONCLUSIONS: To date most published cases of bladder endometriosis appear in urologic journals. The most common therapeutic modality is transurethral resection, carried out in 20 cases (71%). However, it is necessary to inform the patient about the chances of treatment failure after TUR, around 35% after this review. Finally, the reported cases treated by laparoscopic partial cystectomy have been published by gynaecologists.

[Fournier's gangrene secondary to urethral catheterization]. / Gangrena de Fournier secundaria a cateterismo uretral.

OBJECTIVES: We report one case of Fournier's gangrene secondary to urethral catheterization. METHODS: We describe the clinical case, in which the initial cause was identified, and perform a short bibliographic review. RESULTS: Although Fournier's gangrene was initially considered as idiopathic in etiology, currently it is possible to identify the entrance site of the infection. In the present case the insertion of a urethral catheter was the starting mechanism, associated with factors such as diabetes and alcoholism which favour its development. The patient was treated by surgical debridement and partial urethrectomy but finally died. CONCLUSIONS: We want to point out that urethral instrumentation should be done by expert hands due to the severity of possible complications. We should insist in the need of precocious treatment with wide spectrum antibiotics, radical debridement and complete urologic evaluation.

[Preputial neurilemoma]. / Neurilenoma de prepucio.

OBJECTIVE: To present a case of preputial neurilemoma. METHODS: A 23-year-old man presented with a small, nodular, preputial mass that he had noted three years earlier. RESULTS: The tumor was excised under local anesthesia without complications. Currently, no evidence of tumor recurrence has been observed. CONCLUSIONS: Preputial nuerilemoma is rare. Diagnosis is based on the findings of the pathological study.

Incidental pelvic mass identified during ultrasound-guided transrectal needle biopsy of the prostate.

OBJECTIVE: Herein we report an additional case of a seminal vesicle cyst with ipsilateral renal agenesis and ectopic ureter in an asymptomatic individual with a normal examination. METHODS: We review the literature on retrovesical mas regarding the embryology, evaluation, management and treatment.. RESULTS/CONCLUSIONS: Seminal vesicle cysts with ipsilateral renal agenesis and ectopic ureter may appear as an incidental mass by transrectal ultrasound.

[Implementation of a clinical pathway for transurethral resection in benign prostatic hyperplasia]. / Implantación de una vía clínica para la resección transuretral por hiperplasia benigna de próstata.

OBJECTIVE: Clinical pathways constitute a powerful tool for reducing the variability that occurs in clinical practice. The results obtained with the use of a clinical pathway for patients undergoing transurethral resection for benign hyperplasia of the prostate (BPH) are presented. METHODS: A prospective study was carried out on a cohort of 80 consecutive patients that had undergone transurethral resection for BPH after the application of a clinical pathway (5 days hospitalization) and compared with the results of a historical cohort of 80 consecutive patients that had been treated before the application of the clinical pathway. The exclusion criteria were diabetes mellitus, anticoagulation therapy with dicoumarin and other pathologies that changed the length of the preoperative stay established in the clinical pathway. For the evaluation of the degree of satisfaction, patients were asked to fill out a questionnaire included in the pathway documents. RESULTS: 73 patients met the inclusion criteria of the clinical pathway. 67 of the 80 patients that underwent surgery before the application of the clinical pathway were valid for comparative analysis. No statistically significant differences were found between both groups for age, prostate volume measured by DRE and US, previous treatment for prostatism, anesthetic risk and weight of the resected specimen. With the application of the pathway, the mean duration of hospital stay was reduced from 6 (SD 1.7; range 4-15) to 4.9 (SD 1.4; range 3-13) days (p < 0.0001) and the duration of urethral catheterization from 4.5 (SD 1.4; range 3-13) to 3.8 (SD 1.3; range 2-11) days (p < 0.01). Statistically significant differences were found before and after the application of the clinical pathway for degree of compliance of the preestablished antimicrobial prophylaxis guidelines during hospitalisation and after discharge, and thromboembolic prophylaxis. The relative risk of complications after discharge was less after the application of the clinical pathway (RR = 0.66), although it was not statistically significant (CI: 0.41-1.05). 63 of the 73 patients included in the clinical pathway submitted the questionnaire without identifying themselves. Duration of hospitalization was considered adequate by 89%, and coincided with the programmed and actual duration according to 82.5%. CONCLUSIONS: The application of a clinical pathway for patients undergoing transurethral resection for BPH has reduced costs by reducing the length of hospital stay and adverse effects. Furthermore, reducing the variability of medical care has improved its quality.

[Ovarian vein syndrome. Report of 2 cases]. / Síndrome de la vena ovárica. Presentación de 2 casos.

OBJECTIVES: To report the clinicae characteristics and treatment of the ovarian vein syndrome. METHODS: We studied two cases of female patients with obstructive uropathy secondary to ovarian vein syndrome cared for at our department over the last 4 years. RESULTS: Both cases were treated surgically. Postoperative outcomes were satisfactory. CONCLUSIONS: The ovarian vein syndrome is rare. Surgery is the treatment of choice for symptomatic cases.

[Seminal vesicle cyst and ipsilateral renal agenesis]. / Quiste de vesícula seminal y agenesia renal ipsilateral.

OBJECTIVES: To report one case of seminal vesicle cyst with renal agenesis. To describe its clinical, radiological and therapeutic characteristics. METHODS/RESULTS: 42-year-old male presenting with irritative voiding symptoms. Digital rectal examination revealed a soft irregular mass over the prostate. Diagnostic imaging tests showed an enlargement of the left seminal vesicle and ipsilateral renal agenesis. Surgery was carried out with excision of the seminal vesicle cyst by an extravesical and extraperitoneal approach. Two years later the patient remains asymptomatic. CONCLUSIONS: Cystic pathology of the seminal vesicle is rare. Diagnosis is based on clinical symptoms, digital rectal examination and imaging studies. Surgery is necessary for symptomatic cases.

[Bladder perforation as a complication of uterine curettage after spontaneous abortion]. / Perforación vesical como complicación de legrado uterino por aborto espontáneo.

OBJECTIVE: To present a case of bladder and uterine perforation following curettage for first-trimester abortion. METHODS: A 30 years-old female, pregnant of 19 week of gestation had undergone a therapeutic abortion for fetal death. Following the procedure, she presented hematuria and vaginal bleeding. A vesico-uterine perforation was achieved. An exploratory laparatomy was performed with repair of the bladder and the uterus. RESULTS: There were no surgical complications. Eleven days after the laparatomy a cistography demonstrated closure of the perforation. The patient did well postoperatively. Two years later the patient was pregnant. A caesarean procedure with tubaric ligation was performed without complications. CONCLUSIONS: Bladder perforation following uterine curettage is rare. Surgical management is necessary with bladder and uterus repair.

[Fixed drug-induced exanthema of the glans]. / Exantema fijo medicamentoso en glande.

OBJECTIVES: To claim attention on an relatively frequent adverse reaction to drugs affecting genitalia, therefore a reason for consultation to the Urology Department. METHODS: We report a clinical case and a bibliographic review of this disease. RESULTS: Fixed drug eruption is a cutaneous eruption secondary to drug intake that appears every time the drug is taken, always in the same location, being more common in hands and feet. The course of the disease is usually progressive with increasing number of lesions after each dose of drug taken. CONCLUSIONS: Relapsing lesions in the same spot is key for the proper diagnosis of this eruption. To forbid causing drug intake is the treatment of choice, although it may be necessary to administer local or even oral corticosteroids.

[Conservative treatment of a seminal vesicle abscess. Report of one case]. / Tratamiento conservador del absceso de vesícula seminal. Aportación de un caso.

OBJECTIVE: To describe the clinical conditions, the radiological findings and the management of a case of seminal vesicle abscess. METHODS: A 47-year old man presented with irritative voiding symptoms, fever, diminished ejaculated volume, hematuria and testicular pain. Diagnosis was made with digital rectal examination, ultrasound and CT. RESULTS: The patient was managed with antibiotic therapy alone for 4 weeks. Clinical and radiological resolution was achieved. CONCLUSIONS: Seminal vesicle abscess is a rare condition. Diagnosis is based on clinical data and radiological findings. Conservative treatment could be effective in selected cases.

[Necrosis of the penis in a diabetic patient: presentation of a case]. / Necrosis de pene en paciente diabético, presentación de un caso.

OBJECTIVES: To present a short review of the diagnosis, clinical features, and treatment of male genitalia necrosis under the format of a case report. METHODS: We review the case of a diabetic patient without good blood sugar control who suffered from various diabetic complications diagnosed and treated at our hospital of a penile necrosis. We perform a bibliographic review about male genitalia necrosis regarding its etiology, diagnosis and treatment. RESULTS: Male genitalia necrosis is a rare disease but it is associated with high morbidity and mortality. The present case was diagnosed at the emergency room at our Hospital. Conservative treatment with antibiotic therapy and corticosteroid ointments was undertaken successfully. CONCLUSIONS: To perform an etiologic evaluation of the necrosis (dry or infectious) is important to select the right treatment. The high mortality of these diseases requires a precise and early diagnosis, since this influences the good or bad evolution of the disease.