[Minimally invasive management of Choledochal Cyst in pediatric age]. / Manejo mínimamente invasivo de Quiste de Colédoco en edad pediátrica.

INTRODUCTION: The choledochal cyst (also bile duct cyst) is a rare condition. It is important to know its clinical presentation, diagnosis, and treatment alternatives, which allow a resolution with low morbidity. OBJECTIVE: to report the clinical diagnosis together with the laparoscopic techniques for the mana gement of the bile duct cyst. CLINICAL CASES: Case 1: 4-year-old preschooler with history of recurrent abdominal pain. Abdominal ultrasound showed a choledochal cyst. Blood amylase levels 111 IU / L. Other tests were normal. Case 2: 5-year-old preschooler with a 5-days history of abdominal pain, vomiting, and diarrhea. He was admitted due to acute pancreatitis (blood lipase 947 IU / L, blood amylase 217 IU / L). Abdominal CT scan reported a lobulated cystic lesion in the hilum of the liver. Case 3: 3-year-old preschooler with recurrent abdominal pain and a 3-day history of epigastric pain and vomiting. Blood amylase and lipase levels were 248 IU / L and 253 IU / L, respectively, diagnosing acute pancreatitis. Abdominal CT scan showed a finding suggestive of a common bile duct cyst. In all 3 cases, the magnetic resonance cholangiopancreatography reported a type I choledochal cyst. All pa tients underwent laparoscopic surgery, performing cyst resection, and hepaticoduodenostomy. One case presented pneumobilia without requiring specific management, the other two did not present incidents and all remain asymptomatic in the follow-up period that was longer than one year after surgery. CONCLUSIONS: In the choledochal cyst, clinical suspicion and timely diagnosis with imaging studies and minimally invasive surgery are important, which allow optimal results in the medium- and long term.

Mucormicosis Rinocerebral asociado a Cetoacidosis diabética / Rhinocerebral Mucormycosis associated to diabetic ketoacidosis

Mucormycosis is an infrequent fungal infection This infection is difficult to diagnose and treat and have a high morbility and mortality and affects immunocompromised patients, especially those patients with decompensated diabetes mellitus. We report the case of a 60 years old diabetic patient with poor metabolic control who was admitted for diabetic ketoacidosis and days later present right periorbital swelling and pain, is diagnosed of mucomycosis and is successfully treated with amphoterin B and surgery.