RESUMO
Biliary fistula is a rare (less than 8%) cholecystectomy complication, internal fistulae being the most common of them (mainly colonic and duodenal). However, the presence of two fistulas at the same time is extremely rare, with a small number of cases reported in the literature to date. Symptoms tend to be non-specific, leading to a difficult preoperative diagnosis. The standard treatment for bilioenteric fistulas is open cholecystectomy and subsequent closure of the fistula. Nonetheless, modern techniques including laparoscopic and endoscopic approaches have been reported lately for their treatment with favorable results. We present a case of concomitant cholecystoduodenal and cholecystocolic fistula successfully treated with subtotal cholecystectomy and primary closure of the fistulous tracts by laparoscopic approach in a female Hispanic patient.
RESUMO
Low-grade fibromyxoid sarcoma (LGFMS) is a soft tissue neoplasm that occurs preferentially in young, male adults as a slowly growing, asymptomatic mass. According to current literature, the most common anatomical sites where it occurs are the trunk and lower extremities, especially the thigh, perineum, and groin. The risk factors are still unknown. Surgical intervention (simple resection and wide excision) is nowadays considered the best treatment option; however, patients require a long follow-up due to the high recurrence and metastasis rates. We present a low-grade fibromyxoid sarcoma case located in the abdominal wall of a female Hispanic patient.
RESUMO
OBJETIVO: Investigar de manera retrospectiva a 5 años el porcentaje de mortalidad en los pacientes operados de amputación mayor por pie diabético e identificar los factores de riesgo asociados que aumentan la mortalidad en la población mexicana. MÉTODO: Estudio retrospectivo de pacientes sometidos a amputación mayor por pie diabético del 1 de enero al 31 de diciembre de 2009 en un hospital de segundo nivel. RESULTADOS: Se incluyeron en el protocolo de estudio 37 pacientes que cumplían los criterios de inclusión, y se encontró que 10 (27.03%) continuaban con vida y 27 (72.97%) habían fallecido. Los pacientes a quienes se realizó una amputación y tenían tres o más enfermedades concomitantes mostraron un riesgo 1.6 veces más alto de morir (p = 0.018). Cuanto mayor era la glucemia previa al momento de la amputación, mayor fue la probabilidad de muerte a 5 años (p = 0.015). CONCLUSIONES: En México hacen falta estudios con seguimiento prospectivo, de carácter multicéntrico, con una muestra heterogénea, que permitan tener un panorama nacional. OBJECTIVE: To investigate retrospectively at 5 years the mortality rate in postoperative patients of major amputation secondary to diabetic foot and to identify the associated risk factors that increase mortality in the Mexican population. METHOD: Retrospective study that included patients who underwent major amputation secondary to diabetic foot from January 1 to December 31, 2009 in a second-level hospital. RESULTS: 37 patients who met the inclusion criteria were included in the study protocol, finding that 10 patients (27.03%) were still alive and 27 patients (72.97%) had died. Observing In patients who undergo an amputation and have three or more comorbidities, they have a 1.6 times higher risk of dying (p = 0.018) and that the higher the glycemia prior to the amputation, the greater the probability of dying at 5 years (p = 0.015). CONCLUSIONS: Studies are needed in Mexico with prospective follow-up, multicenter in nature, with a heterogeneous sample, which allows us to have a National panorama.