[Gunshot bladder trauma: case report and literature review]. / Traumatismo vesical por arma de fuego: presentación de un caso y revisión de la literatura.

OBJECTIVE: To report one case of gunshot bladder trauma and to review its diagnosis and treatment in the related literature. METHODS: We report the case of a 43-year-old-male with an abdominal firearm wound and gross haematuria. Imaging diagnosis by abdominal and pelvic CT and CT-cystography. Surgical treatment. RESULTS: CT-cystography showed extraperitoneal bladder rupture. Exploratory laparotomy to evaluate for other associated injuries. Bladder wall surgical closure and ureteroneocystostomy with transvesical technique because of complete distal ureter tear. Broad spectrum antibiotherapy. Favourable progress. The patient was discharged at 14th day. CONCLUSIONS: Firearm bladder traumas are a rare entity. Surgical exploration and closure is mandatory. In haemodynamicaly stable patients, abdomen and pelvis CT and CT-cystography allow us to rule out associated injuries and to classify the bladder trauma type. Ureteral damage associated in 5-8,9%, diagnosed during surgical exploration. Broad-spectrum antibiotherapy in all patients.

[Atypical sites of metastatic renal carcinoma. Literature review]. / Carcinoma renal metastásico de localización atípica. Revisión de la literatura.

OBJECTIVE: To review in the literature atypical sites of metastatic renal cell carcinoma, its onset, clinical features, diagnosis, treatment and prognosis. METHODS: To review, using Medline database, atypical sites of metastatic renal cell carcinoma in the last five years Spanish literature. RESULTS: There have been published 15 spanish articles about atypical metastatic renal cell carcinoma in the last five years. Most patients were male with a mean age of 62,3 years and methacronous metastases. Imaging and pathological diagnosis. Main sites: ocular, renal graft, larynx, suprarenal, brain, penis, gastric and pancreatic. Surgical treatment if the surgeon is able to remove the lesion. Inmunotherapy and radiotherapy in the rest of cases. CONCLUSIONS: Renal cell carcinoma represents about 3% of all adult malignancy neoplasms. Its metastatic sites, in order of frequency, are lung, bone and liver, whether synchronic or methacronic. Its location, clinical features, onset, evolution and prognosis is very variable. Individualized diagnostic and therapeutic approach, according to prognostic factors. The knowledge of this atypical sites in patients with renal cell carcinoma in the past can lead us to an earlier diagnosis and treatment which could change the evolution of the illness.

[Surgical complications after kidney transplantation. Research based on 185 cases]. / Complicaciones quirúrgicas post-trasplante renal. Estudio en 185 casos.

OBJECTIVE: To analyze the incidence of surgical complications its diagnosis and treatment after renal transplantation. METHODS: A retrospective study measuring the incidence of surgical complications and reviewing its diagnosis and treatment in 185 renal single transplants. RESULTS: 185 transplants, 27% had surgical complications. Only one patient lost the graft due to surgical complications and there was no associated mortality. Cold ischemia time 20 hours. Double J stenting in 19%, under surgeon's opinion. Vascular complications 3.2% (all of them renal artery stenosis). Urological complications 6.4%. Perinephric haematoma 7%. Lymphocele 4.9%. Peritoneum related complications 4%. Other 4%. The diagnosis was clinical and radiological in most of cases. 14% needed any kind of intervention. CONCLUSIONS: Our results are similar to those reported in other recent series. Only one surgical team involved and the same technique for vascular and vesico-ureteric anastomosis probably makes lower our complications rate. Early postoperative abdominal ultrasonography contributes to the diagnosis of surgical complications. The initial treatment approach is the endoscopic-conservative one, with exceptions.