RESUMEN
We present a rare case of a patient who presented with acute abdominal pain with a previous history of alpha-1-antitrypsin deficiency (alpha1-antitrypsin deficiency). Further clinical deterioration necessitated computed tomography (CT) imaging, which demonstrated a hemoperitoneum. Angiography confirmed the rupture of multiple aneurysms originating from the mesenteric arterial arcade, which were treated successfully with endovascular embolization. The association between mesenteric arterial aneurysm rupture and alpha-1-antitrypsin deficiency is explored.
Asunto(s)
Aneurisma Roto/terapia , Embolización Terapéutica , Arterias Mesentéricas , Deficiencia de alfa 1-Antitripsina/complicaciones , Dolor Abdominal/etiología , Enfermedad Aguda , Aneurisma Roto/diagnóstico por imagen , Aneurisma Roto/etiología , Medios de Contraste , Hemoperitoneo/etiología , Humanos , Masculino , Arterias Mesentéricas/diagnóstico por imagen , Persona de Mediana Edad , Tomografía Computarizada por Rayos X , Resultado del TratamientoAsunto(s)
Drenaje/métodos , Seno Pilonidal/complicaciones , Procedimientos de Cirugía Plástica/métodos , Sepsis/etiología , Adulto , Diagnóstico Diferencial , Femenino , Estudios de Seguimiento , Humanos , Masculino , Seno Pilonidal/cirugía , Recurrencia , Estudios Retrospectivos , Sepsis/cirugía , Factores de Tiempo , Resultado del TratamientoRESUMEN
AIM: The aim of this retrospective study is to compare the immediate and long-term postoperative outcomes of Lichtenstein and Kugel repair of inguinal hernia. METHODS: From 1996 to 2006, 219 consecutive patients underwent inguinal hernia repair - 92 using a standard Lichtenstein repair and 127 with a Kugel patch. Patient characteristics, length of postoperative hospital stay and complication rates were assessed by retrospective review of the notes. Recurrence and chronic groin pain were assessed by postal questionnaire (with a follow up by telephone interview for non-responders). Patients with symptoms or an apparent groin swelling were reassessed by one of the authors (BD). RESULTS: There were 214 men and 5 women. Patients ranged from 18 to 87 years of age (mean 54 years). Seventy two percent of postal questionnaires were returned. Following telephone calls the overall response rate was 80%. The mean follow up period was 60 months (range: 9 - 132 months). Immediate complications were similar in both groups. The recurrence rates were 1.1% for Lichtenstein repair and 6.3% for Kugel patch (p= 0.09). None of the patients in the Lichtenstein group and 1.6% of patients in Kugel patch group complained of severe chronic pain in inguinal region. CONCLUSION: There was no significant difference in the immediate complication rates between the two groups. Although recurrence and chronic groin pain rates are higher with Kugel repair, this was not statistically significant.