RESUMEN
Mature cystic teratoma is the most common ovarian neoplasm. However, mucinous cystadenoma with teratoma has been very rarely reported in literature. This case report, which is very rare, describes a clinical entity not previously reported in literature. A 34-year-old pregnant woman presented in the 23rd gestational week with severe right lower quadrant pain. She was diagnosed with acute abdomen and was then treated surgically. During the surgical intervention, a spontaneously ruptured mass was detected in the right ovary. This was reported histopathologically as a mature cystic teratoma in collision with mucinous cystadenoma. To the best of our knowledge, this case report is the first to have identified a ruptured mature cystic teratoma in collision with mucinous cystadenoma in a pregnant woman.
Asunto(s)
Cistoadenoma Mucinoso/cirugía , Neoplasias Ováricas/cirugía , Complicaciones Neoplásicas del Embarazo/cirugía , Teratoma/cirugía , Adulto , Cistoadenoma Mucinoso/patología , Femenino , Humanos , Neoplasias Ováricas/patología , Embarazo , Complicaciones Neoplásicas del Embarazo/patología , Teratoma/patología , Resultado del TratamientoRESUMEN
Three cases of leiomyoma of the small bowel presenting with recurrent gastrointestinal bleeding diagnosed angiographically in the preoperative period, are discussed. Selective visceral angiography seems to be the most sensitive radiological examination. New types of enteroscopes are being developed.
Asunto(s)
Hemorragia Gastrointestinal/etiología , Neoplasias Intestinales/complicaciones , Intestino Delgado , Leiomioma/complicaciones , Adulto , Anciano , Femenino , Hemorragia Gastrointestinal/diagnóstico por imagen , Hemorragia Gastrointestinal/cirugía , Humanos , Neoplasias Intestinales/irrigación sanguínea , Neoplasias Intestinales/diagnóstico por imagen , Neoplasias Intestinales/cirugía , Leiomioma/irrigación sanguínea , Leiomioma/diagnóstico por imagen , Leiomioma/cirugía , Persona de Mediana Edad , Cuidados Preoperatorios , Radiografía , Recurrencia , Índice de Severidad de la EnfermedadRESUMEN
The Peutz-Jeghers syndrome is an autosomal dominant inherited disease manifested by a combination of mucocutaneous pigmentation and gastrointestinal hamartomatous polyps that usually cause intussusception and intestinal hemorrhage. We report a case in which the patient has been followed-up on for 14 years and who underwent surgical and endoscopic polyp removal several times as well as one intestinal resection. This time, with the use of combined surgery and perioperative endoscopy, 27 polyps were removed, performing only 3 enterotomies. This is the highest number in one session to be reported in the literature. The usefulness of this technique is providing a "clean small intestine" that allows the patient a longer time interval between laparotomies and reduces the complications associated with multiple laparotomies and resections.
Asunto(s)
Endoscopía , Pólipos Intestinales/cirugía , Síndrome de Peutz-Jeghers/cirugía , Pólipos/cirugía , Neoplasias Gástricas/cirugía , Adulto , Aberraciones Cromosómicas/genética , Trastornos de los Cromosomas , Mucosa Gástrica/patología , Genes Dominantes , Humanos , Mucosa Intestinal/patología , Pólipos Intestinales/genética , Pólipos Intestinales/patología , Intususcepción/genética , Intususcepción/patología , Intususcepción/cirugía , Masculino , Síndrome de Peutz-Jeghers/genética , Síndrome de Peutz-Jeghers/patología , Pólipos/genética , Pólipos/patología , Reoperación , Neoplasias Gástricas/genética , Neoplasias Gástricas/patologíaRESUMEN
The HELLP-syndrome (haemolysis, elevated liver enzymes, low platelets) is associated with pre-eclampsia and may cause subcapsular liver haematomas. When hepatic rupture occurs the mortality of mother and unborn is high. Rupture remains a surgical emergency with control of bleeding based on trauma principles. We report a case and discuss the diagnosis and management.
Asunto(s)
Síndrome HELLP/complicaciones , Hematoma/etiología , Hepatopatías/etiología , Adulto , Urgencias Médicas , Femenino , Muerte Fetal/etiología , Hematoma/diagnóstico , Hematoma/cirugía , Humanos , Hipotensión/etiología , Hepatopatías/diagnóstico , Hepatopatías/cirugía , Embarazo , Segundo Trimestre del Embarazo , Rotura Espontánea , Tomografía Computarizada por Rayos X , Ultrasonografía PrenatalRESUMEN
We report on an extraordinary testicular tumour causing intussusception with its intestinal metastases.
Asunto(s)
Carcinoma Embrionario/complicaciones , Carcinoma Embrionario/secundario , Enfermedades del Íleon/etiología , Neoplasias Intestinales/complicaciones , Neoplasias Intestinales/secundario , Intususcepción/etiología , Neoplasias Testiculares/patología , Adulto , Humanos , MasculinoAsunto(s)
Enfermedades del Colon , Enfermedad Iatrogénica , Perforación Intestinal , Sulfato de Bario , Sesgo , Enfermedades del Colon/mortalidad , Colonoscopía/efectos adversos , Enema/efectos adversos , Humanos , Perforación Intestinal/mortalidad , Proyectos de Investigación , Análisis de SupervivenciaRESUMEN
BACKGROUND: The aim of the present study was to evaluate the effects of laparotomy and CO2 insufflation on wound healing in a murine incisional wound healing model. METHODS: Seventy-two male Swiss Albino mice were randomly allocated into three groups of control, laparotomy and CO2 insufflation. A transverse skin incision of 15 mm was made in the dorsum of each mouse, and four interrupted mattress sutures with 4.0 polypropylene thread were laid for wound closure. A median laparotomy was performed in the laparotomy group. CO2 insufflation was performed with an intra-abdominal pressure of 9 mmHg. The retained gas was evacuated from the abdominal cavity at the end of a 60-min period. Mice were killed on the 3rd, 7th and 15th postoperative days. The wound tensile strength and 5-hydroxyproline concentration in the wound tissue were measured. RESULTS: Tensile strength of the incised skin increased as the post-incision period progressed. There was no significant difference between the tensile strengths of the incised skin of control, laparotomy and CO2 insufflation groups throughout the observation period. The skin 5-hydroxyproline concentrations of all groups were not significantly different at the 3rd postoperative day. But laparotomy and CO2 insufflation groups had lower 5-hydroxyproline concentrations at the 7th and 15th postoperative days, when compared to controls (P < 0.02 for 7th and 15th days). CONCLUSION: CO2 insufflation and laparotomy reduce the 5-hydroxyproline concentration of the wound, suggesting a diminished wound healing capacity.
Asunto(s)
Dióxido de Carbono , Insuflación , Laparotomía , Cicatrización de Heridas/fisiología , Animales , Laparoscopía , Masculino , Ratones , Resistencia a la TracciónRESUMEN
OBJECTIVE: To assess the effects of laparotomy, and insufflation of carbon dioxide and air, on the immune system in rats. DESIGN: Randomised laboratory study. SETTING: Teaching hospital, Turkey. ANIMALS: 77 Wistar rats randomly allocated to 2 groups one of which was sensitised with dinitrofluorobenzene (DNFB, n = 43) and one of which was not (n = 34). INTERVENTIONS: The DNFB group was sensitised and subdivided into control (n = 8), laparotomy alone (n = 7), and insufflation with carbon dioxide (CO2) for 30 and 60 mins (n = 7 in each) or room air for 30 and 60 mins (n = 7 in each). A week later DNFB was reapplied to the ears. In the group not sensitised with DNFB the animals were subdivided similarly, the corresponding numbers in each group being, 6, 6, 6, 6, 5, and 5. MAIN OUTCOME MEASURES: Delayed type hypersensitivity (DTH) measured by ear swelling in the DNFB group, and peritoneal bactericidal activity, total free peritoneal cell counts (TPC), and cell types in the non-sensitised group. RESULTS: There were significant differences in the degree of ear swelling in the DNFB group between control and laparotomy groups (p = 0.0001) and between control and both insufflations of air (p = 0.002 and p = 0.0003, respectively). In the non-sensitised group peritoneal bactericidal activity was significantly increased after 7 hours in the 60 mins air insufflation group (p = 0.04). At 24 hours there were no differences among the groups. TPC were not affected. The number of peritoneal polymorphonuclear leucocytes (PMN) was significantly higher in the laparotomy alone group than in the control or any of the insufflation groups (p < 0.05). CONCLUSIONS: Laparotomy and air insufflation depressed cell-mediated immunity. Peritoneal bactericidal activity was affected only after 60 minutes of air insufflation.
Asunto(s)
Laparotomía , Peritoneo/inmunología , Neumoperitoneo Artificial/métodos , Aire , Animales , Dióxido de Carbono , Dinitrofluorobenceno , Hipersensibilidad Tardía/inducido químicamente , Hipersensibilidad Tardía/inmunología , Hipersensibilidad Tardía/microbiología , Inmunidad Celular/efectos de los fármacos , Peritoneo/microbiología , Distribución Aleatoria , Ratas , Ratas WistarRESUMEN
This study was performed to investigate the quality of different intravenous sedation techniques, and the correlation between the Bispectral Index (BIS) values and the Observer's Assessment of Alertness/Sedation (OAA/S) scores. Eighty patients undergoing sinonasal surgery were randomly assigned to one of four groups. Group MF received midazolam and fentanyl, group PF received propofol and fentanyl, group MR received midazolam and remifentanil, and group PR received propofol and remifentanil. Heart rate and mean arterial pressure values were not different among the groups. SpO2 decreased only after intravenous medication in groups MF and MR (P < 0.017). Emesis was less common with propofol. A positive relationship existed between the BIS values and OAA/S scores during the operation in all groups and the strongest correlation was observed in group PR (r = 0.565 and P < 0.001). In conclusion, these four intravenous sedation techniques did not change mean arterial pressure, heart rate or SpO2 clinically and produced a similar level of light sedation. The BIS was useful for monitoring of sedation during sinonasal surgery under local anaesthesia with intravenous sedation.
Asunto(s)
Anestésicos Intravenosos , Sedación Consciente , Fentanilo , Midazolam , Senos Paranasales/cirugía , Piperidinas , Propofol , Adulto , Femenino , Hemodinámica , Humanos , Infusiones Intravenosas , Inyecciones Intravenosas , Masculino , RemifentaniloRESUMEN
AIM: To evaluate the effects of Teicoplanin and/or Granulocyte-Colony Stimulating Factor (G-CSF) on survival in an experimental model of MRSA pneumonia. MATERIAL AND METHOD: Seventy five Swiss Albino mice weighing 35 gr (32-43) were used. 50 microl of clinical isolate of MRSA (3 x 10(8) CFU/ml in saline solution) was administered by tracheal puncture to neutropenic mice. Neutropenia was achieved by using Cyclophosphamide 200 mg per kg intraperitoneally. The groups were consisted of tracheal puncture control in neutropenic mice (group 1) (n = 15), pneumonia in neutropenic mice (group II) (n = 15), Teicoplanin therapy for pneumonia in neutropenic mice (group III) (n = 15), G-CSF therapy for pneumonia in neutropenic mice (group IV) (n = 15), Teicoplanin and G-CSF combined therapy for pneumonia in neutropenic mice (group V) (n = 15). Differences in the survival rates within 72 hours among the groups, microbiological analysis of various tissue samples were accomplished and white blood cell counts were obtained. Kaplan-Meier statistics was used for survival analysis. Subgroup comparisons were done by using Breslow statistics. RESULTS: Teicoplanin therapy increased the survival rate (p = 0.0001) whereas G-CSF therapy did not in comparison to other groups. Teicoplanin and G-CSF combination therapy improved survival rate when compared with groups II, III, IV (p = 0.0001, p = 0.003, p = 0.0001, respectively). CONCLUSION: Teicoplanin and G-CSF combination therapy seems effective in reducing mortality rates in MRSA pneumonia in an experimental setting. Further animal and clinical studies must be done to achieve success in the treatment of nosocomial MRSA pneumonia.