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1.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 13: 1161-1166, jan.-dez. 2021. tab
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1255129

ABSTRACT

Objetivo: Investigar o jejum prolongado em pacientes que submeteram-se a procedimentos cirúrgicos abdominais e do trato gastrointestinal com uso de anestesia geral, e as possíveis complicações no pré, intra e pós-operatório. Método: um estudo exploratório-descritivo, com recorte transversal retrospectivo-documental e abordagem quali-quantitativa, realizado num Hospital Federal do Rio de Janeiro, com análise documental referente ao período de janeiro de 2013 a abril de 2018. Resultado: houve uma grande variação no tempo de jejum pré-operatório, 0,3% dos pacientes fizeram jejum até 8 horas e 11,3% até 12 horas, alguns casos chegaram a fazer mais de 24 horas de jejum. Conclusão: foi perceptível que dentre prontuários analisados, os pacientes permaneceram em jejum perioperatório muito superiores fora dos padrões de segurança estipulados, gerando intercorrências que causam desconforto ao paciente, prejudicam a reabilitação, aumentam o tempo de internação e oneram o sistema


Objective:To investigate prolonged fasting in patients who underwent abdominal and gastrointestinal surgical procedures with general anesthesia, and possible complications in the pre, intra and postoperative periods. Method: an exploratory-descriptive study, with retrospective-documental cross-section and qualitative-quantitative approach, performed at a Federal Hospital of Rio de Janeiro, with documentary analysis from January 2013 to April 2018. Result: there was a great variation in time of preoperative fasting, with 0.3% of patients fasted for up to 8 hours and 11.3% for up to 12 hours, some cases reaching more than 24 hours fasting. Conclusion: Patients were found to be in perioperative fasting far beyond the stipulated safety standards, generating complications that cause discomfort to the patient, impair rehabilitation, increase length of hospital stay, and burden the system


Objetivo: Investigar el ayuno prolongado en pacientes que se sometieron a procedimientos quirúrgicos abdominales y del tracto gastrointestinal con uso de anestesia general, y las posibles complicaciones en el pre, intra y postoperatorio. Metodo: un estudio exploratório y descriptivo, con recorte transversal retrospectivo y documental con el abordaje cuali y cuantitativo, realizado en un Hospital Federal de Rio de Janeiro, con análisis documental referente al período de enero de 2013 a abril de 2018. Resultado:ocorrió una gran variación en el tiempo de ayuno preoperatorio, 0,3% de los pacientes hicieron ayuno hasta 8 horas y 11,3% hasta 12 horas, algunos casos llegaron a hacer más de 24 horas de ayuno. Conclusión: fue notable que entre los prontuarios analizados, los pacientes permanecieron en ayuno perioperatorio muy superiores fuera de los estándares de seguridad estipulados, generando intercurrencias que causan incomodidad al paciente, perjudican la rehabilitación, aumentan el tiempo de internación y el sistema


Subject(s)
Humans , Male , Female , Adolescent , Middle Aged , Aged , Fasting , Perioperative Care/methods , Gastrointestinal Tract/surgery , Abdomen/surgery , Time Factors , Cross-Sectional Studies , Retrospective Studies
2.
An. Fac. Cienc. Méd. (Asunción) ; 54(2): 151-156, 2021.
Article in Spanish | LILACS | ID: biblio-1281113

ABSTRACT

La Colitis Ulcerativa (CU) es una enfermedad crónica multifactorial de etiología desconocida caracterizada por la presencia de inflamación difusa en la mucosa colónica en presencia de diarrea sanguinolenta asociada con urgencia y tenesmo rectal. Una mujer de 51 años, acudió al Servicio de Urgencias por rectorragia con molestias en hipogastrio y tenesmo, además un mes y medio de deposiciones liquidas, sensación febril intermitente, anorexia, nauseas sin vómitos y pérdida de peso de aprox. 10 kilos en 1 mes, con un abdomen distendido, levemente depresible, doloroso en hipogastrio. La colonoscopía y anatomía patológica informan una Rectocolitis Ulcerativa Pancolónica. La paciente continua con mala evolución a pesar de tratamiento médico, por lo que se decide el manejo quirúrgico con una colectomía subtotal con confección de ileostomía y fístula mucosa de sigmoides por colitis aguda grave refractaria al tratamiento. El manejo médico previo al manejo quirúrgico en este caso se vio limitado por la disponibilidad de fármacos. Esto resalta la necesidad del conocimiento del manejo multidisciplinario de las patologías colorectales.


Ulcerative Colitis (UC) is a multifactorial chronic disease of unknown etiology characterized by the presence of diffuse inflammation in the colonic mucosa and often the presence of bloody diarrhea associated with rectal urgency. A 51-year-old woman came to the emergency room due to rectal bleeding with hypogastric pain and tenesmus, in addition to a month and a half of diarrhea, intermittent fever, anorexia, nausea without vomiting and weight loss of approx. 10 kilos in 1 month, with a distended abdomen, slightly depressible, painful in the hypogastrium. Colonoscopy and pathological anatomy report a Pancolonic Ulcerative Rectocolitis. The patient continues with poor evolution despite medical treatment, so a surgical approach is decided with a subtotal colectomy, terminal ileostomy and sigmoid fistula due to severe acute colitis refractory to treatment. Medical treatment prior to a surgical approach in this case was limited by the availability of drugs. This highlights the need for a multidisciplinary management of colorectal pathologies.


Subject(s)
Anorexia , Colitis, Ulcerative , Chronic Disease , Colectomy , Diarrhea , Colon, Sigmoid , Abdomen
3.
Rev. cuba. anestesiol. reanim ; 19(3): e631, sept.-dic. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1138884

ABSTRACT

Introducción: El aumento de la expectativa de vida determina un incremento en la incidencia de enfermedades con indicación quirúrgica. El avance en las técnicas quirúrgicas, los cuidados intensivos y el conocimiento más profundo del proceso de envejecimiento tiende a favorecer la disminución de la morbimortalidad perioperatoria del paciente geriátrico. Objetivo: Determinar la incidencia de complicaciones intra y posoperatorias en pacientes geriátricos durante la cirugía abdominal mayor electiva. Métodos: Se realizó un estudio observacional descriptivo, de corte transversal a 373 pacientes geriátricos programados para intervención quirúrgica abdominal mayor desde enero de 2017 hasta diciembre de 2019 en el Hospital Clínico Quirúrgico Dr. Miguel Enríquez. Se registró la incidencia de complicaciones perioperatorias relacionándolas con las variables de estudio. Resultados: Las complicaciones más frecuentes fueron las cardiovasculares. La mortalidad fue escasa. Conclusiones: Las complicaciones perioperatorias detectadas en los pacientes geriátricos estudiados, se relacionan con las enfermedades previas, el tipo y la envergadura de la cirugía y con el tiempo quirúrgico(AU)


Introduction: The increase in life expectancy determines an increase in the incidence of diseases with surgical indication. Advances in surgical techniques, intensive care and deeper understanding of the aging process tend to favor the reduction of perioperative morbidity and mortality among geriatric patients. Objective: To determine the incidence of intraoperative and postoperative complications among geriatric patients during elective major abdominal surgery. Methods: A descriptive, cross-sectional and observational study was carried out with 373 geriatric patients scheduled for major abdominal surgery from January 2017 to December 2019 at Dr. Miguel Enríquez Clinical-Surgical Hospital. The incidence of perioperative complications was recorded, relating them to the study variables. Results: The most frequent complications were the cardiovascular ones. Mortality was low. Conclusions: The perioperative complications identified among the geriatric patients studied are related with previous diseases, with the type and extent of surgery, and with the surgical time(AU)


Subject(s)
Humans , Aged , Aged, 80 and over , Postoperative Complications/prevention & control , Indicators of Morbidity and Mortality , Perioperative Care/methods , Abdomen/surgery , Intraoperative Care/methods , Postoperative Complications/epidemiology , Aging , Epidemiology, Descriptive , Cross-Sectional Studies , Observational Study
4.
Gac. méd. boliv ; 43(2): 223-227, dic. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1249988

ABSTRACT

El adenocarcinoma de uraco es una enfermedad neoplásica rara, con una incidencia de 1 por 5 millones de habitantes. Clínicamente se manifiesta con hematuria (73%), dolor abdominal (14%), disuria (13%), mucosuria (10%), síntomas irritativos (40%), masa palpable en la parte baja del abdomen (17%), bacteriuria (8%), flujo mucoso umbilical (2%). Presentamos el caso de paciente de 45 años, con diagnóstico de adenocarcinoma de uraco, que recibió múltiples tratamientos sin respuesta, realizándose, cirugía radical con resección en bloque de ombligo, uraco, peritoneo, fascia posterior del musculo recto del abdomen y cistectomía parcial, por abordaje laparoscópico, con excelentes resultados oncológicos y estéticos, con recuperación rápida, y sin complicaciones. El papel de la quimioterapia y radioterapia y su beneficio para el paciente aún no está claro. Con este caso queremos aportar con un nuevo caso a la literatura, además de poder mostrar que el manejo con mínima invasión puede ser adecuada en manos expertas, con resultados iguales a la cirugía abierta, con el beneficio ya conocido del abordaje laparoscópico.


Urachal adenocarcinoma is a rare tumor entity, an average incidence of 1 case per 5 million inhabitants is described. Clinically it manifests with hematuria (73%), abdominal pain (14%), dysuria (13%), mucosuria (10%), irritative symptoms (40%), palpable mass in the lower abdomen (17% ), bacteriuria (8%), umbilical mucosal flow (2%). We present the case of a 45-year-old patient with a diagnosis of urachal adenocarcinoma, who received multiple treatments without response, performing radical surgery with en bloc resection of the umbilicus, urachus, peritoneum, posterior fascia of the rectus abdominis muscle and partial cystectomy. by laparoscopic approach, with excellent oncological and aesthetic results, with fast recovery, and without complications. The role of chemotherapy and radiation therapy and their benefit to the patient is still unclear. With this case we want to contribute a new case to the literature, in addition to being able to show that minimally invasive management can be adequate in expert hands, with results equal to open surgery, with the already known benefit of the laparoscopic approach.


Subject(s)
Female , Middle Aged , Urachus , Adenocarcinoma , Neoplasms , Abdominal Pain , Abdomen
5.
Rev. argent. cir ; 112(4): 539-542, dic. 2020. graf, il
Article in Spanish | LILACS, BINACIS | ID: biblio-1288167

ABSTRACT

RESUMEN Los paragangliomas son tumores originados en las células neuroendocrinas que forman el sistema nervioso autónomo. Se consideran benignos aunque pueden desarrollar malignidad, por lo que su tra tamiento es quirúrgico. La presentación de paraganglioma de ubicación mesentérica es muy inusual.


ABSTRACT Paragangliomas are rare neuroendocrine tumors that arise in the autonomic nervous system. Although these tumors are considered benign, they must be removed by surgery due to their potential malig nant transformation. Mesenteric paragangliomas are extremely rare.


Subject(s)
Humans , Female , Aged , Paraganglioma, Extra-Adrenal/surgery , Mesenteric Cyst/surgery , Tomography, X-Ray Computed , Abdominal Pain/complications , Abdomen/diagnostic imaging
6.
Rev. cuba. med. mil ; 49(3): e457, jul.-set. 2020. fig
Article in Spanish | LILACS, CUMED | ID: biblio-1144487

ABSTRACT

Introducción: Los tumores de gran tamaño han sido descritos a través de la historia, entre ellos los ginecológicos y los de ovario cuando pesan más de 12 kg constituyen una rareza médica. Las masas tumorales en hemiabdomen inferior son causas frecuentes de consulta en cirugía general. Dentro de estas, los quistes de ovarios son los que con más frecuencia se diagnostican. Objetivo: Describir el caso de un quiste gigante de ovario en una paciente que fue atendida en consulta de cirugia general por aumento de tamaño en el abdomen de varios años de evolución. Caso clínico: Se expone el caso de una paciente femenina, con antecedentes de salud, que acude al servicio de cirugía general por aumento de volumen del abdomen, progresivo, insidioso de 2 años de evolución. Se diagnostica masa quística dependiente de ovario y en el transoperatorio se constata una tumoración quística del ovario que en el análisis histopatológico informa un cistoadenoma seroso de ovario. Conclusión: Los tumores del ovario no son tan frecuentes como los del útero y los de la mama, pero constituyen el tercer grupo de tumores benignos y malignos de la mujer. Se presentó el caso por lo infrecuente que resulta, la escasa frecuencia de reporte de estos casos lo cual aporta conocimiento a la comunidad médica sobre el tema(AU)


Introduction: Large tumors have been described throughout history, including gynecological tumors, and ovarian tumors when they weigh more than 12 kg constitute a medical rarity. Tumor masses in lower hemiabdomen are frequent causes of consultation in general surgery. Within these, ovarian cysts are the most frequently diagnosed. Objective: To describe the case of a giant ovarian cyst in a patient who was treated in a general surgery consultation due to an increase in abdomen size of several years of evolution. Clinical case: The case of a female patient, with a history of health, which goes to the general surgery service due to an increase in abdomen volume, progressive, insidious of 2 years of evolution, is presented. Ovarian-dependent cystic mass is diagnosed and a cystic tumor of the ovary is found in the transoperative period, which in the histopathological analysis reports a serous ovarian cystadenoma. Conclusion: Ovarian tumors are not as frequent as those of the uterus and those of the breast, but they constitute the third group of benign and malignant tumors of women. The case was presented because of the infrequent result, the low frequency of reporting these cases, which brings knowledge to the medical community on the subject(AU)


Subject(s)
Humans , Female , Middle Aged , Ovarian Cysts/surgery , Ovary/diagnostic imaging , Uterus , Abdomen
7.
Fisioter. Bras ; 21(4): 396-406, Ago 08, 2020.
Article in Portuguese | LILACS | ID: biblio-1283410

ABSTRACT

Introdução: A adiposidade localizada é considerada uma das disfunções estéticas mais procuradas para tratamento no âmbito da estética. Como opção de tratamento apresentamos a lipoescultura gessada que é um método não invasivo e inovador, que consiste em reduzir a lipodistrofia localizada pelo aumento do metabolismo através da Lei de Van't Hoff. Consta em tratamento baseado em uma linha de cosmecêuticos ortomoleculares da marca Bothanica Mineral®, empregados no combate à celulite, gordura localizada e flacidez, agindo de forma diversificada nas disfunções estéticas. Objetivo: O objetivo deste trabalho foi identificar os efeitos da lipoescultura gessada no abdome em mulheres de 20 a 35 anos com IMC ideal. Métodos: Trata-se de uma pesquisa intervencional. O estudo foi composto por 36 mulheres, apresentando lipodistrofia localizada no abdome, selecionadas através de entrevista. Após seleção, foram coletados dados através da ficha de avaliação da lipoescultura gessada contendo perfil sociodemográfico, bioimpedância, perimetria abdominal e caracterização da gordura, com um total de 8 sessões, 2 vezes na semana. Foi realizada uma reavaliação delas na nona sessão. Resultados: Diversos são os tipos de aparelhos e procedimentos estéticos disponíveis para intensificar os resultados do tratamento da lipodistrofia localizada do abdome em mulheres, porém, uma lipoescultura gessada bem-feita e associada a bons cosméticos e cuidados diários após o tratamento permitem um ótimo resultado, como comprovado em nosso trabalho. Conclusão: Conclui-se, então, que o protocolo de tratamento da lipoescultura gessada resultou em melhorias das condições gerais de gordura das mulheres estudadas, melhorando o contorno corporal. (AU)


Introduction: Localized adiposity is considered one of the most sought aesthetic dysfunctions for aesthetic treatment. As a treatment option we present a noninvasive and innovative method, the plastered liposculpture, which consists in reducing localized lipodystrophy by increasing metabolism through Van't Hoff's Law. It is based on a line of Orthomolecular cosmeceuticals Bothanica Mineral®, used in the therapy against cellulite, localized fat and flaccidity, acting in a diversified way in aesthetic dysfunctions. Objective: The objective of this study was to identify the effects of plastered liposculpture on the abdomen in women aged 20 to 35 years with ideal BMI. Methods: This is an interventional research. The study was composed of 36 women, presenting lipodystrophy located in the abdomen, selected through interview. After selection, data were collected through the plastered liposculpture evaluation card containing sociodemographic profile, bioimpedance, abdominal perimetry and fat characterization, with 8 sessions, 2 times a week. A reassessment was made at the ninth session. Results: Several types of devices and aesthetic procedures are available to intensify the results of the treatment of localized lipodystrophy of the abdomen in women, however, a well-made plastered liposculpture, associated with good cosmetics and daily care after treatment allow a significative result, such as proven in our work. Conclusion: It was concluded that the treatment protocol of plastered liposculpture resulted in improvement in the general fat conditions of the studied women, improving the body contour. (AU)


Subject(s)
Humans , Female , Adult , Adipose Tissue , Abdomen , Fats , Esthetics
8.
Rev. argent. radiol ; 84(4): 123-129, ago. 2020. tab, graf, il.
Article in Spanish | LILACS | ID: biblio-1149664

ABSTRACT

Resumen La diverticulosis es una entidad que predomina en países occidentales. Su prevalencia aumenta con la edad, presentándose en aproximadamente el 80% de la población mayor de 85 años. Los divertículos colónicos adquiridos son herniaciones saculares de la mucosa y submucosa (pseudodivertículos) y predominan en sigma, en países occidentales; los congénitos poseen las tres capas parietales (divertículos verdaderos) y predominan en colon derecho, en países asiáticos. Aproximadamente un 10%-25% de dichos pacientes con diverticulosis presentarán a lo largo de su vida un cuadro de diverticulitis aguda, representando una de las causas más frecuentes de abdomen agudo (3,8%). Clínicamente, se expresa por dolor abdominal en fosa ilíaca izquierda (excepción en dolicosigma/divertículos congénitos derechos) y pueden presentar complicaciones como flemones, abscesos, pileflebitis, peritonitis, con consiguiente riesgo de vida. La tomografía computada (TC) permite el diagnóstico oportuno, identificación de complicaciones y planificación terapéutica. A dicho fin se establecieron diferentes clasificaciones y modificaciones, siendo la más reconocida la propuesta por Hinchey (modificada por Wasvary y col., Kaiser y col.) y otras estableciendo correlaciones con el tratamiento, como la propuesta por Sartelli y col. El objetivo del presente estudio es realizar una revisión iconográfica de esta última (Sartelli y col.) y evaluar sus implicancias terapéuticas.


Abstract Diverticular disease is an entity with high prevalence in western countries that increases with age, and affects approximately 80% of the population over 85 years of age. Acquired colonic diverticula are saccular mucosal and submucosal herniation (pseudodiverticles) and predominate in sigma, in western countries; the congenital ones possess the three parietal layers (true diverticula) and predominate in right side colon, in Asian countries. Approximately 10%-25% of patients with colonic diverticulosis, in their lifetime will present an episode of acute diverticulitis, which represents one of the most frequent causes of acute abdominal pain (3.8%). Clinically it express by abdominal pain in the left iliac fossa (exception in dolicosigma / right congenital diverticula) and may present complications such as phlegmon, abscesses, pylephlebitis, peritonitis, life threatening conditions. Computed tomography (CT) allows timely diagnosis, identification of complications and therapeutic planning. To this end, several classifications have been used, from which Hinchey's is the most renown (modified by Wasvary et al, Kaiser et al.), and other ones establish therapeutic correlation such as the one proposed by Sartelli et al. The objective of the present study is to make an iconographic review of this last one (Sartelli et al.) and to evaluate its therapeutic implications.


Subject(s)
Humans , Adult , Diverticulitis/classification , Diverticulitis/therapy , Diverticulitis/diagnostic imaging , Tomography, X-Ray Computed , Colon , Abdomen/diagnostic imaging
9.
Univ. salud ; 22(2): 148-156, mayo-ago. 2020. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1115964

ABSTRACT

Introducción: El deporte competitivo demanda un intensivo acondicionamiento físico que conlleva a un mayor riesgo de lesión que afectan la salud, el rendimiento físico, la participación en los entrenamientos, las competencias y los logros deportivos. Objetivo: Determinar las características de la estabilidad del core, el equilibrio dinámico de miembros inferiores y la flexibilidad en deportistas universitarios. Materiales y métodos: Estudio de corte transversal, con 86 deportistas universitarios que corresponden al 25% de la población universitaria. Se evaluó la estabilidad del core, el equilibrio dinámico de miembros inferiores y flexibilidad de la cadena posterior, hombro y cadera; se tuvo en cuenta la guía de valoración para la prevención de lesiones del lineamiento de política pública en ciencias del deporte. Resultados: El 83,7% de atletas presentaron un índice de masa corporal normal, el 47,5% mostró una flexibilidad promedio en el Sit and Reach, sin presencia de retracciones en cadera. Respecto al core el 77,9% de los participantes presentaron una mala estabilidad y el 47% riesgo de lesión, producto de las diferencias entre las extremidades inferiores en el equilibrio dinámico. Conclusiones: Los resultados sugieren implementar programas de prevención de lesiones para deportistas universitarios.


Introduction: Competitive sports demand intensive physical conditioning that leads to an increased risk of injury, consequently affecting the health, physical performance, participation in training, competition, and sport achievements of athletes. Objective: To determine core stability, lower limb dynamic balance and flexibility characteristics in university athletes. Materials and methods: A cross-sectional study with 86 university athletes, which corresponds to 25% of the university population. Core stability, lower limb dynamic balance, and flexibility of the posterior chain, shoulders and hip region were evaluated. The assessment guide from the public policy guidelines in sports sciences for the prevention of injuries was taken into account. Results: 83.7% of athletes displayed a normal body mass index and 47.5% showed an average flexibility in the Sit and Reach test without the presence of hip retractions. Regarding the core, 77.9% of the participants showed a poor stability and 47% had a risk of injury due to the differences between the lower extremities in the dynamic balance. Conclusions: These results suggest implementing injury prevention programs for university athletes.


Subject(s)
Humans , Postural Balance , Athletic Performance , Sports , Range of Motion, Articular , Abdomen
10.
Rev. Eugenio Espejo ; 14(2): 92-101, jul. 2020.
Article in Spanish | LILACS | ID: biblio-1117297

ABSTRACT

La hernia diafragmática traumática representa un reto al momento del diagnóstico. Una detección oportuna permite establecer un correcto tratamiento quirúrgico. Se presenta el caso de un paciente masculino de 37 años de edad con antecedente de trauma torácico por arma blanca 4 años antes; quien acude por cuadro de dolor abdominal intenso localizado en epigastrio que se irradia a hipocondrio izquierdo de aparición súbita 72 horas antes de su ingreso. Al examen físico murmullo vesicular disminuido en campo pulmonar izquierdo, y abdomen doloroso a la palpación a nivel de epigastrio e hipocondrio izquierdo. En exámenes de laboratorio no se evidencian alteraciones, mientras que la tomografía reporta hernia diafragmática izquierda; la misma que fue resuelta quirúrgicamente mediante técnica laparoscópica.


Traumatic diaphragmatic hernia represents a challenge at diagnosis. A timely detection allows to establish a correct surgical treatment. It is presented the case of a 37-year-old male patient with a history of stabbing chest trauma 4 years earlier; who comes for symptoms of intense abdominal pain located in the epigastrium that radiates to the left hypochondrium of sudden onset 72 hours before admission. On physical xamination, vesicular murmur decreased in the left lung field, and a painful abdomen on palpation at the level of the epigastrium and left hypochondrium were showed. Laboratory tests did not show any alterations, but tomography reports a left diaphragmatic hernia; this one was solved surgically by laparoscopic technique.


Subject(s)
Humans , Male , Adult , Laparoscopy , Hernia, Diaphragmatic , Hernia, Diaphragmatic, Traumatic , Therapeutics , Diagnosis , Abdomen
11.
Rev. argent. cir ; 112(3): 337-342, jun. 2020. graf
Article in Spanish | LILACS | ID: biblio-1279749

ABSTRACT

RESUMEN La hiperplasia de células neuroendocrinas pancreáticas es una patología donde se produce un aumen to en el número de células de los islotes de Langerhans y a veces puede simular un proceso tumoral. Caso clínico: presentamos el caso de un paciente con tumor sólido de cola de páncreas, sintomático, al que se le realizó esplenopancreatectomía corporocaudal laparoscópica. El resultado anatomopatoló gico posterior informó una hiperplasia neuroendocrina. Conclusión: la hiperplasia de células neuroen docrinas debería considerarse en el diagnóstico diferencial de tumores sólidos de páncreas. La alterna tiva quirúrgica laparoscópica es factible cuando no es posible establecer el diagnóstico prequirúrgico con estudios de imágenes o biopsia.


ABSTRACT Pancreatic endocrine cell hyperplasia is defined as an increase in the number of cells of Langerhans islets and can sometimes mimic a tumoral process. Case report: a male patient with a symptomatic solid tail of pancreas tumor underwent laparoscopic distal pancreatectomy and splenectomy. The pathological examination reported neuroendocrine cell hyperplasia. Conclusion: pancreatic endocrine cell hyperplasia should be considered in the differential diagnosis of solid pancreatic tumors. Laparoscopic surgery is feasible when the preoperative diagnosis with imaging tests of biopsy is not possible.


Subject(s)
Humans , Male , Aged , Pancreas/pathology , Pancreatectomy/methods , Pancreatic Neoplasms/diagnosis , Pancreas/anatomy & histology , Tomography, X-Ray Computed , Ultrasonography , Laparoscopy , Neuroendocrine Cells , Abdomen/diagnostic imaging , Hyperplasia/diagnosis
12.
Rev. bras. cir. plást ; 35(2): 243-248, apr.-jun. 2020. ilus
Article in English, Portuguese | LILACS | ID: biblio-1103839

ABSTRACT

A pele de tilápia possui microbiota não infecciosa e estrutura morfológica semelhante à pele humana. Estudos clínicos fase II, ainda não publicados, mostraram resultados promissores na sua utilização para tratamento de queimaduras. Nos protocolos destes estudos, pacientes com lesões em áreas de dobras de pele, como genitais e região inguinal, foram excluídos, pois achava-se que o biomaterial não aderiria apropriadamente, resultando em um grau de cicatrização inferior. Relato de caso de paciente do sexo feminino, 18 anos, sem comorbidades, com queimaduras de segundo grau profundo em abdômen, região inguinal, parte da genitália e metade superior de ambas as coxas, envolvendo 13,5% da área total da superfície corporal. A pele de tilápia foi aplicada nas lesões levando a uma reepitelização completa com 16 dias de tratamento. Não foram observados efeitos colaterais. A pele de tilápia traz, portanto, a promessa de um produto inovador, de fácil aplicação e alta disponibilidade, que pode se tornar a primeira pele animal nacionalmente estudada e registrada pela Agência Nacional de Vigilância Sanitária, para uso no tratamento de queimaduras. Este relato de caso contribui para reduzir as limitações em relação às áreas anatômicas apropriadas para a aplicação da pele de tilápia, uma vez que, mesmo com a necessidade de reposição de pele, foram obtidos bons resultados com aplicação na genitália e região inguinal.


Tilapia skin has a non-infectious microbiota and a morphological structure similar to human skin. Phase II clinical studies, not yet published, have shown promising results in their use for the treatment of burns. In the protocols of these studies, patients with lesions in areas of skin folds, such as genitals and inguinal regions, were excluded, as it was thought that the biomaterial would not adhere properly, resulting in a lower degree of healing. Case report of a female patient, 18 years old, without comorbidities, with deep second-degree burns in the abdomen, inguinal region, part of the genitalia and upper half of both thighs, involving 13.5% of the total body surface area. Tilapia skin was applied to the lesions leading to a complete re-epithelialization with 16 days of treatment. No side effects were observed. Tilapia skin, therefore, brings the promise of an innovative product, easy to apply, and highly available, which can become the first animal skin nationally studied and registered by the Agência Nacional de Vigilância Sanitária, for use in the treatment of burns. This case report contributes to reduce the limitations concerning the anatomical areas appropriate for the application of tilapia skin, since, even with the need for skin replacement, good results were obtained with application to the genitalia and inguinal region.


Subject(s)
Humans , Female , Adolescent , History, 21st Century , Therapeutics , Transplantation, Autologous , Biological Dressings , Burns , Case Reports , Therapeutic Approaches , Tilapia , Cichlids , Abdomen , Clinical Study , Genitalia , Hip , Therapeutics/methods , Transplantation, Autologous/methods , Transplantation, Autologous/rehabilitation , Biological Dressings/standards , Burns/therapy , Therapeutic Approaches/adverse effects , Therapeutic Approaches/standards , Tilapia/anatomy & histology , Cichlids/anatomy & histology , Genitalia/anatomy & histology , Abdomen/anatomy & histology , Hip/anatomy & histology
14.
Autops. Case Rep ; 10(1): 2020137, Jan.-Mar. 2020. ilus
Article in English | LILACS | ID: biblio-1087663

ABSTRACT

Actinomycosis is an uncommon, endogenous, and chronic infection with varied and nonspecific clinical features such as abdominal, pelvic or cervical masses, ulcerative lesions, abscesses, draining fistula, fibrosis, and constitutional symptoms. The disease ensues when the bacteria disrupt the mucosal barrier, invade, and spread throughout interfascial planes. Currently, the diagnosis of actinomycosis is challenging because of its very low frequency and depending on the clinical presentation it may masquerade malignancies. Therapy consists initially in intravenous penicillin, followed by an oral regimen that may be extended until a year of treatment. A timely diagnosis is crucial to avoid extensive therapeutic attempt as surgery. However, a biopsy or drainage of abscesses and fistula's tract may be required not only as a diagnostic procedure as part of the therapy. We report the case of a 72-year-old woman with an abdominal mass initially misdiagnosed as a liposarcoma. A second biopsy of a skin lesion of the abdominal wall made the diagnosis of actinomycosis, avoiding a major surgical procedure. The patient was treated with a long-term course of antibiotics with favorable outcome. Liposarcoma was ruled out after the patient's full recovery with antibiotics and the misdiagnosis was credit to the overconfidence on the immunohistochemical positivity to MDM2.


Subject(s)
Humans , Female , Aged , Actinomycosis/diagnosis , Abdomen/abnormalities , Liposarcoma/diagnosis , Diagnosis, Differential
15.
Rev. argent. cir ; 112(1): 43-50, mar. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1125780

ABSTRACT

Antecedentes: la colecistitis enfisematosa (CE) es una forma de presentación infrecuente de la colecistitis aguda. Material y métodos: presentecedentes patológicos, mientras que los otros eran diabéticos. A todos se les realizó tomografía computarizada (TC). Dos pacientes fueron sometidos a colecistectomía videolaparoscópica (CL) con buena evolución, mientras que en un caso se realizó colecistostomía percutánea (CP). Discusión: la CE se refiere a la presencia de gas en la luz o en la pared de la vesícula biliar. La tasa de morbilidad es del 50%. Los pacientes suelen padecer diabetes, pero puede presentarse en pacientes más jóvenes sin factores de riesgo. La TC es el método de elección para el diagnóstico. El tratamiento definitivo es la CL, aunque la CP es otra opción válida. Conclusión: la CL se considera un enfoque eficaz y seguro para el tratamiento de la CE.


Background: Emphysematous cholecystitis (EC) is a rare presentation of acute cholecystitis. Material and methods: We report three cases of EC in two men and one woman between 55 and 79 years. One of the patients was otherwise healthy while the other two were diabetics. A computed tomography (CT) scan was performed in all the cases. Two patients underwent video-assisted laparoscopic cholecystectomy with favorable outcome and one patient underwent percutaneous cholecystostomy. Discussion: Emphysematous cholecystitis is characterized by the presence of gas in the gallbladder lumen or wall. Mortality rate is 50%. Most patients are diabetics, but EC may present in younger patients without risk factors. Computed tomography scan is the method of choice for the diagnosis. Cholecystectomy is indicated as definite treatment, but percutaneous cholecystostomy may be a valid option. Conclusions: Laparoscopic cholecystectomy and antibiotics are effective and safe to treat.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Cholecystectomy, Laparoscopic/methods , Emphysematous Cholecystitis/surgery , Cholecystostomy/methods , Tomography, X-Ray Computed/methods , Abdominal Pain/complications , Emphysematous Cholecystitis/drug therapy , Emphysematous Cholecystitis/diagnostic imaging , Diabetes Complications , Abdomen/diagnostic imaging , Hypertension/complications
16.
Int. j. morphol ; 38(1): 17-22, Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1056390

ABSTRACT

Thorough knowledge of splenic artery course and morphology may help clinician to provide better practice. This Study aims at finding out if there was a relationship between splenic artery tortuosity index and age, sex, Body Mass Index (BMI) and abdominal cavity diameters. Routine abdominal Computerized Tomography (CT) scan images were retrospectively analyzed for 219 patients. Splenic artery tortuosity index was calculated. Abdominal cavity diameters were measured. Age, sex, and BMI were recorded. Splenic artery straight length (x) mean was 9.41 cm (SD 1.33). Splenic artery tortuous length mean was 15.15 cm (SD 3.31). Splenic artery tortuosity index mean was 1.63 (SD 0.36). Pearson correlation coefficient for Splenic artery tortuosity index vs. age was: 0.02 (P value 0.80). Splenic artery tortuosity index for females vs. males were 1.70 vs. 1.57 (P value 0.01). Pearson correlation coefficient for Splenic artery tortuosity index vs. BMI was 0.02 (P value 0.75). Pearson correlation coefficient for Splenic artery tortuosity index vs. abdominal cavity diameters were: Anterior-Posterior (AP) diameter -0.01 (P value 0.88) and transverse diameter 0.00 (P value 0.98). There may be a relationship between splenic artery tortuosity and female sex, but not with age, BMI and abdominal cavity diameters (AP and Transverse).


El conocimiento del curso y la morfología de la arteria esplénica puede ayudar al médico a proporcionar un diagnóstico y tratamiento oportuno al paciente. Este estudio tuvo como objetivo determinar si existe una relación entre el índice de tortuosidad de la arteria esplénica y la edad, el sexo, el índice de masa corporal (IMC) y los diámetros de la cavidad abdominal. Se tomaron imágenes retrospectivas, de rutina, de 219 pacientes de tomografía computarizada (TC) abdominal. Se calculó el índice de tortuosidad de la arteria esplénica. Se midieron los diámetros de la cavidad abdominal y se registró la edad, sexo y el IMC. La media de la longitud recta de la arteria esplénica (x) fue de 9,41 cm (DE 1,33). La longitud tortuosa de la arteria esplénica fue de 15,15 cm (DE 3,31). La media del índice de tortuosidad de la arteria esplénica fue de 1,63 (DE 0,36). El coeficiente de correlación de Pearson para el índice de tortuosidad de la arteria esplénica vs. edad fue: 0,02 (valor de P 0,80). El índice de tortuosidad de la arteria esplénica para las mujeres frente a los hombres fue de 1,70 frente a 1,57 (valor de P 0,01). El coeficiente de correlación de Pearson para el índice de tortuosidad de la arteria esplénica versus el IMC fue de 0,02 (valor de P 0,75). El coeficiente de correlación de Pearson para el índice de tortuosidad de la arteria esplénica frente a los diámetros de la cavidad abdominal fue: diámetro anterior-posterior (AP) -0,01 (valor P 0,88) y diámetro transversal 0,00 (valor P 0,98). Puede existir una relación entre la tortuosidad de la arteria esplénica y el sexo femenino, sin embargo no se encontró relación con la edad, el IMC y los diámetros de la cavidad abdominal (AP y transversal).


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Splenic Artery/anatomy & histology , Tomography, X-Ray Computed , Abdomen/diagnostic imaging , Splenic Artery/abnormalities , Splenic Artery/diagnostic imaging , Body Mass Index , Sex Factors , Analysis of Variance , Age Factors , Correlation of Data , Abdomen/anatomy & histology
17.
Int. j. morphol ; 38(1): 35-37, Feb. 2020. graf
Article in English | LILACS | ID: biblio-1056393

ABSTRACT

Ectopic liver tissue is a rare developmental abnormality. It is often asymptomatic and is commonly found incidentally, during surgery or autopsy. It has been reported in various abdominal and extra-abdominal sites, most often in the gall bladder. We are reporting an incidentally found mass in the left subdiafragmatic region, diagnosed as ectopic liver in abdominal CT and intraoperatively. We aim to assess the importance of imaging examinations in the differential diagnosis of intraabdominal masses ranging from benign to malignant entities and to point out that despite the low incidence of ectopic liver, it is necessary to be aware of this diagnostic possibility.


El tejido hepático ectópico es una rara anormalidad del desarrollo. A menudo es asintomático y generalmente se encuentra de manera incidental, durante la cirugía o la autopsia. Se ha informado en varios sitios abdominales y extraabdominales, con mayor frecuencia en la vesícula biliar. Reportamos el caso de una masa encontrada en la región subdiafragmática izquierda, diagnosticada como hígado ectópico en la TC abdominal e intraoperatoriamente. Nuestro objetivo fue evaluar la importancia de los exámenes por imágenes en el diagnóstico diferencial de masas intraabdominales que incluyen masas benignas como también malignas, y señalar que a pesar de la baja incidencia de hígado ectópico, es necesario tener en cuenta esta posibilidad en el diagnóstico.


Subject(s)
Humans , Aged , Choristoma/diagnostic imaging , Abdomen/pathology , Liver/pathology , Tomography, X-Ray Computed , Abdomen/diagnostic imaging
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