RESUMEN
Extragastric leiomyoblastomas are extremely rare. This is the sixth reported case of leiomyoblastoma of the greater omentum, and the only one with acute major bleeding which required an emergency operation. Leiomyoblastomas are low-grade malignant tumors, and especially the gastric ones have an excellent prognosis after surgical removal. Extragastric leiomyoblastomas have a higher rate of dissemination. However, none of the previously reported omental leiomyoblastomas showed signs of metastatic spread at the time of operation. The present patient is alive and well 18 months post-operatively.
Asunto(s)
Hemorragia/etiología , Leiomioma/complicaciones , Neoplasias de Tejido Muscular/complicaciones , Epiplón , Neoplasias Peritoneales/complicaciones , Adulto , Urgencias Médicas , Estudios de Seguimiento , Humanos , Leiomioma/cirugía , Masculino , Neoplasias de Tejido Muscular/cirugía , Neoplasias Peritoneales/cirugíaAsunto(s)
Enfermedades del Colon/etiología , Hemorragia Gastrointestinal/etiología , Hematoma/complicaciones , Perforación Intestinal/etiología , Enfermedades del Bazo/complicaciones , Rotura Gástrica/etiología , Enfermedades del Colon/complicaciones , Humanos , Perforación Intestinal/complicaciones , Masculino , Persona de Mediana Edad , Rotura Gástrica/complicacionesRESUMEN
A case of prostatic carcinoma with unusual lymphatic spread is presented. The usefulness of the immunohistochemical staining reactions for prostate specific antigen and acid prostatic phosphatase along with transrectal ultrasonographic investigation are emphasized.
Asunto(s)
Adenocarcinoma/secundario , Neoplasias de la Próstata/patología , Humanos , Conducto Inguinal , Ganglios Linfáticos/patología , Metástasis Linfática , Masculino , Persona de Mediana EdadRESUMEN
An extremely rare case of progressive perineal clostridial myonecrosis secondary to Thiersch's operation for rectal prolapse illustrates the need for early recognition of the initial clinical findings to maximize the chances for survival. Management of these infections include prompt administration of shock therapy, a broad spectrum of antibiotics, and thorough surgical debridement of all involved tissue. Prophylactic systemic antibiotic therapy must be considered, especially in high risk patients.
Asunto(s)
Gangrena Gaseosa/etiología , Perineo/patología , Prolapso Rectal/cirugía , Infección de la Herida Quirúrgica/etiología , Anciano , Femenino , HumanosRESUMEN
Pudendal block with 20 ml 1% mepivacaine with and without epinephrine was performed in 151 patients during the second stage of labor. No differences in efficacy of the block or in Apgar scores between the two groups were found. The maternal mepivacaine concentration was higher in the plain group than in the epinephrine group (p less than 0.01), but toxic levels were never reached. In the infants, no difference in mepivacaine concentration was found between the groups (p greater than 0.05, type II error 9%) and toxic levels were not reached. The time elapsed from the pudendal block until delivery was prolonged when epinephrine was added (p less than 0.02). We found no effect on blood pressure in either of the groups, with or without oxytocin and/or methergin. Twenty ml 1% mepivacaine (plain) is a safe choice for pudendal block without the possible disadvantages of adding epinephrine.