Rapunzel syndrome is a rare clinical entity in which a trichobezoar is produced by the ingestion of hair at the gastric level, extending in the form of a tail towards the duodenum. It occurs in young patients with trichotillomania and trichophagia. We present the case of a 24-year-old woman with a history of anxiety without treatment, who for 10 years presented trichotillomania and trichophagia, producing a picture of intestinal obstruction that required surgical intervention, evidencing a giant Trichobezoar throughout the gastric cavity and one jejunum associated with diastatic perforation. duodenal.
Bezoars , Duodenal Ulcer , Peptic Ulcer Perforation , Trichotillomania , Female , Humans , Young Adult , Adult , Jejunum , Bezoars/complications , Bezoars/diagnostic imaging , Bezoars/surgery , Duodenum , Trichotillomania/complications , Trichotillomania/therapy , Duodenal Ulcer/complications , Syndrome
BACKGROUND: Most of the studies published to date which assess the role of antibacterial sutures in surgical site infection (SSI) prevention include heterogeneous groups of patients, and it is therefore difficult to draw conclusions. The objective of the present study was to investigate whether the use of Triclosan-coated barbed sutures (TCBS) was associated with a lower incidence of incisional SSI and lower duration of hospital stay compared to standard sutures, in elective laparoscopic colorectal cancer surgery. METHOD: Observational including patients who underwent elective colorectal cancer laparoscopic surgery between January 2015 and December 2020. The patients were divided into two groups according to the suture used for fascial closure of the extraction incision, TCBS vs conventional non-coated sutures (CNCS), and the rate of SSI was analysed. The TCBS cases were matched to CNCS cases by propensity score matching to obtain comparable groups of patients. RESULTS: 488 patients met the inclusion criteria. After adjusting the patients with the propensity score, two new groups of patients were generated: 143 TCBS cases versus 143 CNCS cases. Overall incisional SSI appeared in 16 (5.6%) of the patients with a significant difference between groups depending on the type of suture used, 9.8% in the group of CNCS and 1.4% in the group of TCBS (OR 0.239 (CI 95%: 0.065-0.880)). Hospital stay was significantly shorter in TCBS group than in CNCS, 5 vs 6 days (p < 0.001). CONCLUSION: TCBS was associated with a lower incidence of incisional SSI compared to standard sutures in a cohort of patients undergoing elective laparoscopic colorectal cancer surgery.
Colorectal Neoplasms , Surgical Wound Infection , Sutures , Humans , Cohort Studies , Colorectal Neoplasms/surgery , Laparoscopy , Propensity Score , Surgical Wound Infection/epidemiology , Sutures/adverse effects , Triclosan
El tumor de células de la granulosa extraovárico es una neoplasia infrecuente donde la identificación de la mutación de FOXL2 puede ser utilizada como una herramienta diagnóstica adicional complementaria a los hallazgos histopatológicos e inmunohistoquímicos clásicos. Presentamos un nuevo caso de tumor de células de la granulosa extraovárico en una paciente femenina de 57 años de edad con una masa tumoral subhepática y dolor abdominal. En el estudio histopatológico del tumor resecado se encontraron características morfológicas sugestivas de tumor de células de la granulosa del adulto con positividad inmunohistoquímica para α-inhibina, calretinina, WT1, S100, CD99 y receptores de progesterona. En el estudio por biología molecular se encontró mutación en FOXL2. El diagnóstico final fue de tumor de células de la granulosa del adulto extraovárico. Discutimos el diagnóstico diferencial histopatológico e inmunohistoquímico
Extraovarian granulosa cell tumor is a very uncommon tumor and the identification of a recurrent mutation in FOXL2 may be used as another diagnostic tool along with the classical morphological and immunohistochemical findings. Here, we report a new case of extraovarian granulosa cell tumor in a 57 years old female patient presented with a sub-hepatic mass and abdominal pain. Histopathological examination of the excised mass showed features of adult-type granulosa cell tumor with α-inhibin, calretinin, WT1, S100, CD99 and progesterone receptor immunoreactivity. A FOXL2 mutation was detected on molecular biology study. A final diagnosis was an extraovarian adult-type granulosa cell tumor. We discuss the histopathological and immunohistochemical differential diagnosis
Humans , Female , Middle Aged , Granulosa Cell Tumor/diagnostic imaging , Granulosa Cell Tumor/pathology , Forkhead Box Protein L2/genetics , Biomarkers, Tumor/genetics , Abdominal Neoplasms/diagnostic imaging , Abdominal Neoplasms/pathology , Tomography, X-Ray Computed , Granulosa Cell Tumor/surgery , Abdominal Neoplasms/surgery , Diagnosis, Differential , Immunohistochemistry , Mutation
Extraovarian granulosa cell tumor is a very uncommon tumor and the identification of a recurrent mutation in FOXL2 may be used as another diagnostic tool along with the classical morphological and immunohistochemical findings. Here, we report a new case of extraovarian granulosa cell tumor in a 57 years old female patient presented with a sub-hepatic mass and abdominal pain. Histopathological examination of the excised mass showed features of adult-type granulosa cell tumor with α-inhibin, calretinin, WT1, S100, CD99 and progesterone receptor immunoreactivity. A FOXL2 mutation was detected on molecular biology study. A final diagnosis was an extraovarian adult-type granulosa cell tumor. We discuss the histopathological and immunohistochemical differential diagnosis.
Forkhead Box Protein L2/genetics , Granulosa Cell Tumor/genetics , Granulosa Cell Tumor/pathology , Liver Neoplasms/genetics , Liver Neoplasms/pathology , 12E7 Antigen/analysis , Calbindin 2/analysis , Diagnosis, Differential , Female , Granulosa Cell Tumor/chemistry , Humans , Inhibins/analysis , Liver Neoplasms/chemistry , Middle Aged , Receptors, Progesterone/analysis , S100 Proteins/analysis , WT1 Proteins/analysis
