OBJECTIVES: Coronary artery calcification (CorCa) identifies high cardiovascular risk in the general population. In this setting, aortic valve calcification (AoCa) showed contradictory results. Our goal has been to assess the prognostic power of CorCa and AoCa in patients with chest pain who underwent an ECG-gated cardiac multidetector CT (cardiac-MDCT). METHODS: A total of 528 patients without previous known coronary artery disease, with chest pain who underwent a cardiac-MDCT multidetector, were retrospectively recruited. The primary endpoint included death, acute coronary syndrome, stroke, and heart failure. RESULTS: A total of 61 patients (11.6%) had an event during a mean follow-up of almost 6 years (5.95 ± 2.98). The most frequent event was acute coronary syndrome (6.4%). Total mortality was 4.5%. Patients with CorCa > 0 had more events than those without CorCa (17.3% versus 4.3%; p < 0.001). Likewise, when only patients without AoCa were considered (n = 118), clinical events were more frequent in those with CorCa (12.7% versus 3.6%; p = 0.004). After excluding patients with coronary artery disease, events were more frequent in those with CorCa (12.6% versus 4.3%; p = 0.004). The higher the Agatston score, the more frequent the events. Patients with AoCa > 0 had more events than those without (16.5% versus 7.3%; p < 0.001), but in patients without CorCa, no difference in events was seen (6.2% versus 3.6%; p = 0.471). A Cox regression analysis showed age, smoking, prior stroke, and CorCa but not AoCa to be independently related to events. CONCLUSIONS: In summary, CorCa, but not AoCa, is related to cardiovascular events in patients with chest pain who undergo a cardiac-MDCT. CLINICAL RELEVANCE STATEMENT: We show that coronary artery calcification, but not aortic valve calcification, detected in a coronary CT scan is tightly related to cardiovascular events. Although this is a message already shown by other groups in the general population, we do believe that this work is unique because it is restricted to patients with chest pain sent to coronary CT. In other words, our work deals with what we face in our routine everyday practice. KEY POINTS: ⢠The presence and the amount of coronary artery calcification are associated with cardiovascular events in patients with chest pain. ⢠Aortic valve calcification is not associated with cardiovascular events in patients with chest pain.
Acute Coronary Syndrome , Aortic Valve Stenosis , Aortic Valve/pathology , Calcinosis , Coronary Artery Disease , Stroke , Vascular Calcification , Humans , Coronary Artery Disease/complications , Coronary Artery Disease/diagnostic imaging , Aortic Valve/diagnostic imaging , Calcium , Prognosis , Retrospective Studies , Risk Factors , Chest Pain/diagnostic imaging , Stroke/complications , Vascular Calcification/complications , Vascular Calcification/diagnostic imaging
Archaeological research in the Dolmen of El Pendón (Reinoso, Burgos, Spain) has brought to light the complex biography of a megalithic monument used throughout the 4th millennium cal. BC. The ossuary of this burial holds the bones of nearly a hundred individuals who suffered from diverse pathologies and injuries. This study presents the discovery of a skull with two bilateral perforations on both mastoid bones. These evidences point to a mastoidectomy, a surgical procedure possibly performed to relieve the pain this prehistoric individual may have suffered as a result of otitis media and mastoiditis. The hypothesis of surgical intervention is also supported by the presence of cut marks at the anterior edge of the trepanation made in the left ear. Furthermore, the results of this paper demonstrate the survival of the individual to both interventions. Given the chronology of this dolmen, this find would be the earliest surgical ear intervention in the history of mankind.
OBJECTIVES: The aims of this study were to determine the rate of noncentered coronary ostia and their risk for coronary overlap (CO) and to develop an improved orientation strategy for transcatheter aortic valve replacement (TAVR) devices taking into account anatomical cues to identify patients at risk for CO regardless of commissural alignment and compute an alternative, CO-free TAVR rotation angle for those patients. BACKGROUND: Commissural alignment during TAVR reduces CO risk. However, eccentricity of coronary ostia from the center of the sinus of Valsalva may result in CO even after perfect alignment of TAVR commissures. METHODS: Baseline computed tomography from TAVR candidates helped identify distance from commissures to the right coronary artery (RCA) and the left coronary artery (LCA). Then, for each case, a virtual valve was simulated with ideal commissural or coronary alignment, and the degree of CO was determined. On the basis of the potential BASILICA (bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction) efficacy, 3 groups were defined: no risk for CO (>35° from neocommissure to coronary ostia), moderate risk (20°-35°), and severe risk (≤20°). RESULTS: Computed tomographic studies from 107 patients were included. After excluding 7 patients (poor quality or bicuspid valve), 100 patients were analyzed. The RCA showed greater eccentricity compared with the LCA (18.5° [IQR: 3.3°-12.8°] vs 6.5° [IQR: 3.3°-12.8°]; P < 0.001). The mean intercoronary angle was 140.0° ± 18.7° (95% CI: 136.3°-143.7°). Thirty-two patients had moderate to severe risk for CO (≤35°) despite ideal commissural alignment. Greater coronary eccentricity (cutoff for RCA, 24.5°; cutoff for LCA, 19°) and intercoronary angle >147.5° or <103° were associated with greater risk for moderate to severe CO despite commissural alignment (area under the curve: 0.97; 95% CI: 0.91-0.99). If optimal coronary alignment was simulated, this prevented severe CO in all cases and reduced moderate CO from 27% to 5% (P < 0.001). CONCLUSIONS: One third of patients would have CO during TAVR-in-TAVR despite commissural alignment; a 6-fold decrease in this risk was achieved with optimized coronary alignment. Coronary eccentricity and intercoronary angle were the main predictors.
Bioprosthesis , Heart Valve Prosthesis , Transcatheter Aortic Valve Replacement , Aortic Valve/diagnostic imaging , Aortic Valve/surgery , Humans , Prosthesis Design , Treatment Outcome
INTRODUCTION AND OBJECTIVES: Final position of the neo-commissures is uncontrolled during transcatheter aortic valve implantation (TAVI), potentially hindering coronary access and future procedures. We aimed to develop a standard method to achieve commissural alignment with the ACURATE neo valve. METHODS: The relationship between native and TAVI neo-commissures was analyzed in 11 severe aortic stenosis patients undergoing TAVI. Based on computed tomography analysis, an in silico model was developed to predict final TAVI commissural posts position. A modified implantation technique, accurate commissural alignment (ACA) and a dedicated delivery system were developed. TAVI implants were tested in 3-dimensional (3D) printed models and in vivo. Commissural misalignment and coronary overlap (CO) were analyzed. RESULTS: The in silico model accurately predicted final position of commissural posts irrespective of the implantation technique performed (correlation coefficient, 0.994; 95%CI, 0.989-0.998; P<.001). TAVI implant with patient-specific rotation was simulated in 3D printed models and in 9 patients. ACA-oriented TAVI implants presented adequate commissural alignment in vivo (mean commissural misalignment of 7.7 ±3.9°). None of the ACA oriented implants showed CO, whereas in silico conventional implants predicted CO in 6 of the 9 cases. CONCLUSIONS: Accurate commissural alignment of the ACURATE neo device is feasible by inserting the delivery system with a patient-specific rotation based on computed tomography analysis. This is a simple and reproducible method for commissural alignment that can be potentially used for all kinds of TAVI devices.
Aortic Valve Stenosis , Heart Valve Prosthesis , Transcatheter Aortic Valve Replacement , Aortic Valve/surgery , Aortic Valve Stenosis/surgery , Humans , Prosthesis Design , Treatment Outcome
BACKGROUND: There are controversies about the optimal management of AO subtype A3 burst fractures. The most common surgical treatment consists of posterior fixation with pedicle screw and rod augmentation. Nevertheless, a loss of correction in height restoration and kyphotic reduction has been observed. OBJECTIVES: The aim of this study was to assess long-term outcomes of a minimally invasive technique using a percutaneous intravertebral expandable titanium implant (PIETI). STUDY DESIGN: This prospective, single center, pilot study was carried out on a consecutive case series of 44 patients with acute (< 2 weeks) traumatic thoracolumbar fractures AO type A3. The average follow-up was 5.6 years. SETTING: A single center in Castilla y Leon, SpainMETHODS: Clinical outcomes (pain intensity on visual analog scale [VAS], Oswestry Disability Index [ODI], analgesic consumption) and radiographic outcomes (anterior/mid/posterior vertebral body height, vertebral area, local kyphosis angle, traumatic regional angulation) were analyzed before surgery, at one month after surgery, and at the end of the follow-up period. RESULTS: At one-month postsurgery, significant improvements in VAS score and ODI score were observed. PIETI achieved significant vertebral body height restoration with median height increases of 2.9 mm/4.3 mm/2.3 mm for anterior/middle/posterior parts, respectively. Significant correction of the local kyphotic angle and improvement of the traumatic regional angulation were accomplished. All these improvements were maintained throughout the follow-up period. The only complication reported was a case of cement leakage. LIMITATIONS: In our opinion, the main limitation of the study is the small number of patients. However, the sample is superior to that shown in other papers. CONCLUSIONS: This study showed that using a PIETI in the treatment of fractures type A3 is a safe and effective method that allows marked clinical improvement, as well as anatomical vertebral body restoration. Unlike with other treatments, results were maintained over time, allowing a better long-term clinical and functional improvement. The rate of cement leakage was lower than other reports.
Spinal Fractures , Titanium , Follow-Up Studies , Fracture Fixation, Internal , Humans , Lumbar Vertebrae/diagnostic imaging , Lumbar Vertebrae/injuries , Lumbar Vertebrae/surgery , Pilot Projects , Prospective Studies , Spinal Fractures/surgery , Thoracic Vertebrae/diagnostic imaging , Thoracic Vertebrae/injuries , Thoracic Vertebrae/surgery , Treatment Outcome
Intervertebral Disc Degeneration/surgery , Mesenchymal Stem Cell Transplantation , Adult , Disability Evaluation , Female , Humans , Intervertebral Disc Degeneration/diagnostic imaging , Intervertebral Disc Degeneration/physiopathology , Magnetic Resonance Imaging , Male , Mesenchymal Stem Cell Transplantation/adverse effects , Pain Measurement , Recovery of Function , Time Factors , Transplantation, Homologous , Treatment Outcome
Objetivo Revisar la patología tumoral del uraco, haciendo énfasis en su clínica, los métodos diagnósticos empleados y el manejo terapéutico. Métodos Presentamos el caso de un varón de 39 años con carcinoma del uraco que simuló clínicamente un absceso umbilical. Resultados Los hallazgos en la TC fueron sospechosos de patología del uraco. El examen anatomopatológico reveló células atípicas y la PET-TC demostró extensión a pared abdominal y epiplón, requiriéndose la resección completa. Conclusiones El carcinoma del uraco es una neoplasia muy poco frecuente, que tiene su origen en el epitelio que recubre la luz del uraco, un vestigio de la alantoides que conecta la vejiga con el ombligo y normalmente involuciona en la etapa embrionaria. La clínica insidiosa hace que el diagnóstico sea tardío y el pronóstico pobre. Las pruebas de imagen tienen un papel fundamental en su sospecha, así como en la definición de la relación con la pared vesical y posible extensión local o a distancia. Una vez confirmado el diagnóstico histológicamente, está indicada la resección quirúrgica completa.
Objective To review tumoral pathology of urachus, emphasizing its clinical manifestations, diagnostic methods and therapeutic management. Method We present the case of a 39-year-old male with urachal carcinoma who clinically mimicked an umbilical abscess. Result CT findings were suspected of urachus pathology. Histologic analysis of the resected specimen demonstrated atypical cells, and PET-CT showed extension to the abdominal wall and omentum, requiring complete resection. Conclusions Urachal carcinoma is a very rare neoplasm that originates in the epithelium that covers the lumen of the urachus, a vestige of the allantois that connects the bladder with the navel and normally involves in the embryonic stage. The insidious clinic makes late diagnosis and poor prognosis. Imaging tests play a fundamental role in their suspicion, as well as in the definition of the relationship with the bladder wall and possible local or distant extension. Once the diagnosis has been confirmed histologically, complete surgical resection is indicated.
Humans , Male , Adult , Urachus , Urachus/pathology , Carcinoma , Urachus/abnormalities , Urinary Bladder , Allantois , Neoplasms
Objetivo. Estudiar la utilidad de la tomografía computarizada multidetector (TCMD) en la evaluación previa y el seguimiento de los pacientes sometidos a ablación de venas pulmonares mediante radiofrecuencia, y la actitud terapéutica basada en los hallazgos. Método. Análisis retrospectivo de 92 estudios de TCMD consecutivos realizados entre enero de 2011 y junio de 2013 en 80 pacientes; de ellos, 70 (76%) antes de un primer procedimiento de ablación y 22 (24%) en pacientes que ya habían recibido algún procedimiento de ablación. Resultados. Se encontraron hallazgos relevantes en el 34% de los pacientes en quienes se realizó el estudio antes del primer procedimiento de ablación y en el 68% de los estudios realizados tras algún procedimiento. La incidencia de ictus asociado al procedimiento de ablación fue del 3%, similar a la registrada en nuestro centro antes de utilizar la TCMD para la evaluación de la anatomía de la aurícula izquierda. Todos los pacientes sintomáticos tenían algún grado de estenosis de las venas pulmonares, significativa en el 80%. Además, la progresión de estas fue muy rápida; el tratamiento con angioplastia-balón se asoció a reestenosis precoz. El implante de stent fue una alternativa en los casos de angioplastia fallida. Conclusión. La TCMD en la evaluación previa y el seguimiento de los pacientes sometidos a un procedimiento de ablación de venas pulmonares permite guiar el tratamiento y detectar complicaciones (AU)
Objective. To analyze the usefulness of multidetector computed tomography (MDCT) in the preprocedural evaluation and follow-up of patients undergoing radiofrequency ablation of pulmonary veins and the impact of the MDCT findings on the approach to treatment. Method. We retrospectively analyzed 92 consecutive MDCT studies done in 80 patients between January 2011 and June 2013; 70 (76%) studies were done before a first ablation procedure and 22 (24%) were done in patients who had undergone an ablation procedure. Results. Findings were useful in 34% of the patients who underwent MDCT before the first ablation procedure and in 68% of the studies done after a procedure. The incidence of stroke associated with the ablation procedure was 3%, similar to the incidence recorded in our center before we started to use MDCT to evaluate the anatomy of the left atrium. All symptomatic patients had some pulmonary vein stenosis, and 80% had significant stenosis. Furthermore, the stenoses progressed very rapidly; treatment with balloon angioplasty was associated with early restenosis. Stenting was an alternative in cases of failed angioplasty. Conclusion. In the preprocedural evaluation and postprocedural follow-up of patients undergoing pulmonary vein isolation, MDCT is useful for guiding treatment and detecting complications (AU)
Humans , Pulmonary Veins , Multidetector Computed Tomography/instrumentation , Multidetector Computed Tomography/methods , Atrial Fibrillation , Pulmonary Valve Stenosis , Catheter Ablation , High-Intensity Focused Ultrasound Ablation/instrumentation , Coronary Restenosis , Angioplasty, Balloon, Coronary , Retrospective Studies
OBJECTIVE: To analyze the usefulness of multidetector computed tomography (MDCT) in the preprocedural evaluation and follow-up of patients undergoing radiofrequency ablation of pulmonary veins and the impact of the MDCT findings on the approach to treatment. METHOD: We retrospectively analyzed 92 consecutive MDCT studies done in 80 patients between January 2011 and June 2013; 70 (76%) studies were done before a first ablation procedure and 22 (24%) were done in patients who had undergone an ablation procedure. RESULTS: Findings were useful in 34% of the patients who underwent MDCT before the first ablation procedure and in 68% of the studies done after a procedure. The incidence of stroke associated with the ablation procedure was 3%, similar to the incidence recorded in our center before we started to use MDCT to evaluate the anatomy of the left atrium. All symptomatic patients had some pulmonary vein stenosis, and 80% had significant stenosis. Furthermore, the stenoses progressed very rapidly; treatment with balloon angioplasty was associated with early restenosis. Stenting was an alternative in cases of failed angioplasty. CONCLUSION: In the preprocedural evaluation and postprocedural follow-up of patients undergoing pulmonary vein isolation, MDCT is useful for guiding treatment and detecting complications.
Atrial Fibrillation/surgery , Catheter Ablation , Multidetector Computed Tomography , Pulmonary Veins/diagnostic imaging , Pulmonary Veins/surgery , Female , Humans , Male , Middle Aged , Postoperative Care , Preoperative Care , Retrospective Studies , Vascular Surgical Procedures/methods
BACKGROUND: Degenerative disc disease often causes severe low-back pain, a public health problem with huge economic and life quality impact. Chronic cases often require surgery, which may lead to biomechanical problems and accelerated degeneration of the adjacent segments. Autologous mesenchymal stromal cells (MSC) treatments have shown feasibility, safety and strong indications of clinical efficacy. We present here a randomized, controlled trial using allogeneic MSC, which are logistically more convenient than autologous cells. METHODS: We randomized 24 patients with chronic back pain diagnosed with lumbar disk degeneration and unresponsive to conservative treatments into 2 groups. The test group received allogeneic bone marrow MSCs by intradiscal injection of 25 × 10 cells per segment under local anesthesia. The control group received a sham infiltration of paravertebral musculature with the anesthetic. Clinical outcomes were followed up for 1 year and included evaluation of pain, disability, and quality of life. Disc quality was followed up by magnetic resonance imaging. RESULTS: Feasibility and safety were confirmed and indications of clinical efficacy were identified. MSC-treated patients displayed a quick and significant improvement in algofunctional indices versus the controls. This improvement seemed restricted to a group of responders that included 40% of the cohort. Degeneration, quantified by Pfirrmann grading, improved in the MSC-treated patients and worsened in the controls. CONCLUSIONS: Allogeneic MSC therapy may be a valid alternative for the treatment of degenerative disc disease that is more logistically convenient than the autologous MSC treatment. The intervention is simple, does not require surgery, provides pain relief, and significantly improves disc quality.
Bone Marrow Cells/cytology , Intervertebral Disc Degeneration/surgery , Lumbar Vertebrae , Mesenchymal Stem Cell Transplantation/methods , Mesenchymal Stem Cells/cytology , Adult , Feasibility Studies , Female , Follow-Up Studies , Humans , Intervertebral Disc Degeneration/diagnosis , Magnetic Resonance Imaging , Male , Pilot Projects , Prospective Studies , Quality of Life , Treatment Outcome
BACKGROUND CONTEXT: Pedicle screws in spinal surgery have allowed greater biomechanical stability and higher fusion rates. However, malposition is very common and may cause neurologic, vascular, and visceral injuries and compromise mechanical stability. PURPOSE: The purpose of this study was to compare the malposition rate between intraoperative computed tomography (CT) scan assisted-navigation and free-hand fluoroscopy-guided techniques for placement of pedicle screw instrumentation. STUDY DESIGN/SETTING: This is a prospective, randomized, observational study. PATIENT SAMPLE: A total of 114 patients were included: 58 in the assisted surgery group and 56 in the free-hand fluoroscopy-guided surgery group. OUTCOME MEASURES: Analysis of screw position was assessed using the Heary classification. Breach severity was defined according to the Gertzbein classification. Radiation doses were evaluated using thermoluminescent dosimeters, and estimates of effective and organ doses were made based on scan technical parameters. METHODS: Consecutive patients with degenerative disease, who underwent surgical procedures using the free-hand, or intraoperative navigation technique for placement of transpedicular instrumentation, were included in the study. RESULTS: Forty-four out of 625 implanted screws were malpositioned: 11 (3.6%) in the navigated surgery group and 33 (10.3%) in the free-hand group (p<.001). Screw position according to the Heary scale was Grade II (4 navigated surgery, 6 fluoroscopy guided), Grade III (3 navigated surgery, 11 fluoroscopy guided), Grade IV (4 navigated surgery, 16 fluoroscopy guided), and Grade V (1 fluoroscopy guided). There was only one symptomatic case in the conventional surgery group. Breach severity was seven Grade A and four Grade B in the navigated surgery group, and eight Grade A, 24 Grade B, and one Grade C in free-hand fluoroscopy-guided surgery group. Radiation received per patient was 5.8 mSv (4.8-7.3). The median dose received in the free-hand fluoroscopy group was 1 mGy (0.8-1.1). There was no detectable radiation level in the navigation-assisted surgery group, whereas the effective dose was 10 µGy in the free-hand fluoroscopy-guided surgery group. CONCLUSIONS: Malposition rate, both symptomatic and asymptomatic, in spinal surgery is reduced when using CT-guided placement of transpedicular instrumentation compared with placement under fluoroscopic guidance, with radiation values within the safety limits for health. Larger studies are needed to determine risk-benefit in these patients.
Neurosurgical Procedures/adverse effects , Pedicle Screws/adverse effects , Postoperative Complications , Surgery, Computer-Assisted/adverse effects , Aged , Female , Fluoroscopy , Humans , Lumbar Vertebrae/diagnostic imaging , Lumbar Vertebrae/surgery , Male , Middle Aged , Neurosurgical Procedures/methods , Prospective Studies , Random Allocation , Surgery, Computer-Assisted/methods , Tomography, X-Ray Computed
BACKGROUND: The aim of our study was to determine the presence of heterotopic ossifications (HO) in a series of patients with cervical disk arthroplasty treated with different type of prosthesis, as well as to analyze the most suitable systems for diagnosis. METHODS: A retrospective study of patients with cervical disk disease treated with cervical arthroplasty between May 2005 and December 2009, was performed. Patients were divided into 3 groups, depending on the prosthesis implanted: (Group A: Baguera prosthesis, Group B: ProDisc prosthesis, and Group C: PCM prosthesis). The presence of heterotopic ossifications was evaluated with both, simple radiology and computed tomography. RESULTS: As a summary of the results on motion preservation, computed tomography scans showed that 63% of the cervical arthroplasties in Group A presented good mobility at the first check point (December 2010), whereas cervical arthroplasties in Group B and Group C had 74% and 65% severe motion restrictions, respectively (Grade III or Grade IV, according to McAfee classification). The differences between groups were statistically significant when comparing Groups A and B, and Groups A and C (P < 0.05), but there were no differences between Groups B and C (P < 0.05). At the second check point (December 2014), the good mobility was just preserved in the 26% of the disk replacements (all in Group A). CONCLUSIONS: Our results showed that, although cervical disks provide optimal mid-term results, the incidence of HO seems to increase with time. Long term studies, with a larger sample size should be conducted to evaluate the appearance of HO and cervical motion after total disk replacement.
Intervertebral Disc Degeneration/surgery , Intervertebral Disc Displacement/surgery , Ossification, Heterotopic/etiology , Postoperative Complications/etiology , Total Disc Replacement/adverse effects , Adult , Aged , Female , Humans , Longitudinal Studies , Magnetic Resonance Imaging , Male , Middle Aged , Ossification, Heterotopic/diagnostic imaging , Postoperative Complications/diagnostic imaging , Postoperative Hemorrhage/diagnostic imaging , Postoperative Hemorrhage/etiology , Retrospective Studies , Severity of Illness Index , Tomography, X-Ray Computed
Aortic Valve Stenosis/diagnostic imaging , Aortic Valve/pathology , Calcinosis/diagnostic imaging , Chest Pain/diagnostic imaging , Coronary Vessels/diagnostic imaging , Multidetector Computed Tomography/standards , Vascular Calcification/diagnostic imaging , Aged , Aortic Valve/diagnostic imaging , Aortic Valve Stenosis/complications , Calcinosis/complications , Chest Pain/etiology , Cohort Studies , Female , Follow-Up Studies , Humans , Male , Middle Aged , Multidetector Computed Tomography/methods , Prognosis , Vascular Calcification/complications
No disponible
Humans , Male , Aged , Thoracic Vertebrae/microbiology , Thoracic Vertebrae , Tuberculosis, Meningeal/diagnosis , Tuberculosis, Miliary/diagnosis , Tuberculosis, Osteoarticular/diagnosis , Tuberculosis, Pulmonary/diagnosis , Tuberculosis, Meningeal , Tuberculosis, Miliary , Tuberculosis, Osteoarticular , Tuberculosis, Pulmonary
Thoracic Vertebrae , Tuberculosis, Meningeal/diagnosis , Tuberculosis, Miliary/diagnosis , Tuberculosis, Osteoarticular/diagnosis , Tuberculosis, Pulmonary/diagnosis , Aged , Humans , Magnetic Resonance Imaging , Male , Thoracic Vertebrae/diagnostic imaging , Thoracic Vertebrae/microbiology , Tomography, X-Ray Computed , Tuberculosis, Meningeal/diagnostic imaging , Tuberculosis, Miliary/diagnostic imaging , Tuberculosis, Osteoarticular/diagnostic imaging , Tuberculosis, Pulmonary/diagnostic imaging
Describimos el caso de un paciente varón de 43 años recientemente diagnosticado de enfermedad de Crohn de íleon que presenta una perforación intestinal por un divertículo de Meckel, detectándose enterolitos en la luz intestinal. Rara vez se ha comunicado la coexistencia de enfermedad de Crohn, divertículo de Meckel y enterolitos. El divertículo de Meckel puede hacer más difícil el tratamiento del paciente con enfermedad de Crohn (AU)
We describe the case of a 43-year-old man recently diagnosed with ileal Crohn's disease complicated by a free peritoneal perforation of a Meckel's diverticulum and the presence of enteroliths in the intestinal lumen. The coexistence of Crohns disease, Meckel's diverticulum and enteroliths has rarely been reported. Meckel's diverticulum can hamper the management of Crohn's disease (AU)
Humans , Male , Adult , Meckel Diverticulum/complications , Crohn Disease/complications , Intestinal Perforation/complications , Intestinal Obstruction/etiology , Risk Factors
We describe the case of a 43-year-old man recently diagnosed with ileal Crohn's disease complicated by a free peritoneal perforation of a Meckel's diverticulum and the presence of enteroliths in the intestinal lumen. The coexistence of Crohns disease, Meckel's diverticulum and enteroliths has rarely been reported. Meckel's diverticulum can hamper the management of Crohn's disease.
Crohn Disease/complications , Intestinal Obstruction/etiology , Lithiasis/etiology , Meckel Diverticulum/etiology , Adult , Humans , Male
Dyspnea/etiology , Gastric Dilatation/diagnosis , Heart Failure/diagnosis , Intra-Abdominal Hypertension/diagnosis , Acute Disease , Aged , Decompression/instrumentation , Fatal Outcome , Gastric Dilatation/complications , Gastric Dilatation/therapy , Heart Failure/etiology , Humans , Intra-Abdominal Hypertension/etiology , Intra-Abdominal Hypertension/therapy , Male , Tomography, X-Ray Computed , Treatment Outcome
