Eosinophilic granuloma of cranial location: report of a case and bibliographic review / [Granuloma eosinófilo de localización craneal: reporte de un caso y revisión bibliográfica]

Introduction: Eosinophilic granuloma is an unusual benign disease that usually affects the pediatric population and young adults. It is the most benign of the diseases traditionally known as histiocytosis X that are now called Langerhans cell histiocytosis. Clinical Case: Pediatric patient with a painful lump in the temporal region. The imaging tests carried out reveal the existence of an osteolytic lesion with an aggressive pattern compatible with eosinophilic granuloma. The patient underwent surgery with a conclusive definitive histological diagnosis of eosinophilic granuloma. Discussion: Eosinophilic granuloma can affect one or multiple bones, of which the most frequent are the cranial bones, epiphyses of long bones and ribs, requiring individualized diagnosis and treatment strategies for optimal management and results, with surgical treatment of First choice. Conclusion: Eosinophilic granuloma is an infrequent benign condition that requires a correct anamnesis and clinical examination of the patient, as well as the demonstration of the characteristic radiological images, allowing a generally accurate presumptive diagnosis to be reached that in most cases can be considered definitive.

Introducción: El granuloma eosinófilo es una enfermedad benigna poco usual que suele afectar a la población pediátrica y adultos jóvenes. Es la afección más benigna de las enfermedades tradicionalmente conocidas como histiocitosis X que en la actualidad reciben la denominación de histiocitosis de células de Langerhans. Caso Clínico: Paciente pediátrico con bultoma doloroso en región temporal. Las pruebas de imagen realizadas ponen de manifiesto la existencia de una lesión osteolítica con patrón de agresividad compatible con granuloma eosinófilo. El paciente es intervenido mediante cirugía con diagnóstico histológico definitivo concluyente de granuloma eosinófilo. Discusión: El granuloma eosinófilo puede afectar a uno o múltiples huesos, de los cuáles los más frecuentes son los huesos craneales, epífisis de huesos largos y costillas, precisando estrategias de diagnóstico y tratamiento individualizadas para un manejo y resultado óptimo, siendo el tratamiento quirúrgico de primera elección. Conclusión: El granuloma eosinófilo es un cuadro benigno infrecuente que requiere de una correcta anamnesis y exploración clínica del paciente, así como la demostración de las imágenes radiológicas características, permitiendo llegar a un diagnóstico de presunción generalmente certero que en la mayoría de ocasiones se puede considerar definitivo.

Pelvic Venous Disorders in Women due to Pelvic Varices: Treatment by Embolization: Experience in 520 Patients.

PURPOSE: The purpose of this study was to determine the efficacy and safety of embolization treatment in pelvic venous disorders in women refluxing in the ovarian and or internal iliac veins in women with chronic pelvic pain. MATERIALS AND METHODS: A retrospective study conducted from January 2000 to June 2017 in 617 patients diagnosed with pelvic venous disorders (PeVDs) with a mean age of 43.2 ± 7.2 years were treated using an embolization procedure. A total of 520 were included, and 97 patients were excluded. The main inclusion criteria were PeVD symptoms for more than 6 months and transvaginal Doppler ultrasonography (TV-DUS) diagnosis of varicose veins in the pelvis with a diameter greater than 6 mm. The main objective was to embolize the 4 main pelvic venous plexi (ovarian and internal iliac veins) whenever possible. Follow-up was performed using clinical symptoms (visual analog scale) and TV-DUS at 1, 3, 6, and 12 months and then every year up to 5 years. RESULTS: The technical success (embolization of the 4 main pelvic veins) was achieved in 84.4% of the patients. The average follow-up was 58.7 ± 5.7 months. The visual analog scale was improved from 7.63 ± 0.9 points pretreatment to 0.91 ± 1.5 at 5 years. A total of 26 patients (5%) presented with symptom recurrence and pelvic varicose veins. There were 57 minor complications (10.9%) and 11 major complications (2.1%), with 7 cases (1.34%) of device migration to the lung. CONCLUSIONS: The embolization of pelvic varicose veins is a safe and effective procedure. The selection of the embolic agents and the number of veins needed to be treated.

COVID-19 Outbreak: Infection Control and Management Protocol for Vascular and Interventional Radiology Departments-Consensus Document.

COVID-19 (SARS-CoV-2 virus) pandemic was recently declared by the WHO as a global health emergency. A group of interventional radiology senior experts developed a consensus document for infection control and management of patients with COVID-19 in interventional radiology (IR) departments. This consensus statement has been brought together at short notice with the help of different protocols developed by governmental entities and scientific societies to be adapted to the current reality and needs of IR Departments. Recommendations are the specific strategies to follow in IR departments, preventive measures and regulations, step by step for donning and doffing personal protective equipment, specific IR procedures which can not be delayed, and aerosol-generating procedures in IR with COVID-19 patients. It is advisable with this document to be adapted to local workplace policies.

Absorbable stents for treatment of benign biliary strictures: long-term follow-up in the prospective Spanish registry.

OBJECTIVES: Benign strictures of the bile duct may be difficult to treat endoscopically due to altered bowel anatomy. Furthermore, recurrence of stenosis and symptoms remains high. The aim of the Spanish Prospective Registry BiELLA study was to investigate the safety and efficacy of absorbable stents in the treatment of benign biliary strictures and their outcomes on the medium and long-term follow-up. METHODS: A prospective, multicenter, observational, non-randomized study (the BiELLA study) was conducted from January 2014 to September 2018. One hundred fifty-nine patients with benign biliary strictures, mostly postsurgical, were enrolled for implantation of absorbable biliary stents in the 11 participating Spanish tertiary hospitals. The average patient follow-up was 45.4 ± 15.9 months (range, 12-60 months). The follow-up data included symptoms, biochemical parameters, and ultrasound images at 1, 6, and 12 months and then yearly for up to 60 months. RESULTS: The immediate technical and clinical success rates were 100%. In all patients, stent placement resulted in improvement of clinical symptoms and biochemical parameters. The primary mean patency for stent was 86.7, 79.6, and 78.9% at 12, 36, and 60 months, respectively (95% CI). Biliary restenosis and occlusion occurred in 40 (26.6%) patients. Of the 40 patients, 18 (12%) patients were treated with a second stent and 22 (14.6%) patients had operative repair of the recurrent strictures. There were no major complications associated with stent implantation. CONCLUSIONS: Implantation of an absorbable polydioxanone biliary stent is safe and effective for treatment of benign biliary strictures refractory to balloon dilatation or other biliary intervention. KEY POINTS: • Percutaneous implantation of biodegradable prostheses for the treatment of benign postsurgical biliary strictures is a safe and effective procedure. • More than 75% of the patients presented patency of the stented biliary tree at 5 years follow-up. • Absorbable stents improved clinical symptoms and signs (jaundice, itching, fever), and laboratory parameters in a few days after stent placement.