ABSTRACT
Introducción: la displasia fibromuscular (DFM) es una patología poco frecuente de la capa muscular de las arterias. El síndrome de ligamento arcuato medio (SLAM) es una entidad infrecuente causada por la compresión extrínseca del tronco celíaco por el diafragma. Caso clínico: presentamos el caso de una mujer joven con DFM diagnosticada de afectación a nivel del tronco celíaco y de la arteria hepática común. Ante clínica de dolor abdominal, se solicita angio TC, que describe un SLAM asociado a la DFM. Se decide sección quirúrgica del ligamento arcuato y descompresión del tronco celíaco mediante abordaje robótico. Discusión: en ambas entidades la angiografía es el trataminto de referencia para el diagnóstico. El tratamiento de primera línea de la DFM es el endovascular mediante angioplastia, y del SLAM, el quirúrgico, seccionando el ligamento arcuato.(AU)
Introduction: fibromuscular dysplasia (FMD) is a rare disorder that affects the muscular layer of the arteries. The medianarcuate ligament syndrome (MALS) is also a rare disorder due to the extrinsic compression of the celiac trunk by thediaphragm.Case report: we report the case of a young woman with FMD and splachnic involvement of the celiac trunk and thecommon hepatic artery level. After presenting with abdominal pain, a CCTA was performed that revealed the presenceof FMD-related MALS. The surgical section of the arcuate ligament and decompression of celiac trunk were decided andperformed through robotic approach.Discussion: the gold standard for the diagnosis of both entities is angiography. However, while the first-line therapy ofFMD is endovascular, in the case MALS the best alternative is surgical treatment sectioning the arcuate ligament.(AU)
Subject(s)
Humans , Female , Adult , Fibromuscular Dysplasia/diagnosis , Fibromuscular Dysplasia/drug therapy , Median Arcuate Ligament Syndrome , Angiography , Inpatients , Physical ExaminationABSTRACT
We present the case of an 83-year-old male, with a past medical history of benign pneumoperitoneum secondary to pneumatosis intestinalis which evolved for a number of years with periodic follow-ups. The patient comes to the Emergency Room with sintomatology of intestinal obstruction. Urgent surgical management is decided, an exploratory laparotomy is performed where an intestinal obstruction secondary to pneumatosis intestinalis, with loss of structure of the intestinal wall as visualized in the images, is determined; therefore resection of the affected small intestine segment and primary anastomosis are performed. The pathology report confirms the diagnosis. The patient progresses favorably during the postoperative period and is currently asymptomatic after 12 months.
Subject(s)
Intestinal Obstruction , Pneumatosis Cystoides Intestinalis , Male , Humans , Aged, 80 and over , Pneumatosis Cystoides Intestinalis/complications , Pneumatosis Cystoides Intestinalis/diagnostic imaging , Pneumatosis Cystoides Intestinalis/surgery , Intestinal Obstruction/diagnostic imaging , Intestinal Obstruction/etiology , Intestinal Obstruction/surgery , Intestine, Small , Intestines , Tomography, X-Ray ComputedABSTRACT
Resumen El divertículo de Meckel (DM) es un remanente de la persistencia del conducto onfalomesentérico presente en un 2% de la población general. Normalmente cursa de forma silente y solo se descubre ante la presencia de complicaciones. El diagnóstico preoperatorio es infrecuente. En general se acepta que el tratamiento más adecuado ante un DM sintomático es la resección quirúrgica. El manejo del DM asintomático sigue sin estar claro. Se presenta un caso clínico que no solo engloba algunas de las complicaciones que puede presentar un DM, sino que además tiene la peculiaridad de que un leiomioma es el origen de las mismas. La presencia de enfermedad neoplásica a nivel del DM representa un 3,2% de sus complicaciones. El tumor carcinoide es el más frecuente. Existen pocas publicaciones que hagan referencia a las neoplasias benignas albergadas en los DM debido a su baja incidencia (AU)
Abstract Meckel's diverticulum (MD) is a persistent embryonic remnant occurring in 2% of the general population. This entity is usually clinically silent and is only discovered when complications occur. Diagnosis is rarely made preoperatively. Surgical resection of symptomatic MD is widely accepted but the most appropriate management of asymptomatic MD remains unclear. We present a case of MD that summarizes some of the complications that may occur. The peculiarity of this case was that the complications were caused by a leiomyoma. The presence of tumoral disease in MD accounts for 3.2% of complications. The most common neoplasm is carcinoid tumor. Few publications have reported benign neoplasms in MD, probably due to their low incidence (AU)
Subject(s)
Humans , Male , Aged , Leiomyoma/pathology , Meckel Diverticulum/pathology , Carcinoid Tumor/pathology , Choristoma/pathologySubject(s)
Appendix/pathology , Gastrointestinal Hemorrhage/etiology , Iliac Artery/pathology , Intestinal Fistula/diagnosis , Cecal Diseases/complications , Cecal Diseases/diagnosis , Female , Humans , Intestinal Fistula/complications , Middle Aged , Rectum , Vascular Diseases/complications , Vascular Diseases/diagnosisSubject(s)
Humans , Female , Aged , Carcinoid Tumor/pathology , Liver Neoplasms/pathology , Neuroendocrine Cells/pathologyABSTRACT
Meckel's diverticulum (MD) is a persistent embryonic remnant occurring in 2% of the general population. This entity is usually clinically silent and is only discovered when complications occur. Diagnosis is rarely made preoperatively. Surgical resection of symptomatic MD is widely accepted but the most appropriate management of asymptomatic MD remains unclear. We present a case of MD that summarizes some of the complications that may occur. The peculiarity of this case was that the complications were caused by a leiomyoma. The presence of tumoral disease in MD accounts for 3.2% of complications. The most common neoplasm is carcinoid tumor. Few publications have reported benign neoplasms in MD, probably due to their low incidence.
