ABSTRACT
24-year-old man with positive HIV, with a giant exofitic anal condyloma, with a clinical presentation of a painfull suppurative anal condyloma with a pathology report of an in situ squamous cell carcinoma. The purpose of the investigation is a case report and the procedure was observational. The finding was a Buschke-Lowenstein tumor.
Varón de 24 años, con infección por el virus de la inmunodeficiencia humana, que presenta una tumoración exofítica, dolorosa y supurativa, con reporte positivo de virus de papiloma humano y reporte histopatológico de carcinoma espinocelular sin evidencia de diseminación (in situ). El propósito de la investigación es un reporte de caso y el procedimientos fue observacional. El hallazgo fue un tumor de Buschke-Lowenstein.
Subject(s)
Buschke-Lowenstein Tumor , Carcinoma, Squamous Cell , Condylomata Acuminata , Male , Humans , Buschke-Lowenstein Tumor/surgery , Buschke-Lowenstein Tumor/pathology , Condylomata Acuminata/complications , Condylomata Acuminata/diagnosis , Condylomata Acuminata/surgery , Carcinoma, Squamous Cell/complications , Carcinoma, Squamous Cell/diagnosis , Carcinoma, Squamous Cell/surgery , Anal CanalABSTRACT
BACKGROUND: Topical exogenous lipase has been approved for cosmetic use and has been used to mobilize fat from adipocytes. The objective of this study was to determine the effects of exogenous lipase in the subcutaneous adipose tissue. METHODS: Three different concentrations of exogenous lipase 1× (2 Units per ml), 5× (10 units per ml), and 10× (20 units per ml) were applied in a porcine model. Normal saline (NS) solution (as negative control) and phosphatidylcholine (as positive control) were also injected. Skin and subcutaneous tissue biopsies, up to the fascia, were obtained from each injection site on the 3rd day after injection. The number of cells per 20× field was counted as an indirect measurement of the size of the adipocytes. RESULTS: For 1× lipase, the number of cells per field was 47.80 (±7.63) versus 27.26 (±4.93), and 34.66 (±6.84) for NS, and phosphatidylcholine, respectively. For 5× lipase, the count was 36.06 (±4.74) versus 24.13 (±5.18), and 33.2 (±9.34). For 10× lipase, it was 40.06 (±4.35) versus 29.26 (±2.34) and 32.66 (±6.30) (p < .05 for all groups). CONCLUSIONS: A higher number of cells per field were observed in the lipase samples, inferring a decreased volume of adipocytes. No inflammation and/or loss of cell architecture were evidenced in the exogenous lipase groups.
Subject(s)
Adipose Tissue , Lipase , Swine , Animals , Lipase/pharmacology , Adipose Tissue/pathology , Subcutaneous Fat , Phosphatidylcholines/pharmacology , Models, AnimalABSTRACT
INTRODUCTION: Biliary pathology is a common disorder during pregnancy and its complications can put the pregnancy at risk. MATERIAL AND METHODS: A retrospective study of laparoscopic cholecystectomies in pregnant women was carried out during the period from January 2017 to April 2020 at Hospital Universitario "Dr. José Eleuterio González". RESULTS: A total of 46 cases were obtained, only 3 patients had product loss, 1 immediately after surgery, second at 8 weeks' gestation, and the third due to complications of gestational hypertension. CONCLUSION: Pancreatic-biliary cases during pregnancy are high risk for gestation, so it is preferable to perform laparoscopic cholecystectomy in selected cases were arising complications.
INTRODUCCIÓN: La patología biliar es un trastorno muy común durante el embarazo y sus complicaciones pueden poner en riesgo el embarazo. MATERIAL Y MÉTODOS: Se realizó un estudio retrospectivo de las colecistectomías laparoscópicas en embarazadas durante el período de enero del 2017 a abril del 2020 en el Hospital Universitario "Dr. José Eleuterio González". RESULTADOS: Se obtuvieron 46 casos en total, de los cuales solo 3 pacientes se obtuvo pérdida del producto, 1 inmediatamente posterior a la cirugía, la segunda a las 8 semanas de gestación y la tercera por complicaciones de la hipertensión gestacional. CONCLUSIONES: Los cuadros pancreato-biliares en el embarazo son de alto riesgo para la gestación, por lo que es preferible realizar colecistectomía laparoscópica en cuadros seleccionados en vías de complicación.
Subject(s)
Cholecystectomy, Laparoscopic , Pregnancy Complications , Female , Gestational Age , Humans , Pregnancy , Pregnancy Complications/epidemiology , Pregnancy Complications/surgery , Retrospective StudiesABSTRACT
Neimeier, in 1934, proposed a classification for gallbladder perforation. The first type is fistulation between the gallbladder and adjacent viscerae. The second type is a subacute perforation surrounded by an abscess walled off by adhesions from the general peritoneal cavity; and the third type is a peritonitis due to free biliary spillage into the peritoneal cavity without protective adhesions. We will analyze a Neimeier's type 1 perforation. The patient is a 72-year-old male diagnosed with a cholecystolithiasis and empyema due to a cholecystopleural fistula. Was operated by laparoscopic surgery because its low rate of complications, and lower days at hospital staying. Everything went as planned with no complications. Even though it is not a common presentation, it sets a precedent for it to be furthermore researched, and for it to be used as a literary option in a discussion to know which type of surgery is better for these cases.
ABSTRACT
Resumen Objetivo: Evaluar la seguridad de la colecistectomía laparoscópica durante el embarazo, reportando complicaciones y desenlaces obstétricos y perinatales en nuestra institución. Materiales y Método: Estudio retrospectivo, observacional. Se incluyeron pacientes embarazadas, con diagnóstico de patología biliar sometidas a colecistectomía laparoscópica. Se describieron variables sociodemográficas, obstétricas, complicaciones o muerte posoperatoria. Resultados: Se realizaron 46 colecistectomías laparoscópicas, edad media de 25 años; 82,6% cursaban el segundo trimestre de embarazo; mostrando tasa de complicaciones de 4,4% directamente relacionadas con el procedimiento sin mortalidad materna. Discusión: Se asocia a la cirugía biliar a una tasa elevada de complicaciones durante el embarazo, sin embargo, existe mayor evidencia que apoya la idea de la intervención temprana en enfermedad biliar sintomática, con un mayor riesgo de muerte fetal bajo manejo conservador que bajo un abordaje quirúrgico, así como mayor tasa de recurrencia. Se ha demostrado que la cirugía no aumenta el riesgo de mortalidad para la madre y el feto y su retraso puede resultar en un incremento de morbilidad a corto y largo plazo. Conclusiones: Observamos una baja tasa de complicaciones asociadas al procedimiento quirúrgico, así como una nula mortalidad materna.
Aim: To evaluate the safety of laparoscopic cholecystectomy during pregnancy, reporting complications and obstetric and perinatal outcomes in our institution. Materials and Method: Retrospective, observational study. Pregnant patients with a diagnosis of biliary pathology undergoing laparoscopic cholecystectomy were included. Sociodemographic, obstetric variables, complications or postoperative death were described. Results: 46 laparoscopic cholecystectomies were performed, mean age 25 years; 82.6% were in the second trimester of pregnancy; showing a complication rate of 4.4% directly related to the procedure with zero maternal mortality. Discussion: Biliary surgery is associated with a high rate of complications during pregnancy, however, there is more evidence supporting the idea of early intervention in symptomatic biliary disease, with a higher risk of fetal death under conservative management than under a laparoscopic approach, 14 as well as a higher recurrence ratecd. Surgery has been shown not to increase the risk of mortality for the mother and the fetus and its delay may result in an increase in morbidity in the short and long term. Conclusión: We observed a low rate of complications associated with the surgical procedure, as well as no maternal mortality.
Subject(s)
Humans , Female , Pregnancy Complications/surgery , Pregnancy Outcome , Cholecystectomy, Laparoscopic/adverse effects , Pregnancy Trimester, Second , Pregnancy Trimester, Third , Pregnancy Trimester, First , Retrospective Studies , Cholecystectomy, Laparoscopic/methodsABSTRACT
Antecedentes: La hernia de Morgagni (HM) es una anomalía rara que constituye el 2-5% de las todas las hernias diafragmáticas, siendo rara su evolución hasta la edad adulta. Caso clínico: Paciente masculino de 34 años que padece durante 3 años cuadros de mareos, diaforesis y disnea de leve a intermitente. En examen físico se ausculta hemitórax derecho hipoventilado. Se le realiza telerradiografía de tórax y tomografía axial computada (TAC), realizando diagnóstico de HM. Se repara quirúrgicamente mediante abordaje laparoscópico exitoso. Discusión: La HM corresponde a un defecto congénito de la cara anteromedial del diafragma, cuya presentación es infrecuente en el adulto. Comprende menos del 5% de las hernias diafragmáticas congénitas. Conclusión: Este reporte de caso confirma el concepto de la literatura sobre las ventajas conocidas del tratamiento laparoscópico de esta rara patología.
Background: Morgagni hernia (MH) is a rare anomaly that constitutes 2-5% of all diaphragmatic hernias, the evolution until adult life is rare. Clinical case: 34 year old patient who referred 3 years with mild effort dyspnea. During physical exploration right hemithorax was found with hypoventilated. Chest x-ray showed right diaphragmatic herniation. Computer tomography (CT) diagnosed Morgagni herniation. The patient was programmed for laparoscopic repair with double layer mesh and it was fixated with tackers. Discussion: Morgagni herniation corresponds to a genetical defect in the anteromedial diaphragm, this presentation is rare in adults. It represents 5% of congenital hernias. Conclusion: Laparoscopic repair takes much less time to operate, faster recovery time and less postsurgical pain with short hospital stay.