Tumor miofibroblástico inflamatorio (pseudotumor inflamatorio) ocasionando abdomen agudo / Inflammatory myofibroblastic tumor as a cause of acute abdomen

Background: Inflammatory myofibroblastic tumor (IMT) is a rare disease, usually benign, although with possible progression to malignancy. The clinical features depend on its location. If the resection is completed, surgery is curative, but recurrence is possible. The diagnosis is always histopathological. Case report: We report a 20 years old female admitted for a progressive abdominal pain lasting 24 hours. The patient was subjected to an appendectomy but in the postoperative period she continued with nausea and vomiting. The patient was operated again, finding a small bowel tumor with multiple adhesions, occluding the intestinal lumen and a Meckel diverticulum. The pathological study of the tumor reported the presence of an inflammatory myofibroblastic tumor. The patient had an uneventful postoperative outcome.

Introducción: El tumor miofibroblástico inflamatorio (TMI) es una enfermedad poco frecuente, en general benigna, aunque con posible evolución a malignidad. Las características clínicas dependen del lugar en el que esté ubicado. La cirugía es curativa siempre y cuando la resección sea total; aunque no se excluye la posibilidad de recidivas. El diagnóstico siempre es histopatológico. Dadas sus características clínicas y sitios de presentación se ha denominado de distintas formas e incluso sigue siendo motivo de estudio a fin de entender completamente su fisiopatología. Caso clínico: Presentamos un caso de esta rara entidad con un cuadro clínico de un abdomen agudo.

Cistadenoma mucinoso del apéndice cecal como causa de gangrena intestinal / Appendiceal mucocele causing large bowel gangrene

Introduction: Appendiceal mucocele are lesions located in the cecum, which are found in 0.2 to 0.3 percent of appendectomies and correspond to 8-10 percent of all appendiceal tumors. Clinical case: We report a 83 years old female consulting for abdominal pain lasting 24 hours. On physical examination, signs of peritoneal irritation were found. The patient was operated, finding an appendiceal tumor that was coiled up in the mesentery with large bowel gangrene. An intestinal resection, terminal ileostomy, appendectomy and surgical lavage were performed. The pathological study of the surgical piece reported a mucinous cystadenoma.

Introducción: Los tumores del Apéndice Cecal corresponden al 0,5 por ciento de las neoplasias gastrointestinales y se encuentran entre el 0,8 por ciento y el 1 por ciento de las apendicectomías. El término Mucocele Apendicular (AM), se refiere a un grupo de lesiones localizados a nivel del ciego cuyo rango de incidencia está entre el 0,2 por ciento y el 0,3 por ciento de todas las apendicectomías, y entre el 8-10 por ciento de todos los tumores apendiculares. Las presentaciones clínicas más frecuentes son: cuadro clínico de apendicitis aguda, como hallazgo incidental como en el caso de esta paciente, o como masa abdominal en fosa ilíaca derecha. Caso clínico: Se presenta un caso de Cistade-noma Mucinoso Apendicular (CAM) encontrado como hallazgo incidental en un abdomen agudo quirúrgico con la particularidad de presentarse con una necrosis intestinal.

Pielonefritis, colecistitis y cistitis enfisematosas en paciente con diabetes mellitus descompensada / Pyelonephritis, cholecystitis, and emphysematous cystitis in a diabetic patient

Background. Emphysematous pyelonephritis is a necrotizing infection characterized by gas production that usually is located in the kidney tissue, urinary tract and retroperitoneal tissue. Gas can escape following the renal veins and accumulate in the hepatic veins and other places. E coli is the most common causative organism. Clinical case: We report a 62 years old diabetic female, admitted to the hospital with a diabetic ketoacidosis. An abdominal CT scan disclosed a left emphysematous pyelonephritis, cholecystitis and cystitis. The patient was operated, performing a left nephrectomy, cholecystectomy and placement of sub hepatic and retroperitoneal drainages. The pathological study of the surgical piece showed an acute pyelonephritis with abscess formation and chronic cholecystitis. The patient died due to a multi systemic failure.

Introducción: La Pielonefritis enfisematosa es una infección necrotizante caracterizada por la producción de gas, que habitualmente se ubica en el parénquima renal, las vías urinarias y los tejidos retroperi-toneales. Cuando el gas es abundante puede escapar siguiendo las venas renales y acumularse en las venas hepáticas, y el resto del sistema. La E. coli es el patógeno más frecuente. Caso clínico: Presentamos el caso de paciente femenina de 62 años, diabética que ingresa con sintomatología de vías urinarias diagnosticada como pielonefritis enfisematosa izquierda por tomografía y encontrando como hallazgos adicionales.

In vitro evaluation of the amebicidal activity of Buddleia cordata (Loganiaceae, H.B.K.) on several strains of Acanthamoeba.

Infectious diseases produced by free-living amoebae from the genus Acanthamoeba have been recently recognized. The need for antiamebic compounds is urgent as the occurrence of these diseases is being registered more frequently since the late sixties. We screened the aqueous and methanolic extract of a plant used by folk medicine (Buddleia cordata) against eye and skin inflammation for antiamebic activity. We tested the extracts on 29 strains of free-living amoebae, with the result that they were amebostatic for 14 and 15 strains, respectively. We obtained linarin and vanillic acid from the extracts, but only linarin was amebostatic to all the strains and vanillic acid had no activity. However, acetyl vanillic acid had similar effects on amoebae to linarin. Threshold values of these two active compounds ranged from 31.25 microg/ml to 4 mg/ml and from 31.25 microg/ml to 8 mg/ml for linarin and acetyl vanillic acid, respectively. These differences in threshold values were observed even on several strains belonging to the same species (as in the case of A. castellanii and A. polyphaga) indicating the need of susceptibility testing for each clinical isolate of free-living amoebae.

Prevalence of pathogenic Acanthamoeba (Protozoa:Amoebidae) in the atmosphere of the city of San Luis Potosi, Mexico.

Several species of pathogenic Acanthamoeba cause infections to humans, but amoebic keratitis is more frequently found than any other due to the increasing number of contact lens wearers in the world. Cysts and trophozoites of these amebas are airborne and may pollute water from the air. We investigated the proportion of pathogenic Acanthamoeba from the atmosphere of the city of San Luis Potosi. Samples were taken by the impinger method, every month during one year. We isolated 23 strains of Acanthamoeba, 61% of them were non-pathogenic, 31% were non-pathogenic with invasive capacity and 8% were pathogenic to mice. Almost 40% of these strains represent danger of infections to humans. The isolations were more abundant during the dry season in the south (urban) and west (suburban) stations, which means that the sanitary conditions around stands may enhance the proportion of pathogenic strains in the surroundings.

Amoebological study of the atmosphere of San Luis Potosi, SLP, Mexico.

A one year round survey was conducted for isolation of free living amoebae (FLA) in the city of San Luis Potosi, (SLP), Mexico, which is placed in a desert environment. Samples were taken by modified impinger method and cultivated in laboratory conditions for FLA isolation following a week period of rehidration. 57 strains were isolated, 39% belonged to Acanthamoeba genus (which is important because it bears opportunistic pathogens that produce amoebic keratitis and granulomatous amoebic encephalitis in humans), 16% to Hartmannella, 9% to Vahlkampfia and the other proportion was divided among 6 other genera. The isolations were more abundant during dry season and the main genera were present in all four stands. The difference among them was the species variety which is discused as connected with abundance of organic wastes and lack of urbanization near the stations.