RESUMEN
One-anastomosis gastric bypass has now become the third most commonly performed bariatric technique worldwide. However, as a consequence of the configuration of this surgery, it can present some chronic complications (anastomotic mouth ulcers and biliary reflux) that physicians must come to better understand and assess. In this narrative review, we aimed to update our knowledge of both the diagnosis and treatment of these two complications in the context of bariatric surgeries. We concluded that a series of pre-, intra-, and postoperative preventive strategies should be considered by surgeons to help reduce the appearance of these complications.
Asunto(s)
Cirugía Bariátrica , Reflujo Biliar , Derivación Gástrica , Úlcera Péptica , Cirujanos , Humanos , Derivación Gástrica/efectos adversos , Derivación Gástrica/métodos , Reflujo Biliar/etiología , Úlcera Péptica/cirugía , Úlcera Péptica/complicaciones , Cirugía Bariátrica/efectos adversosRESUMEN
BACKGROUND: Angiomyolipoma is a benign mesenchymal neoplasm of a wide histological heterogeneity belonging to the PEComa "family." The liver, after the kidney, is their second most frequent location. However, inflammatory hepatic AMLs constitute a rare entity, with only fourteen documented cases until 2020. These neoplasms can overlap morphological features of IgG4-related diseases, being of great diagnostic relevance to demonstrating myomelanocytic-lineage differentiation of the neoplastic cells. CASE PRESENTATION: we present a new case of an inflammatory hepatic AML resembling an IgG4-related disease in a 35-year-old woman with a subcapsular 5 cm mass confined to segment VII of the right hepatic lobe. Although having reduced its size along the tumor's natural evolution, complete tumor resection was decided due to its hypermetabolic behavior (max. SUV = 12,6) assessed by PET-CT scan. Finally, the patient underwent a right hepatectomy due to spontaneous rupture and bleeding of the lesion during the intervention. All the diagnostic and therapeutic procedures occurred in the last months of the COVID-19 pandemic. CONCLUSIONS: This review aims to describe inflammatory hepatic AML histological and immunohistochemical features. We further sought to establish a clinicopathological contextualization of this tumoral subtype.
Asunto(s)
Angiomiolipoma , COVID-19 , Neoplasias Gastrointestinales , Neoplasias Hepáticas , Femenino , Humanos , Adulto , Angiomiolipoma/diagnóstico , Angiomiolipoma/cirugía , Angiomiolipoma/patología , Neoplasias Hepáticas/patología , Tomografía Computarizada por Tomografía de Emisión de Positrones , Pandemias , Prueba de COVID-19RESUMEN
Portal pneumatosis has been considered an ominous sign associated with intestinal ischemia, with a mortality rate of up to 90% as long as it is associated with sepsis. However, the prognosis of mesenteric ischemia depends on the etiology rather than the presence of portal pneumatosis. We present a patient with portal pneumatosis that disappeared 24 hours after the first surgery, but irreversible ischemic lesions were established in the terminal ileum. It should be noted that the excretion of the intravenous contrast is mainly through the kidneys, and it can be eliminated through alternative routes such as the bile duct or the mucosa of the small intestine (vicariant excretion), especially in patients with renal pathology.
Asunto(s)
Isquemia Mesentérica , Neumatosis Cistoide Intestinal , Humanos , Isquemia Mesentérica/diagnóstico por imagen , Isquemia Mesentérica/complicaciones , Vena Porta , Isquemia/etiología , Isquemia/complicaciones , Intestino Delgado , Íleon , Neumatosis Cistoide Intestinal/complicacionesRESUMEN
Pulmonary Tuberculosis (TB) has increased in Spain in recent years due to multiple factors. Peritoneal tuberculosis represents the sixth cause of extrapulmonary tuberculosis, accounting for 11% of tuberculosis cases. We report a 28-year-old male from Mali, who arrived at our hospital with an acute abdomen due to intestinal perforation with a computed tomography scan (CT) performed peritoneal tuberculosis mimicking primary carcinomatosis. This presents a diagnostic and therapeutic challenge, since the surgical approach differs in both cases, and the prognosis is very different between them.
Asunto(s)
Neoplasias Peritoneales , Peritonitis Tuberculosa , Tuberculosis , Masculino , Humanos , Adulto , Neoplasias Peritoneales/diagnóstico por imagen , Peritonitis Tuberculosa/diagnóstico por imagen , Colon , Tomografía Computarizada por Rayos XRESUMEN
We present the exceptional case of a 76-year-old woman with an incidental finding of a liver tumor compatible with an epithelioid angiomyolipoma, a rare neoformation about which there is still controversy regarding its management, due to its presumed potential for malignancy.
Asunto(s)
Angiomiolipoma , Neoplasias Renales , Neoplasias Hepáticas , Femenino , Humanos , Anciano , Angiomiolipoma/diagnóstico , Neoplasias Renales/patología , Neoplasias Hepáticas/diagnóstico por imagen , Neoplasias Hepáticas/patología , Tomografía Computarizada por Rayos XRESUMEN
We report the exceptional case of a 71-year-old patient with a giant mesenteric mass causing mass effect, dyspnea and abdominal pain. After surgical resection and histopathological analysis of the specimen, the result was a cavernous lymphangioma, an unusual diagnosis due to both the location and age of presentation.
Asunto(s)
Linfangioma , Mesenterio , Dolor Abdominal/etiología , Adulto , Anciano , Humanos , Linfangioma/diagnóstico por imagen , Linfangioma/cirugía , Mesenterio/diagnóstico por imagen , Mesenterio/patologíaRESUMEN
A 39-year-old patient consulted for an incidental finding of a mesenteric-epiploic mass measuring 11x6x9.5 cm. Laparoscopic excision of the lesion and cholecystectomy were indicated, revealing a myolipomatous mesenchymal neoplasm in the hepatic round ligament.
Asunto(s)
Leiomioma , Lipoma , Ligamento Redondo del Útero , Adulto , Colecistectomía , Femenino , Humanos , Leiomioma/cirugía , Lipoma/cirugía , Hígado/diagnóstico por imagen , Hígado/cirugía , Ligamento Redondo del Útero/patología , Ligamento Redondo del Útero/cirugíaAsunto(s)
Derivación Gástrica , Reflujo Gastroesofágico , Gastropexia , Laparoscopía , Obesidad Mórbida , Derivación Gástrica/efectos adversos , Derivación Gástrica/métodos , Reflujo Gastroesofágico/etiología , Reflujo Gastroesofágico/cirugía , Humanos , Laparoscopía/métodos , Obesidad Mórbida/cirugíaRESUMEN
We have read with interest the article by Pérez Montiel CA et al., in which goblet cell adenocarcinoma (GCA) is described as a cause of acute appendicitis. Although the article is brilliant in terms of histopathological description of the appendiceal GCA, the surgical indication for right hemicolectomy should be analyzed in depth due to the great controversy that exists in the scientific literature.