Surgical acute abdomen and COVID-19 vaccination.

In response to the publication "Acute appendicitis, foreign bodies and COVID-19 vaccination: correspondence", we reviewed the association between acute surgical abdomen and COVID-19 vaccination.

Uncommon causes of acute appendicitis: foreign bodies in the cecal appendix.

A 50-year-old woman with a history of hysterectomy for endometrial cancer in 2015 visited because of abdominal pain for 1 week and fever simultaneous with her third dose of the COVID-19 vaccine. Physical examination revealed a mobile mass in the right iliac fossa, and laboratory testing showed C-reactive protein at 3 mg/dL, with no further changes. Ultrasound results were consistent with an appendiceal inflammatory mass, and a CT scan revealed an appendicolith as likely cause. The patient was subjected to laparoscopy, which found inside the mass a metallic piece (dental prosthesis) that perforated the appendiceal lumen at the mid portion of the appendix. Appendectomy was completed and the patient was discharged on the third day post-procedure.

Disposition of Dietary Polyphenols in Breast Cancer Patients' Tumors, and Their Associated Anticancer Activity: The Particular Case of Curcumin.

SCOPE: Some polyphenol-derived metabolites reach human breast cancer (BC) tissues at concentrations that induce cell senescence. However, this is unknown for isoflavones, curcuminoids, and lignans. Here, their metabolic profiling in normal (NT) and malignant (MT) mammary tissues of newly-diagnosed BC patients and the tissue-occurring metabolites' anticancer activity are evaluated. METHODS AND RESULTS: Patients (n = 26) consumed 3 capsules/day (turmeric, red clover, and flaxseed extracts plus resveratrol; 296.4 mg phenolics/capsule) from biopsy-confirmed diagnosis to surgery (5 ± 2 days) or did not consume capsules (n = 13). NT and MT, blood, and urine are analyzed by UPLC-QTOF-MS using targeted metabolomics. Anticancer activity was tested in MCF-7 and MDA-MB-231 BC cells. Mainly phase-II metabolites were detected (108, 84, 49, and 47 in urine, plasma, NT, and MT, respectively). Total metabolite concentrations reached 10.7 ± 11.1 and 2.5 ± 2.4 µmol L-1 in NT and MT, respectively. Free curcumin, but not its glucuronide, was detected in the tissues (1.1 ± 1.8 and 0.2 ± 0.2 µmol L-1 in NT and MT, respectively). Breast tissue-occurring metabolites' antiproliferation was mainly exerted in p53-wild-type MCF-7 cells by curcuminoids through cell cycle arrest, senescence, and apoptosis induction via p53/p21 induction, while isoflavone-derived metabolites exerted estrogenic-like activity. CONCLUSION: Curcuminoids could be coadjuvants that might help fight BC upon regular consumption.

Mastitis granulomatosa: experiencia de 5años / Granulomatous mastitis: a 5-year experience

Introducción: La mastitis granulomatosa es una entidad benigna poco frecuente en la que no existe consenso sobre el tratamiento más adecuado. El objetivo fue analizar las características de esta enfermedad y su manejo en nuestra experiencia y compararlo con los antecedentes descritos en la literatura. Material y métodos: Se realizó un estudio descriptivo retrospectivo de los pacientes diagnosticados de mastitis granulomatosa en nuestro centro entre 2013 y 2018. Resultados: De las 4 mujeres con diagnóstico histológico de mastitis granulomatosa, ninguna presentaba historia de reciente embarazo, lactancia ni tratamiento anticonceptivo. Como factores de riesgo solo se identificó el hábito tabáquico en una paciente y un antecedente traumático en otra. La clínica de presentación más frecuente fue la de tumoración palpable unilateral. Como exploraciones complementarias se realizaron mamografía/tomosíntesis y ecografía en todos los casos y el diagnóstico se estableció tras el estudio histológico de una biopsia con aguja gruesa. Respecto al tratamiento, en 2 casos fue observacional y en otros 2 médico; hubo una sola complicación en forma de absceso mamario. Conclusiones: Para instaurar el diagnóstico definitivo de mastitis granulomatosa y descartar el cáncer de mama es necesario el estudio histológico, debido a la poca especificidad de otras pruebas

Introduction: Granulomatous mastitis is a rare breast disease. There is no consensus on the optimal treatment. The aim of this study was to analyse the characteristics of this disease and its management in our centre and to compare the findings with those reported in the literature. Material and methods: We conducted a descriptive retrospective study of patients with a diagnosis of granulomatous mastitis in our centre between 2013 and 2018. Results: None of the 4 women with a histological diagnosis of granulomatous mastitis had a recent history of pregnancy, lactation, or contraceptive treatment. One patient was a smoker and another had a history of trauma. The most common symptom was a unilateral palpable mass. Mammography/tomosynthesis and ultrasonography were performed in all patients and the definitive diagnosis was based on histological analysis after core needle biopsy. Two patients received no treatment (only observation) and the other 2 received medical treatment. There was only one complication (breast abscess). Conclusions: To establish a definitive diagnosis of granulomatous mastitis and to rule out breast cancer, histological study is necessary due to the low specificity of other tests

Manejo de las perforaciones duodenales tras colangiopancreatografía retrógrada endoscópica / Management of duodenal perforations after endoscopic retrograde cholangiopancreatography

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Management of duodenal perforations after endoscopic retrograde cholangiopancreatography.

OBJECTIVE: To describe our experience regarding post-endoscopic retrograde cholangio-pancreatography (ERCP) perforations and its conservative management. MATERIAL AND METHODS: Retrospective study of the therapeutic management of post-ERCP perforations occurred over the period 2012-2017 in our hospital. RESULTS: There were 12 perforations after ERCP, with choledocholithiasis being the main indication for the test (66.6%). In 9 cases (75%) an initial conservative attitude was attempted, but only 3 of them (25%) managed to solve the problem with broad-spectrum antibiotics, parenteral nutrition and close monitoring of the patient. DISCUSSION: Management of post-ERCP perforations must be individualized for each patient, depending on the clinical situation. Surgery remains the best option for the treatment of post-ERCP perforations, although conservative medical management is an option to be assessed, assuming that if it fails, delaying surgery is associated with high morbidity and mortality rates.

Metástasis cutánea esternal de colangiocarcinoma hiliar / Sternal cutaneous metastasis of hilar cholangiocarcinoma

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Angiosarcoma primario de mama. A propósito de un caso / Primary breast angiosarcoma. A case report

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Sternal cutaneous metastasis of hilar cholangiocarcinoma.

Subcutaneous metastasis is a rare initial manifestation of visceral tumors, and represent advanced stages with poor prognosis. We report the case of a female patient with a subcutaneous nodule over the sternum, which was ultimately found to be a metastasis of hilar cholangiocarcinoma. Only 20 cases of subcutaneous metastasis from Klatskin tumors have been reported - a rare occurrence with poor survival rates.

Carcinoma papilar intraquístico de mama en un varón joven. Presentación de un caso / Intracystic papillary carcinoma of the breast in a young man. Case report

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Esophageal perforation by a Sengstaken balloon.

Iatrogenic esophageal perforations are rare but associated with a high morbidity and mortality. Secondary to placing a Sengstaken ballon are even more extraordinary because of the infrequency which this measure is used to control upper gastrointestinal bleeding. Therefore, we think it is of interest to communicate this complication, to remember the need to check the correct placement of the Sengstaken ballon before insufflation, since it would help further decrease this complication.

Esophageal perforation by a Sengstaken balloon / Perforación esofágica por balón de Sengstaken

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[Laparoscopic cleavage in splenic symptomatic cyst]. / Escisión laparoscópica en quiste esplénico sintomático.

BACKGROUND: Splenic cysts are rare diseases that are diagnosed incidentally during imaging studies. When cysts are recognized, surgical treatment is recommended adapted to the particular case, depending on the size and location of the cyst and the age of the patient in order to avoid dangerous complications such as spleen rupture or cyst infection with abscess. CLINICAL CASE: We report 2patients with symptomatic splenic epidermoid cyst treated by laparoscopic cleavage. CONCLUSIONS: Laparoscopic cleavage is a surgical option for splenic cyst, with the goal of reducing postoperative complications while preserving splenic function.

Acute abdomen from duodenal diverticulitis. A case report.

Duodenal diverticula are a rare, usually asymptomatic clinical condition. When a complication arises clinical suspicion is key for the diagnosis. On occasion these patients receive a delayed diagnosis and undergo inadequate medical therapy. We report the case of a patient with evidence of duodenal diverticulitis in association with gallbladder inflammation by contiguity, as well as his diagnosis and management.

Abdomen agudo por diverticulitis duodenal. Caso clínico / Acute abdomen from duodenal diverticulitis. A case report

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Small bowel mesenchymal tumors: description of two unusual cases.

We present two cases of intestinal ileal GIST who developed complications of nonspecific signs and required to be operated urgently, providing unusual images of tumors because of its characteristics.

Management of non-surgical pneumoperitoneum.

Percutaneous endoscopic gastrostomy (PEG) is the best approach to feeding patients not eligible for oral nutrition who have a functioning digestive system. Pneumoperitoneum after PEG is a relatively common complication. As regards management, the most important decision is whether conservative therapy or an exploratory laparotomy should be indicated. We report the case of a patient with giant pneumoperitoneum following PEG, who was successfully managed with percutaneous air drainage.

Tumores mesenquimales de intestino delgado: descripción de dos casos inusuales / Small bowel mesenchymal tumors: description of two unusual cases

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