Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Neumopericardio/complicaciones , Neumopericardio/diagnóstico , Neumatosis Cistoide Intestinal/complicaciones , Neumatosis Cistoide Intestinal/diagnóstico , Neumoperitoneo/complicaciones , Neumoperitoneo/diagnóstico , Radiografía Torácica/métodos , Metronidazol/uso terapéutico , Neumatosis Cistoide Intestinal/fisiopatología , Neumatosis Cistoide Intestinal , Electrocardiografía , Dolor Abdominal/etiologíaRESUMEN
La poliquistosis renal dominante del adulto, aunque es la enfermedad hereditaria más frecuente en la población española, presenta una prevalencia muy baja. Los síntomas iniciales son generalmente inespecíficos y difíciles de detectar por el médico. El método de elección para el diagnóstico de la enfermedad, cuando esta es asintomática, es la ecografía. Presentamos un caso clínico poco frecuente, en el cual el diagnóstico de poliquistosis renal complicada se realiza de forma incidental durante el estudio de un cuadro que simulaba una colecistitis aguda. Queremos resaltar la importancia que tienen una anamnesis detallada y metodológica en el diagnóstico precoz de esta enfermedad (AU)
Adult polycystic kidney disease, although it is the most common hereditary disease in the Spanish population, has very low prevalence. Initial symptoms are usually nonspecific and difficult to detect by the physician. The ultrasonography is the method of choice for diagnosing when the disease is asymptomatic. We report a rare clinical case in which complicated polycystic kidney disease was diagnosed by chance during the study of a simulated acute cholecystitis. We emphasize the importance of making a detailed and methodological medical history for the early diagnosis of this disease (AU)
Asunto(s)
Humanos , Masculino , Adulto , Colecistitis Aguda/complicaciones , Colecistitis Aguda/diagnóstico , Colecistitis Aguda/terapia , Anamnesis/métodos , Enfermedades Renales Poliquísticas/complicaciones , Enfermedades Renales Poliquísticas/diagnóstico , Colecistitis Aguda/fisiopatología , Colecistitis Aguda , Diagnóstico Precoz , Enfermedades Renales Poliquísticas/fisiopatología , Enfermedades Renales Poliquísticas/terapia , Riñón Poliquístico Autosómico Dominante/complicacionesRESUMEN
Marjolin's ulcer is the malignant transformation of a scar, usually as a squamous cell carcinoma. An uncommon presentation form is from a laparostomy scar. A 49-year-old patient that had a laparostomy during the treatment of a necrohemorrhagic pancreatitis in 1987 complained 13 years later of a 20-cm ulcer on the laparostomy scar. A resection of the abdominal wall including the ulcer and a segmental transverse colectomy were performed because of infiltration by an invasive squamous cell carcinoma. Ten months later, axillary lymphadenectomy was performed because of lymph node metastasis. Currently, the patient is free of disease. Lymph node infiltration is frequent in squamous cell carcinoma on Marjolin's ulcer and survival is not good. Prophylaxis of this disease includes meticulous care of wounds, with early skin grafts when required and treatment of infections.