RESUMEN
El cáncer de la vesícula biliar es una enfermedad rara, con una incidencia mundial de 2 casos por cada 100 000 individuos con un pronóstico desfavorable. Con el aumento de colecistectomías por causas benignas, se ha incrementado la detección incidental de neoplasias vesiculares en las piezas quirúrgicas, siendo este el método diagnóstico más frecuente, generando retrasos en el manejo y requiriendo reintervenciones extensas. Debido a lo anterior, se resalta la importancia de un diagnóstico temprano preoperatorio, con el objetivo de ofrecer un tratamiento quirúrgico potencialmente curativo. Se presenta el caso de un paciente masculino de 72 años con un cuadro intermitente de dolor abdominal y pérdida de peso de un año de evolución, el cual fue diagnosticado con cáncer vesicular en etapa temprana y sometido a una colecistectomía laparoscópica extendida con linfadenectomía y hepatectomía parcial con una evolución a 6 meses sin complicaciones y bajo un protocolo de vigilancia periódica.
Gallbladder cancer is a rare disease, accounting a global incidence of 2 cases per 100 000 individuals with an unfavorable prognosis. The rise in cholecystectomies for benign causes has increased an incidental detection of vesicular neoplasms in the surgical specimens, being the main diagnostic method, therefore it generated delay in the management, requiring extensive re-interventions. It is important to improve early preoperative diagnosis, with the aim of offering a potentially curative surgical treatment. We present a case of a 72-year-old male with intermittent abdominal pain and weight loss of one year of evolution, who was diagnosed with early stage gallbladder cancer and underwent an extended laparoscopic cholecystectomy with lymphadenectomy and partial hepatectomy with a 6 months evolution without complications and under a periodic surveillance protocol.
RESUMEN
Acute appendicitis is the most common cause of acute abdominal pain in the pediatric population. The physiopathology is secondary to luminal obstruction of the appendix by several causes, among these, one of the rarest is due to parasitosis by Enterobius vermicularis in 0.005-3 %. We hereby present a case of a 10-year-old Latin male with abdominal pain with irradiation to right iliac fossa, nausea, vomiting and fever, following the national Mexican guides for ultrasound and blood tests were ordered, patient was treated with laparoscopic appendectomy with intraoperative finding of live helminths, which pathology examination revealed to be Enterovirus vermicularis. The patient has an uneventful postoperative course and was discharged after completing antiparasitic therapy. The lessons from this case are the importance of a good and quick diagnosis for acute abdomen in children, the possibility of a parasitic entity in the finding of eosinophilia with appendicitis and the good results with the correct surgical treatment.
