Pseudohernia intercostal tras un traumatismo torácico cerrado / Intercostal pseudohernia following blunt chest trauma

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Tonsilolito gigante como causa de disnea, perforación esofágica y mediastinitis / Giant tonsillolith causing dyspnea, esophageal perforation, and mediastinitis

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[Spleen-preserving surgery after blunt abdominal trauma with splenic hilum involvement]. / Cirugía preservadora de órgano tras traumatismo esplénico cerrado con implicación hiliar.

BACKGROUND: Splenic involvement secondary to blunt abdominal trauma is often treated by performing a splenectomy. The severity of the post-splenectomy syndrome is currently well known (blood loss, sepsis), so there is an increasing tendency to preserve the spleen. The case is presented of splenic preservation after blunt abdominal trauma with hilum involvement, emphasising the role of Floseal as a haemostatic agent, as well as the use of resorbable meshes to preserve the spleen. CLINICAL CASE: A 22-year-old woman presenting with a grade IV splenic lesion secondary to a blunt abdominal trauma after a traffic accident. Partial splenic resection was performed and bleeding was controlled with Floseal and use of a reinforcing polyglycolic acid mesh. No postoperative complications occurred, being discharged on day 5. The long-term follow-up has been uneventful. CONCLUSION: The use of haemostatic agents such as thrombin and the gelatine gel (FloSeal) and the use of polyglycolic acid meshes enable spleen-preserving surgery, making it a feasible and reproducible procedure and an alternative to classical splenectomy.

Miopatía vacuolar del esfínter anal interno como causa infrecuente de proctalgia fugaz y estreñimiento / Vacuolar internal anal sphincter myophaty as a rare cause of proctalgia fugax and constipation

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Carcinoma neuroendocrino de vía biliar extrahepática / Neuroendocrine carcinoma of the common bile duct

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Abdomen agudo secundario a complicación de miomatosis uterina gigante / Acute abdomen secondary to complication of a giant uterine myoma

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