[Multiple colonic anastomoses in the surgical treatment of short bowel syndrome. A new technique]. / Anastomosis colónica múltiple en el tratamiento quirúrgico del intestino corto. Una nueva técnica.

BACKGROUND: Some surgical pathologies eventually require intestinal resection. This may lead to an extended procedure such as leaving 30 cm of proximal jejunum and left and sigmoid colon. One of the most important consequences of this type of resection is "intestinal failure" or short bowel syndrome. This complex syndrome leads to different metabolic and water and acid/base imbalances, as well as nutritional and immunological challenges along with the problem accompanying an abdomen subjected to many surgical procedures and high mortality. Many surgical techniques have been developed to improve quality of life of patients. METHODS: We designed a non-transplant surgical approach and performed the procedure on two patients with postoperative short bowel syndrome with <40 cm of proximal jejunum and left colon. RESULTS: There are a variety of non-transplant surgical procedures that, due to their complex technique or high mortality rate, have not resolved this important problem. However, the technique we present in this work can be performed by a large number of surgeons. The procedure has a low morbimortality rate and offers the opportunity for better control of metabolic and acid/base balance, intestinal transit and proper nutrition. CONCLUSIONS: We consider that this technique offers a new alternative for the complex management required by patients with short bowel syndrome and facilitates their long-term nutritional control.

Anastomosis colónica múltiple en el tratamiento quirúrgico del intestino corto: una nueva técnica / Multiple colonic anastomoses in the surgical treatment of short bowel syndrome: a new technique

BACKGROUND: Some surgical pathologies eventually require intestinal resection. This may lead to an extended procedure such as leaving 30 cm of proximal jejunum and left and sigmoid colon. One of the most important consequences of this type of resection is [quot ]intestinal failure[quot ] or short bowel syndrome. This complex syndrome leads to different metabolic and water and acid/base imbalances, as well as nutritional and immunological challenges along with the problem accompanying an abdomen subjected to many surgical procedures and high mortality. Many surgical techniques have been developed to improve quality of life of patients. METHODS: We designed a non-transplant surgical approach and performed the procedure on two patients with postoperative short bowel syndrome with <40 cm of proximal jejunum and left colon. RESULTS: There are a variety of non-transplant surgical procedures that, due to their complex technique or high mortality rate, have not resolved this important problem. However, the technique we present in this work can be performed by a large number of surgeons. The procedure has a low morbimortality rate and offers the opportunity for better control of metabolic and acid/base balance, intestinal transit and proper nutrition. CONCLUSIONS: We consider that this technique offers a new alternative for the complex management required by patients with short bowel syndrome and facilitates their long-term nutritional control.

Mucormicosis de la pared abdominal: informe de un caso / Abdominal wall infection due to Mucormycosis: case report

Zygomycosis are infections due to fungus from the Zygomycetes family, and one of them is Mucor. They are a rare opportunist species that may cause severe invasive and often fatal infections. This infection has a special predilection for diabetic patients, transplant patients and those undergoing intensive cancer therapies, as well as other patients with an immunocompromised condition. Rapid diagnosis and opportune and current treatment is the key for patient surveillance. The most frequent site of this infection is the upper respiratory tract due to spore transport by air, although there are other sites in which these organisms can produce infection such as soft tissue of the abdominal wall. In this study, we present an abdominal wall infection by Mucor and describe its medical and surgical treatment.

[Abdominal wall infection due to Mucormycosis. Case report]. / Mucormicosis de la pared abdominal. Informe de un caso.

Zygomycosis are infections due to fungus from the Zygomycetes family, and one of them is Mucor. They are a rare opportunist species that may cause severe invasive and often fatal infections. This infection has a special predilection for diabetic patients, transplant patients and those undergoing intensive cancer therapies, as well as other patients with an immunocompromised condition. Rapid diagnosis and opportune and current treatment is the key for patient surveillance. The most frequent site of this infection is the upper respiratory tract due to spore transport by air, although there are other sites in which these organisms can produce infection such as soft tissue of the abdominal wall. In this study, we present an abdominal wall infection by Mucor and describe its medical and surgical treatment.

[Use of vacuum-assisted closure in the treatment of surgical infection sites]. / Uso del sistema de cierre asistido al vacío VAC en el tratamiento de las heridas quirúrgicas infectadas. Experiencia clínica.

Surgical site infection is one of the most important health problems representing an increase in morbi-mortality and economical devastation for the patient. There have been a variety of procedures that surgeons have employed to control this situation, from very refined surgical procedures, advanced antimicrobial therapy to local therapy with alginates, hydrocolloid dressings and many others with active topical substances. One of the newest treatments is the VAC (Vacuum-Assisted Closure). This therapy has been proven to be useful in wound infection control and we used it to carry out this study in 38 patients with wound infections. We present the results with this therapy in our institution.

[Appendiceal stump appendicitis. Case report]. / Apendicitis del muñón apendicular. Informe de un caso.

Acute appendicitis is still the first cause of abdominal surgery worldwide, with 1.4 cases/1000 in the general population. As frequent as this is, appendiceal stump appendicitis is a very rare surgical event, due to an incomplete appendix resection and misleading cecum base identification due to cecum edema, abscesses, abnormal anatomy position of the appendix or multiple adhesions. The incidence of appendiceal stump appendicitis is not well known; however, there are some reports that suggest a slight increase in this pathology possibly due to laparoscopic surgical techniques. This report attempts to point out this diagnostic possibility to be considered by the surgeon when presented with a patient with acute abdominal pain and a past appendectomy.

[Intraabdominal hypertension and abdominal compartment syndrome in patients with acute pancreatitis]. / Hipertensión intraabdominal y síndrome compartamental abdominal en pacientes con pancreatitis aguda.

BACKGROUND: Intra-abdominal pressure rises in some circumstances and can cause abdominal compartment syndrome. Severe acute pancreatitis frequently causes abdominal compartment syndrome. OBJECTIVE: Our objective was to identify the relationship between severity of pancreatitis and abdominal pressure. MATERIAL AND METHODS: From September 2001 to September 2002, all patients with acute severe pancreatitis were included in the study; exclusion was effected with history of abdominal surgery for pancreatitis or ventral hernias. In all patients, we carried out laboratory tests to establish ranson criteria, Apache II score, and indirect measurement of abdominal pressure. Lineal regression and chi-square test were done. RESULTS: A total of 25 patients was included, 10 men and 15 women, average age 49.4 years, 11 with mild pancreatitis and 14 with severe acute pancreatitis. Abdominal pressure was 2 to 19 cm H2O. On statistic analysis, there was strong positive correlation between Apache II score and IAP and 0.781 of correlation coefficient and 99.5% confidence interval.