Endometriosis de pared abdominal / Abdominal Wall Endometriosis

Introducción: La endometriosis es una patología caracterizada por la presencia de tejido endometrial fuera de la cavidad uterina. La localización en la pared abdominal es una de las formas poco frecuentes. Objetivo: Determinar las características diagnósticas de esta entidad. Métodos: Análisis retrospectivo de 11 casos de pacientes a quienes se les realizó una ecografía de pared abdominal entre marzo de 2007 y enero de 2014, por dolor en la región y correlación histopatológica posquirúrgica. Resultados: La edad promedio de las pacientes fue 29 años. Todas presentaban dolor abdominal y antecedentes de cirugías pelvianas. Ecográficamente mostraban una formación en la pared abdominal, menor a 25 mm, generalmente hipoecoica, sólida o mixta, bien delimitada, ubicada en un caso en topografía de la cicatriz de laparoscopia y en los restantes en los músculos rectos anteriores. Conclusiones: En una paciente con dolor abdominal y antecedente de cirugía pelviana, que ecográficamente presente una masa sólida o mixta bien delimitada en la pared abdominal, deberá considerarse el diagnóstico de endometrioma.

Introduction: Endometriosis is a condition characterized by the presence of endometrial tissue outside the uterine cavity. The location at the abdominal wall is an unusual form of presentation. Objective: To determine the ultrasound characteristics of abdominal wall endometriosis. Methods: Retrospective analysis of 11 patients who were scanned by an abdominal wall ultrasound due to abdominal pain between March 2007 and January 2014. Ultrasound findings were correlated with postoperative pathologic diagnoses. Results: The average age of the patients was 29 years. All of them suffered from abdominal pain and had a history of pelvic surgery. Ultrasound showed a mass at the abdominal which was less than 25mm, usually hypoechoic, solid, or mixed, well-circumscribed, located at the laparoscopy scar in one case and in the rectus muscle in the remaining ones. Conclusions: A diagnosis of endometrioma should be considered in female patients with abdominal pain and a history of pelvic surgery, if the ultrasound reveals a well delimitated solid or mixed mass in the abdominal wall.

[The outstanding achievements of Adolf Kussmaul]. / Adolf Kussmaul (1822-1902), su biografía y descripciones.

BACKGROUND: Adolf Kussmaul was born in Graben, close to Karlsruhe, Germany, on February 22,1822. He graduated at Heidelberg University in 1845 and he received his medical degree in 1855. He made original descriptions, such as the ophthalmoscope, the gastroscope or endoscope, and Kussmaul signs, besides the respiration named after him. He was the first to perform a thoracocenteses, peritoneal and gastric lavages. He rediscovered progressive bulbar paralysis (previously described by Guillaume Duchenne in 1861), polyarteritis nodosa (which was described by Karl von Rokitansky en 1852), dyslexia, (described by Thomas Willis in 1672) and pulsus paradoxus named after him, but that was reported by Richard Lower in 1669. During his 80 years of life, he wrote about different issues and topics (cardiology, rheumatology, endocrinology, gastroenterology, psychiatry, and neurology). Kussmaul was a student and professional without limits in his observation capacity. He preached with his own example in pursuit of science: observation, hypothesis, experimentation and analysis.

[William Osler (1849-1919): the man and his descriptions]. / William Osler: el hombre y sus descripciones.

BACKGROUND: William Osler was generally regarded as the greatest and most respected physician of his time. This paper describes Osler's life, his philosophy and views. He was an outstanding clinician who emphasized bedside teaching and observation. He possessed an extraordinary charm that inspired many others. As Professor of Medicine at four institutions in three countries, he was a great influence on medical education. He was a prolific writer, and his textbook became the most popular and widely read treatise on medicine in the world. He also was a medical historian, a classical scholar, and an avid bibliophile. He emphasized the value of hard work and ongoing education. His compassion and concern for patients and colleagues reflected his personality. We summarize Osler's descriptions, and some of his aphorisms. His wisdom is as relevant now, as it was in his time. Osler blended the art and science of Medicine perhaps better than anyone else, and remains a valuable role model for students and physicians more than ninety two years after his death.