RESUMO
Cytomegalovirus infection is an uncommon illness that mainly affects immunocompromised subjects being associated with high morbidity and mortality rates. Reactivation or reinfection of the virus causes various symptoms ranging from asymptomatic forms to severe organ-specific complications, such as severe lower gastrointestinal bleeding. Once diagnosed the infection it is important and necessary to establish an adequate treatment with antivirals, with the surgical option for those cases with gastrointestinal complications depending on the patients clinical situation. We report two cases of immunocompromised patients that after presenting rectal bleeding, were diagnosed of cytomegalovirus colitis, requiring urgent surgery.
La infección por citomegalovirus es poco frecuente, afecta sobre todo a sujetos inmunocomprometidos y los pacientes de este grupo tienen una alta morbilidad y mortalidad. La clínica de la reactivación o reinfección del virus puede variar desde formas asintomáticas hasta complicaciones graves específicas de órgano, como la hemorragia del tracto gastrointestinal masiva. Es de vital importancia un tratamiento adecuado con antivirales; la opción quirúrgica se reserva para las complicaciones gastrointestinales de acuerdo con la situación clínica del paciente. Se presentan los casos de dos pacientes inmunocomprometidas que luego presentar episodios de rectorragia se diagnostican con colitis por citomegalovirus que exige tratamiento quirúrgico.
Assuntos
Colite/virologia , Infecções por Citomegalovirus/complicações , Hemorragia Gastrointestinal/etiologia , Doenças Retais/etiologia , Colite/complicações , Feminino , Humanos , Pessoa de Meia-Idade , Índice de Gravidade de DoençaRESUMO
This paper reports a case of Petersen's space hernia after mini gastric bypass. This is an anecdotal post-operative complication in the mini gastric bypass technique, with an estimated rate of 1/5000 cases. Similar cases described in the literature were treated by the surgical hernia reduction and the closure of the mesenteric defect. Our patient had a unique management, performing a conversion to Roux-en-Y gastric bypass with dissection of the biliopancreatic limb at the anastomosis and creation of a variable foot-point anastomosis with excellent mid-term post-operative results. This should provide better long-term results as compared to simple mesenteric closure, avoiding the complications of mini gastric bypass technique.
