Diagnóstico y tratamiento de las complicaciones biliares postrasplante hepático / No disponible

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Hemosuccus pancreaticus causado por un seudoaneurisma de la arteria esplénica / Haemosuccus pancreaticus caused by a splenic artery pseudoaneurysm

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Indicaciones infrecuentes de trasplante: síndrome de Budd-Chiari y enfermedad poliquística del hígado / No disponible

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Retroperitoneoscopy to extract dropped gallstones after laparoscopic cholecystectomy.

Complications resulting from gallstones left in the peritoneal cavity are most often reported after laparoscopic treatment of cholelitiasis. Gallstones are frequently dropped in the posterior subhepatic space, which can lead to the development of abscesses that usually require laparotomy for extraction of the stones. We present a novel technique for treating collections associated with dropped gallstones, using retroperitoneoscopy with two 10-mm ports after ultrasound localization of the abscess. We carried out this procedure in two patients and successfully extracted the gallstones without postoperative complications or recurrences. We consider this approach to be technically feasible, safe, and effective. It avoids the usual inefficacy of simple percutaneous drainage of these collections and the complications associated with the drainage of intra-abdominal abscesses by laparotomy.

Rotura traumática del diafragma / Traumatic diaphragmatic rupture

La rotura traumática del diafragma es una lesión infrecuente que ocurre como consecuencia de traumatismos cerrados y penetrantes del abdomen o del tórax. Su diagnóstico precoz continúa siendo un desafío y se asocia con una elevada morbimortalidad. El diagnóstico preoperatorio es difícil y sólo un alto nivel de sospecha, un examen minucioso de la radiografía simple de tórax y la intervención quirúrgica inmediata son determinantes para el éxito en el tratamiento de estos pacientes. Presentamos el caso de un paciente con rotura del hemidiafragma izquierdo, diagnosticado y tratado con éxito en las primeras horas, y se revisan los aspectos controvertidos del diagnóstico y tratamiento en la bibliografía (AU)

Traumatic diaphragmatic rupture is an infrequent lesion that can result from penetrating or blunt trauma to the abdomen or chest. Early diagnosis continues to be a challenge and this type of injury is associated with high morbidity and mortality. Preoperative diagnosis is difficult and a high level of suspicion, careful scrutiny of the chest x-ray, and early surgical treatment are required for successful management. We present a case of rupture of the left hemidiaphragm that was diagnosed and treated successfully within the first few hours. We also review the literature on controversial issues in the diagnosis and treatment of this injury (AU)

[Traumatic diaphragmatic rupture]. / Rotura traumática del diafragma.

Traumatic diaphragmatic rupture is an infrequent lesion that can result from penetrating or blunt trauma to the abdomen or chest. Early diagnosis continues to be a challenge and this type of injury is associated with high morbidity and mortality. Preoperative diagnosis is difficult and a high level of suspicion, careful scrutiny of the chest x-ray, and early surgical treatment are required for successful management. We present a case of rupture of the left hemidiaphragm that was diagnosed and treated successfully within the first few hours. We also review the literature on controversial issues in the diagnosis and treatment of this injury.

Effect of pretreatment with interleukin-1 beta on inflammatory infiltrates and tissue damage after experimental endotoxic challenge.

OBJECTIVE: To evaluate the effect of treatment with murine recombinant interleukin-1 beta on inflammatory infiltrate and tissue damage after experimental endotoxic challenge. DESIGN: Randomized, controlled study. SETTING: Experimental Unit, Virgen de las Nieves University Hospital. SUBJECTS: Seventy-two female CBA/H mice, 20-21 g, supplied by the animal center of the Experimental Unit. INTERVENTION: The mice were randomized into three groups of 24. Group 1 (sham) received two intraperitoneal doses of 0.1 mL of phosphate-buffered saline; group 2 (lipopolysaccharide) was injected with 125 mg/kg lipopolysaccharide (Escherichia coli, intraperitoneally) 24 hrs after 0.1 mL of phosphate-buffered saline; group 3 was pretreated with 80 ng of recombinant interleukin-1 beta per mouse (intraperitoneally) 24 hrs before the endotoxic challenge. MEASUREMENTS AND MAIN RESULTS: At 1, 2, 4, and 24 hrs after the endotoxic challenge, we studied inflammatory infiltrate and tissue damage in lung, liver, and intestine by determining myeloperoxidase and malondialdehyde tissue concentrations. When we compared the pretreated group with the lipopolysaccharide group, myeloperoxidase concentrations decreased significantly in lung (p <.001) and liver (p <.001) at all study times, and in intestine (p <.001) at 2, 4, and 24 hrs; malondialdehyde concentrations significantly decreased in lung at 1 (p <.05), 2 (p <.01), and 24 (p <.001) hrs, in liver at 2 (p <.001), 4 (p <.01), and 24 (p <.001) hrs, and in intestine at 1 (p <.001), 2, 4 (p <.05), and 24 (p <.001) hrs. CONCLUSION: Pretreatment with recombinant interleukin-1 beta significantly reduces inflammatory infiltrate and tissue damage in mouse lung, liver, and intestine after an experimental endotoxic challenge.