Successful outcome of combined surgical and negative pressure therapy in complex enterocutaneous fistulas: a case report.

An enterocutaneous fistula (ECF) is a complex medical issue that occurs when abnormal communication between the small intestine and the skin occurs. This can lead to the leakage of digestive contents, such as feces and food, onto the skin's surface. The case of an 86-year-old woman is presented, who developed high-output ECF after undergoing Hartmann surgery, intestinal transit reconstruction for perforated diverticulitis and incisional hernia treatment involving hernioplasty and polypropylene mesh. The patient had suffered from a serous-purulent discharge from a low-volume surgical wound for several years. Despite optimizing the patient's nutritional status, a laparotomy and small bowel resection were performed successfully. However, using vacuum dressing as a cover for the fistula in the lower gastrointestinal tract remains a subject of debate and limited research. No officially recognized international guidelines recommend its use for small bowel ECF.

Expressão do P16 e do PDGFR-Beta no adenocarcinoma gástrico / Expression of P16 and PDGFR-Beta in gastric adenocarcinoma

OBJETIVO: Detectar a expressão imunoistoquímica do p16 e do PDGFR-beta no adenocarcinoma gástrico. MÉTODOS: Foram estudados 36 pacientes submetidos a cirurgia para adenocarcinoma gástrico entre 1998 e 2002 no Hospital da Santa Casa de Porto Alegre. As variáveis investigadas foram: idade, sexo, tamanho e localização do tumor, número de linfonodos dissecados, número de linfonodos metastáticos, tipo histológico, extensão da ressecção cirúrgica e estadiamento patológico. RESULTADOS: Não foi detectada expressão do PDGFR-beta nas peças cirúrgicas. Em relação ao p16, detectou-se perda de expressão menor que 10 por cento e menor que 1 por cento respectivamente em 89 por cento e 79 por cento das peças estudadas. CONCLUSÃO: Não houve correlação entre a perda de p16 e as variáveis estudadas.

OBJECTIVES: To detect immunohistochemistry expression of p16 and PDGFR-beta on gastric adenocarcinoma. METHODS: Thirty six patients submitted to surgery for gastric adenocarcinoma between 1998 and 2002 at Santa Casa de Porto Alegre Hospital have been studied. Variables investigated were: age, gender, tumour size and localization, number of dissected and metastatic nodes, histological type, surgical resection extension and pathological staging. RESULTS: No expression of PDGFR-beta has been detected on surgical specimens. Concerning to p16, loss of expression lower than 10 percent and 1 percent has been detected respectively on 89 percent and 79 percent of the specimens studied. CONCLUSION: There has been no correlation among p16 loss and variables studied.

Expression of P16 and PDGFR-beta in gastric adenocarcinoma.

OBJECTIVES: To detect immunohistochemistry expression of p16 and PDGFR-beta on gastric adenocarcinoma. METHODS: Thirty six patients submitted to surgery for gastric adenocarcinoma between 1998 and 2002 at Santa Casa de Porto Alegre Hospital have been studied. Variables investigated were: age, gender, tumour size and localization, number of dissected and metastatic nodes, histological type, surgical resection extension and pathological staging. RESULTS: No expression of PDGFR-beta has been detected on surgical specimens. Concerning to p16, loss of expression lower than 10% and 1% has been detected respectively on 89% and 79% of the specimens studied. CONCLUSION: There has been no correlation among p16 loss and variables studied.

Síndrome de Mirizzi e fístula colecistobiliar / Mirizzi syndrome and cholecystobiliar fistula

A Síndrome de Mirizzi é uma entidade rara, definida como uma obstrução do ducto hepático comum, secundária à compressão externa causada por cálculos impactados no infundíbulo da vesícula biliar ou no ducto cístico. O objetivo deste trabalho é revisar os critérios diagnósticos, classificação e tratamentos propostos para essa síndrome