Síndrome de Dumping con hipoglucemia grave tras funduplicatura de Nissen en el adulto. Caso clínico y revisión de la literatura / Dumping syndrome with severe hipoglycemia after Nissen fundoplication in adults. Case report and literature review

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Abdomen agudo como primera manifestación clínica de endometriosis / Acute abdomen as the first clinical manifestation of endometriosis

La endometriosis en una afección de patrón inflamatorio, con prevalencia en aumento, que puede afectar a cualquier mujer en edad fértil con un amplio abanico de presentaciones clínicas que van desde dismenorrea hasta un cuadro de obstrucción secundario a síndrome adherencial e incluso perforación intestinal. La endometriosis apendicular es una afección poco frecuente, siendo en múltiples ocasiones diagnosticada como apendicitis aguda, que se manifiesta como dolor abdominal recurrente, pudiendo ser la primera manifestación de esta enfermedad ginecológica y que debe ser tenida en cuenta a la hora de realizar el amplio diagnóstico diferencial de dolor abdominal (AU)

Endometriosis is an inflammatory disease that can affect any woman of childbearing age. The incidence of this disease is increasing. Clinical presentations vary widely, ranging from dysmenorrhea to obstructive symptoms, adhesions, and even bowel perforation. Appendiceal endometriosis is rare and is frequently diagnosed as acute appendicitis, which manifests as recurrent abdominal pain. Acute abdomen may be the first manifestation of this gynecological disorder and should be taken into account when making the broad differential diagnosis of abdominal pain (AU)

Tumor de gist ileal como causa de absceso hepatico / Ileal gastrointestinal stromal tumour (GIST) as a cause of a liver abscess

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Hemangioma cavernoso tímico / Cavernous Hemangioma of the Thymus

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Absceso hepático roto en portadora de dispositivo intrauterino / Rupture of a liver abscess in a patient with an intrauterine device

Introducción. Aunque el dispositivo intrauterino es seguro para la mayoría de las mujeres, se ha descrito su asociación con absceso hepático y puede producir sepsis grave. Caso clínico. Presentamos el caso de una paciente portadora de dispositivo intrauterino que acudió a urgencias con abdomen agudo segundario a absceso hepático roto. La paciente requirió laparotomía exploradora para drenaje quirúrgico. Conclusión. El dispositivo intrauterino debe ser considerado como etiología en mujeres con infección intraabdominal (AU)

Background. Although intrauterine device is safe for the most women, its association with liver abscess has been reported and can produce fatal sepsis. Clinical case. We report a case of a patient wearing intrauterine device who arrived at the emergency department with acute abdomen due to ruptured liver abscess. The patient underwent exploratory laparotomy for surgical drainage. Conclusion. Intrauterine device can be considered the etiology in a woman with intraabdominal infection (AU)

[Bezoar after ingestion of metallic foreign bodies]. / Bezoar por ingestión de cuerpos extraños metálicos.

BACKGROUND: Ingestion of foreign bodies represents a common feature in psychiatric patients and prisoners. Bezoar is a conglomeration of partially or undigested foreign material in the gastrointestinal tract. These are classified into several types according to the materials which they are composed of, the least frequent being metals. There are few cases reported in the literature. CLINICAL CASE: We report a case of a patient with a pathological history of mental disorder. The patient complained of abdominal pain 24 h prior, and there were no other symptoms. Physical examination revealed pain in the upper quadrant without peritoneal irritation. Laboratory tests were normal and plain x-ray of the abdomen showed several metallic foreign bodies, some sharp, >5 cm in length and with intestinal prolongation. Surgical intervention was performed several hours later: gastrotomy to remove the gastric bezoar that was composed of several screws, nails, scrap metal, lighters, clothespins, radio antennas and one coin. Four metallic foreign bodies were found in the small bowel after reviewing the abdominal cavity, so enterotomy was also performed to remove them. Postoperative course was uneventful. CONCLUSIONS: Surgical treatment must be considered in cases of multiple, large, sharp objects or complications. An exhaustive study of the case is essential to avoid delay in treatment and potential complications.