[Retrorectal cystic hamartoma (tailgut cyst): an uncommon cause of recurrent abdominal pain.] / Hamartoma quístico retrorrectal (tailgut cyst): una causa infrecuente de dolor abdominal recurrente.

Retrorectal cystic hamartomas are rare congenital lesions that arise from aberrant remnants of the postanal gut. Most of them appear as asymptomatic lesions in middle-aged women but they can manifest with nonspecific symptoms such as abdominal or pelvic pain, constipation or diarrhoea, genitourinary symptoms, etc. Due to their anatomical position and variable presentation these lesions are often misdiagnosed. Complications include infection and malignant transformation, which is the reason why surgical treatment is always indicated. We report a case of a woman with recurrent episodes of abdominal pain that lasted for many years and increased progressively, conditioning her daily life activities. Image studies showed a non-complicated retrorectal cystic hamartoma. Complete surgical excision was achieved and the patient remains asymptomatic nowadays. Key words. Retrorectal cystic hamartoma. Abdominal pain.

[Cystic tumors in the retrorectal space. Do these two cases have something in common?]. / Tumoraciones quísticas del espacio retrorrectal. ¿Tienen algo en común estos dos casos?

Cystic lesions in the retrorectal or presacral space present a broad differential diagnosis. Rare but typical lesions at this site are those related to embryonic development, which are the most frequent presacral congenital lesions in adults. Amongst these tumors, epidermoid cysts and cystic hamartomas are the most common lesions. Cystic masses, which are asymptomatic in approximately 50% of the cases at diagnosis, may show complications such as infection or malignant degeneration. Initial diagnosis is based on imaging techniques although definite lesion characterization, essential due to their malignancy risk, is given by the pathological analysis of the surgical piece.

Tumoraciones quísticas del espacio retrorrectal. ¿Tienen algo en común estos dos casos? / Cystic tumors in the retrorectal space. Do these two cases have something in common?

Las lesiones del espacio retrorrectal o presacro plantean un amplio diagnóstico diferencial. Una patologíatípica aunque rara de esta localización son las masas quísticas relacionadas con el desarrollo embrionario, que constituyen las lesiones congénitas presacras más frecuentes en el adulto. De éstas, los quistes epidérmicos y los hamartomas quísticos son las más comunes. Asintomáticas hasta en la mitad de los casos al diagnóstico, las masas quísticas pueden presentar complicaciones infecciosas e incluso degeneración maligna. El diagnóstico inicial se basa en las pruebas de imagen, aunque la caracterización definitiva, de gran importancia dado el riesgo de malignización, viene dada por la anatomía patológica de la pieza quirúrgica. Presentamos dos casos clínicos de lesiones quísticas retrorrectales diagnosticadas en nuestro centro (AU)

Cystic lesions in the retrorectal or presacral space present a broad differential diagnosis. Rare but typical lesions at this site are those related to embryonic development, which are the most frequent presacral congenital lesions in adults. Amongst these tumors, epidermoid cysts and cystic hamartomas are the most common lesions. Cystic masses, which are asymptomatic in approximately 50 % of the cases at diagnosis, may show complications such as infection or malignant degeneration. Initial diagnosis is based on imaging techniques although definite lesion characterization, essential due to their malignancy risk, is given by the pathological analysis of the surgical piece (AU)

Fractura abierta de apófisis cervical transversa producida por herida por asta de toro / Open fracture of a cervical transverse process as a result of a bull-horn wound

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Fibrosis retroperitoneal postraumática como causa de dolor lumbar / Post traumatic retroperitoneal fibrosis as a cause of low-back pain

We present the case of a male patient with posttraumatic retroperitoneal fibrosis whose main clinical expression was low-back pain. Diagnosis was establis hedusing CAT-scan and MRI, which revealed a largemass of soft tissue that almost entirely enveloped the abdominal aorta. Treatment with 40 mg of prednisone every 24 hours was established. This dose was reduced gradually, and progressive remission of clinical sign sand symptoms was achieved, with a significant improvement of subsequent imaging-test results. Treatment was continued for one year. Two and a half years later the patient remains symptom-free, with no recurrence of his condition (AU)

Se presenta el caso de un paciente varón afecto de una fibrosis retroperitoneal postraumática, a cuyo diagnóstico se llegó a partir de dolor lumbar como síntoma principal. El diagnóstico se efectuó en base a los estudios mediante CT y RM, los cuales demostraron una gran masa de tejido de partes blandas que rodeabanla aorta. El tratamiento consistió en dosis de prednisonaque inicialmente se instauró a 40 mg cada 24 horas, y posteriormente se fue reduciendo de forma gradual hasta la remisión de los signos y síntomas, y consecuentemente de los estudios de imagen. El tratamiento con corticoides se mantuvo durante un año. Dos años y medio el paciente está libre de síntomas sin recidivade su proceso (AU)

Post traumatic retroperitoneal fibrosis as a cause of low-back pain.

We present the case of a male patient with post traumatic retroperitoneal fibrosis whose main clinical expression was low-back pain. Diagnosis was established using CAT-scan and MRI, which revealed a large mass of soft tissue that almost entirely enveloped the abdominal aorta. Treatment with 40 mg of prednisone every 24 hours was established. This dose was reduced gradually, and progressive remission of clinical signs and symptoms was achieved, with a significant improvement of subsequent imaging-test results. Treatment was continued for one year. Two and a half years later the patient remains symptom-free, with no recurrence of his condition.

Tromboflebitis séptica de la vena porta (pileflebitis): diagnóstico y manejo a propósito de tres casos / Septic thrombophlebitis of the portal vein (pylephlebitis): diagnosis and management of three cases

Fundamento. La pileflebitis es la tromboflebitis séptica de la vena porta y/o de sus ramas, de manera aguda y generalmente como complicación de procesos inflamatorios intraabdominales o de intervenciones quirúrgicas en pacientes con discrasias sanguíneas. Siendo la clínica bastante inespecífica, los hallazgos radiológicos aunque no patognomónicos, son de gran utilidad para el diagnóstico precoz y un mejor pronóstico vital de estos pacientes. El objetivo de este trabajo es revisar la patogenia de esta entidad y sus modos de presentación clínica y radiológica, que permitan cierto grado de sospecha precoz. Casos clínicos. Se presentan tres casos de pileflebitis, dos de ellos postquirúrgicos, en los que los únicos datos clínicos comunes de sospecha fueron la febrícula y la leucocitosis. El diagnóstico se consiguió a partir de los hallazgos de la tomografía computarizada helicoidal con contraste i.v. _Somaton Siemens_ y de la ecografía abdominal _Ellegra Siemens_ realizados en los tres. El resultado de estas pruebas resultó decisivo para el diagnóstico precoz, el tratamiento eficaz y la evolución satisfactoria en los tres casos. Discusión. Queremos enfatizar la importancia de una sospecha clínica y radiológica precoz para el diagnóstico temprano de esta entidad, que permita la instauración de un tratamiento dirigido y eficaz

Background. Pylephlebitis is thrombophlebitis of the portal vein and/or of its branches; it is acute and generally arises as a complication of inflammatory intra-abdominal processes or of surgical interventions in patients with blood discrasies. As its clinical picture is fairly non-specific, radiological findings, while not pathognomonic, are of great use in early diagnosis and improved vital prognosis of these patients.The aims of this study are to review the pathophysiology of this entity and its clinical and radiological presentation, which allow for early clinical suspicion. Clinical cases. Three cases of pylephlebitis are presented, two of them post-surgical, in which the only common clinical data for suspicion were the febricula and leucocytosis. Diagnosis was obtained from the finding of helicoidal computer tomography with IV contrast – Somaton Siemens – and abdominal echography – Ellegra Siemens – carried out on the three. The result of these tests was decisive for an early diagnosis, efficient treatment and satisfactory evolution in the three cases.Discussion. We wish to emphasize the importance of clinical suspicion and early radiology for an early diagnosis of this entity, which make it possible to establish an efficient treatment

[Septic thrombophlebitis of the portal vein (pylephlebitis): diagnosis and management of three cases]. / Tromboflebitis séptica de la vena porta (pileflebitis): diagnóstico y manejo a propósito de tres casos.

BACKGROUND: Pylephlebitis is thrombophlebitis of the portal vein and/or of its branches; it is acute and generally arises as a complication of inflammatory intra-abdominal processes or of surgical interventions in patients with blood discrasies. As its clinical picture is fairly non-specific, radiological findings, while not pathognomonic, are of great use in early diagnosis and improved vital prognosis of these patients. The aims of this study are to review the pathophysiology of this entity and its clinical and radiological presentation, which allow for early clinical suspicion. CLINICAL CASES: Three cases of pylephlebitis are presented, two of them post-surgical, in which the only common clinical data for suspicion were the febricula and leucocytosis. Diagnosis was obtained from the finding of helicoidal computer tomography with IV contrast - Somaton Siemens - and abdominal echography - Ellegra Siemens - carried out on the three. The result of these tests was decisive for an early diagnosis, efficient treatment and satisfactory evolution in the three cases. DISCUSSION: We wish to emphasize the importance of clinical suspicion and early radiology for an early diagnosis of this entity, which make it possible to establish an efficient treatment.

[Retroperitoneal bronchogenic cyst mimicking adrenal gland tumor]. / Quiste broncogénico retroperitoneal simulando un tumor suprarrenal.

OBJECTIVE: To report a case of retroperitoneal bronchogenic cyst, an anomaly during the development of the primitive anterior intestine from which the bronchi and lungs are developed. METHODS/RESULTS: A 38-year-old male presented with left lumbar pain. Patient evaluation disclosed a left adrenal polycystic mass which was removed by surgery. Pathological analysis of the surgical specimen demonstrated a bronchogenic cyst. This case is compared with some of the few cases reported in the literature. CONCLUSIONS: Retroperitoneal bronchogenic cyst is a cause of retroperitoneal tumors in the splenic or hepato-renal region. Although it is uncommon, it should be taken into account when making the differential diagnosis.