[V grade renal trauma in patient with union pyeloureteral stenosis not known.] / Traumatismo renal grado v en paciente con estenosis de la unión pieloureteral no conocida.

Paciente de 40 años de edad, sin alergias medicamentosas conocidas y sin antecedentesde interés, que es traído a Urgencias por dispositivo de cuidados críticos por politraumatismo tras accidente de moto...

Paciente de 40 años de edad, sin alergias medicamentosas conocidas y sin antecedentesde interés, que es traído a Urgencias por dispositivo de cuidados críticos por politraumatismo tras accidente de moto...

Traumatismo renal grado v en paciente con estenosis de la unión pieloureteral no conocida / V grade renal trauma in patient with union pyeloureteral stenosis not known

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Traumatismo renal grado IV parenquimatoso con ruptura de la vía y urinoma secundario. Manejo conservador / Renal injury grade IV: Laceration and secondary urinoma. Conservative management

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Ex vivo construction of a novel model of bioengineered bladder mucosa: A preliminary study.

OBJECTIVE: To generate and to evaluate ex vivo a novel model of bioengineered human bladder mucosa based on fibrin-agarose biomaterials. METHODS: We first established primary cultures of stromal and epithelial cells from small biopsies of the human bladder using enzymatic digestion and selective cell culture media. Then, a bioengineered substitute of the bladder lamina propria was generated using cultured stromal cells and fibrin-agarose scaffolds, and the epithelial cells were then subcultured on top to generate a complete bladder mucosa substitute. Evaluation of this substitute was carried out by cell viability and histological analyses, immunohistochemistry for key epithelial markers and transmission electron microscopy. RESULTS: The results show a well-configured stroma substitute with a single-layer epithelium on top. This substitute was equivalent to the control bladder mucosa. After 7 days of ex vivo development, the epithelial layer expressed pancytokeratin, and cytokeratins CK7, CK8 and CK13, as well as filaggrin and ZO-2, with negative expression of CK4 and uroplakin III. A reduction of the expression of CK8, filaggrin and ZO-2 was found at day 14 of development. An immature basement membrane was detected at the transition between the epithelium and the lamina propria, with the presence of epithelial hemidesmosomes, interdigitations and immature desmosomes. CONCLUSIONS: The present results suggest that this model of bioengineered human bladder mucosa shared structural and functional similarities with the native bladder mucosa, although the epithelial cells were not fully differentiated ex vivo. We hypothesize that this bladder mucosa substitute could have potential clinical usefulness after in vivo implantation.

[Metastatic testicular melanoma. Case report]. / METÁSTASIS TESTICULAR DE MELANOMA. A PROPÓSITO DE UN CASO.

A 33 year-old male, who five years earlier was operated for a nodular melanoma in vertical growth phase of 1.5mm thick (Breslow), Clark II-III, presented to the Emergency department with a progressive increase of the left testicle. Ultrasound scan examination revealed a 2 x 2 cm solid mass in the left testis, with normal right testis.With the diagnosis of testicular neoplasm, we requested Alpha-fetoprotein and beta HCG levels, and patient underwent radical orchiectomy.

[Testicular epidermoid cyst: A rare entity]. / QUISTE EPIDERMOIDE TESTICULAR: UNA RARA ENTIDAD CLÍNICA.

OBJECTIVE: Testicular epidermoid cyst is a rare clinical entity that accounts for 1% of testicular neoplasias. METHODS AND RESULTS: We report two cases of testicular epidermoid cysts in a 18 and 19 year old males with a painless testicular lesion. Testicular US was carried out showing a hypoechoic nodule in both cases. With the suspicion of testicular neoplasm inguinal orchiectomy was carried out with placement of testicular prostheses in the same act. The pathology report was testicular epidermoid cyst in both cases. CONCLUSIONS: Testicular epidermoid cysts are an uncommon benign entity. When there is a suspicion of this diagnosis, based on tumor markers and ultrasound or MRI images, testicular parenchyma-sparing surgery must be attempted.

Metástasis testicular de melanoma. A propósito de un caso / Metastatic testicular melanoma. Case report

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Spontaneous hemoperitoneum secondary to retroperitoneal tumor rupture.

OBJECTIVE: To report a case of GIST type retroperitoneal tumor with spontaneous rupture to the abdominal cavity causing acute abdomen secondary to hemoperitoneum. METHODS/RESULTS: We report the case of an 84 year-old man with history of BPH and chronic atrial fibrillation. He presented to the Emergency Department with diffuse abdominal pain, syncope and accompanying vegetative symptoms. Diagnostic work up showed a 19 cm retroperitoneal mass dependent of the left kidney with active bleeding and secondary hemoperitoneum. Left radical nephrectomy was performed with pathology report of gastrointestinal stromal tumor attached to the renal capsule. CONCLUSIONS: Spontaneous hemoperitoneum is a rare entity and it has various etiologies. It is rarely described in retroperitoneal tumors.

Hemoperitoneo espontáneo por rotura de tumor retroperitoneal / Spontaneous hemoperitoneum secondary to retroperitoneal tumor rupture

OBJETIVO: Describimos un caso de tumor retroperitoneal tipo GIST con rotura espontánea a cavidad abdominal, ocasionando un cuadro de abdomen agudo secundario a hemoperitoneo. MÉTODO Y RESULTADOS: Varón de 84 años que acude a servicio de Urgencias de nuestro hospital por cuadro sincopal, con dolor abdominal difuso y cortejo vegetativo acompañante. Tras la realización de diferentes pruebas complementarias se objetiva una masa retroperitoneal de pendiente de riñón izquierdo de unos 19 cm con sangrado activo y hemoperitoneo secundario, por lo que se realiza una nefrectomía radical izquierda con resultado anatomopatológico de tumor estromal gastrointestinal dependiente de la capsula renal. CONCLUSIONES: El hemoperitoneo espontáneo es una entidad poco frecuente y de una etiología variada estando descrita en muy raras ocasiones en tumores retroperitoneales

OBJECTIVE: To report a case of GIST type retroperitoneal tumor with spontaneous rupture to the abdominal cavity causing acute abdomen secondary to hemoperitoneum. METHODS/RESULTS: We report the case of an 84 year-old man with history of BPH and chronic atrial fibrillation. He presented to the Emergency Department with diffuse abdominal pain, syncope and accompanying vegetative symptoms. Diagnostic work up showed a 19 cm retroperitoneal mass dependent of the left kidney with active bleeding and secondary hemoperitoneum. Left radical nephrectomy was performed with pathology report of gastrointestinal stromal tumor attached to the renal capsule. CONCLUSIONS: Spontaneous hemoperitoneum is a rare entity and it has various etiologies. It is rarely described in retroperitoneal tumors

Hematoma subcapsular de 13 cm en paciente con aneurisma aorta toraco-abdominal de 10 cm y trombo mural / Thirteen centimeter subcapsular haematoma in a patient with thoracoabdominal aortic aneurysm and mural thrombus

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Hematocele secondary to rupture of an abdominoscrotal hydrocele.

OBJECTIVE: To describe one case of hematocele secondary to rupture of an abdominoscrotal hydrocele in an adult patient. METHODS AND RESULTS: We report a huge hematocele in a patient with this unusual type of hydrocele that suffered a minimal scrotal trauma. It was a hydrocele that extended through the inguinal canal to the retroperitoneal space. CONCLUSIONS: Abdominoscrotal hydrocele is a rare condition in children and even rarer in adults. The presence of a hematocele requires early surgical treatment.

Hematocele gigante secundario a la ruptura de un hidrocele abdomino-escrotal / Hematocele secundary to rupture of an abdominoscrotal hydrocele

OBJETIVO: Presentación de un caso de hematocele secundario a un hidrocele abdomino escrotal en la edad adulta. MÉTODO Y RESULTADO: Presentamos el caso de un paciente que presentó este inusual tipo de hidrocele que tras un mínimo traumatismo escrotal ocasionó un importante hematocele. Se trata de un hidrocele que se extiende a través del canal inguinal hacia el espacio retroperitoneal, reseñando su aproximación diagnóstica así como el tratamiento quirúrgico. CONCLUSIONES: El hidrocele abdomino escrotal es una patología infrecuente en niños y lo es aún más en adultos. La presencia de un hematocele exige un tratamiento quirúrgico precoz (AU)

OBJECTIVE: To describe one case of hematocele secondary to rupture of an abdominoscrotal hydrocele in an adult patient. METHODS AND RESULTS: We report a huge hematocele in a patient with this unusual type of hydrocele that suffered a minimal scrotal trauma. It was a hydrocele that extended through the inguinal canal to the retroperitoneal space. CONCLUSIONS: Abdominoscrotal hydrocele is a rare condition in children and even rarer in adults. The presence of a hematocele requires early surgical treatment (AU)

Cuerpo extraño intraureteral / Intraurethral foreign body

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Urogenital sinus cyst in a 21-year-old man.

We report a case of a rare congenital malformation, a urogenital sinus cyst in a young patient with non-specific symptoms for several months. A 21-year-old male presented with vague and intermittent abdominal pain. Ultrasound scan showed a retrovesical hypoechoic collection (approximately 6 cm) and left renal agenesis, compatible with a possible congenital malformation. These findings were confirmed by MRI. A laparoscopic excision of the cyst was performed with no complications. Pathology report confirmed a urogenital sinus cyst. The postoperative recovery was uneventful and the patient was discharged within 48 h. Urogenital sinus cysts are rare entities with few cases described in the literature. Imaging techniques such as ultrasound, CT or MRI may help with diagnosis. Therapeutic modalities range from observation to needle aspiration or surgical removal. In our case, we chose a laparoscopic approach to minimize morbidity and achieve an early recovery.