Trombosis venosa portal como manifestación de una mutación del Factor XII / Portal vein thrombosis as a manifestation of a factor XII mutation

La trombosis venosa abdominal es una forma poco común de enfermedad tromboembólica venosa en niños. Si bien las tasas de mortalidad son bajas, una proporción significativa de niños afectados pueden sufrir morbilidad a largo plazo. Entre sus etiologías, se sabe que existe asociación con trastornos protrombóticos, siendo poco frecuente la ausencia del factor XII. El tratamiento incluye anticoagulación y la resección quirúrgica de los órganos isquémicos con potencial trasplante posterior (AU)

Abdominal venous thrombosis is a rare form of venous thromboembolic disease in children. Although the associated mortality is low, a significant proportion of affected children suffer from long-term morbidity. Among its aetiologies, there is evidence of an association with prothrombotic disorders, absence of factor XII being an infrequent one. Treatment includes anticoagulant medication and surgical resection of the ischaemic organs, potentially followed by transplantation. (AU)

Secondary extra-articular synovial osteochondromatosis with involvement of the leg, ankle and foot. An exceptional case.

Extraarticular synovial osteochondromatosis is a very rare benign disease whose aetiology may be primary or secondary to pre-existing pathology or after trauma. The diagnosis can be made with plain radiography and CT, and MRI is necessary to evaluate the non-mineralized soft tissue component and assess extension. It must be confirmed with a pathological study by biopsy or resection. There is up to a 5% chance of malignant transformation. The treatment of choice for the extensive extra-articular form is surgery by open resection. The case presented illustrates an atypical form of secondary extraarticular OCS with multiple involvement of the leg, ankle and foot.

Osteocondromatosis sinovial extraarticular secundaria con afectación de pierna, tobillo y pie. Un caso excepcional / Secondary Extra-Articular Synovial Osteochondromatosis with Involvement of the Leg, Ankle and Foot. An Exceptional Case

La osteocondromatosis sinovial (OCS) extraarticular es una enfermedad benigna muy infrecuente cuya etiología puede ser primaria o secundaria a una enfermedad preexistente o tras traumatismos. El diagnóstico puede realizarse con radiografía simple y TC, siendo necesaria la RM para evaluar el componente de partes blandas no mineralizado y valorar la extensión. Debe confirmarse con estudio anatomopatológico mediante biopsia o resección. Tiene hasta un 5% de posibilidades de experimentar transformación maligna. El tratamiento de elección de la forma extraarticular extensa es quirúrgico mediante resección abierta. El caso presentado ilustra una forma de aparición atípica de la OCS extraarticular secundaria con afectación múltiple de la pierna, el tobillo y el pie.(AU)

Extraarticular synovial osteochondromatosis is a very rare benign disease whose aetiology may be primary or secondary to pre-existing pathology or after trauma. The diagnosis can be made with plain radiography and CT, and MRI is necessary to evaluate the non-mineralized soft tissue component and assess extension. It must be confirmed with a pathological study by biopsy or resection. There is up to a 5% chance of malignant transformation. The treatment of choice for the extensive extra-articular form is surgery by open resection. The case presented illustrates an atypical form of secondary extraarticular OCS with multiple involvement of the leg, ankle and foot.(AU)

Pneumatosis intestinalis as an incidental finding in a patient with COVID-19 infection.

In reference to the article by Láinez Ramos-Bossini AJ et al., recently published in your Journal, we would like to provide our experience regarding a probable causal association between pneumoperitoneum and pneumatosis intestinalis in patients affected by COVID-19 (1).

Acute cholangitis in the context of Lemmel syndrome with signs of diverticulitis.

Here, we present the case of a 51-year-old male with pain in the right hypochondrium, jaundice, fever, chills and septic shock. A computed tomography (CT) scan showed a juxtapapillary diverticulum with inflammatory changes, which caused bile duct ectasia and left biliary radicals. We considered this to be a septic shock of a biliary origin due to the cholangitis associated with Lemmel syndrome, with signs of juxtapapillary diverticulitis.

Secondary Extra-Articular Synovial Osteochondromatosis with Involvement of the Leg, Ankle and Foot. An Exceptional Case. / Osteocondromatosis sinovial extraarticular secundaria con afectación de pierna, tobillo y pie. Un caso excepcional.

Extraarticular synovial osteochondromatosis is a very rare benign disease whose aetiology may be primary or secondary to pre-existing pathology or after trauma. The diagnosis can be made with plain radiography and CT, and MRI is necessary to evaluate the non-mineralized soft tissue component and assess extension. It must be confirmed with a pathological study by biopsy or resection. There is up to a 5% chance of malignant transformation. The treatment of choice for the extensive extra-articular form is surgery by open resection. The case presented illustrates an atypical form of secondary extraarticular OCS with multiple involvement of the leg, ankle and foot.

Fascitis necrotizante secundaria a úlcera por presión / Necrotizing fasciitis secondary to pressure ulcer

La fascitis necrotizante es una infección agresiva y altamente destructiva de la fascia y el músculo con una alta morbimortalidad. Se suele presentar en pacientes inmunocomprometidos tales como VIH, diabéticos, oncológicos o trasplantados, siendo sus localizaciones más habituales las extremidades, pared abdominal y periné; en esta última localización recibe el nombre de gangrena de Fournier. Su asociación con úlceras de decúbito es infrecuente, relacionándose en la mayoría de las ocasiones con procesos osteomielíticos, traumatismos con heridas cutáneas o presencia de cuerpos extraños. Presentamos un caso clínico de un paciente con fascitis necrotizante secundaria a úlcera de decúbito. Nos parece interesante presentar las características clínicas, así como exponer los hallazgos radiológicos de esta entidad y, por otra parte, acentuar la importancia de un adecuado cuidado de las úlceras por presión, ya que pueden ser el origen de la fascitis necrotizante

Necrotizing fasciitis is an aggressive and highly destructive infection of the fasciae and muscles with high morbidity and mortality. It usually occurs in immunocompromised patients such as HIV, diabetic, oncology or transplant patients. Its most common locations are the extremities, abdominal wall and perineum; in this latter location it is called Fournier's gangrene. Its association with pressure ulcers is infrequent, being connected in most cases with osteomyelitic processes, traumas with skin wounds or presence of foreign bodies. We present the clinical case of a patient with necrotizing fasciitis secondary to pressure ulcer. We find it interesting to present the clinical characteristics as well as the radiological findings of this entity and, on the other hand, to emphasize the importance of an adequate care of pressure ulcers, since they can be the origin of necrotizing fasciitis

Oclusión venosa pulmonar como complicación del tratamiento ablativo de la fibrilación auricular / Pulmonary Venous Occlusion as a Complication of Ablation Therapy for Atrial Fibrillation

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Angiosarcoma primario de mama bilateral sincrónico en el periodo de lactancia / Bilateral synchronous angiosarcoma of the breast during the breastfeeding period

El angiosarcoma primario de mama es una neoplasia agresiva muy infrecuente. Su diagnóstico es difícil por aparecer en mujeres jóvenes y porque la clínica y los hallazgos radiológicos son inespecíficos, pudiendo simular entidades inflamatorias o infecciosas. Se ha relacionado con el embarazo, aunque no se ha demostrado hormonodependencia. Presentamos un caso de angiosarcoma mamario bilateral sincrónico en el periodo de lactancia. A pesar de ser infrecuente debe incluirse en el diagnóstico diferencial de una lesión palpable de rápido crecimiento en mujeres jóvenes (AU)

Primary angiosarcoma of the breast is an uncommon aggressive tumour. Its diagnosis is particularly difficult because it occurs in young women and the clinical and imaging findings are non-specific and may simulate inflammatory or infectious entities. This tumour has been associated with pregnancy, although it has not been shown to be a hormone-dependent tumour. We present a case of bilateral synchronous angiosarcoma of the breast with onset in the lactation period. Despite being an extremely rare neoplasm, it should be included in the differential diagnosis of a rapidly growing palpable lesion in young women (AU)

Rotura esplénica atraumática como complicación de pancreatitis crónica reagudizada, un fenómeno poco frecuente / Atraumatic splenic rupture as a complication of acute exacerbation of chronic pancreatitis, an unusual disease

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Atraumatic splenic rupture as a complication of acute exacerbation of chronic pancreatitis, an unusual disease.

We report the case of a patient with acute exacerbation of chronic pancreatitis and he suffered an atraumatic splenic rupture. Splenic rupture not associated with trauma is a rare entity that can occurs in normal spleen (spontaneous) or damaged spleen (pathological). This entity may be associated with local inflammatory processes, such as pancreatitis. Ultrasound is a non-invasive technique which is used in unstable patients. CT is useful for making a diagnosis of extension in patients with hemodynamic stability. Atraumatic splenic rupture as a complication of chronic pancreatitis is an unusual disease that requires a high index of suspicion which allows us an early diagnosis because it is a treatable entity that compromises the patient's life.

Classifying thoracolumbar fractures: role of quantitative imaging.

This article describes different types of vertebral fractures that affect the thoracolumbar spine and the most relevant contributions of the different classification systems to vertebral fracture management. The vertebral fractures types are based on the three columns model of Denis that includes compression, burst, flexion-distraction and fracture-dislocation types. The most recent classifications systems of these types of fractures are reviewed, including the Thoracolumbar Injury Classification and Severity score (TLICS) and the Arbeitsgemeinschaft für Osteosynthesefragen Spine Thoracolumbar Injury Classification and Severity score (AOSpine-TLICS). Correct classification requires a quantitative imaging approach in which several measurements determine TLICS or AOSpine-TLICS grade. If the TLICS score is greater than 4, or the AOSpine-TLICS is greater than 5, surgical management is indicated. In this review, the most important imaging findings and measurements on radiography, multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) are described. These include degree of vertebral wedging and percentage of vertebral height loss in compression fractures, degree of interpedicular distance widening and spinal canal stenosis in burst fractures, and the degree of vertebral translation or interspinous widening in more severe fractures types, such as flexion-distraction and fracture-dislocation. These findings and measurements are illustrated with schemes and cases of our archives in a didactic way.