RESUMO
The haemocholecyst is a rare disease with a low index of suspiction, which is even lower if the patient does not present risk factors. Likewise, the course of this pathology with a haemoperitoneum without vesicular perforation is equally infrequent. We present an unusual case in which the diagnosis of the patient was carried out intraoperatively. We consider that communicating these unusual cases in clinical practice helps to increase clinical suspiction and prompt diagnosis.
El hemocolecisto es una patología poco frecuente y con un índice bajo de sospecha, que todavía es menor si el paciente no presenta factores de riesgo. Asimismo, su curso con clínica de hemoperitoneo sin perforación vesicular es igualmente infrecuente. Presentamos un caso poco habitual en el cual el diagnóstico de la paciente se llevó a cabo intraoperatoriamente. Consideramos que comunicar estos casos poco habituales en la práctica clínica colabora a aumentar la sospecha clínica y el diagnóstico precoz.
Assuntos
Colecistite Aguda , Doenças da Vesícula Biliar , Colecistite Aguda/complicações , Hemoperitônio/etiologia , Humanos , Doenças RarasRESUMO
Patients who suffer from cancer are at a higher risk of complications when they experience malnutrition. Evidence shows that oral nutritional supplements favor the healing process. The main objective of this study was to evaluate the efficacy of preoperative oral nutritional intervention in oncological patients undergoing surgery. This study assessed retrospectively 55 cancer patients who previously had undergone abdominal surgery and did not have receive pre-surgical nutritional support (control group), and prospectively 30 oncological patients undergoing gastrointestinal surgery and received pre-surgical high-protein nutritional support (experimental group). All patients had to have a NRS 2002 score ≥ 3. Analytical and clinical parameters were analyzed and the NRS 2002 screening test was performed. Post-operative assessments of surgical wound complications were also carried out to determine the impact of nutrition support. Pre-surgical nutritional interventions reduced the incidence and severity of wound complications as well as the length of hospital stays. Only 26.7% of patients in the experimental group had complications compared to 60% of the control group (P = 0.003). We conclude that pre-surgical nutritional interventions of patients undergoing surgery can improve post-surgical patient outcomes of malnourished patients.
Assuntos
Neoplasias/cirurgia , Apoio Nutricional/métodos , Procedimentos Cirúrgicos Operatórios/efeitos adversos , Ferida Cirúrgica/prevenção & controle , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Nutrição Enteral/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/patologia , Cuidados Pré-Operatórios/métodos , Estudos Retrospectivos , Ferida Cirúrgica/etiologia , Ferida Cirúrgica/patologia , Adulto JovemRESUMO
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