Tomografía computarizada multidetector urgente de la cirugía del cáncer colorrectal: Cambios posquirúrgicos y complicaciones tempranas / Urgent multidetector computed tomography in colon cancer: postsurgical changes and early complications

Las complicaciones posquirúrgicas del cáncer colorrectal son frecuentes en los servicios de urgencias. La tomografía computarizada multidetector tiene un papel fundamental en el seguimiento de los pacientes operados, ya que hace posible el reconocimiento de complicaciones y recidiva. Es importante que el radiólogo esté familiarizado con las diferentes técnicas quirúrgicas y los cambios postoperatorios normales, con objeto de diferenciarlas de potenciales complicaciones y recidivas. El objetivo de este trabajo es revisar los hallazgos en tomografía computarizada multidetector que pueden considerarse normales tras la intervención quirúrgica, y hacer una revisión de las complicaciones tempranas que con mayor frecuencia encontramos en los servicios de urgencias

Complications after surgery for colorectal cancer are common in emergency departments. Multidetector computed tomography plays a fundamental role in the follow-up of patients after surgery, because it enables the detection of relapse and complications. Radiologists need to be familiar with different surgical techniques and the normal postsurgical changes so that we can differentiate them from potential complications and relapse. This article reviews the multidetector computed tomography findings that can be considered normal after surgical intervention for colorectal cancer as well as the most common early complications seen in postsurgical colorectal cancer patients presenting at emergency departments

Urgent Multidetector Computed Tomography in Colon Cancer: Postsurgical Changes and Early Complications. / Tomografía computarizada multidetector urgente de la cirugía del cáncer colorrectal: Cambios posquirúrgicos y complicaciones tempranas.

Complications after surgery for colorectal cancer are common in emergency departments. Multidetector computed tomography plays a fundamental role in the follow-up of patients after surgery, because it enables the detection of relapse and complications. Radiologists need to be familiar with different surgical techniques and the normal postsurgical changes so that we can differentiate them from potential complications and relapse. This article reviews the multidetector computed tomography findings that can be considered normal after surgical intervention for colorectal cancer as well as the most common early complications seen in postsurgical colorectal cancer patients presenting at emergency departments.

Análisis comparativo de los conocimientos en ventilación mecánica no invasiva de profesionales de cuidados intensivos / Intensive care unit profesionals's knowledge about non invasive ventilation comparative analysis

Objetivo: La bibliografía destaca la falta de protocolos de ventilación mecánica no invasiva (VNI) y la variabilidad de conocimientos entre unidades y hospitales, por lo que se pretende comparar los conocimientos en VNI en enfermeras de 4 UCI polivalentes y una quirúrgica. Métodos: Estudio descriptivo multicéntrico en hospitales universitarios de nivel 3. Se diseñó una encuesta ad-hoc, con fiabilidad interobservador Kappa = 0,9. Contestar la encuesta era indicación de consentimiento informado. Análisis con Chi cuadrado. Resultados: Respondieron 117 (65%) enfermeras, con 11 ± 9,7 años de experiencia en UCI y 9,2 ± 7,2 en uso de VNI. Una de las UCI polivalentes había iniciado la VNI una media de 6 años más tarde que las otras (IC 95% [3,3 a 8,6], P <0,001).Solo el 23,1% de las enfermeras colocaría una mascarilla sin puerto espiratorio en respirador convencional, el resto cualquier mascarilla buconasal. El 12,7% cree que la mascarilla debe permitir el paso de 2 dedos mientras que el 29% apretaría la máscara a la cara del paciente y taparían el puerto espiratorio para facilitar la sincronización con el respirador. En la UCI quirúrgica se identifica mayoritariamente la agitación como una complicación de la VNI comparado con las polivalentes (31,6 vs. 1,8%, P < 0,001).El 56,4% de las enfermeras no consideran la fisioterapia respiratoria como un cuidado enfermero, sin diferencia entre unidades. Conclusiones: El conocimiento en tipos de interfase es muy dependiente del material de la unidad. Falta formación para detectar complicaciones de VNI como la agitación y el manejo de secreciones

Aims: The literature highlights the lack of noninvasive vntilation (NIV) protocols and the variability of the knowledge of NIV between intensive care units (ICU) and hospitals, so we want to compare NIV nurses's Knowledge from 4 multipurpose ICU and one surgical ICU. Methods: Multicenter, crosscutting, descriptive study in three university hospitals. The survey instrument was validated in a pilot test, and the calculated Kappa index was 0.9. Returning a completed survey is an indication of informed consent. Analysis by Chi square test. Results: 117 responded (65%) nurses, 11 ± 9.7 years of experience in ICU and 9.2 ± 7.2 in use of NIV. One of the multipurpose ICU, was initiated NIV an average of 6 years later than the others (95% CI [3.3 to 8.6], P < .001). Only 23.1% of nurses would place a non-vented mask (with no exhalation port) by conventional ventilator, the rest any kind of face mask. 12.7% believed that the mask must be adjusted to the '2-finger' fit while 29% would seal the mask to the patient's face and cover the mask opening where air escapes to facilitate patient/ventilator synchronization. In the surgical ICU agitation identifies mostly as a complication of NIV compared with multipurpose UCIs (31.6% vs 1.8%, P < .001). 56.4% of nurses do not consider respiratory physiotherapy as nursing care, with no difference between units. Conclusions: Knowledge about types of interface is very dependent on the material of the unit. More training for complications of NIV as agitation and handling secretions it is necessary

[Intensive care unit profesionals's knowledge about non invasive ventilation comparative analysis]. / Análisis comparativo de los conocimientos en ventilación mecánica no invasiva de profesionales de cuidados intensivos.

AIMS: The literature highlights the lack of noninvasive ventilation (NIV) protocols and the variability of the knowledge of NIV between intensive care units (ICU) and hospitals, so we want to compare NIV nurses's Knowledge from 4 multipurpose ICU and one surgical ICU. METHODS: Multicenter, crosscutting, descriptive study in three university hospitals. The survey instrument was validated in a pilot test, and the calculated Kappa index was 0.9. Returning a completed survey is an indication of informed consent. Analysis by Chi square test. RESULTS: 117 responded (65%) nurses, 11±9.7 years of experience in ICU and 9.2±7.2 in use of NIV. One of the multipurpose ICU, was initiated NIV an average of 6 years later than the others (95% CI [3.3 to 8.6], P<.001). Only 23.1% of nurses would place a non-vented mask (with no exhalation port) by conventional ventilator, the rest any kind of face mask. 12.7% believed that the mask must be adjusted to the "2-finger" fit while 29% would seal the mask to the patient's face and cover the mask opening where air escapes to facilitate patient/ventilator synchronization. In the surgical ICU agitation identifies mostly as a complication of NIV compared with multipurpose UCIs (31.6% vs 1.8%, P<.001). 56.4% of nurses do not consider respiratory physiotherapy as nursing care, with no difference between units. CONCLUSIONS: Knowledge about types of interface is very dependent on the material of the unit. More training for complications of NIV as agitation and handling secretions it is necessary.

Cistoadenocarcinoma mucinoso retroperitoneal ocurrido a los 7 años de apendicectomía y hemicolectomía derecha / Retroperitoneal mucinous cystadenocarcinoma presenting seven years after appendectomy and right hemicolectomy

El cistoadenocarcinoma mucinoso retroperitoneal (CMR) sin afectación de estructuras vecinas es una patología muy infrecuente, tanto si su origen es primario como si es secundario. Describimos un caso de CMR a los 7 años de apendicectomía y hemicolectomía derecha, planteando ambas posibilidades diagnósticas (AU)

Retroperitoneal mucinous cystadenocarcinoma (RMC) with no involvement of neighboring structures is very rare, regardless of whether the lesion is primary or secondary. We report the case of a patient who presented RMC seven years after appendectomy and right hemicolectomy. We discuss both diagnostic possibilities (AU)

[Retroperitoneal mucinous cystadenocarcinoma presenting seven years after appendectomy and right hemicolectomy]. / Cistoadenocarcinoma mucinoso retroperitoneal ocurrido a los 7 años de apendicectomía y hemicolectomía derecha.

Retroperitoneal mucinous cystadenocarcinoma (RMC) with no involvement of neighboring structures is very rare, regardless of whether the lesion is primary or secondary. We report the case of a patient who presented RMC seven years after appendectomy and right hemicolectomy. We discuss both diagnostic possibilities.