Quiste hidatídico retro-peritoneal: Una enfermedad frecuente en una ubicación inusual / Retroperitoneal hydatid cyst: A common disease in a rare location

Echinococcal disease remains a major problem within some endemic areas. We report a case of a single primary echinococcal cyst located in the retroperitoneal space. A 54-year-old woman, born in a rural area of southern Chile, was admitted with a 3-month history of right hip pain and painful swelling of the gluteal region. Hidatid disease was confirmed with serologic test, radiological examinations and histo-pathology. There were no cysts in any other location. A percutaneous drainage was performed and antihelminthics were administered for 12 weeks and is now being closely followed up, with good response to therapy. Especially in the endemic areas hydatid cyst should be considered when evaluating retroperitoneal cystic masses.

La hidatidosis sigue siendo un problema prevalente en áreas endémicas. Presentamos el caso de un quiste hidatídico primario ubicado en el espacio retro-peritoneal. Mujer de 54 años, procedente de área rural del sur de Chile, hospitalizada por cuadro de coxalgia derecha y aumento de volumen glúteo, con tres meses de evolución. Se realizó el diagnóstico de hidatidosis complicada por medio de exámenes de imágenes, tests serológicos y anatomía patológica. No se demostraron quistes hidatídicos en otras ubicaciones. Se realizó un drenaje percutáneo del quiste infectado y se administraron antihelmínticos durante 12 semanas y actualmente permanece en seguimiento cercano con buena respuesta al tratamiento. El quiste hidatídico debe ser considerado en el diagnóstico diferencial de masas quísticas retro-peritoneales, especialmente en áreas endémicas.

Pileflebitis asociada a apendicitis aguda en una niña de 11 años / Pylephlebitis associated to acute appendicitis: report of an eleven years old patient

We report a 11 years old female who presented fever and pain in the lower abdomen. An abdominal CAT sean showed the presence of an acute appendicitis and a mesenteric vein thrombosis. The patient was operated laparoscopically and received antimicrobials and anticoagulants, with a good evolution. It is important an early suspicion and aecurate treatment for this complication.

Se presenta el caso clínico de una paciente de 11 años de edad, que cursa un cuadro febril asociado a dolor abdominal hipogástrico. Se realizan estudios de laboratorio e imágenes y se diagnostica una apendicitis aguda asociada a una trombosis de la vena mesentérica superior. Se efectúa apendicectomía laparoscópica y se administra tratamiento antibiótico y anticoagulante, tras lo cual la paciente evoluciona en buenas condiciones. Es importante una sospecha precoz y un tratamiento adecuado para tratar esta complicación.

Primum non nocere: tacto rectal en niños es realmente necesario / Primum non nocere: digital rectal examination in children: is it really necessary

Traditionally we have performed digital rectal examination to children in a great number of conditions. We review the evidence supporting this practice like in acute abdomen, constipation, gastrointestinal bleeding, irritability, trauma, among others. However there is not enough evidence to support the rutinary digital rectal examination and is probably not always necessary.

Tradicionalmente se ha indicado practicar el tacto rectal en niños en una amplia variedad de afecciones. Se realizó una revisión de la evidencia existente en la literatura respecto a este examen en diferentes entidades infantiles, como es el caso del abdomen agudo, la constipación, la hemorragia gastrointestinal, la irritabilidad y el trauma, entre otros. La evidencia respecto a su real utilidad es escasa y tal vez, sea probable, que la práctica rutinaria del examen rectal no sea necesaria.

[Retroperitoneal hydatid cyst: a common disease in a rare location]. / Quiste hidatídico retro-peritoneal: Una enfermedad frecuente en una ubicación inusual.

Echinococcal disease remains a major problem within some endemic areas. We report a case of a single primary echinococcal cyst located in the retroperitoneal space. A 54-year-old woman, born in a rural area of southern Chile, was admitted with a 3-month history of right hip pain and painful swelling of the gluteal region. Hidatid disease was confirmed with serologic test, radiological examinations and histo-pathology. There were no cysts in any other location. A percutaneous drainage was performed and antihelminthics were administered for 12 weeks and is now being closely followed up, with good response to therapy. Especially in the endemic areas hydatid cyst should be considered when evaluating retroperitoneal cystic masses.