[A preliminary experience in the laparoscopic approach to bowel obstruction]. / Experiencia inicial en el abordaje laparoscópico de la obstrucción intestinal.

BACKGROUND: The laparoscopic approach to bowel obstruction is still controversial. OBJECTIVE: To evaluate our initial results in the laparoscopic treatment of bowel obstruction. MATERIAL AND METHODS: A retrospective study on patients diagnosed with bowel obstruction that underwent laparoscopic surgery within the time frame of January 2008 to June 30, 2012. The variables employed were: age, sex, occlusion etiology, previous surgeries, clinical progression, pneumoperitoneum creation, use of an auxiliary incision, anesthesia duration, conversion rate, postoperative hospital stay, time needed to tolerate liquids, and complications. RESULTS: Twenty-six patients, 18 women (69.2%) and 8 men (30.8%), with a mean age of 64.35 years (range: 21-92 years) were analyzed. The most frequent obstruction etiology was secondary to adhesions and presented in 12 cases. Nine patients (34.6%) underwent a completely laparoscopic approach and laparoscopy was complemented by an auxiliary incision in another 9 patients (34.6%), resulting in 18 cases (69.2%) of successful laparoscopic approach. Eight patients (30.8%) required conversion to open surgery. The mean anesthesia duration was 95min (range: 55-165min), mean postoperative hospital stay was 6 days (range: 3-72 days), and the mean amount of time needed to tolerate liquids was 3 days (range: 1-10 days). The patients that underwent complete laparoscopic approach presented with shorter hospital stay, they were able to ingest liquids earlier, and they presented with a lower number of postoperative complications; this latter variable was the only one that was statistically significant. CONCLUSIONS: The initial results of our experience were good, although more patients are needed in order to standardize and extend the use of this technique.

Cornada envainada. Una lesión poco evidente pero devastadora / Sheathed goring. A not evident but devastating lesion

Las heridas por asta de toro son una patología frecuente en el mundo latino, donde los espectáculos con este tipo de animales son algo habitual. Estas lesiones tienen unas características especiales que las diferencian de cualquier otro tipo de heridas. Existe un tipo especial de cornada que se conoce con el nombre de cornada envainada. En este tipo de cornada, la piel recupera su aspecto original, pero las lesiones por debajo de ella pueden ser extremadamente graves. Presentamos el caso de un paciente que sufrió una cornada envainada con evisceración intestinal en el que únicamente la piel cubría el contenido abdominal. Se requirió intervención quirúrgica urgente para la reparación abdominal (AU)

Bull horn lesions are frequent in the Latin world due to the existence of spectacles involving these animals. These wounds have special features that make them different from all other lesions. There is a special type of bull horn wound called sheathed goring. In this type of lesion, the skin returns to its normal appearance after the goring, but the injury is done. We report one patient with a sheathed goring and bowel evisceration that was only covered by the skin. The patient required emergency surgical intervention to repair the damaged bowel (AU)

[Subcutaneous seeding of hepatocellular carcinoma after fine-needle percutaneous biopsy]. / Implante subcutáneo de un carcinoma hepatocelular tras la punción aspiración con aguja fina.

Subcutaneous tumor seeding after fine-needle percutaneous biopsy for hepatocellular carcinoma is a rarely seen complication. The authors describe a case of subcutaneous neoplastic seeding in a 70-year-old woman with chronic hepatitis C virus complicated by hepatocellular carcinoma. Ultrasonically guided fine-needle aspiration biopsy was performed in segment II of the liver. The neoplastic seeding developed along the needle track used to carry out the fine-needle biopsy. The subcutaneous tumor was excised, and histological examination revealed a well-differentiated hepatocellular carcinoma.

Adenocarcinoma de esófago 36 años después de una estenosis hipertrófica de píloro / Esophageal adenocarcinoma 36 years later of a hypertrophic stenosis of the pylorus

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Implante subcutáneo de un carcinoma hepatocelular tras la punción aspiración con aguja fina / Subcutaneous seeding of hepatocellular carcinoma after fine-needle percutaneous biopsy

Los implantes subcutáneos son una complicación rara tras la punción aspiración con aguja fina de los carcinomas hepatocelulares. Los autores describen un caso de implante subcutáneo neoplásico en una mujer de 70 años con cirrosis hepática por virus C complicada con un carcinoma hepatocelular. Se efectuó una punción aspiración con aguja fina en el segmento II hepático. El implante tumoral se desarrolló en el trayecto de la punción aspiración. La tumoración subcutánea fue extirpada quirúrgicamente y el estudio anatomopatológico confirmó que se trataba de un carcinoma hepatocelular bien diferenciado

Subcutaneous tumor seeding after fine-needle percutaneous biopsy for hepatocellular carcinoma is a rarely seen complication. The authors describe a case of subcutaneous neoplastic seeding in a 70-year-old woman with chronic hepatitis C virus complicated by hepatocellular carcinoma. Ultrasonically guided fine-needle aspiration biopsy was performed in segment II of the liver. The neoplastic seeding developed along the needle track used to carry out the fine-needle biopsy. The subcutaneous tumor was excised, and histological examination revealed a well-differentiated hepatocellular carcinoma