RESUMO
Mucormycosis is a rare but serious opportunistic fungal infection. Several clinical forms have been described, including cutaneous localization that is frequently associated with soft tissue trauma or burns. We report a case of cutaneous mucormycosis in a diabetic patient with severe occlusive arterial disease. The diagnosis was made early with mold growth on an amputation wound and the presence of nonseptate hyphae on direct microscopic examination, later identified on culture as Lichtheimia ramosa. Aggressive treatment, including the control of underlying diseases, systemic and local amphotericin B, and extensive surgical debridement permitted successful outcomes.
Assuntos
Cotos de Amputação/microbiologia , Amputação Cirúrgica/efeitos adversos , Extremidade Inferior/irrigação sanguínea , Mucorales/isolamento & purificação , Mucormicose/microbiologia , Doença Arterial Periférica/cirurgia , Infecção da Ferida Cirúrgica/microbiologia , Idoso de 80 Anos ou mais , Anfotericina B/administração & dosagem , Cotos de Amputação/cirurgia , Antifúngicos/administração & dosagem , Desbridamento , Humanos , Masculino , Mucormicose/diagnóstico , Mucormicose/terapia , Doença Arterial Periférica/diagnóstico , Reoperação , Infecção da Ferida Cirúrgica/diagnóstico , Infecção da Ferida Cirúrgica/terapia , Fatores de Tempo , Resultado do Tratamento , CicatrizaçãoRESUMO
Pyloric exclusion is a method of treatment for duodenal injury. Surgery is usually needed to restore digestive continuity in due time, yet a new surgical procedure can be challenging due to fibrotic adhesion development. We present here a retrospective case series of three patients with pyloric exclusion who underwent endoscopic ultrasound-guided duodenal repermeabilization using metallic stents. All procedures were successful with no complication and allowed regular feeding. This case series shows that endoscopic ultrasound-guided recanalization is a feasible and safe procedure.
RESUMO
Leiomyosarcoma of the superior vena cava is a very rare tumor and only a few cases have been reported, with various techniques of vascular reconstruction. We describe a new case of leiomyosarcoma of the superior vena cava in a 61-year-old woman with extension to the brachiocephalic arterial trunk. Resection and vascular reconstruction were performed using, respectively, polytetrafluoroethylene and polyethylene terephtalate vascular grafts.