RESUMO
Lymphogranuloma Venereum (LGV) is a notifiable disease linked to high-risk sexual practices such as cruising, chemsex, or orgies. The anorectal manifestation is associated with receptive anal sex and presents with characteristic symptoms such as proctitis, tenesmus, suppuration, and in advanced cases, anorectal fistulas or stenosis. The case of a 57-year-old man engaging in high-risk sexual practices is presented, showing symptoms such as discharge, fistulizations, rectal stenosis, and a weight loss of 15 kg. Following diagnostic studies, a neoplastic and inflammatory origin was ruled out, confirming the LGV diagnosis. Although the patient responded positively to a three-week course of doxycycline, the stenosis persisted, ultimately necessitating a terminal colostomy. The patient was scheduled to undergo a protectomy to control the inflammatory and infectious process, a procedure that took place months later without significant incidents. The primary treatment for LGV continues to be doxycycline. In cases of complications, such as fistulas, abscesses, or stenosis, surgical interventions, drainage, or pneumatic dilations may be necessary.
RESUMO
Vanek's Tumor, also known as Inflammatory Fibroid Polyp (IFP), is a rare submucosal mesenchymal lesion with spindle cells and eosinophilic infiltration. Its etiology is unknown but linked to chronic cellular damage. IFP can develop in various gastrointestinal segments, most commonly in the gastric antrum (70%), small intestine (18-20%), colon, and rectum (4-7%). IFP are usually symptomless and are often found incidentally during colonoscopies or gastroscopies. Most cases can be treated with simple endoscopic resection. In rare cases where larger lesions over 1 cm are identified through endoscopic ultrasound without deeper layer involvement, submucosal endoscopic dissection can be done with good outcomes and minimal risk. Some polyps may cause dyspeptic, hemorrhagic, or obstructive symptoms based on size and location. We report a case of a 56-year-old patient with a 24-hour history of obstructive symptoms, including bowel cessation and vomiting. The patient also had abdominal pain and gradual weight loss over the past two months. Notably, the patient had a prior diagnosis of Crohn's disease 12 years ago, without treatment or continuous medical monitoring.
RESUMO
The diagnosis of hypocalcemia-induced tetany following a total thyroidectomy is not common. However, there is a higher risk in patients with a history of gastric bypass surgery due to their malabsorption condition. This case describes postoperative hungry bone syndrome resulting from chronic malabsorption in a patient with a history of bariatric surgery. It is important to consider alternative treatment options if the initial management proves ineffective. Typically, this is a temporary condition, but it's crucial to prioritize prevention in high-risk patients by providing perioperative calcium and vitamin D supplementation.