Splenic Rupture after Infective Endocarditis by Enterococcus faecalis: Case Report.

Aims: In patients with infective endocarditis, with risk of embolization, early identification of parenchymal changes may suggest the risk of splenic rupture. Presentation of Case: A 68-year-old male presented with a history of 2 months of fever and also left upper quadrant pain initiated 2 days before admission. Transesophageal echocardiogram demonstrated the presence of two mobile vegetations on the ventricular side of the aortic valve; the largest diameter being 2.1 cm. Enterococcus faecalis was isolated in blood culture after a diagnosis of subacute aortic valve infective endocarditis. He complained of abdominal pain. An abdominal computed tomography scan revealed infarction of the upper region of the spleen (septic embolism). Therapy with penicillin and gentamicin was initiated, but the patient developed symptoms of heart failure that led to a surgical treatment, and aortic bioprosthesis was implanted on day 14. On day 5 postoperatively, the patient developed sudden hemorrhagic shock signs due to splenic rupture and underwent emergency splenectomy. A pathological examination revealed areas of splenic laceration of the capsule, splenic infarction areas, and the absence of abscesses. Splenic rupture is a complication much rarely occurring due to infectious endocarditis caused by E. faecalis. Conclusion: This case highlights the importance of conducting serial imaging, particularly in symptomatic patients, for the early detection of parenchymal changes that may suggest the risk of rupture.

Estudo comparativo do processo de cicatrização com o uso de óleo de semente de girassol e triglicérides de cadeia-média: modelo experimental em ratos / Comparative study of the scar formation processin rats using sunflower seed oil and medium-chain triglycerides: experimental model

Os autores pretendem, no entanto, fazer um estudo experimental comparativo em ratos sobre os efeitos da cicatrização na pele a partir do uso triglicérides de cadeia-média, os quais vêm sendo utilizados em diversas intervenções cirúrgicas, e do óleo de semente de girassol. Três grupos foram estabelecidos: grupo C (controle), grupo T(triglicérides de cadeia-média-TCM) e o grupo G (óleo de semente de girassol-OSG). Foram analisadas as características microscópicas quanto à granulação e a intensidade de fibrose, neovascularização e reepitalização, tipo de reação inflamatória e tipo de célula predominante. Os resultados obtidos demonstram que tanto o triglicérides de cadeia-média quanto o óleo de semente de girassol alteram o processo de formação de cicatriz de forma benéfica quando comparado com o frupo controle.