Ruptured cystic mesothelioma diagnosed after blunt trauma; case report and literature review

The majority of blunt trauma is secondary to motor vehicle crashes,especially in those wearing seat belts or sitting in the front or passenger seat location. Hollow viscus gastrointestinal injuries occur more frequently in small bowel, followed by colorectal, duodenum, stomach and appendix

A 25-year-old male presents after being involved in a motor vehicle accident. Initial workup was significant for moderate amount of pelvic free fluid and curvilinear,cysticlike structures in the pelvis. He subsequently developed peritonitis and under went diagnostic laparoscopy, which revealed multiple cystic nodules arising from the peritoneum

Pathology demonstrated benign cystic mesothelioma [BCM]

BCM is a very rare condition of mesotheliallined, variably sized, fluidfilled cysts that arises from the serous, pericardial or peritoneal lining. Due to the scarcity of cases, its management and prognosis are not fully established. This singular case highlights the necessity for a clinician to have a wide differential forunusual causes of free pelvic fluid after blunt abdominal trauma

El Triatoma infestans como vector del virus B de la hepatitis. / Triatoma infestans as a vector of hepatitis B virus

Dada la capacidad de mosquitos y chinches de actuar como posibles transmisores del virus de la hepatitis B, nos intereso estudiar lo que sucede con la vinchuca (Triatoma infestans), ya que se trata de un insecto hematofago muy difundido en todo el territorio de la Republica Argentina. Con tal objeto se procesaron 130 Triatoma infestans, de los que se seleccionaron dos lotes de 25 triatominos cada uno, alimentados con suero o sangre entera contaminados con virus de hepatitis B.En las heces y homogenatos de los insectos se investigo la presencia de HBSAg por radioinmunoensayo, hallandose resultados positivos en las muestras correspondientes a los 7, 14 y 21 dias posteriores a la ingesta contaminante. Considerando los habitos domesticos de la vinchuca y su condicion de insecto hematofago, se plantea la posibilidad de que actue como transmisora del virus B ya sea por picadura directa o a traves de sus deyecciones.Destacamos la trascendencia epidemiologica de este hallazgo. A su vez mencionamos dos lineas de investigacion programadas para continuar este descubrimiento, y tratar de clarificar otros interesantes aspectos del problema