ABSTRACT
La compresa quirúrgica retenida o textiloma es el resultado de un error quirúrgico poco frecuente y evitable. Se ha reportado que la incidencia es 1 por cada 1 000 a 15 000 cirugías intraabdominales. La compresa quirúrgica retenida puede causar graves complicaciones que llevan hasta la muerte. Se presenta el caso de una paciente de 26 años quien llegó por dolor abdominal. Tenía un antecedente quirúrgico de cesárea 20 meses antes. Durante la laparotomía, se encontró una compresa quirúrgica retenida a 25 centímetros de la válvula ileocecal, que fue resecada en bloque. Aunque rara en la práctica diaria, se debe considerar la retención de compresas intraperitoneales en pacientes que se presentan con síntomas abdominales complejos posteriores a una cirugía abdominal previa.
Retained surgical swab or textiloma is an infrequent but avoidable result of surgical error. The reported incidence is 1 in 1 000 to 15 000 intraabdominal surgeries. A retained surgical swab may cause serious complications and may lead to death. We present the case of a 26 year-old woman who was seen for abdominal pain. Her surgical history included a cesarean section 20 months ago. During laparotomy, a retained surgical sponge located 25 centimeters from the ileocecal valve was found and resected en bloc. Although rare in daily practice, a retained intraperitoneal swab body should be considered in patients with complex abdominal symptoms following a history of abdominal surgery.
ABSTRACT
In chest wall reconstruction after wide chest wall resection, the use of a musculocutaneous flap or prosthetic materials is inevitable for maintaining thoracic movement and a closed pleural cavity. We report a case of a 63-year-old male with a large invasive thymic carcinoma in the anterior mediastinum. The mass measured 6.8 cm and involved the sternum, left side of the parasternal area, ribs, and intercostal muscles. The patient underwent subtotal sternectomy, radical thymectomy, and reconstruction with biological mesh (Permacol). Successful chest wall reconstruction without any other complications was achieved, demonstrating the effectiveness of Permacol.
Subject(s)
Humans , Male , Collagen , Intercostal Muscles , Mediastinum , Pleural Cavity , Ribs , Sternum , Thoracic Wall , Thymectomy , ThymomaABSTRACT
Para a execução de cada uma das etapas do procedimento cirúrgico utilizam-se instrumentos distintos e são necessários ordem e método para permitir ao cirurgião executar o procedimento com precisão e rapidez. Para isso, o instrumental cirúrgico deve ser listado e preparado com antecedência, de acordo com o tipo de cirurgia a ser realizada e preferência do cirurgião.
Distinct instruments are employed during the accomplishment of each of the stages of a surgical procedure. For the surgeon to perform the procedure accurately and efficiently, order and method are mandatory. To this end, surgical instruments should be listed and prepared well in advance, according to the surgery type and the surgeon's preferences.
Subject(s)
Surgical Instruments , Surgical Procedures, Operative/methodsABSTRACT
Se presenta el caso de una paciente de 71 años, con antecedente de colecistectomía hace 27 años, remitida al departamento de cirugía para evaluación de masa intraabdominal, por hallazgo imagenológico de masa calcificada sugestiva de lesión tumoral tanto por ecografía como por tomografía axial computarizada abdominal, por lo cual fue llevada a cirugía en donde se evidenció textiloma quirúrgico. El hallazgo de calcificación en la tomografía axial computarizada probablemente fue el factor de confusión causante del diagnóstico erróneo. El textiloma debe ser incluido dentro de los diagnósticos diferenciales de masas abdominales, especialmente en pacientes con antecedentes de cirugías abdominales previas, incluso ante hallazgos típicos sugestivos de características tumorales en los estudios de imágenes preoperatorias. Se exponen imágenes de los estudios prequirúrgicos del caso, de la pieza quirúrgica extraída durante el procedimiento y se realiza una revisión de la literatura.
The case of a 71 year-old patient is presented, with a history of cholecystectomy 27 years ago, who was referred to the surgery department for evaluation of an intrabdominal mass. On imaging studies there was a calcificated mass suggestive of tumoral lesion either by abdominal ecography and abdominal computed tomography, because of this she was carried to surgery where a textiloma was found. The calcification on the abdominal computed tomography probably was the factor which caused the wrong diagnosis. Textiloma should be included in the differential diagnosis of abdominal masses, especially in patients with a prior history of abdominal surgery, even with typical tumorous characteristics on preoperative imaging studies. Hereafter are exposed image of preoperative studies of the case, of the surgical piece removed during the procedure and a literature review is made.