Primary abdominal gas gangrene: a report of two autopsy cases

Primary hepatic gas gangrene is a form of primary abdominal gas gangrene. The condition is caused by Clostridium perfringens, other clostridia, and non-clostridia bacterial species producing gas. Unlike classical gas gangrene or myonecrosis, the disease develops without a wound or a port of entry. Instead, gas-producing bacteria in the gastrointestinal tract colonize an underlying pathological process with foci of necrosis, producing excessive gas and spreading hematogenously to other organs. Herein we present two autopsy cases of primary hepatic gas gangrene diagnosed on autopsy, with the gross and histological changes that can be considered specific for this rare condition. Both patients had severe underlying liver disease-prone for this entity development. The gross changes in the cases are postmortem subcutaneous emphysema, skin bullae with pooled blood, pneumothorax, pneumoabdomen, abundant gas in the circulatory system, porous structure of the internal organs (tissue gas bubbles), and advanced tissue lysis, not corresponding to the post mortem time. Histology showed optically empty areas of varying size in the internal organs, which weave the structure of the organs and rod-shaped bacteria with scarcity or complete absence of inflammatory reaction.

Abdominal Actinomycosis misdiagnosed as liposarcoma

Actinomycosis is an uncommon, endogenous, and chronic infection with varied and nonspecific clinical features such as abdominal, pelvic or cervical masses, ulcerative lesions, abscesses, draining fistula, fibrosis, and constitutional symptoms. The disease ensues when the bacteria disrupt the mucosal barrier, invade, and spread throughout interfascial planes. Currently, the diagnosis of actinomycosis is challenging because of its very low frequency and depending on the clinical presentation it may masquerade malignancies. Therapy consists initially in intravenous penicillin, followed by an oral regimen that may be extended until a year of treatment. A timely diagnosis is crucial to avoid extensive therapeutic attempt as surgery. However, a biopsy or drainage of abscesses and fistula's tract may be required not only as a diagnostic procedure as part of the therapy. We report the case of a 72-year-old woman with an abdominal mass initially misdiagnosed as a liposarcoma. A second biopsy of a skin lesion of the abdominal wall made the diagnosis of actinomycosis, avoiding a major surgical procedure. The patient was treated with a long-term course of antibiotics with favorable outcome. Liposarcoma was ruled out after the patient's full recovery with antibiotics and the misdiagnosis was credit to the overconfidence on the immunohistochemical positivity to MDM2.

Onfaloplastia em triângulo isósceles e com dupla fixação na abdominoplastia / Omphaloplasty based on an isosceles triangle with double fixation in abdominoplasty

Introdução: Na abdominoplastia convencional, a cicatriz do novo umbigo representa o ponto de maior desafio. Em sua execução, já foram descritas e utilizadas várias técnicas e táticas cirúrgicas, com resultados nem sempre satisfatórios, sob o ponto de vista do paciente e também do médico. O objetivo é demonstrar a aplicabilidade e satisfação com a onfaloplastia em triângulo isósceles e com dupla fixação na abdominoplastia. Métodos: Foram selecionadas 97 pacientes do sexo feminino, com idades entre 25 e 65 anos. Todas foram submetidas à dermolipectomia abdominal clássica associada à lipoaspiração moderada de todo abdome anterior e flancos e avaliadas com 90, 180 e 360 dias pós-operatórios, pelo mesmo cirurgião. Resultados: Observou-se um índice de resultados satisfatórios das cicatrizes umbilicais na maioria dos casos (92,8%). Algumas cicatrizes umbilicais apresentaram estenoses (3,1%) e outras, cicatrizes inestéticas (4,1%). Não se observaram necroses. Conclusão: A utilização desta técnica demonstrou ser eficaz, de fácil execução e com resultados muito satisfatórios na estética da cicatriz umbilical nas dermolipectomias abdominais.

Introduction: In conventional abdominoplasty, the creation of a new umbilical scar is challenging. Several surgical techniques and approaches have previously been described and applied, but not always with satisfactory results. The objective is to demonstrate the applicability and satisfaction with omphaloplasty based on an isosceles triangle with double fixation in abdominoplasty. Methods: The study included 97 female patients aged between 25 and 65 years. All underwent classic abdominal dermolipectomy with moderate abdominal liposuction of the entire anterior abdomen and flanks by the same surgeon and were evaluated at 90, 180, and 360 days postoperatively. Results: Patients were satisfied with the umbilicus in most cases (92.8%). Some umbilical scars had contracted (3.1%) and others appeared unsightly (4.1%). No necrosis was observed. Conclusion: This technique was effective and easy to perform, with satisfactory umbilical scar aesthetic outcomes in abdominal dermolipectomy.

Brida amniótica abdominal, reporte de un caso / Precordial pain in pediatrics. Update

Existe un amplio espectro de deformidades causadas por bandas amnióticas, siendo las extremidades la ubicación más común. La banda de constricción en el abdomen es un lugar raro para el síndrome de brida amniótica. Presentamos un caso de banda de constricción circunferencial congénita del abdomen sin otras malformaciones. La condición no afectó la ventilación, la alimentación, las deposiciones o el crecimiento. Se planificaron múltiples Z-Plasties en el abdomen antes del primer mes de vida. Revisamos la literatura que hace hincapié en la presentación clínica y el tratamiento de esta rara entidad clínica.

There is a wide spectrum of deformities caused by amniotic bands, being the extremities the most common location. The constriction band in the abdomen is a rare location for constriction band syndrome. We report a case of congenital circumferential constriction band of abdomen without other malformations. The condition did not affect ventilation, feeding, bowel movements, or growth. Multiple Z-plasties were planned in the abdomen before the first month from birth. We reviewed the literature emphasizing on the clinical presentation and management of this rare clinical entity.

Factores asociados a las complicaciones en pacientes con laparotomía innecesaria (negativa o no terapéutica) en trauma de abdomen en Hospital Rosales del año 2012 al 2016 / Factors associated with complications in patients with unnecessary laparotomy (negative or non-therapeutic) in abdominal trauma at Rosales Hospital from 2012 to 2016

La incidencia del trauma se ha visto aumentada en los últimos años en todos los centros de traumatología. Durante años se han utilizado diversos métodos diagnósticos para su evaluación: siendo el examen físico la principal herramienta diagnóstica, seguido por el lavado peritoneal diagnóstico, el Ultrasonido Enfocado en Trauma, Tomografía Computarizada, y la Laparoscopía Diagnóstica. Estos métodos son de vital importancia porque nos conducen a la toma decisión en cuanto al tratamiento quirúrgico o no quirúrgico. Los autores hemos considerado de suma importancia el estudio de complicaciones en laparotomía negativas en el Hospital Nacional Rosales. Se realizó un estudio retrospectivo analítico de casos y controles no apareados, en pacientes intervenidos en la Unidad de Emergencia del Hospital Nacional Rosales por trauma abdominal, cuyo resultado fue laparotomía negativa en el periodo del 1ero de enero del 2012 al 30 de junio del 2016. Se encontró una muestra de 44 pacientes a quienes se les realizo laparotomía innecesaria. De los cuales fueron 40(90.9%) hombres y 4 mujeres (9.1%). Edad media de 31.57 años. Del total de Laparotomías Innecesarias, 26 (59%) eran sin hallazgos y 18 (41%) eran no terapéuticas. 12 pacientes presentaron complicaciones postquirúrgicas, conformando el grupo caso, y 32 no presentaron complicaciones postquirúrgicas, conformando el grupo control. De todas las variables estudiadas como posibles factores de riesgo la única que muestra significancia estadística es el tipo de laparotomía, a favor de las que son sin hallazgos operatorios

Abdominoplasty after bariatric surgery: experience in 315 cases / Abdominoplastia pós cirurgia bariátrica: experiência de 315 casos

Introduction: The abdomen is a critical region and is subjected to body contour deformity after significant weight loss. Knowing the profile of patients who undergo abdominoplasty after bariatric surgery facilitates the choice of the optimal time and surgical technique to restore abdominal contour, which is associated with a minimal rate of complications. Methods: A cross-sectional, descriptive, analytical, and retrospective clinical study was performed on medical record data of 315 patients who underwent abdominal dermolipectomy following bariatric surgery from January 2013 to December 2014. Results: A total of 265 female and 50 male patients were analyzed, with an average age of 39.9 years and an average body mass index of 27.5 kg/m2 after weight loss. The average time interval between bariatric surgery and dermolipectomy was 3 years and 11 months. Anchor abdominoplasty was used in 252 patients, while suprapubic transverse abdominoplasty was performed in 63 patients. The complication rate was 17.3%, including minor complications such as hematomas, seromas, and pathological scars, in addition to one case of pulmonary embolism. Conclusion: The epidemiological profile of patients with deformity of the abdominal contour after bariatric surgery was in agreement with that reported in the current literature, except for earlier hospital discharge in the group studied.

Introdução: O abdome é considerado área crítica de deformidade do contorno corporal após perda ponderal significativa. Conhecer o perfil dos pacientes submetidos à abdominoplastia pós-cirurgia bariátrica facilita a escolha do tempo ideal e da técnica cirúrgica que visa restaurar este contorno com uma taxa mínima de complicações. Métodos: Estudo clínico, transversal, descritivo, analítico e retrospectivo com dados de 315 prontuários de pacientes submetidos à dermolipectomia abdominal pós-cirurgia bariátrica de janeiro de 2013 a dezembro de 2014. Resultados: Foram analisados 265 pacientes do gênero feminino e 50 do gênero masculino, com idade média de 39,9 anos e índice de massa corporal médio de 27,5 Kg/m2 após emagrecimento. O tempo médio de intervalo entre a cirurgia bariátrica e a dermolipectomia foi de 3 anos e 11 meses. A abdominoplastia em âncora foi utilizada em 252 pacientes e em 63 realizou-se abdominoplastia com cicatriz transversal suprapúbica. A taxa de complicações foi de 17,3%, incluindo complicações menores como hematomas, seromas e cicatrizes patológicas e um caso de embolia pulmonar. Conclusão: O perfil epidemiológico dos pacientes com deformidade de contorno abdominal pós-cirurgia bariátrica estudados assemelha-se ao apresentado na literatura atual, exceto pela alta hospitalar precoce.

Malformações detectadas pelo ultrassom abdominal em crianças com cardiopatia congênita / Malformations detected by abdominal ultrasound in children with congenital heart disease

FUNDAMENTO: Malformações extracardíacas podem estar presentes em pacientes com cardiopatia congênita (CC), trazendo maior risco de comorbidade e mortalidade. OBJETIVO: Verificar a frequência e os tipos de anormalidades abdominais detectadas em crianças com e sem CC através do ultrassom abdominal (USA), comparar os pacientes quanto a seus achados dismórficos/citogenéticos e realizar uma estimativa do custo-benefício da triagem pelo USA. MÉTODOS: Foi realizado um estudo transversal com controle. Os casos consistiram de pacientes com CC admitidos pela primeira vez em uma unidade de terapia intensiva pediátrica; os controles consistiram de crianças sem CC submetidas ao USA no hospital logo após cada caso. Todos os pacientes com CC foram submetidos ao USA, ao cariótipo de alta resolução e à hibridização in situ fluorescente (FISH) para microdeleção 22q11.2. RESULTADOS: USA identificou anormalidades clinicamente significativas em 12,2% dos casos e em 5,2% dos controles (p = 0,009), com um poder de significância de 76,6%. A maioria das malformações com significado clínico foi de anomalias renais (10,4% nos casos e 4,9% nos controles, p = 0,034). No Brasil, o custo de um exame de USA pelo Sistema Único de Saúde é de 21 dólares. Uma vez que anormalidades clinicamente significativas foram observadas em um a cada 8,2 pacientes com CC, o custo para identificar uma criança afetada foi de 176 dólares. CONCLUSÃO: Pacientes com CC apresentam uma frequência significativa de anomalias detectadas pelo USA, um método diagnóstico barato e não invasivo, com boa sensibilidade. O custo da triagem para esses defeitos é consideravelmente menor que o custo para tratar as complicações do diagnóstico tardio de malformações abdominais, como a doença renal.

BACKGROUND: Extracardiac malformations may be present in patients with congenital heart disease (CHD), bringing greater risk of comorbidity and mortality. OBJECTIVE: Verify frequency and types of abdominal abnormalities detected in children with and without CHD through abdominal ultrasound (AUS), compare the patients in relation to their dysmorphic/cytogenetic findings and perform an estimative of the cost-effectiveness of the screening through AUS. METHODS: We conducted a cross-sectional study with a control cohort. The cases consisted of patients with CHD admitted for the first time in a pediatric intensive care unit; the controls consisted of children without CHD who underwent AUS at the hospital shortly thereafter a case. All patients with CHD underwent AUS, high-resolution karyotype and fluorescence in situ hybridization (FISH) for microdeletion 22q11.2. RESULTS: AUS identified clinically significant abnormalities in 12.2% of the cases and 5.2% of controls (p= 0.009), with a power of significance of 76.6%. Most malformations with clinical significance were renal anomalies (10.4% in cases and 4.9% in controls; p= 0.034). In Brazil, the cost of an AUS examination for the Unified Health System is US$ 21. Since clinically significant abnormalities were observed in one in every 8.2 CHD patients, the cost to identify an affected child was calculated as approximately US$ 176. CONCLUSION: Patients with CHD present a significant frequency of abdominal abnormalities detected by AUS, an inexpensive and noninvasive diagnostic method with good sensitivity. The cost of screening for these defects is considerably lower than the cost to treat the complications of late diagnoses of abdominal malformations such as renal disease.

Anomalías congénitas / Congenital anomalies

Las anomalías congénitas en conjunto con la restricción del crecimiento intrauterino dan cuenta del 50 a 60 por ciento de la mortalidad fetal. En este artículo se describen las malformaciones congénitas más importantes divididas por sistemas, la mayoría son diagnosticables a través del ultrasonido; sin embargo, hay un grupo de ellas que no son posibles de diagnosticar, otras que se desarrollan tardíamente en el embarazo y finalmente existen casos en que el examen ultrasonográfico puede sugerir una anormalidad inexistente. También se profundiza en la incidencia, etiología y factores de riesgo de las malformaciones congénitas, se describe la importancia y características del diagnóstico prenatal y de la prevención por medio de la suplementación de ácido fólico en la dieta.

Congenital anomalies in conjunction with intrauterine growth restriction account for 50-60 percent of fetal mortality. This article describes major birth defects by systems; most can be diagnosed by ultrasound while others cannot. Some anomalies develop later in pregnancy and in some cases sonographic examination may suggest the presence of a nonexistent abnormality. Incidence, etiology and risk factors of congenital malformations are described, as well as the importance and characteristics of prenatal diagnosis and prevention through folic acid supplementation in the diet.

Understanding the processus vaginalis: the abdomino scrotal hydrocoele / Entendiendo el proceso vaginal: el hidrocele abdomino-escrotal

A knowledge of the embryology and descent of the testes is essential for all clinicians. Congenital hydrocoele, though an embryologic anomaly can present in adulthood. A abdomino scrotal hydrocole must be considered when a mass in the lower abdomen co exists with a scrotal hydrocoele.

El conocimiento de la embriología y el descenso de los testículos es esencial para todos los clínicos. El hidrocele congénito, aunque es una anomalía embriológica se puede presentar en la edad adulta. Un hidrocele abdomino-escrotal debe ser considerado cuando una masa en la parte inferior del abdomen co existe con un hidrocele testicular.

Value of abdominal pressure measurement in neonatal abdominal surgical emergencies

To assess the predictive and prognostic value of abdominal pressure measurement in neonatal abdominal surgical emergencies. Case series. Zagazig University Hospitals [Egypt] and King Fahd Hospital, Hofuf [KSA]. Seventy nine neonatal abdominal surgical emergencies admitted and managed over a four-year period [Jan 2005 to Jan 2009] Measurement of abdominal pressure through management period. Abdominal pressure was classified into pressure at presentation [T1], preoperative [T2], and postoperative pressure [T3]. The levels of pressure were classified into [pA] below 12 mmHg, [pB] 12-20 mmHg, and [pC] more than 20 mmHg. Seventy-nine neonates were included. There was significant high abdominal pressure in jejunoileal atresia, necrotizing enterocolitis [NEC], and duodenal obstruction. In pyloric stenosis, there was no significant abdominal hypertension all over the management period. Temporary elevations occurred preoperatively [T1] in meconium ileus, cecal perforation, and jejunal stenosis. Significant association was found between [T1] and mortality, postoperative blood transfusion, need for mechanical ventilation, and sepsis. No correlation was found with blood need or sepsis. Postoperative complications had significant association with elevated postoperative abdominal pressure [T3]. Intra-abdominal pressure [IAP] can be of importance in monitoring changes which accompany neonatal surgical emergencies. It can be of predictive and prognostic value in neonatal surgical emergencies. However, more controlled studies are needed to confirm this conclusion

Hallazgos estomatológicos en insuficiencia renal crónica debido a síndrome de Prune Belly: reporte de caso / Oral findings in renal chronic failure from Prune Belly syndrome: case report

El síndrome de Prune Belly es una alteración congénita que puede conducir a insuficiencia renal crónica y alteraciones metabólicas como hiperparatiroidismo secundario. El presente caso describe un individuo masculino que padece insuficiencia renal crónica debido al síndrome de Prune Belly y presenta hallazgos estomatológicos como hipoplasia de esmalte, signos radiográficos de osteopenia a nivel de los maxilares y ausencia de lesiones de caries. Los exámenes radiográficos demostraron retardo de edad biológica en el paciente. Se brindó tratamiento odontológico preventivo.

Prune Belly's syndrome is a congenital alteration that can lead to chronic renal failure and metabolic alterations as secondary hyperparathyroidism. The present case describes a male who suffers chronic renal failure due to Prune Belly's syndrome and presents oral findings like hipoplasia of enamel, radiographic signs of osteopenia in the upper maxilla and absence of carious lesions. Radiographic analyses showed a delay in the biological age in the patient. Preventive treatment was offered to the patient.

Lipoabdominoplastia no tratamento de anormalidades estéticas do abdome / Lipoabdominoplasty in the treatment of abdominal aesthetic abnormalities

Objetivo: Avaliação da lipoabdominoplastia (LAP) no tratamento de alterações cosméticas da parede abdominal anterior. Método: Estudo prospectivo no qual 25 pacientes entre 21 a 51 anos, afetadas por acúmulos de gordura e excesso de pele na parede abdominal anterior, foram submetidas a LAP, que consiste na combinação da lipoaspiração com uma dermolipectomia convencional com descolamento reduzido do retalho abdominal. Resultados: Em média, as cirurgias duraram cerca de 3 horas e 15 minutos, com aspiração de 500 ml de gordura por paciente. Disestesias (88%), hipertrofias cicatriciais (76%), endurações (72%), distúrbios de contorno (52%), acúmulo e drenagem de coleções líquidas (36%), sufusões hemorrágicas (32%), dor intensa (20%), deiscências (8%), epiteliose (4%) e trombose venosa profunda (4%) foram os problemas encontrados. Não houve complicações graves, como embolia pulmonar, choque circulatório, infecção, necrose de pele, perfurações de cavidade peritoneal, cicatrização queloidiana ou óbitos. Os resultados cosméticos foram considerados satisfatórios na grande maioria dos casos (84%). Conclusões: A LAP demonstrou-se segura e com bons resultados estéticos.

Objective: Evaluation of lipoabdominoplasty (LAP) in the treatment of anterior abdominal wall aesthetic abnormalities. Method: A prospective study in 25 patients aged between 21 to 51 years, affected by the excess of fat and skin in the anterior abdominal wall, submitted to LAP, which is the combination of liposuction with a conventional dermolipectomy with small detachment of the abdominal flap. Results: Mean surgical time was 3 hours and 15 minutes, with 500 ml of aspirated fat per patient. Dysesthesia (88%), hypertrophic scarring (76%), induration (72%), abnormal body contour (52%), accumulation and drainage of fluid collections (36%), hemorrhagic disorders (32%), severe pain (20%), dehiscence (8%), epiteliosis (4%) and deep venous thrombosis (4%) were the problems encountered. There were no severe complications, such as pulmonary embolism, circulatory shock, infection, skin necrosis, peritoneal cavity perforation, keloid scar or deaths. The cosmetic results were considered satisfactory in most cases (84%). Conclusions: The LAP was safe and with good aesthetic results.

Multiple vascular anomalies in the abdomen: a gross anatomical study / Múltiples anomalías vasculares en el abdomen: un estudio anatómico macroscópico

Knowledge of the branching pattern of the abdominal aorta is clinically important for any abdominal surgeon operating on parts of the gut or neighboring structures like the suprarenals, spleen, pancreas, liver, kidneys and ureter. The presence of abnormal inferior phrenic artery associated with aberrant branch from the celiac trunk supplying the pancreas and duodenum is a rare anomaly. In the present case, we observed four branches of the celiac artery i.e. (a) left gastric artery (b) common hepatic artery (c) splenic artery and (d) an aberrant branch, which took a course inferiorly towards the pancreas. The aberrant artery supplied the body of the pancreas and gave a branch which supplied the horizontal part of the duodenum and then entered the transverse mesocolon to supply the hepatic flexure and some portions of the ascending and the transverse colon. The inferior phrenic artery was absent on the left side. Concomitant anomalies of such type are to be kept in mind by the surgeon, while operating cases of carcinoma head of pancreas and performing kidney transplantations.

El conocimiento del patrón de ramificación de la aorta abdominal es clínicamente importante para cualquier cirujano abdominal que opere en partes del intestino o estructuras vecinas, como glándulas suprarenales, bazo, páncreas, hígado, riñones y uréteres. La presencia anormal de la arteria frénica inferior asociada con una rama aberrante originada del tronco celiaco, supliendo el páncreas y duodeno, es una variación anatómica rara. En el presente caso, se observaron cuatro ramas de la arteria celiaca: (a) arteria gástrica izquierda (b) arteria hepática común (c) arteria esplénica y (d) una rama aberrante, que tuvo un curso inferior hacia el páncreas. La arteria aberrante suministraba irrigación al cuerpo del páncreas y daba una rama para la parte horizontal del duodeno para luego entrar en el mesocolon transverso para irrigar la flexura hepática y algunas partes del colon ascendente y transverso. La arteria frénica inferior estaba ausente en el lado izquierdo. Anomalías concomitantes de este tipo deben ser consideradas por el cirujano, en casos de operación de carcinoma de cabeza de páncreas y la realización de trasplante renal.

Frequency of abnormalities detected by upper abdominal ultrasound.

OBJECTIVE: The present study was undertaken to categorize frequency of abnormalities detected by upper abdominal ultrasound. MATERIAL AND METHOD: The present study was conducted on 3,398 people between the ages of 16 and 93 years old, who had the annual health check-up between October 2003 and May 2004 at the Health Promotion Center Bangkok Hospital Medical Center (all of those participating were defined as "patients"). Of these, 1,930 are men (56.8%) and 1,468 are women (43.2%). In the present study, the data of age, gender, and upper abdominal ultrasound findings were assessed. RESULTS: Of the 3,398 subjects, 1,782 patients (52.4%) had positive findings; 1,147 of which were men (64.4%) and 635 were women (35.6%). Fatty liver, being the most common positive finding, was observed in 1,219 patients (35.9%); 831 of which were men (68.2%) and 388 were women (31.8%). The finding of a liver mass, as the second positive finding, was observed in 209 patients (6.2%); of which were 124 patients (59.3%) with hepatic cyst, 51 patients (24.4%) with hemangioma, 16 patients (7.7%) with indetermined nodule, 11 patients (5.3%) with calcification, and 7 patients (3.4%) with malignant tumor while 664 patients (19.5%) had other positive findings. The top four included gallbladder polyp observed in 181 patients (5.3%), renal cyst observed in 155 patients (4.6%), gallstone observed in 141 patients (4.2%), and renal stone observed in 101 patients (3.0%). CONCLUSION: The prevalence of abnormalities detected by upper abdominal ultrasound was 52.44%. The most common finding was fatty liver (35.87%). Although the majority of positive findings were benign conditions, some of them might have an adverse effect to the health condition of patients in the long run. The ultrasound findings also yielded the patient management to prevent subsequent disease and to perform medical treatment or follow up.

Open indirect cardiac massage in neonate.

Open, direct cardiac massage (OCM), as a technique of resuscitation has not been very inspiring due to its various limitations. We report a case of resuscitation where open 'indirect' cardiac massage was used to resuscitate a neonate successfully. A 24 hr old neonate with multiple gastrointestinal anomalies presented for emergency laparotomy. Intraoperatively she suffered a cardiac arrest. External chest compressions (ECC) failed to produce detectable circulation and surgeons were asked to initiate direct cardiac compressions. They could palpate and successfully compress the heart without the need to split the diaphragm. This 'infra-diaphragmatic' approach resulted in adequate circulation and subsequent uncomplicated recovery.

Avaliação de malformações de tronco, face e membros fetais por ressonância magnética / Evaluation of fetal trunk, face and limbs malformations by magnetic resonance imaging

O uso da ultra-sonografia durante a gestação fornece uma grande quantidade de informações valiosas a respeito do bem estar materno e fetal. Entretanto, em alguns casos a qualidade da imagem pode ser ruim devido a fatores como obesidade materna, posicionamento fetal e outros. A ressonância magnética pode fornecer imagens multiplanares sem exposição à radiação. Melhorias na tecnologia de aquisição de imagens por ressonância magnética vêm reduzindo o tempo de exame. / The use of ultrasound scan during gestation supplies a great amount of valuable information regarding the maternal and fetal health. However, in some cases the quality of the image can be bad due to factors such as maternal obesity, fetal positioning and others. The magnetic resonance can supply multiplanar images without radiation...

Reconstrucción cardiaca en gemelos toracopagos mediante imagenes de tomografia computada y resonancia magnetica / Cardiac reconstruction in thoracopagus conjoined twins using computarized tomography and magnetic resonance imaging

En Chile las malformaciones congénitas son la segunda causa de mortalidad infantil. La colección de fetos y recién nacidos malformados con que cuenta la Sección de Teratología del Departamento de Anatomía, Facultad de Medicina de la Universidad de Chile, permite conocer y estudiar patologías que, por su baja frecuencia sólo son conocidas por los especialistas. Los gemelos unidos son una condición, en la cual existe predominio en el sexo femenino y su etiología es desconocida. Se estudia el caso, de gemelos unidos del tipo tóraco-onfalópagos, con una fusión amplia desde el esternón hasta la región umbilical, que hubiese requerido de exactitud diagnóstica, para delimitar la interdependencia anatómica y sus posibles consecuencias funcionales, ante una eventual corrección quirúrgica y posible viabilidad. Con este objetivo, se utilizaron técnicas convencionales y avanzadas de imagenología en su estudio, como radiografías, ultrasonografías, TC y RM. Estas dos últimas, se digitalizaron para realizar una reconstrucción anatómica tridimensional in situ con el programa Somavisión.