Rotura traumática simultánea y bilateral del tendón del cuádriceps en un paciente fisicoculturista: informe de caso y revisión de la literatura / Simultaneous bilateral traumatic quadriceps tendon rupture in a bodybuilding patient: case report and literature review

La rotura traumática, simultánea y bilateral del tendón cuadricipital es una lesión infrecuente, generalmente asociada a otras enfermedades sistémicas tales como insuficiencia renal o trastornos endocrinos. Presentamos el caso de un varón sano y atleta de 38 años que sufrió esta lesión mientras realizaba una sentadilla en el gimnasio. (AU)

The traumatic bilateral and simultaneous quadriceps tendon rupture is a rare injury, usually associated with other systemic diseases such as renal insufficiency or endocrine disorders. We present the case of a 38-year-old healthy male athlete who sustained this injury while performing a squat at the gym. (AU)

Rupturas del tendón del supraespinoso: correlación entre RMN y hallazgos quirúrgicos / Supraspinatus tendon ruptures: correlation between MRI and surgical findings

Resumen: Introducción: En la ruptura del manguito de los rotadores, el tendón del supraespinoso ocupa el primer lugar en frecuencia. La resonancia magnética es el estudio de elección para el diagnóstico y planificación preoperatoria. El objetivo de este estudio fue evaluar la concordancia entre los hallazgos observados con la IRM y los hallazgos transoperatorios en pacientes con ruptura del tendón del supraespinoso. Material y métodos: Se realizó un análisis retrospectivo de Enero de 2014 a Enero de 2020. Se incluyeron pacientes mayores de 18 años, con IRM y reporte de ruptura del tendón del supraespinoso. Se realizó un análisis de χ2 para la sensibilidad, especificidad, valores predictivos y certeza diagnóstica utilizando los hallazgos quirúrgicos como referencia. Se utilizó el índice de Kappa para mostrar la concordancia entre IRM y hallazgos transoperatorios. Resultados: Un total de 79 pacientes se incluyeron en el estudio, 45 masculinos y 34 femeninos. La edad promedio fue de 52.14 años. La IRM diagnosticó correctamente 60.76% de las rupturas del supraespinoso, mostró una sensibilidad de 74% y especificidad de 96% para rupturas completas. Para rupturas parciales mostró una sensibilidad de 96% y una especificidad de 33%. El índice de Kappa mostró una concordancia de 0.90 para rupturas totales y de 0.53 para rupturas parciales. Conclusiones: La resonancia magnética demostró una buena sensibilidad y especificidad para el diagnóstico de rupturas completas, con una buena concordancia con los hallazgos quirúrgicos. La IRM demostró ser un estudio poco específico para la identificación de rupturas parciales, lo cual genera que estas lesiones estén sobrediagnosticadas.

Abstract: Introduction: In rotator cuff rupture, the supraspinatus tendon ranks first in frequency. MRI is the study of choice for preoperative diagnosis and planning. The objective of this study was to assess the concordance between findings observed with MRI and transoperative in patients with supraspinatus tendon rupture. Material and methods: A retrospective analysis was conducted from January 2014 to January 2020. Including patients over the age of 18, with MRI and supraspinatus tendon rupture report. A χ2 analysis was performed for sensitivity, specificity, predictive values and diagnostic certainty using surgical findings as a reference. The kappa index was used to show the concordance between MRI and transoperative findings. Results: A total of 79 patients were included in the study, 45 male and 34 female. The average age was 52.14 years. MRI correctly diagnosed 60.76% of supraspinatus ruptures, showing 74% sensitivity and 96% specificity for complete ruptures. For partial ruptures I show a sensitivity of 96%, a specificity of 33%. The kappa index showed a match of 0.90 for total ruptures and 0.53 for partial. Conclusions: MRI demonstrated good sensitivity and specificity for diagnosing complete ruptures, with good match to surgical findings. MRI proved to be a non-specific study for the identification of partial ruptures, which causes these lesions to be overdiagnosed.

Hallazgos ecográficos normales y complicaciones de implantes mamarios en Colombia / Normal Ultrasound Findings and Complications of Breast Implants in Colombia

La mamoplastia de aumento con implantes y la reconstrucción mamaria posmastectomía son algunos de los procedimientos quirúrgicos más frecuentes en cirugía plástica. Los implantes mamarios se encuentran entre los dispositivos médicos con mayor cantidad de informes por eventos adversos en el país. La extracción del implante es el estándar de oro ante la sospecha de la ruptura del mismo; sin embargo, hay poca claridad respecto a qué estrategias e imágenes son las adecuadas para la evaluación no invasiva de estos. La ecografía de alta resolución ha mostrado ser una alternativa para la evaluación inicial. Debido a la variabilidad de los implantes es necesario reconocer sus características imagenológicas. En este artículo se presentan los hallazgos ecográficos de los implantes, incluyendo aquellos que se pueden generar por marquillas o distintivos propios de la marca, y los propios de las complicaciones más comunes asociadas a ellos.

Implant augmentation mammoplasty and post-mastectomy breast reconstruction are some of the most frequent surgical procedures in plastic surgery. Breast implants are among the medical devices with the highest amount of reports of adverse events in our country. In suspicion of rupture, removal is the gold standard. However, there is little clarity regarding which strategies and images are adequate for non-invasive evaluation. High resolution ultrasound has shown to be an alternative for the initial evaluation. Due to the variability of the implants it is necessary to recognize their imaging characteristics. This article presents the findings of the ultrasound of the implants, including those that can be generated by tags or marks distinctive of the brand and those of the most common complications associated with them

CT-guided minimally-invasive penile fracture repair

ABSTRACT We present the case of a 28 year old patient with an incomplete tear of the tunica albuginea occurred after having sexual intercourse in the female superior position. The diagnostic assessment was performed first clinically, then with CT, owing to its high resolution, allowed to exactly detect the tear location leading to precise preoperative planning. After adequate diagnosis through imaging and proper planning, the patient was performed a selective minimally invasive surgical approach to repair the lesion. The patient had good erection with no angular deformity or plaque formation after a 3-month follow-up.

Ruptura diafragmatica postraumatica en pediatria: A proposito de un caso / Post traumatic diaphragmatic rupture in children: Case report

La ruptura diafragmática es una entidad relativamente infrecuente en pediatría que se puede presentar como consecuencia de un traumatismo de alto impacto. Solo entre el 25% y el 50% de los casos es detectado en la evaluación inicial del paciente, lo que aumenta el riesgo de complicaciones. En este trabajo, se presenta el caso de una paciente asintomática, de 8 años de edad, que, tras un accidente vehicular y la evaluación inicial en otro centro, fue derivada a nuestra Institución para el control evolutivo. A las 36 horas del ingreso, presentó hipoventilación pulmonar izquierda. La tomografía demostró un ascenso intratorácico del ángulo esplénico del colon y asas de intestino delgado. Se efectuó la exploración y el tratamiento quirúrgico. Los controles radiográficos diferidos no mostraron signos de recidiva.

Diaphragmatic rupture is a relatively uncommon entity in pediatrics that can occur as a result of a high-impact trauma. Only between 25 and 50% of the cases are detected in the initial evaluation of the patient, which increases the risk of complications. This paper presents the case of an asymptomatic 8-year-old patient who was referred to our institution after a vehicular accident. A day and a half after admission, a left pulmonary hypoventilation was detected. Computed tomography scan showed intrathoracic elevation of the splenic angle of the colon and the small bowel. Surgical exploration and treatment were performed. Deferred radiographic controls showed no signs of relapse.

Traumatic rupture of liver hydatid cysts into the peritoneal cavity of an 11-year-old boy: a case report from Iran

Abstract This is the first published case report of an 11-year-old patient with a rupture of a liver hydatid cyst (HC) into the peritoneal cavity after an abdominal trauma in Iran. The disease was diagnosed using focused abdominal sonography for trauma. To date, no cases of traumatic ruptures of liver HCs in children have been reported in Iran. In the endemic regions of the world, where patients suffer from a history of trauma and constant abdominal symptoms or anaphylactic shock, early diagnosis of HC is crucial as it may disseminate to other organs. The condition needs conservative surgery and follow-up.

Hepatic hydatid cyst rupture and anaphylaxis after a fall.

A 15-year-old boy presented to the emergency unit complaining of dyspnea, urticaria and vomiting developed after he fell down when he was playing football. Abdominal ultrasound showed a ruptured hydatid cyst in the right lobe of the liver which was of communicating type. Echinococcus granulosus serologic tests were positive. Medical treatment was started immediately. One week later, follow up US showed no changes in the findings. Intrabdominal fluid leakage was not detected. Patient's general condition showed improvement and he was discharged 12 days later.

Ruptured Epidermal Inclusion Cysts in the Subareolar Area: Sonographic Findings in Two Cases

Epidermal inclusion cyst of the breast is an uncommon benign lesion and it is usually located in the skin layer. We report here on two cases of ruptured epidermal inclusion cysts in the subareolar area, which is a very unusual location for these cysts and these lesions can be mistaken for breast malignancies.

Diagnosis and Follow-up US Evaluation of Ruptures of the Medial Head of the Gastrocnemius ("Tennis Leg")

OBJECTIVE: The purpose of this study was to demonstrate the ultrasonographic (US) findings of rupture and the healing process of the medial head of the gastrocnemius ("Tennis Leg"). MATERIALS AND METHODS: Twenty-two patients (age range: 30 to 45 years) with clinically suspected ruptures of the medial head of the gastrocnemius were referred to us for US examination. All the patients underwent US of the affected limb and the contralateral asymptomatic limb. Follow-up clinical evaluation and US imaging of all patients were performed at two-week intervals during the month after injury and at one-month intervals during the following six months. RESULTS: Of the 22 patients who had an initial US examination after their injury, partial rupture of the medial head of the gastrocnemius muscle was identified in seven patients (31.8%); the remaining 15 patients were diagnosed with complete rupture. Fluid collection between the medial head of the gastrocnemius and the soleus muscle was identified in 20 patients (90.9%). The thickness of the fluid collection, including the hematoma in the patients with complete rupture (mean: 9.7 mm), was significantly greater than that seen in the patients with partial tear (mean: 6.8 mm) (p < 0.01). The primary union of the medial head of the gastrocnemius with the soleus muscle in all the patients with muscle rupture and fluid collection was recognized via the hypoechoic tissue after four weeks. CONCLUSION: Ultrasonography is a useful imaging modality for the diagnosis and follow-up examination for the patients suffering with rupture of the medial head of the gastrocnemius.