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1.
Arq. bras. med. vet. zootec. (Online) ; 73(2): 383-394, Mar.-Apr. 2021. graf, ilus
Article in English | ID: biblio-1248923

ABSTRACT

This study used B-mode and Doppler ultrasonography to characterize the abdominal structures of healthy peccaries raised in captivity. Fifteen peccaries were used for this study. The urinary vesicle appeared as an ovoid structure, located in the abdominal and pelvic transition, with a hyperechogenic, thin, smooth, and regular wall. The kidneys presented retroperitoneal topography and had similar sizes. The kidney/aorta ratio had an average value of 10.53±15cm (right) and 10.23±0.12 (left). The right adrenal gland had a length of 1.93±0.34cm and diameter of 0.56±0.16cm. The left adrenal gland had a length of 1.85±0.42cm and diameter of 0.52±0.11cm. The spleen had a diameter of 1.13±0.18cm. The hepatic vein demonstrated polyphasic flow in pulsed Doppler, with two retrograde peaks and an anterograde peak with a flow velocity of 25.7±0.83cm/s. The abdominal aorta had a diameter of 0.58±0.05cm and a flow velocity of 115.17±5.32cm/s. The morphological and hemodynamic study of the abdominal structures of the peccary, observed through B-mode and Doppler ultrasonography, aided in identifying the size, shape, position, echogenicity, and echotexture of the abdominal organs and in making inferences about the normal parameters for these structures in this species.(AU)


Este estudo teve como objetivo utilizar as ultrassonografias de modo-B e Doppler para caracterizar as estruturas abdominais de um cateto sadio criado em cativeiro. Quinze catetos foram utilizados para este estudo. A vesícula urinária apareceu como uma estrutura ovoide, localizada na transição entre as partes abdominal e pélvica, com uma parede hiperecogênica, fina, lisa e regular. Os rins apresentaram topografia retroperitoneal e tamanhos semelhantes. A relação rim/aorta teve um valor médio de 10,53 ± 15cm (direita) e 10,23 ± 0,12cm (esquerda). A glândula adrenal direita tinha um comprimento de 1,93 ± 0,34cm e um diâmetro de 0,56 ± 0,16cm. A glândula suprarrenal esquerda tinha um comprimento de 1,85 ± 0,42cm e um diâmetro de 0,52 ± 0,11cm. O baço tinha um diâmetro de 1,13 ± 0,18cm. A veia hepática demonstrou fluxo polifásico no Doppler pulsátil, com dois picos retrógrados e um pico anterógrado com velocidade de fluxo de 25,7±0,83cm/s. A aorta abdominal tinha um diâmetro de 0,58 ± 0,05cm e uma velocidade de fluxo de 115,17±5,32cm/s. Os estudos morfológico e hemodinâmico das estruturas abdominais do queixada, observadas por meio das ultrassonografias modo-B e Doppler, auxiliaram na identificação do tamanho, da forma, da posição, da ecogenicidade e da ecotextura dos órgãos abdominais e na realização de inferências sobre os parâmetros de normalidade para as estruturas nas espécies.(AU)


Subject(s)
Animals , Artiodactyla/anatomy & histology , Abdomen/diagnostic imaging , Hemodynamics , Echocardiography, Doppler/veterinary , Ultrasonography, Doppler/veterinary
2.
Rev. argent. cir ; 112(4): 539-542, dic. 2020. graf, il
Article in Spanish | LILACS, BINACIS | ID: biblio-1288167

ABSTRACT

RESUMEN Los paragangliomas son tumores originados en las células neuroendocrinas que forman el sistema nervioso autónomo. Se consideran benignos aunque pueden desarrollar malignidad, por lo que su tra tamiento es quirúrgico. La presentación de paraganglioma de ubicación mesentérica es muy inusual.


ABSTRACT Paragangliomas are rare neuroendocrine tumors that arise in the autonomic nervous system. Although these tumors are considered benign, they must be removed by surgery due to their potential malig nant transformation. Mesenteric paragangliomas are extremely rare.


Subject(s)
Humans , Female , Aged , Paraganglioma, Extra-Adrenal/surgery , Mesenteric Cyst/surgery , Tomography, X-Ray Computed , Abdominal Pain/complications , Abdomen/diagnostic imaging
3.
Rev. argent. radiol ; 84(4): 123-129, ago. 2020. tab, graf, il.
Article in Spanish | LILACS | ID: biblio-1149664

ABSTRACT

Resumen La diverticulosis es una entidad que predomina en países occidentales. Su prevalencia aumenta con la edad, presentándose en aproximadamente el 80% de la población mayor de 85 años. Los divertículos colónicos adquiridos son herniaciones saculares de la mucosa y submucosa (pseudodivertículos) y predominan en sigma, en países occidentales; los congénitos poseen las tres capas parietales (divertículos verdaderos) y predominan en colon derecho, en países asiáticos. Aproximadamente un 10%-25% de dichos pacientes con diverticulosis presentarán a lo largo de su vida un cuadro de diverticulitis aguda, representando una de las causas más frecuentes de abdomen agudo (3,8%). Clínicamente, se expresa por dolor abdominal en fosa ilíaca izquierda (excepción en dolicosigma/divertículos congénitos derechos) y pueden presentar complicaciones como flemones, abscesos, pileflebitis, peritonitis, con consiguiente riesgo de vida. La tomografía computada (TC) permite el diagnóstico oportuno, identificación de complicaciones y planificación terapéutica. A dicho fin se establecieron diferentes clasificaciones y modificaciones, siendo la más reconocida la propuesta por Hinchey (modificada por Wasvary y col., Kaiser y col.) y otras estableciendo correlaciones con el tratamiento, como la propuesta por Sartelli y col. El objetivo del presente estudio es realizar una revisión iconográfica de esta última (Sartelli y col.) y evaluar sus implicancias terapéuticas.


Abstract Diverticular disease is an entity with high prevalence in western countries that increases with age, and affects approximately 80% of the population over 85 years of age. Acquired colonic diverticula are saccular mucosal and submucosal herniation (pseudodiverticles) and predominate in sigma, in western countries; the congenital ones possess the three parietal layers (true diverticula) and predominate in right side colon, in Asian countries. Approximately 10%-25% of patients with colonic diverticulosis, in their lifetime will present an episode of acute diverticulitis, which represents one of the most frequent causes of acute abdominal pain (3.8%). Clinically it express by abdominal pain in the left iliac fossa (exception in dolicosigma / right congenital diverticula) and may present complications such as phlegmon, abscesses, pylephlebitis, peritonitis, life threatening conditions. Computed tomography (CT) allows timely diagnosis, identification of complications and therapeutic planning. To this end, several classifications have been used, from which Hinchey's is the most renown (modified by Wasvary et al, Kaiser et al.), and other ones establish therapeutic correlation such as the one proposed by Sartelli et al. The objective of the present study is to make an iconographic review of this last one (Sartelli et al.) and to evaluate its therapeutic implications.


Subject(s)
Humans , Adult , Diverticulitis/classification , Diverticulitis/therapy , Diverticulitis/diagnostic imaging , Tomography, X-Ray Computed , Colon , Abdomen/diagnostic imaging
4.
Rev. argent. cir ; 112(3): 337-342, jun. 2020. graf
Article in Spanish | LILACS | ID: biblio-1279749

ABSTRACT

RESUMEN La hiperplasia de células neuroendocrinas pancreáticas es una patología donde se produce un aumen to en el número de células de los islotes de Langerhans y a veces puede simular un proceso tumoral. Caso clínico: presentamos el caso de un paciente con tumor sólido de cola de páncreas, sintomático, al que se le realizó esplenopancreatectomía corporocaudal laparoscópica. El resultado anatomopatoló gico posterior informó una hiperplasia neuroendocrina. Conclusión: la hiperplasia de células neuroen docrinas debería considerarse en el diagnóstico diferencial de tumores sólidos de páncreas. La alterna tiva quirúrgica laparoscópica es factible cuando no es posible establecer el diagnóstico prequirúrgico con estudios de imágenes o biopsia.


ABSTRACT Pancreatic endocrine cell hyperplasia is defined as an increase in the number of cells of Langerhans islets and can sometimes mimic a tumoral process. Case report: a male patient with a symptomatic solid tail of pancreas tumor underwent laparoscopic distal pancreatectomy and splenectomy. The pathological examination reported neuroendocrine cell hyperplasia. Conclusion: pancreatic endocrine cell hyperplasia should be considered in the differential diagnosis of solid pancreatic tumors. Laparoscopic surgery is feasible when the preoperative diagnosis with imaging tests of biopsy is not possible.


Subject(s)
Humans , Male , Aged , Pancreas/pathology , Pancreatectomy/methods , Pancreatic Neoplasms/diagnosis , Pancreas/anatomy & histology , Tomography, X-Ray Computed , Ultrasonography , Laparoscopy , Neuroendocrine Cells , Abdomen/diagnostic imaging , Hyperplasia/diagnosis
6.
Rev. argent. cir ; 112(1): 43-50, mar. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1125780

ABSTRACT

Antecedentes: la colecistitis enfisematosa (CE) es una forma de presentación infrecuente de la colecistitis aguda. Material y métodos: presentecedentes patológicos, mientras que los otros eran diabéticos. A todos se les realizó tomografía computarizada (TC). Dos pacientes fueron sometidos a colecistectomía videolaparoscópica (CL) con buena evolución, mientras que en un caso se realizó colecistostomía percutánea (CP). Discusión: la CE se refiere a la presencia de gas en la luz o en la pared de la vesícula biliar. La tasa de morbilidad es del 50%. Los pacientes suelen padecer diabetes, pero puede presentarse en pacientes más jóvenes sin factores de riesgo. La TC es el método de elección para el diagnóstico. El tratamiento definitivo es la CL, aunque la CP es otra opción válida. Conclusión: la CL se considera un enfoque eficaz y seguro para el tratamiento de la CE.


Background: Emphysematous cholecystitis (EC) is a rare presentation of acute cholecystitis. Material and methods: We report three cases of EC in two men and one woman between 55 and 79 years. One of the patients was otherwise healthy while the other two were diabetics. A computed tomography (CT) scan was performed in all the cases. Two patients underwent video-assisted laparoscopic cholecystectomy with favorable outcome and one patient underwent percutaneous cholecystostomy. Discussion: Emphysematous cholecystitis is characterized by the presence of gas in the gallbladder lumen or wall. Mortality rate is 50%. Most patients are diabetics, but EC may present in younger patients without risk factors. Computed tomography scan is the method of choice for the diagnosis. Cholecystectomy is indicated as definite treatment, but percutaneous cholecystostomy may be a valid option. Conclusions: Laparoscopic cholecystectomy and antibiotics are effective and safe to treat.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Cholecystectomy, Laparoscopic/methods , Emphysematous Cholecystitis/surgery , Cholecystostomy/methods , Tomography, X-Ray Computed/methods , Abdominal Pain/complications , Emphysematous Cholecystitis/drug therapy , Emphysematous Cholecystitis/diagnostic imaging , Diabetes Complications , Abdomen/diagnostic imaging , Hypertension/complications
7.
Int. j. morphol ; 38(1): 17-22, Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1056390

ABSTRACT

Thorough knowledge of splenic artery course and morphology may help clinician to provide better practice. This Study aims at finding out if there was a relationship between splenic artery tortuosity index and age, sex, Body Mass Index (BMI) and abdominal cavity diameters. Routine abdominal Computerized Tomography (CT) scan images were retrospectively analyzed for 219 patients. Splenic artery tortuosity index was calculated. Abdominal cavity diameters were measured. Age, sex, and BMI were recorded. Splenic artery straight length (x) mean was 9.41 cm (SD 1.33). Splenic artery tortuous length mean was 15.15 cm (SD 3.31). Splenic artery tortuosity index mean was 1.63 (SD 0.36). Pearson correlation coefficient for Splenic artery tortuosity index vs. age was: 0.02 (P value 0.80). Splenic artery tortuosity index for females vs. males were 1.70 vs. 1.57 (P value 0.01). Pearson correlation coefficient for Splenic artery tortuosity index vs. BMI was 0.02 (P value 0.75). Pearson correlation coefficient for Splenic artery tortuosity index vs. abdominal cavity diameters were: Anterior-Posterior (AP) diameter -0.01 (P value 0.88) and transverse diameter 0.00 (P value 0.98). There may be a relationship between splenic artery tortuosity and female sex, but not with age, BMI and abdominal cavity diameters (AP and Transverse).


El conocimiento del curso y la morfología de la arteria esplénica puede ayudar al médico a proporcionar un diagnóstico y tratamiento oportuno al paciente. Este estudio tuvo como objetivo determinar si existe una relación entre el índice de tortuosidad de la arteria esplénica y la edad, el sexo, el índice de masa corporal (IMC) y los diámetros de la cavidad abdominal. Se tomaron imágenes retrospectivas, de rutina, de 219 pacientes de tomografía computarizada (TC) abdominal. Se calculó el índice de tortuosidad de la arteria esplénica. Se midieron los diámetros de la cavidad abdominal y se registró la edad, sexo y el IMC. La media de la longitud recta de la arteria esplénica (x) fue de 9,41 cm (DE 1,33). La longitud tortuosa de la arteria esplénica fue de 15,15 cm (DE 3,31). La media del índice de tortuosidad de la arteria esplénica fue de 1,63 (DE 0,36). El coeficiente de correlación de Pearson para el índice de tortuosidad de la arteria esplénica vs. edad fue: 0,02 (valor de P 0,80). El índice de tortuosidad de la arteria esplénica para las mujeres frente a los hombres fue de 1,70 frente a 1,57 (valor de P 0,01). El coeficiente de correlación de Pearson para el índice de tortuosidad de la arteria esplénica versus el IMC fue de 0,02 (valor de P 0,75). El coeficiente de correlación de Pearson para el índice de tortuosidad de la arteria esplénica frente a los diámetros de la cavidad abdominal fue: diámetro anterior-posterior (AP) -0,01 (valor P 0,88) y diámetro transversal 0,00 (valor P 0,98). Puede existir una relación entre la tortuosidad de la arteria esplénica y el sexo femenino, sin embargo no se encontró relación con la edad, el IMC y los diámetros de la cavidad abdominal (AP y transversal).


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Splenic Artery/anatomy & histology , Tomography, X-Ray Computed , Abdomen/diagnostic imaging , Splenic Artery/abnormalities , Splenic Artery/diagnostic imaging , Body Mass Index , Sex Factors , Analysis of Variance , Age Factors , Correlation of Data , Abdomen/anatomy & histology
8.
Int. j. morphol ; 38(1): 35-37, Feb. 2020. graf
Article in English | LILACS | ID: biblio-1056393

ABSTRACT

Ectopic liver tissue is a rare developmental abnormality. It is often asymptomatic and is commonly found incidentally, during surgery or autopsy. It has been reported in various abdominal and extra-abdominal sites, most often in the gall bladder. We are reporting an incidentally found mass in the left subdiafragmatic region, diagnosed as ectopic liver in abdominal CT and intraoperatively. We aim to assess the importance of imaging examinations in the differential diagnosis of intraabdominal masses ranging from benign to malignant entities and to point out that despite the low incidence of ectopic liver, it is necessary to be aware of this diagnostic possibility.


El tejido hepático ectópico es una rara anormalidad del desarrollo. A menudo es asintomático y generalmente se encuentra de manera incidental, durante la cirugía o la autopsia. Se ha informado en varios sitios abdominales y extraabdominales, con mayor frecuencia en la vesícula biliar. Reportamos el caso de una masa encontrada en la región subdiafragmática izquierda, diagnosticada como hígado ectópico en la TC abdominal e intraoperatoriamente. Nuestro objetivo fue evaluar la importancia de los exámenes por imágenes en el diagnóstico diferencial de masas intraabdominales que incluyen masas benignas como también malignas, y señalar que a pesar de la baja incidencia de hígado ectópico, es necesario tener en cuenta esta posibilidad en el diagnóstico.


Subject(s)
Humans , Aged , Choristoma/diagnostic imaging , Abdomen/pathology , Liver/pathology , Tomography, X-Ray Computed , Abdomen/diagnostic imaging
10.
Rev. cir. (Impr.) ; 71(3): 230-237, jun. 2019. tab, graf, ilus
Article in Spanish | LILACS | ID: biblio-1058262

ABSTRACT

INTRODUCCIÓN: La prevalencia de diverticulosis colónica en población general varía entre 20-60% según referencias internacionales, sin embargo, hay escasos datos nacionales. Un buen método para la detección de esta entidad es la tomografía computarizada de abdomen y pelvis (TACP). OBJETIVOS: Determinar la prevalencia de diverticulosis colónica en población general como hallazgo en tomografías computarizadas de abdomen y pelvis. MATERIALES Y MÉTODO: Estudio de corte transversal con estadística observacional, seleccionando pacientes sin antecedentes de diverticulosis que se realizaron TCAP en un hospital clínico en un periodo de 3 meses. Se revisan 1.449 TCAP y se incluyen 1.177 casos. RESULTADOS: La prevalencia general de divertículos colónicos fue de 28,3%, esta cifra aumenta con la edad alcanzando un 60% en mayores de 80 años. Casi un 90% se localizan en colon izquierdo, y los casos en lado derecho se acumulan en menores de 60 años. CONCLUSIONES: La prevalencia global de diverticulosis, detectadas por TCAP en esta población, corresponde a cerca del 30% de los pacientes.


INTRODUCTION: Asymptomatic colonic diverticular prevalence varies in the general population between 20 and 60% in international references, however, we couldn't find statistics about it in national reports. A method for detection of this nosological entity is the abdomen and pelvis computed tomography. AIM: Determine the prevalence of asymptomatic colonic diverticulosis in the general population as a find in abdomen and pelvis computed tomography (TCAP). MATERIALS AND METHOD: Cross-sectional study with descriptive statistics, selecting patients with no history of diverticulosis, who underwent TCAP in our Hospital. 1,449 cases are reviewed and 1,177 are included. RESULTS: The general prevalence of colonic diverticula was 28.3%. Their presence increases with age, being close to 60% in > 80 years. Almost 90% are located in the left colon, being more frequent the right side diverticulosis in population under 60 years. CONCLUSIONS B The overall prevalence of asymptomatic colonic diverticulosis, detected as a finding in TCAP, corresponds to about one third of patients.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Diverticulosis, Colonic/epidemiology , Pelvis/diagnostic imaging , Tomography, X-Ray Computed , Chile/epidemiology , Prevalence , Cross-Sectional Studies , Diverticulosis, Colonic/diagnostic imaging , Age and Sex Distribution , Asymptomatic Diseases , Abdomen/diagnostic imaging
11.
Acta bioquím. clín. latinoam ; 53(2): 175-182, jun. 2019. ilus, graf, tab
Article in Spanish | LILACS | ID: biblio-1019251

ABSTRACT

La injuria renal aguda es una entidad clínica compleja, caracterizada por la disminución abrupta de la función renal. La hipercalcemia como etiología de la misma es poco frecuente. Los mecanismos involucrados en su desarrollo son múltiples y poco estudiados. Se presenta el caso de un paciente varón de 59 años que desarrolló un cuadro severo de falla renal aguda como complicación de crisis hipercalcémica por un adenoma de paratiroides. Se observó alteración en los marcadores de daño y función renal. La bioquímica urinaria mostró una necrosis tubular aguda. Los niveles de calcio, parathormona y calciuria se asociaron a endocrinopatía. La ecografía, el centellograma y la biopsia paratiroidea mostraron la presencia de un adenoma. Se presentaron otras complicaciones sistémicas concomitantes como pancreatitis y complicaciones cardíacas. El tratamiento paliativo fue la hemodiálisis y el definitivo la paratiroidectomía. El síndrome de hueso hambriento se presentó como una complicación postquirúrgica. Tras el alta, la recuperación de la función renal nunca fue total. El daño renal agudo asociado a disfunción sistémica por hipercalcemia puede llevar a una recuperación parcial de la función renal. Se debe considerar el desarrollo de enfermedad renal crónica posterior a la falla renal aguda por hipercalcemia como complicación de la misma.


Acute renal injury is a complex clinical entity, characterized by the abrupt worsening in renal function. Hypercalcemia as its etiology is rare. The mechanisms involved in its development are multiple and rarely studied. The case of a 59-year-old male patient who developed a severe acute renal failure as a complication of an hypercalcemic crisis due to a parathyroid adenoma is presented here. Alterations in markers of damage and renal function were observed. Urinary biochemistry showed acute tubular necrosis. Calcium, parathormone and urine calcium levels were associated with endocrinopathy. The ultrasound, the scintigraphy and the parathyroid biopsy showed the presence of an adenoma. There were other concomitant systemic complications such as pancreatitis and cardiac complications. Hemodialysis was the palliative treatment, while the definitive treatment was parathyroidectomy. The hungry bone syndrome occurred as a postoperative complication. After discharge, recovery of renal function was never complete. Acute renal damage associated with systemic dysfunction due to hypercalcemia can lead to a partial recovery of renal function. The development of chronic kidney disease after acute renal failure due to hypercalcemia should be considered one of its complications.


A Lesão renal aguda é uma entidade clínica complexa, caracterizada pela diminuição abrupta da função renal. A hipercalcemia como etiologia da mesma não é muito frequente. Os mecanismos que participam no seu desenvolvimento são múltiplos e pouco estudados. Apresenta-se o caso de um paciente, homem, de 59 anos, que desenvolveu um quadro severo de insuficiência renal aguda como complicação de crise hipercalcêmica por um adenoma da paratireóide. Foi observada alteração nos marcadores de dano e função renal. A bioquímica urinária mostrou uma necrose tubular aguda. Os níveis de cálcio, paratormona e calciúria foram associados a endocrinopatia. A ultra-sonografia, a cintilografia, e a biópsia da paratireóide mostraram a presença de um adenoma. Apresentaram-se outras complicações sistêmicas concomitantes como pancreatite e cardíacas. O tratamento paliativo foi hemodiálise e o definitivo, a paratireoidectomia. A síndrome do osso faminto apresentou-se como uma complicação pós-operatória. Após a alta, a recuperação da função renal nunca foi total. O dano renal agudo associado à disfunção sistêmica por hipercalcemia pode levar para uma recuperação parcial da função renal. Deve ser considerado o desenvolvimento da doença renal crônica posterior à insuficiência renal aguda por hipercalcemia como complicação da mesma.


Subject(s)
Humans , Male , Middle Aged , Acute Kidney Injury/diagnosis , Hypercalcemia/complications , Thyroid Gland/diagnostic imaging , Abdomen/diagnostic imaging , Hypercalcemia/urine , Kidney Tubular Necrosis, Acute/urine
12.
Rev. argent. cir ; 111(2): 107-110, jun. 2019. ilus
Article in English, Spanish | LILACS | ID: biblio-1013354

ABSTRACT

Los quistes congénitos de la vía biliar son infrecuentes y se definen por la dilatación quística del árbol biliar en cualquiera de sus porciones. Los quistes del conducto cístico son aún menos frecuentes. Su etiología permanece incierta y el tratamiento consiste en la resección debido a su potencial desarrollo de malignidad. Presentamos el caso de una paciente en la que se diagnosticó dilatación del conducto cístico y fue tratada por vía laparoscópica.


Congenital biliary duct cysts are rare and are defined as cystic dilatations of the biliary tree in any of its portions. Cystic duct cysts are more uncommon. Their etiology remains uncertain and they should be resected due to the possible development of malignancy. We report the case of a female patient with a diagnosis of dilation of the cystic duct that was treated with laparoscopic surgery.


Subject(s)
Humans , Female , Adult , Young Adult , Choledochal Cyst/diagnostic imaging , Laparoscopy/methods , Biliary Tract Diseases/diagnosis , Cholecystitis/diagnosis , Ultrasonography , Abdomen/diagnostic imaging
14.
Rev. argent. cir ; 110(4): 218-219, dic. 2018. ilus
Article in Spanish | LILACS | ID: biblio-985194

ABSTRACT

Se registra el caso de una paciente femenina de 73 años con antecedente de colecistitis crónica, quien al examen físico presentaba una tumoración palpable en hipocondrio derecho que se extendía a fosa ilíaca derecha. La ecografía abdominal mostró aumento del tamaño vesicular que alcanzaba fosa ilíaca derecha con contenido multilitiásico; se confirmó dicho hallazgo con estudio tomográfico. Se realizó laparotomía exploradora con hallazgo operatorio de vesícula gigante de paredes engrosadas, tensa, adherida a órganos circundantes, de dificultosa disección, que requirió punción para drenaje de su contenido. Se efectuó, además, colecistectomía convencional según técnica de Pribram, y se obtuvo una pieza quirúrgica de aproximadamente 15 × 10 cm, con informe de anatomía patológica de colecistitis crónica. En contraste con la presentación habitual de la colecistitis crónica, el caso de referencia obedece a una presentación atípica con una vesícula gigante.


We report the case of a 73-year old female patient with a history of chronic cholecystitis with a palpable mass extending from the right hipochondrium to the right iliac region. An abdominal ultrasound showed an enlarged gallbladder extending to the right iliac region with multiple gallstones confirmed by computed tomography scan. An exploratory laparotmy was performed. A giant gallbladder with thickened walls and presence of adhesions to the neighbor organs that were difficult to remove were found and required drainage. A conventional cholecystectomy was performed using the Pribram's technique. A surgical specimen measuring 15 x 10 cm was sent to the pathologist who made a diagnosis of chronic cholecystitis. This case is an atypical presentation of chronic cholecystitis due to a giant gallbladder.


Subject(s)
Humans , Female , Aged , Cholecystectomy , Gallbladder/diagnostic imaging , Thorax/diagnostic imaging , Tomography, X-Ray Computed , Abdominal Pain/complications , Cholecystitis/complications , Ultrasonography , Abdomen/diagnostic imaging , Laparotomy
15.
Rev. argent. cir ; 110(4): 215-217, dic. 2018. ilus
Article in Spanish | LILACS | ID: biblio-985193

ABSTRACT

Los schwannomas, también llamados neurilemomas, son tumores originados en la vaina de los nervios periféricos. El 45% ocurren en cabeza y cuello, solo el 9% en mediastino y el 0,7-2,7% en retroperitoneo. La multicentricidad es extremadamente rara. Presentamos el caso de un paciente de 30 años que consultó por dolor torácico derecho asociado a derrame pleural, al que se le diagnosticó un schwannoma mediastinal posterior, el cual fue resecado en forma completa por cirugía videoasistida. A los 3 años, vuelve a consultar por dolor en flanco derecho y, al estudiarlo, se constata un nuevo schwannoma de localización retroperitoneal, que se resecó por vía abierta dada su posición retrocava. Describimos la metodología de estudio de esta neoplasia y los hallazgos histopatológicos que demostraron su benignidad. Conclusión: es una patología muy infrecuente pero con excelente pronóstico posoperatorio si la resección quirúrgica es completa.


Schwannomas, also known as neurilemmoma, are neurogenic tumors that arise from the peripheral nerve sheaths. Forty-five percent of schwannomas occur in the head and neck, 9% in the mediastinum and 0.7-2.7% in the retroperitoneum. Multiple shwannomas are extremely rare. We report the case of a 30-year old male patient with chest pain in the right hemithorax associated with pleural effusion due to schwannoma of the posterior mediastinum that was completely resected with video-assisted thoracoscopy. Three years later, he presented pain on the right lumbar region due to a retroperitoneal schwannoma behind the vena cava that was completely removed with open surgery. We describe the tests used to evaluate this tumor and the histopathological findings confirming its benign nature. Conclusion: Schwannoma is a rare condition with excellent postoperative outcome after complete surgical resection.


Subject(s)
Humans , Male , Adult , Retroperitoneal Neoplasms/diagnostic imaging , Mediastinal Neoplasms/surgery , Neurilemmoma/surgery , Biopsy , Tomography, X-Ray Computed , Video-Assisted Surgery , Abdomen/diagnostic imaging
16.
Rev. argent. cir ; 110(2): 114-116, jun. 2018. ilus
Article in Spanish | LILACS | ID: biblio-957906

ABSTRACT

Los linfangiomas son tumores benignos raros del sistema linfático, más comunes en la población pediátrica. La localización intraabdominal es muy infrecuente: tan solo el 1% de los linfangiomas aparece en el retroperitoneo. Se describe una tumoración quística infrecuente tanto por su localización como por la edad de presentación. Los linfangiomas retroperitoneales son tumores raros y su etiopatogenia es incierta. El diagnóstico se realiza mediante estudios de imagen; las técnicas de elección son la ultrasonografía (USG), la resonancia magnética (RM) o la tomografía computarizada (TC). A pesar de que se trata de tumores de naturaleza benigna, la exéresis quirúrgica completa es el tratamiento de elección para prevenir complicaciones como la sobreinfección, la rotura o el sangrado. Nuestro caso resulta infrecuente tanto por la localización retroperitoneal del tumor como por la tardía edad de presentación.


Background: lymphangiomas are rare benign tumors of the lymphatic system, being more common in the pediatric population. Intra-abdominal localization is very rare; only 1 % of lymphangiomas appear in the retroperitoneum. We report a case of a rare tumor because of its location and the elderly age of presentation. Retroperitoneal lymphangioma is a rare tumor with an unertain pathogenesis. Diagnosis is usually confirmed by imaging studies , e.g., US, MRI or CT. Although they are benign tumors, complete surgical resection is the treatment of choice. With this treatment, complications like infection, perforation or bleeding are prevented. Our case is unusual because of the retroperitoneal location of the tumor and the late age of presentation.


Subject(s)
Humans , Female , Adult , Retroperitoneal Neoplasms/diagnostic imaging , Lymphangioma, Cystic/diagnostic imaging , Laparotomy , Magnetic Resonance Spectroscopy , Tomography, X-Ray Computed , Abdominal Pain/complications , Abdomen/diagnostic imaging
19.
Acta méd. (Porto Alegre) ; 39(1): 369-377, 2018.
Article in Portuguese | LILACS | ID: biblio-911380

ABSTRACT

Objetivo: O objetivo do presente trabalho é revisar a literatura recente com relação ao uso de ultrassonografia abdominal para auxílio de procedimentos e diagnóstico semiológico em pacientes emergenciais, analisando a importância da ecografia e qual seu papel no contexto atual. Método: Foi realizada busca de artigos nas bases de dados LILACS, Pubmed, Medline, Up to date e Medscape, durante o mês de maio de 2018, com critério de atualidade definido como publicado nos últimos cinco anos. Resultado: Foram encontrados 90 artigos em uma primeira busca e 27 artigos com descritores diferentes. Destes, foram selecionados 20 pelos seus resumos. Após análise cuidadosa, apenas 12 artigos preencheram critérios mínimos de qualidade. Conclusão: O ultrassom mostrou-se uma excelente ferramenta para o atendimento médico nas patologias emergenciais do abdômen. O seu uso em ambiente hospitalar e extra-hospitalar proporciona uma investigação mais rápida e eficaz na determinação do diagnóstico, de forma a complementar a anamnese e o exame físico. Desta maneira, evitam-se procedimentos desnecessários, beneficiando o paciente. É um exame que apresenta boa acurácia em diversos contextos e as imagens são, em geral, rápidas e fáceis de serem obtidas.


Aim: The objective of the present study is to review the recent literature regarding the use of abdominal ultrasonography to aid procedures and semiologic diagnosis in emergency patients. In addition, analyzing the importance of ultrasound and what its role in the current context. Method: Search of articles in the databases LILACS, Pubmed, Medline, Up to Date and Medscape. It was carried out during the month of May of 2018, with the criterion of actuality defined as published in the last five years. Result: It was found 90 articles in a first search and 27 articles with different descriptors, of which 20 were selected for their abstracts. After careful reading, only 12 articles met the minimum quality criteria. Conclusion: Ultrasound proved to be an excellent tool for emergency medical care in emergency abdominal pathologies. Its use in hospital and in extra-hospital environments provides a faster and more effective investigation in the determination of the diagnosis, in order to complement the anamnesis and physical examination. In this way, unnecessary procedures are avoided, benefiting the patient. It is an exam that shows good accuracy in several contexts and the images are, in general, fast and easy to obtain.


Subject(s)
Abdomen/diagnostic imaging , Emergencies , Ultrasonography
20.
Egyptian Journal of Hospital Medicine [The]. 2017; 67 (1): 415-424
in English | IMEMR | ID: emr-189195

ABSTRACT

Background: Nonalcoholic fatty liver disease [NAFLD] is a spectrum of fat-associated liver conditions that can result in end stage liver disease. NAFLD patients when compared to control subjects have a higher prevalence of atherosclerosis which is independent of obesity and other established risk factors. Recent studies have identified NAFLD as a risk factor for early subclinical abnormalities in myocardial metabolism as well as in cardiac structure and function. In particular, it has been shown that NAFLD is associated with left ventricular hypertrophy and impaired diastolic function


The Objective: The aim of this study is to assess left ventricular diastolic function in NAFLD patients


Patients and Methods: The study included thirty Egyptian NAFLD patients their age between 20 and 45 years old, and twenty healthy control subjects who were age and sex matched. Full medical history, complete physical examination and laboratory tests were done in form of ALT, AST, total cholesterol, LDL, HDL, triglyceride, hemoglobin A1C, creatinine, urea and CBC. Abdominal ultrasonography and transthoracic echocardiography also were done


Results: NAFLD patients had higher diastolic blood pressures, increased body mass indices, ALT, AST and glycated hemoglobin A1C more than controls. Also in our study the mean of E, E/A ratio, DT, lateral E/e and septal E/e is significant higher in NAFLD patients than control group. The mean of lateral e and septal e is lower in NAFLD patients than control group


Conclusion: Patients with NAFLD had significant impairment on diastolic function in the non-diabetic and normotensive NAFLD patients compared to the controls as measured by two-dimensional echocardiography Doppler imaging in addition to tissue Doppler imaging


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Diastole , Non-alcoholic Fatty Liver Disease/physiopathology , Echocardiography , Abdomen/diagnostic imaging
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