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1.
Rev. habanera cienc. méd ; 20(5): e4392, 2021. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1352075

ABSTRACT

Introducción: La ascitis se define como la presencia de líquido en la cavidad peritoneal. La etiología más común la constituyen las enfermedades hepáticas que cursan con hipertensión portal, dentro de ellas la cirrosis hepática reportada en un 40 por ciento, a 5 años de seguimiento de los casos. Estudios previos muestran que la ascitis por enfermedad cirrótica hepática es entre un 80-85 por ciento, también la carcinomatosis se presenta en un 10 por ciento, y dentro de las causas más raras están la insuficiencia cardiaca y la tuberculosis peritoneal en un 3 por ciento, junto con la trombosis de la vena porta, sarcoidosis, tumores intraperitoneales, ascitis pancreática y la enteritis eosinofílica. Objetivo: Describir presentaciones clínicas infrecuentes como causa de ascitis en pacientes hospitalizados en el Hospital Clínico Quirúrgico Hermanos Ameijeiras. Presentación de casos: Se presentan cinco casos que ingresaron en el Hospital Hermanos Ameijeiras con diagnóstico de Ascitis: quilosa, hemorrágica, eosinofílica y coloide, con las patologías que los llevaron a esa manifestación clínica y una breve descripción de la misma. Conclusión: El análisis de las presentaciones clínicas de los casos, los hallazgos en los estudios imagenológicos y en los exámenes de laboratorio, así como los resultados anatomopatológicos permitieron el diagnóstico de las entidades causantes de ascitis atípicas en estos pacientes(AU)


Introduction: Ascites is defined as the presence of fluid in the peritoneal cavity. The most common etiology is liver diseases with portal hypertension; among them liver cirrhosis is reported in 40 percent of cases with 5-year follow-up. Previous studies demonstrate that ascites due to cirrhotic liver disease occurs in 80-85 percent of the cases, that carcinomatosis is also present in 10 percent, and also that among the rarest causes, heart failure and peritoneal tuberculosis are present in 3 percent of cases along with portal vein thrombosis, sarcoidosis, intraperitoneal tumors, pancreatic ascites and eosinophilic enteritis. Objective: To describe uncommon clinical presentations as cause of ascites in patients admitted to Hermanos Ameijeiras Clinical Surgical Hospital. Case presentation: Five cases of patients admitted to Hermanos Ameijeiras Clinical Surgical Hospital with the diagnosis of ascites: chylous, hemorrhagic, eosinophilic and colloid as well as the pathologies that led them to this clinical manifestation and a brief description of it are presented. Conclusion: The analysis of the clinical presentation of the cases, the findings in the imaging studies and laboratory tests and the anatomopathological results allowed the diagnosis of the entities causing atypical ascites in these patients(AU)


Subject(s)
Humans , Peritoneal Cavity , Ascites/diagnostic imaging , Heart Failure , Ascites/complications , Aftercare
2.
Rev. bras. med. fam. comunidade ; 16(43): 2664, 20210126. ilus, tab
Article in Portuguese | LILACS | ID: biblio-1282466

ABSTRACT

Introduction: The world was surprised by COVID - 19 Pandemic, a viral infection caused by SARS-COV-2, which started in Wuhan, People's Republic of China, in December 2019. In addition to this new disease, the entire Brazil continued to deal with other diseases that have plagued our patients for decades. We present a case report of infection of the peritoneal cavity operative site that occurred at the beginning of the Pandemic by COVID-19 in Brazil. Case Report: patient who underwent radical prostatectomy, evolved with infection of the operative site 30 days after surgery, had a collection in the abdominal wall that was interconnected with pelvis cavity that could be drained with a wall drain. Discussion: The rate of infection of the operative site can reach up to 5% in radical prostatectomy surgeries, which is an acceptable rate. The beginning of the Pandemic in Brazil prevented the patients from returning to the big hospitals to some extent, either due to fear or uncertainty. Conclusion: We present a case of infection of the surgical site that coincided with the beginning of the Coronavirus Pandemic in Brazil that can be treated in a Basic Health Unit.


Introdução: O mundo foi surpreendido pela pandemia COVID-19, uma infecção viral causada pelo SARS-COV-2, iniciada em Wuhan, na República Popular da China, em dezembro de 2019. Além dessa nova doença, o Brasil inteiro continuou a lidar com outras doenças que atormentam nossos pacientes há décadas. Apresentamos um relato de caso de infecção do sítio operatório da cavidade peritoneal que ocorreu no início da Pandemia pelo COVID-19 no Brasil. Relato De Caso: paciente submetido a prostatectomia radical, evoluiu com infecção do sítio operatório 30 dias após a cirurgia, possuía coleção na parede abdominal e na pelve interconectadas entre si, que poderia ser drenada com dreno de parede. Discussão: A taxa de infecção do sítio operatório pode chegar a 5% em cirurgias de prostatectomia radical, que é uma taxa aceitável. O início da pandemia no Brasil impediu que os pacientes retornassem aos grandes hospitais, de certa forma, devido ao medo ou à incerteza. Conclusão: Apresentamos um caso de infecção do sítio cirúrgico que coincidiu com o início da pandemia de coronavírus no Brasil que pode ser tratada em uma unidade básica de saúde.


introducción: El mundo se sorprendió con la pandemia COVID-19, una infección viral causada por el SARS-COV-2, que se inició en Wuhan, en la República Popular China, en diciembre de 2019. Además de esta nueva enfermedad, todo Brasil continuó lidiando con otras enfermedades que han afectado a nuestros pacientes durante décadas. Presentamos el reporte de un caso de infección del sitio operatorio de la cavidad peritoneal que ocurrió al inicio de la Pandemia por COVID-19 en Brasil. Relato De Caso: paciente que fue sometido a prostatectomía radical, desarrolló una infección del sitio operatorio 30 días después de la cirugía, tenía una colección en la pared abdominal y pelvis interconectada entre sí, que podía drenarse con un drenaje mural. Discusión: La tasa de infección del sitio operatorio puede llegar al 5% en las cirugías de prostatectomía radical, lo que es una tasa aceptable. El inicio de la pandemia en Brasil impidió que los pacientes regresaran a los grandes hospitales, en cierto modo, por miedo o incertidumbre. Conclusión: Presentamos un caso de infección del sitio quirúrgico que coincidió con el inicio de la pandemia de coronavirus en Brasil que puede ser tratado en una unidad básica de salud.


Subject(s)
Humans , Male , Middle Aged , Peritoneal Cavity , General Surgery , Coronavirus , COVID-19 , Infections
3.
Rev. bras. med. fam. comunidade ; 16(43): 2664, 20210126. ilus
Article in Portuguese | LILACS | ID: biblio-1282227

ABSTRACT

Introduction: The world was surprised by COVID - 19 Pandemic, a viral infection caused by SARS-COV-2, which started in Wuhan, People's Republic of China, in December 2019. In addition to this new disease, the entire Brazil continued to deal with other diseases that have plagued our patients for decades. We present a case report of infection of the peritoneal cavity operative site that occurred at the beginning of the Pandemic by COVID-19 in Brazil. Case Report: patient who underwent radical prostatectomy, evolved with infection of the operative site 30 days after surgery, had a collection in the abdominal wall that was interconnected with pelvis cavity that could be drained with a wall drain. Discussion: The rate of infection of the operative site can reach up to 5% in radical prostatectomy surgeries, which is an acceptable rate. The beginning of the Pandemic in Brazil prevented the patients from returning to the big hospitals to some extent, either due to fear or uncertainty. Conclusion: We present a case of infection of the surgical site that coincided with the beginning of the Coronavirus Pandemic in Brazil that can be treated in a Basic Health Unit.


Introdução: O mundo foi surpreendido pela pandemia COVID-19, uma infecção viral causada pelo SARS-COV-2, iniciada em Wuhan, na República Popular da China, em dezembro de 2019. Além dessa nova doença, o Brasil inteiro continuou a lidar com outras doenças que atormentam nossos pacientes há décadas. Apresentamos um relato de caso de infecção do sítio operatório da cavidade peritoneal que ocorreu no início da Pandemia pelo COVID-19 no Brasil. Relato De Caso: paciente submetido a prostatectomia radical, evoluiu com infecção do sítio operatório 30 dias após a cirurgia, possuía coleção na parede abdominal e na pelve interconectadas entre si, que poderia ser drenada com dreno de parede. Discussão: A taxa de infecção do sítio operatório pode chegar a 5% em cirurgias de prostatectomia radical, que é uma taxa aceitável. O início da pandemia no Brasil impediu que os pacientes retornassem aos grandes hospitais, de certa forma, devido ao medo ou à incerteza. Conclusão: Apresentamos um caso de infecção do sítio cirúrgico que coincidiu com o início da pandemia de coronavírus no Brasil que pode ser tratada em uma unidade básica de saúde.


introducción: El mundo se sorprendió con la pandemia COVID-19, una infección viral causada por el SARS-COV-2, que se inició en Wuhan, en la República Popular China, en diciembre de 2019. Además de esta nueva enfermedad, todo Brasil continuó lidiando con otras enfermedades que han afectado a nuestros pacientes durante décadas. Presentamos el reporte de un caso de infección del sitio operatorio de la cavidad peritoneal que ocurrió al inicio de la Pandemia por COVID-19 en Brasil. Relato De Caso: paciente que fue sometido a prostatectomía radical, desarrolló una infección del sitio operatorio 30 días después de la cirugía, tenía una colección en la pared abdominal y pelvis interconectada entre sí, que podía drenarse con un drenaje mural. Discusión: La tasa de infección del sitio operatorio puede llegar al 5% en las cirugías de prostatectomía radical, lo que es una tasa aceptable. El inicio de la pandemia en Brasil impidió que los pacientes regresaran a los grandes hospitales, en cierto modo, por miedo o incertidumbre. Conclusión: Presentamos un caso de infección del sitio quirúrgico que coincidió con el inicio de la pandemia de coronavirus en Brasil que puede ser tratado en una unidad básica de salud


Subject(s)
Humans , Male , Middle Aged , Peritoneal Cavity , Prostatectomy , General Surgery , Coronavirus , Infections
4.
Acta Physiologica Sinica ; (6): 175-180, 2021.
Article in English | WPRIM | ID: wpr-878246

ABSTRACT

The great omentum is an intraperitoneal organ and plays an important role in protecting the environment of the peritoneal cavity. Several specialized innate immune cells including B1 cells and resident macrophages are found in the omentum, which may be attributed to the unique niche and its special stromal cells. However, it is not clear how these omental innate immune cells contribute to the peritoneal immunity. This review attempts to summarize the latest research on the omental innate immunity and discuss its involvement in the immune response of the peritoneal cavity.


Subject(s)
Immunity, Innate , Macrophages , Omentum , Peritoneal Cavity , Stromal Cells
5.
Article in English | WPRIM | ID: wpr-762455

ABSTRACT

BACKGROUND: Anti-carbohydrate antibody responses, including those of anti-blood group ABO antibodies, are yet to be thoroughly studied in humans. Because anti-ABO antibody-mediated rejection is a key hurdle in ABO-incompatible transplantation, it is important to understand the cellular mechanism of anti-ABO responses. We aimed to identify the main human B cell subsets that produce anti-ABO antibodies by analyzing the correlation between B cell subsets and anti-ABO antibody titers. METHODS: Blood group A-binding B cells were analyzed in peritoneal fluid and peripheral blood samples from 43 patients undergoing peritoneal dialysis and 18 healthy volunteers with blood group B or O. The correlation between each blood group A-specific B cell subset and anti-A antibody titer was then analyzed using Pearson's correlation analysis. RESULTS: Blood group A-binding B cells were enriched in CD27⁺CD43⁺CD1c− B1, CD5⁺ B1, CD11b⁺ B1, and CD27⁺CD43⁺CD1c+ marginal zone-B1 cells in peripheral blood. Blood group A-specific B1 cells (P=0.029 and R=0.356 for IgM; P=0.049 and R=0.325 for IgG) and marginal zone-B1 cells (P=0.011 and R=0.410 for IgM) were positively correlated with anti-A antibody titer. Further analysis of peritoneal B cells confirmed B1 cell enrichment in the peritoneal cavity but showed no difference in blood group A-specific B1 cell enrichment between the peritoneal cavity and peripheral blood. CONCLUSIONS: Human B1 cells are the key blood group A-specific B cells that have a moderate correlation with anti-A antibody titer and therefore constitute a potential therapeutic target for successful ABO-incompatible transplantation.


Subject(s)
Antibodies , Antibody Formation , Ascitic Fluid , B-Lymphocyte Subsets , B-Lymphocytes , Healthy Volunteers , Humans , Immunoglobulin M , Peritoneal Cavity , Peritoneal Dialysis
6.
Rev. argent. cir ; 112(2): 193-196, 2020. ilus
Article in English, Spanish | LILACS | ID: biblio-1125802

ABSTRACT

Presentamos el caso de una paciente septuagenaria, con vómitos, neumonía por broncoaspiración y síndrome de impregnación neoplásica. Los estudios por imágenes muestran la totalidad del estómago herniado en el pericardio a través de una ventana pericardio-peritoneal realizada previamente. Se realizó la resolución quirúrgica del caso. Se hacen consideraciones sobre las opciones para el tratamiento del derrame pericárdico persistente, la hernia gástrica intrapericárdica como complicación, su presentación clínica, hallazgos intraoperatorios, forma de estudio y tratamiento.


We report the case of a 73-year- old female patient with vomiting, aspiration pneumonia and constitutional symptoms. The imaging tests showed total gastric herniation in the pericardial sac through a pericardio-peritoneal window previously created. The case was solved with surgery. The therapeutic options for persistent pericardial effusion are considered. Intrapericardial gastric hernia as a complication, its clinical presentation, intraoperative findings, complementary tests and treatment are discussed.


Subject(s)
Humans , Female , Aged , Pericardium/surgery , Herniorrhaphy , Hernia/complications , Pericardial Effusion , Peritoneal Cavity , Breast Neoplasms/complications , Radiography, Thoracic
7.
Med. leg. Costa Rica ; 36(2): 108-114, sep.-dic. 2019. tab
Article in Spanish | LILACS | ID: biblio-1040451

ABSTRACT

Resumen La diálisis peritoneal es uno de los métodos de reemplazo renal para pacientes con enfermedad renal crónica avanzada. Las infecciones representan la segunda causa de muerte y corresponden a gran morbilidad en este grupo de pacientes. La peritonitis asociada a diálisis peritoneal es una patología prevenible y es la principal complicación de este procedimiento. En la mayoría de ocasiones, la etiología es secundaria a bacterias Gram positivas colonizadoras de la piel, aunque no se puede subestimar la importancia de las bacterias Gram negativas. El diagnóstico se basa tanto en el criterio clínico como microbiológico. El tratamiento corresponde en antibióticos por un periodo de por lo menos dos semanas. Esta revisión de tema permite informar al personal de salud, pacientes y cuidadores sobre esta frecuente complicación con el fin de prevenirla, y en su defecto, un diagnóstico y tratamiento temprano con el fin de reducir la morbimortalidad y las complicaciones de dicho cuadro clínico.


Abstract Peritoneal dialysis is one of the main renal replacement therapies for end-stage renal disease. Infections represent the second leading cause of death and correspond to great morbidity in this group of patients. Peritonitis associated with peritoneal dialysis is a preventable disease, and it is also the main complication of this procedure. Most cases are secondary to Gram-positive bacteria skin colonizers; although the importance of Gram-negative bacteria cannot be underestimated. Diagnosis is based both on clinical and microbiological criteria. Treatment consists on at least a two-week period antibiotic scheme. This topic review allows health care providers, patients and caregivers to be informed about this usual complication in order to prevent it, diagnose it and initiate early treatment with the intention to minimize its morbidity, mortality and complications.


Subject(s)
Humans , Peritoneal Cavity , Peritonitis/complications , Peritoneal Dialysis , Renal Replacement Therapy , Renal Insufficiency, Chronic
8.
Int. braz. j. urol ; 45(6): 1283-1284, Nov.-Dec. 2019.
Article in English | LILACS | ID: biblio-1056351

ABSTRACT

ABSTRACT Objective & Introduction: To show the feasibility of a combined transperitoneal (TP) and retroperitoneal (RP) laparoscopic approach in a Von Hipple-Lindau (VHL) patient with multiple kidney tumors. VHL is an autosomal dominant inherited syndrome characterized by a high incidence of benign and malignant tumors and cysts in many organs. Renal cell carcinoma is one of the most common and a leading cause of mortality (1). Surgical approach is usually complex because of its multiplicity and the need of maximum kidney function preservation due to the risk of future recurrences (2, 3). Intracorporeal renal hypothermia may be useful in these cases to prevent permanent renal function loss (4). Materials and Methods: A 40 years old male was being monitored for multiple bilateral renal masses. Family history included a VHL syndrome affecting his mother and sister. Past medical history included a VHL syndrome with multiple cerebellar and medular hemangioblastomas, a pancreatic cystoadenoma and bilateral kidney tumors which had significantly grown up during follow-up. The patient was scheduled for laparoscopic multiple partial nephrectomy. A combined TP and RP approach with intracorporeal hypothermia was chosen. Results: A total of six right kidney tumors were removed. Operative time was 240 min. Cold ischemia time was 50 min. Average kidney temperature was 23.7°C. Blood losses were negligible. The patient was discharged after 72 hours. No major changes in serum creatinine were found during the follow-up. Final pathology revealed a clear cell renal cell carcinoma, pT1a, ISUP grade 2 in most of the tumors but one ISUP grade 3. Surgical margins were negative. Conclusions: Combined TP and RP is a feasible alternative for the treatment of multiple renal tumors. It's safe and effective, allowing the use of intracorporeal hypothermia which may improve postoperative renal function. Consistent experience is needed before embarking on this surgery.


Subject(s)
Humans , Male , Adult , Carcinoma, Renal Cell/surgery , Laparoscopy/methods , von Hippel-Lindau Disease/surgery , Hypothermia, Induced/methods , Kidney Neoplasms/surgery , Nephrectomy/methods , Peritoneal Cavity/surgery , Reproducibility of Results , Treatment Outcome
9.
Int. j. morphol ; 37(2): 730-734, June 2019. tab, graf
Article in English | LILACS | ID: biblio-1002285

ABSTRACT

In this work the quantitative data of the surfaces that limit the sub-spaces that constitute the peritoneal space are shown. The methodology of measurement of the two sheets (parietal and visceral) of the peritoneal serosa applied in our previous paper (Albanese et al., 2009), in non-eviscerated corpses, allowed us to know for the first time, the surface or total extension of the peritoneum "in situ". This methodology was useful to determine the surface or area of the two sheets of the peritoneum, which limit the peritoneal space. Our objective in this study was to determine the total peritoneal areas (visceral + parietal) in human corpses that are not eviscerated, which limit the different sub-spaces that make up the peritoneal space. Ten female cadavers fixed in 5 % formaldehyde solution were used. Small cellophane films were placed directly on the peritoneal sheets. The digital images were obtained by scanning these models. The surface was determined by the "Scion image for Windows" program. The results were expressed as mean +/- SE. The analysis of variance (ANOVA) was used for the statistical study. The results obtained showed that the peritoneal sub-space of greater surface area was retro-omental (mean +/- SE 7767.81 +/- 646.70 cm2 p <0.01 ANOVA), due to the large extension of its visceral surface ( mean +/- SE 7401.82 +/- 640.99 cm2). More than 50 % of the surface of the entire peritoneum corresponds to said sub-space. The smallest peritoneal sub-space (3 % of the total peritoneal surface) was the pelvic sub-space (mean +/- SE 431.30 +/- 41.62 cm2). We believe that this information may be useful in case of peritoneal pathological processes or those affected by prolonged peritoneal dialysis, and that knowledge of the surface and extension of the peritoneal space involved may contribute to the estimation of the peritoneal surface involved and help to plan the treatment.


En este trabajo se muestran los datos cuantitativos de las superficies que limitan el espacio peritoneal y los sub-espacios que lo componen. La metodología de medición de las dos hojas (parietal y visceral) de la serosa peritoneal empleada en cadáveres no eviscerados, permitió conocer por primera vez, la superficie o extensión total del peritoneo in situ. El objetivo en este trabajo fue determinar -en cadáveres humanos no evisceradoslas áreas peritoneales totales (visceral + parietal) que limitan los distintos sub-espacios que conforman el espacio peritoneal. Se han utilizado diez cadáveres femeninos no eviscerados fijados en solución de formaldehido al 5 %. Pequeñas películas de celofán se colocaron directamente sobre las hojas peritoneales. La obtención de imágenes digitales se realizó escaneando estos modelos. La superficie fue determinada por el programa "Scion image for Windows". Los resultados se expresaron como media +/- SE. Para el estudio estadístico se utilizó el análisis de varianza (ANOVA). Los resultados obtenidos demostraron que el sub-espacio peritoneal de mayor superficie fue el retro-omental (media +/- SE 7767,81 +/ - 646,70 cm2 p<0.01 ANOVA), debido a la gran extensión de su superficie visceral (media +/- SE 7401,82 +/- 640,99 cm2). Más del 50 % de la superficie de todo el peritoneo corresponde a dicho sub-espacio. El sub-espacio peritoneal más pequeño (3 % de la superficie peritoneal total) fue el sub-espacio pélvico (media +/SE 431,30 +/- 41,62 cm2). Esta información podrá ser de utilidad en el caso de procesos patológicos peritoneales o áreas afectadas por diálisis peritoneal prolongada. De esta manera el conocimiento de la extensión del espacio peritoneal involucrado, puede contribuir a la estimación de la magnitud y gravedad de la superficie peritoneal comprometida. Además puede ayudar a planificar el tratamiento.


Subject(s)
Humans , Female , Peritoneum/anatomy & histology , Peritoneal Cavity/anatomy & histology , Cadaver , Analysis of Variance
10.
Article in Korean | WPRIM | ID: wpr-758473

ABSTRACT

OBJECTIVE: Unperforated and perforated acute appendicitis need to be differentiated because appendicitis with a free perforation requires an emergency operation to prevent contamination inside the bowel from spreading into the peritoneal cavity. The sensitivity of imaging tests is not reliable enough alone for determining the existence of a perforation. The aim of this study was to determine the differences in laboratory values between unperforated and perforated acute appendicitis to help distinguish perforated acute appendicitis. METHODS: The laboratory values and demographic data of a total of 175 patients who visited the emergency room and were diagnosed with acute appendicitis were collected. The time elapsed from symptom presentation to the ER visit, length of admission, patient demographics, and laboratory values, including sex, age, leukocyte count, neutrophil %, neutrophil count, C-reactive protein (CRP), platelet count, prothrombin time (PT), activated partial thromboplastin time, international normalized ratio (INR), serum glucose, blood urea nitrogen, creatinine, total and direct bilirubin, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, and gamma-glutamyltransferase were analyzed. RESULTS: The factors associated with appendix perforations were an elevated leukocyte count, neutrophil count, neutrophil %, CRP, serum glucose and total bilirubin; and delayed PT and INR. CONCLUSION: Acute appendicitis patients without definite imaging evidence of the perforation but with the laboratory values suggesting a perforation, such as elevated leukocyte count, neutrophil count, neutrophil %, CRP, serum glucose, and total bilirubin; and delayed PT, and INR should raise concern for a possible undiscovered perforation.


Subject(s)
Abdomen, Acute , Alanine Transaminase , Alkaline Phosphatase , Appendicitis , Appendix , Aspartate Aminotransferases , Bilirubin , Blood Glucose , Blood Urea Nitrogen , C-Reactive Protein , Creatinine , Demography , Diagnosis, Differential , Emergencies , Emergency Service, Hospital , gamma-Glutamyltransferase , Humans , International Normalized Ratio , Leukocyte Count , Neutrophils , Partial Thromboplastin Time , Patient Admission , Peritoneal Cavity , Platelet Count , Prothrombin Time
11.
Article in English | WPRIM | ID: wpr-765791

ABSTRACT

Splenic flexure mobilization during laparoscopic colorectal surgery, which is used for elongation of the remaining colon after resecting the left colon or rectum, is sometimes essential for making a secure anastomosis without tension. However, laparoscopic splenic flexure mobilization is often time consuming and technically demanding, particularly in obese patients with severe adhesion. Therefore, three surgical approaches are introduced to make the procedure easier according to the method of entering the lesser sac: anterior approach, inferio-medial approach, and lateral approach.


Subject(s)
Colon , Colon, Transverse , Colorectal Surgery , Humans , Laparoscopy , Methods , Peritoneal Cavity , Rectum
12.
Immune Network ; : e15-2019.
Article in English | WPRIM | ID: wpr-764016

ABSTRACT

To this date, the criteria to distinguish peritoneal macrophages and dendritic cells (DCs) are not clear. Here we delineate the subsets of myeloid mononuclear cells in the mouse peritoneal cavity. Considering phenotypical, functional, and ontogenic features, peritoneal myeloid mononuclear cells are divided into 5 subsets: large peritoneal macrophages (LPMs), small peritoneal macrophages (SPMs), DCs, and 2 MHCII⁺CD11c⁺CD115⁺ subpopulations (i.e., MHCII⁺CD11c⁺CD115⁺CD14⁻CD206⁻ and MHCII⁺CD11c⁺CD115⁺CD14⁺CD206⁺). Among them, 2 subsets of competent Ag presenting cells are demonstrated with distinct functional characteristics, one being DCs and the other being MHCII⁺CD11c⁺CD115⁺CD14⁻CD206⁻ cells. DCs are able to promote fully activated T cells and superior in expanding cytokine producing inflammatory T cells, whereas MHCII⁺CD11c⁺CD115⁺CD14⁻CD206⁻ cells generate partially activated T cells and possess a greater ability to induce Treg under TGF-β and retinoic acid conditions. While the development of DCs and MHCII⁺CD11c⁺CD115⁺CD14⁻CD206⁻ cells are responsive to the treatment of FLT3 ligand and GM-CSF, the number of LPMs, SPMs, and MHCII⁺CD11c⁺CD115⁺CD14⁺CD206⁺ cells are only influenced by the injection of GM-CSF. In addition, the analysis of gene expression profiles among MHCII⁺ peritoneal myeloid mononuclear cells reveals that MHCII⁺CD11c⁺CD115⁺CD14⁺CD206⁺ cells share high similarity with SPMs, whereas MHCII⁺CD11c⁺CD115⁺CD14⁻CD206⁻ cells are related to peritoneal DC2s. Collectively, our study identifies 2 distinct subpopulations of MHCII⁺CD11c⁺CD115⁺ cells, 1) MHCII⁺CD11c⁺CD115⁺CD14⁻CD206⁻ cells closely related to peritoneal DC2s and 2) MHCII⁺CD11c⁺CD115⁺CD14⁺CD206⁺ cells to SPMs.


Subject(s)
Animals , Antigen Presentation , Dendritic Cells , Granulocyte-Macrophage Colony-Stimulating Factor , Macrophages , Macrophages, Peritoneal , Mice , Peritoneal Cavity , T-Lymphocytes , Transcriptome , Tretinoin
13.
Article in English | WPRIM | ID: wpr-760645

ABSTRACT

The long-term survival of heavily pretreated patients with primary peritoneal cancer (PPC) is uncommon. Here, we report on a patient with PPC refractory to multiple lines of intravenous chemotherapy, namely, a combined regimen of paclitaxel and carboplatin, and single regimens of topotecan, docetaxel, cisplatin, and gemcitabine. However, after intraperitoneal (IP) chemotherapy with paclitaxel-cisplatin, the patient's condition improved, and she has been progression-free for more than 4 years. Interestingly, before the IP chemotherapy, the recurrences were limited to the peritoneal cavity. These results suggest that IP recurrence might be a predictor of a good response to IP chemotherapy.


Subject(s)
Carboplatin , Cisplatin , Drug Therapy , Humans , Infusions, Parenteral , Neoplasm Recurrence, Local , Ovarian Neoplasms , Paclitaxel , Peritoneal Cavity , Peritoneal Neoplasms , Recurrence , Topotecan
14.
Neonatal Medicine ; : 213-217, 2019.
Article in Korean | WPRIM | ID: wpr-786439

ABSTRACT

Chyle only occurs in the peritoneal cavity or around the pericardium through damage to the lymph nodes or improper drainage of the lymph and is characterized by a colostrum-like color and being rich in triglyceride. We encountered a case of a newborn infant with abdominal distention and further diagnosed chylous ascites and hydrocele by inspecting and analyzing the fluid obtained from the abdominal cavity and scrotum. Additionally, a lymphoscintigraphy was performed, which showed a decrease in the uptake of radioactive isotopes in the left iliac nodes and a delayed appearance. Here, we report a case of chyle diagnosed through puncture analysis and its subsequent successful treatment.


Subject(s)
Abdominal Cavity , Chyle , Chylous Ascites , Drainage , Humans , Infant, Newborn , Lymph Nodes , Lymphoscintigraphy , Pericardium , Peritoneal Cavity , Punctures , Radioisotopes , Scrotum , Triglycerides
15.
Article in English | WPRIM | ID: wpr-786100

ABSTRACT

Pyogenic hepatic abscess caused by an ingested foreign body is extremely uncommon, and reports on the laparoscopic treatment for it are very rare. We report here on a case of hepatic abscess caused by an ingested chicken bone which was treated with a laparoscopic approach. A 61-year-old man visited an emergency room with the chief complaints of high fever. He was diagnosed with pyogenic liver abscess that contained a sharp calcified foreign body seen on a CT-scan. At first, percutaneous transhepatic drainage of the abscess was performed to achieve recovery of the patient's condition. Subsequent laparoscopic exploration found and removed the foreign body in the lesser sac. The foreign body turned out to be an ingested chicken bone. The patient was discharged on the 10th day after surgery.


Subject(s)
Abscess , Chickens , Drainage , Emergency Service, Hospital , Fever , Foreign Bodies , Humans , Laparoscopy , Liver Abscess , Liver Abscess, Pyogenic , Middle Aged , Peritoneal Cavity
16.
Article in English | WPRIM | ID: wpr-786095

ABSTRACT

PURPOSE: To report our initial experience with laparoscopic mini-gastric bypass (LMGB) in Korean obese patients.MATERIALS AND METHODS: From July 2016 to February 2018, 14 male patients underwent LMGB for morbid obesity at a single institution. Five trocars were placed in a U-shape formation and 1 trocar was placed at the epigastrium as a liver retractor; a window was created between the vagal nerve and lesser curvature at the gastric angle for entering the lesser sac; a narrow gastric tube (~100–120 ml volume) was made; a linear-stapled gastrojejunostomy was created after bypassing the jejunum 200 cm from the Treitz' ligament; and the Petersen defect was closed to prevent internal hernia. Patient demographics, operative time, estimated blood loss, postoperative hospital stay, complications, weight loss, and resolution of comorbidities were evaluated during 1 year of follow-up.RESULTS: All procedures were successful by laparoscopy. The average age was 29 (19–49) years; weight, 164.9 (127-250) kg; and body mass index, 51.0 (42.4–81.6) kg/m². In 1 case, nephrectomy was simultaneously performed for early renal cell carcinoma. The mean operative time was 148.8 (120-175) min. The mean postoperative hospital stay was 1.9 (1–4) days. The percentage excess weight loss at 1, 3, 6, 9, and 12 months was 16.6%, 31.0%, 41.4%, 45.4%, and 50.4%, respectively. The resolution rate of type 2 diabetes mellitus, hypertension, and dyslipidemia was 75%, 40%, and 66.7%, respectively. There was no major complication including mortality during the follow-up.CONCLUSION: LMGB is a technically simple, safe, and effective procedure in Korean obese patients.


Subject(s)
Bariatric Surgery , Body Mass Index , Carcinoma, Renal Cell , Comorbidity , Demography , Diabetes Mellitus, Type 2 , Dyslipidemias , Follow-Up Studies , Gastric Bypass , Hernia , Humans , Hypertension , Jejunum , Laparoscopy , Length of Stay , Ligaments , Liver , Male , Mortality , Nephrectomy , Obesity, Morbid , Operative Time , Peritoneal Cavity , Postoperative Hemorrhage , Surgical Instruments , Weight Loss
17.
Article in English | WPRIM | ID: wpr-785879

ABSTRACT

Desmoplastic small round cell tumor (DSRCT) is a rare and aggressive malignancy common in young male patient. Typical imaging features of DSRCT include multiple soft tissue masses in the peritoneal cavity, omentum, or mesentery without an organ of origin. This report presents a rare manifestation of DSRCT revealing a solitary large retroperitoneal mass with hepatic metastasis and malignant portal vein thrombosis in 70-year-old women together with the review of literature. The tumor showed a hemorrhagic and necrotic mass with peripheral portion of T2 hypo-intensity and delayed enhancement that indicated desmoplastic stroma with dense cellularity.


Subject(s)
Aged , Desmoplastic Small Round Cell Tumor , Female , Humans , Magnetic Resonance Imaging , Male , Mesentery , Neoplasm Metastasis , Omentum , Peritoneal Cavity , Portal Vein , Venous Thrombosis
18.
Acta cir. bras ; 33(9): 824-833, Sept. 2018. tab, graf
Article in English | LILACS | ID: biblio-973497

ABSTRACT

Abstract Purpose: To evaluate the effects of hyperbaric oxygenation on prevention of adhesions in the abdominal cavity after laparotomy. Methods: Fifty four rats underwent laparotomy; stitches were made in the four quadrant parietal peritoneum and abdominal cavity closure. Animals were divided into three groups: 1 - control; 2 - subjected to high pressures and oxygenation; 3 - subjected to 100% hyperbaric oxygenation. The animals in groups 2 and 3 were daily submitted to oxygenation hyperbaric chamber after surgery. On the seventh day another laparotomy, registration of procedure, assessment of adhesions and biopsies of the peritoneum were held. Professionals analyzed the videos and the biopsies. Results: Peritoneal cavity adhesions occurred in animals of three groups with no difference between them. In Group 3, the adhesions presented more fragile and vascular proliferation more pronounced, and there was no difference in comparison with the first and second groups. However, there was no significant difference in the evaluation of these parameters between the animals in groups 1 and 2. Conclusions: Postoperative hyperbaric oxygenation in rats submitted to laparotomy did not alter the frequency, but reduced the density of adhesions in the peritoneal cavity and promoted vascular proliferation. The change in atmospheric pressure alone had no influence on the results.


Subject(s)
Animals , Rats , Peritoneal Cavity/surgery , Postoperative Complications/prevention & control , Tissue Adhesions/prevention & control , Hyperbaric Oxygenation/methods , Peritoneal Cavity/pathology , Rats, Wistar , Disease Models, Animal , Laparotomy
19.
Cambios rev. méd ; 17(1): 48-51, ene. - 2018. ^etab
Article in Spanish | LILACS | ID: biblio-981099

ABSTRACT

Introducción. El tratamiento adecuado de la cavidad peritoneal en la peritonitis secundaria constituye una preocupación permanente de los cirujanos y es primordial en el manejo integral del paciente. Objetivo. Evaluar los resultados de lavar la cavidad abdominal frente al secado peritoneal en los casos de peritonitis secundaria, por apendicitis aguda perforada. Material y métodos. Estudio observacional retrospectivo en el Servicio de Cirugía General del Hospital de Especialidades Carlos Andrade Marín, período enero 2016 a diciembre 2017. Se incluyeron 301 historias clínicas de pacientes con diagnóstico de apendicitis aguda perforada. El objetivo principal del estudio fue evaluar las complicaciones presentadas con cada uno de los procedimientos quirúrgicos empleados. Resultados. Los registros de 301 pacientes, 212 (70,4%) sometidos a lavado peritoneal y 89 (29,6%) a secado del peritoneo. La frecuencia de complicaciones entre los grupos estudiados fue similar, no hubo diferencias significativas. La única variable significativa fue el tiempo operatorio (OR 1,01, p<0,005). Conclusiones. No se encontraron diferencias significativas con el tipo de manejo de cavidad en pacientes con peritonitis secundaria a apendicitis aguda perforada (lavado versus secado de cavidad) en cuanto a complicaciones posoperatorias. El lavado peritoneal requirió un tiempo quirúrgico mayor al secado de la cavidad.


Introduction. The adequate treatment of the peritoneal cavity in peritonitis is a primary concern in the comprehensive management of the patient. Objective. To compare the results of thoroughly washing the peritoneal cavity vs simply just drying the peritoneal cavity in cases of secondary peritonitis due to acute perforated appendicitis. Materials and methods. A retrospective observational study was carried out in the General Surgery Department at Carlos Andrade Marín Specialties Hospital, from January 2016 until December 2017. The study main end-point was assessing the postoperative complication between peritoneal lavage versus cavity drying. Results. The records of 301 patients, 212 (70.4%) who underwent peritoneal lavage and 89 (29.6%) with just drying the peritoneum. The frequency of complications between both groups did not reach statistical significance. The only significant variable was the operative time (OR 1.01, p<0.005). Conclusions. No statistically significant differences were found with the type of cavity management in patients with peritonitis secondary to perforated appendicitis (lavage versus cavity drying). Peritoneal lavage required more time than cavity drying.


Subject(s)
Humans , Appendicitis , Peritoneal Cavity , Peritonitis , Peritoneal Lavage , Ascitic Fluid
20.
Rev. bras. cancerol ; 64(4): 575-579, 2018.
Article in Portuguese | LILACS | ID: biblio-1025129

ABSTRACT

Introdução: O tumor desmoplásico de pequenas células redondas é uma rara neoplasia que se inicia e se espalha pela superfície peritoneal. Foi descrito pela primeira vez em 1989 e, em 1991, houve seu reconhecimento como entidade clínica e patológica distintas. Relato do caso: Homem de 34 anos apresentou quadro de dor abdominal e perda de peso, evoluindo para obstrução intestinal dois meses após. A laparotomia demonstrou grande massa abdominopélvica irressecável. O laudo anatomopatológico associado à imuno-histoquímica evidenciou diagnóstico de tumor desmoplásico de pequenas células redondas. A tomografia computadorizada confirmou derrame pleural bilateral, implantes peritoneais e massas abdominais e pélvicas. Realizou-se quimioterapia com carbo/taxol com intervalo de 21 dias. Substituiu-se o esquema para VAC/IE com intervalo de 21 dias, com resposta parcial, porém ainda se mantendo um tumor irressecável. Houve piora progressiva da performance do paciente, com evolução ao óbito por obstrução intestinal no 15º mês de seguimento. Conclusão: O tumor desmoplásico de pequenas células redondas, em razão da sua raridade, continua sendo um desafio para o diagnóstico e o tratamento.


Introduction: The desmoplastic small round cell tumor is a rare neoplasm that starts and spreads through the peritoneal surface. It was first described in 1989 and in 1991 was recognized as a distinct clinical and pathological entity. Case report: A 34-year-old man presented with abdominal pain and weight loss, progressing to an intestinal obstruction after two months. Laparotomy showed an unresectable abdominopelvic mass. Anatomopathological an immunohistochemistry analysis showed a desmoplastic small-round-cell tumor. Computerized Tomography showed bilateral pleural effusion, peritoneal implants, along with masses in the abdominal and pelvic region. Chemotherapy with carbo/taxol was administered at intervals of 21-days. Later, the chemotherapy was changed to VAC/IE at a 21-day interval, with a partial response, but it was still an unresectable tumor. There was a worsening in patient performance, and he died of an abdominal obstruction on the 15º month of follow-up. Conclusion: Due to its rarity, the desmoplastic small-round-cell tumor, is still a diagnostic and treatment challenge.


Introducción: El tumor desmoplásico de células pequeñas y redondas es una neoplasia rara que comienza y se disemina a través de la superficie peritoneal. Fue descrito por primera vez en 1989 y en 1991 fue reconocido como una entidad clínica y patológica distintas. Relato del caso: Un hombre de 34 años presentó dolor abdominal y pérdida de peso, progresando a una obstrucción intestinal después de dos meses. La laparotomía mostró una masa abdominopélvica irresecable. El análisis anatomopatológico e inmunohistoquímico mostró un tumor desmoplásico de células pequeñas y redondas. La tomografía computarizada mostró derrame pleural bilateral, implantes peritoneales y masas en la región abdominal y pélvica. Se administró quimioterapia con carbo/taxol en un intervalo de 21 días. Más tarde, la quimioterapia cambió a VAC/IE con un intervalo de 21 días, con una respuesta parcial, pero seguía siendo un tumor irresecable. Hubo un empeoramiento en el estado del paciente, y murió de una obstrucción intestinal en el 15º mes de seguimiento. Conclusión: Debido a su rareza, tumor desmoplásico de células pequeñas y redondas, sigue siendo un desafío de diagnóstico y tratamiento.


Subject(s)
Humans , Male , Adult , Peritoneal Cavity , Peritoneal Neoplasms/diagnosis , Desmoplastic Small Round Cell Tumor/diagnosis , Connective Tissue
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