Heterotopic Gastric Mucosa in the Gallbladder Simulating a Tumor: A Case Report

Heterotopia is defined as an ectopic localization of normal tissue; the heterotopia of the gastric mucosa can be observed all along the digestive tract. The localization in the gallbladder is exceptional. The diagnosis is histological, it may present some complications including ulceration and the risk of malignancy.We report the case of heterotopia of the gastric mucosa in the gallbladder while presenting the clinical, radiological and therapeutic features ofthis exceptional lesion.

[Posterior uretral valves, about a series of 44 cases]

To explore the physical symptoms and radiological findings for the diagnosis of posterior urethral valves [PUV], to point of the therapeutic snags depending on gravity and delay of lesions. We reviewed the records of 44 patients with PUV. Mean age: 2 years 1/2 [range 1 day-13 years]. More than 75% of patients were less than 2 years old. In utero diagnosis was made in 8 patients [14%]. After birth, the diagnosis was based on urological signs [as frequent as diagnosis is made belatedly] and extra urological signs. Cystourethrography [CUG] showed posterior urethral dilation in all cases. Ultrasonography [US] showed abnormalities in 30 cases and intravenous urography [IVU], made in 21 cases, was normal in appearance in 7 of them. At diagnosis, it was a renal failure in 36 patients and 8 of them had a terminal renal deficiency. Urethroscopy made in 40 patients, showed PUV in all cases. There were 29 types I valves, 3 type II valves, 5 type III and 3 unclassifiables cases. Treatment was endoscopic in 41 cases and by lamination in the 3 others. Mean follow up is 9 years [range16months-19 years] and 19 patients have terminal renal failure from which 3 are deceased. PUV are dangerous obstructive uropathies in boy whom end at terminal renal failure in more than 33% of cases. Precocious diagnosis and early ablation of PUV are able to limit the complications inherent to this pathology

Gastric leiomyosarcoma un-related to GIST tumour

Primary leiomyosarcoma of the stomach is rare, accounting for 1% of gastric tumours. Endoscopic ultrasound and biopsy are helpful in establishing diagnosis. Surgical resection is the treatment of choice for gastric leiomyosarcomas. We report a rare case of leiomyosarcoma of the stomach, which presented at the age of 16 years with massive haematemesis and was diagnosed after exploratory laparotomy. The patient was treated by subtotal gastrectomy

maladie de gaucher. Traitement enzymatique substitutif a props d'un cas avec revue de la lettirature.

Gaucher's disease, rare, hereditary and potentially mortal affection is characterized by the reduced concentration of the glucocerebroside lipid within the macrophage lysosomes. We report the case of a young 2 years old patient treated by transfusion since he was 9 months because of chronic anemia. According the clinical examination, the general state of the patients was bad with important delayed stanturoponderal growth, a cutaneomucous paller and enormous splenomegaly. The blood count formula showed anemia with major thrombocytopenia. The myelogram was poor and the osteomedullar biopsy showed the presence of Gaucher's cells. The diagnosis has been confirmed by enzymatic dosage [Leucocytar b-glucosidase]. The treatment of the patient has been substitutive enzymatic [inifucerase] with very favorable response. During Gaucher's disease, the enzymatic deficiency results in the pathologic accumulation of the substrate [glucocerebroside] in the lyososomes, this metabolic overloading may cause polyvisceral disease with spontaneous evolution after mortal. The recent discovery of a recombining glucocerebrosidase [imiglucerase] transformed the prognosis of this disease

Metástasis en puerto umbilical por adenocarcinoma incidental de vesícula biliar / Metastasis in umbilical port by incidental adenocarcinoma of gallbladder

El tratamiento de elección de la colelitiasis es la colecistectomía por vía laparoscópica. El hallazgo de un cáncer de vesícula biliar no sospechado durante colecistectomía laparoscópica, puede alterar la evolución natural y pronóstico de esta neoplasia maligna. La recidiva tumoral en el puerto umbilical o en las incisiones de los demás trócares laparoscópicos es una complicación cuya frecuencia es aún conocida, pero no obstante es necesario tenerla en consideración para lograr prevenirla o bien evitar su progresión a través de una nueva intervención. En este artículo se presenta un paciente que desarrolló matástasis en puerto laparoscópico umbilical posterior a la realización de una colecistectomía por vía laparoscópica y posteriormente se realiza una revisión de la literatura médica sobre el tema.

Reconstrucción labial: principios y técnicas / Labial reconstruction: principles and techniques

Los labios constituyen estructuras de gran importancia funcional y estética que puede ser alterada por diferentes mecanismos como trauma, quemaduras de diversas índole y tumores benignos o malignos. Su reconstrucción ha sido objeto de innumerables publicaciones, sin embargo no se encuentra fácilmente en la literatura una sistematización de técnicas que permita orientar al cirujano general y al especialista, sobre su enfrentamiento. El objetivo de este trabajo es dar una visión global del tema y hacer hincapié en los principios generales que debe respetar el cirujano, detallando gráficamente las técnicas existentes.

Ingestión de cuerpo extraño asociado a trastorno psiquiátrico / Foreign body ingestion associated with psychiatric disorder

Se discute el enfrentamiento psiquiátrico asociado al tratamiento de cuerpos extraños autoingeridos, en relación al caso de un paciente con ateraciones conductuales y antecedentes de ingestión a repetición de múltiples cuerpos extraños. Se analizan aspectos psicopatológicos propios del perfil de estos pacientes y el enfoque terapéutico, tanto de su patología de base como del tratamiento endoscópico de los cuerpos extraños.