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@#Oesophageal perforation is a not uncommon condition, yet it carries a high mortality rate and has been observed as the most grievous trauma to the digestive tract. Common causes include iatrogenic instrumentation, foreign-body swallowing, and physical injury. This report highlighted a case of oesophageal perforation complicated by formation of proximal descending aorta pseudoaneurysm as a result of okra ingestion. The patient was successfully treated with conservative treatment. The possible mechanism of oesophageal rupture, diagnosis, treatment, and other complication will be further discussed.
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La respuesta clínica completa posterior a la terapia neoadyuvante del cáncer localmente avanzado de recto, se ha considerado suficiente para la implementación de una estrategia no quirúrgica, de observación y seguimiento por algunos autores. El manejo estándar de esta patología es la realización de manejo quirúrgico oncológico radical del tumor primario, 6 a 10 semanas posterior a la finalización de la neoadyuvancia. En esta revisión se exponen los pros y contras de cada propuesta y se describen las implicaciones y recomendaciones de cada alternativa de manejo.
Complete clinical response after neoadjuvant therapy for locally advanced rectal cancer has been considered sufficient for implementation of a non-surgical approach of observation and monitoring by some authors. Standard management of this condition is radical resection of the primary tumor six to ten weeks after completion of neoadjuvant therapy. In this review the pros and cons of each proposal are presented, and implications and recommendations for each alternative are described.
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Humanos , Terapia Neoadyuvante , Neoplasias del RectoRESUMEN
Introduction: Cysticercosis occurs when man is infested by the larvae of Taenia solium. Cysticercosis involving the maxillofacial region is not only an uncommon event, but also represents a difficulty in clinical diagnosis. Objective: The present manuscript highlights masseteric cysticercosis as a differential diagnosis of chronic maxillofacial swellings and the role of high resolution sonography as an important noninvasive and non-ionizing imaging modality. Case report: We present a case of masseteric cysticercosis in an eight year old Indian boy, its clinical features, the imaging modalities required and adequate management of the case. Conclusion: Cysticercosis should always be a part of the differential diagnosis of maxillofacial swellings. A thorough case history, clinical examination, proper investigations and conservative treatment forms the mainstay for management of affected patients.
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Objective To investigate the standards for management of traumatic intrapulmonary hematoma and hematocele.Methods A retrospective study was conducted on the data of 21 patients with traumatic pulmonary hematoma or hematocele (AIS≥4 points) treated at Chongqing Emergency Medical Center from August 1999 to August 2010.Results The overall mortality was 14％ (3/21)and death causes were respiratory passage hemorrhea and asphyxia.About 67％ of patients ( 14/21 ) were associated with hemoptysis,which lasted for 1-240 days (mean,15.8 days).The duration of hemoptysis due to traumatic intrapulmonary hematoma hematocele was about 3.4 times longer than that due to simple traumatic pneumatocele.The hematoma or cyst disappeared at average 61.6 days,with 3.4 times longer than the disappearance time of intrapulmonary hematoma or hematocele in comparison with that of simple pneumatocele.The size and position of traumatic pulmonary hematoma or pneumatocele influenced the treatment methods,outcomes and prognosis.Conclusions Standardized treatment for traumatic pulmonary hematoma or hematocele is key to improving the cure rate.Early emergency definitive surgery is required for patients with traumatic intrapulmonary hematoma or hematocele greater than 6.0 cm in diameter and for those with pneumatocele greater than 6.0 cm in diameter combined with incapability of keeping breathing due to severe air leakage.
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Nonsurgical management of four cases of the parasagittal epidural hematoma were experienced. Patients were mildly symptomatic or minimal neurological disturbances on admission. Patients were treated conservatively because of stable neurologic sign. All patients had who diastatic fracture and / or suture have become a complete neurological recovery with satisfactory absorption of EDH over a period of 5 to 12 weeks.