Clinical and laboratorial correlation of postoperative hypocalcemia after extensive thyroidectomy

The medical records of 84 patients submitted to extensive thyroidectomy from January 1991 to April 1995 were reviewed and the data there was analyzed in order to verified a correlation between postoperative laboratories results and physical findings suggestive of hypocalcemia. It was verifed that was hypocalcemia in 51.2 percent of the patients, of which only 18.6 percent presented symptoms. It was concluded that asymptomatic hypocalcemia is frequent in extensive thyroidectomy and a routine screening for serum calcium in the postoperative period following thyroidectomy and calcium reposition must be systematic.

Lesäo diafragmática isolada por ferimento penetrante tratada por videolaparoscopia / Diaphragmatic penetrating injury repaired by videolaparoscopy

Penetrating trauma to the thoraco-abdominal region is a difficult clinical problem, in particular or the detection of diaphragmatic injuries. While patients with hemodynamic instability or peritonitis undergo laparotomy, clinically stable patients with equivocal peritoneal signs pose a challenge in management. This repor summarizes our preliminary experience with therapeutic laparoscopy in the assesment of four patients presenting penetrating wounds in lower chest abdomen, with isolated diaphragmatic injuries. The patients were stable on admission, with normal thoracic X-rays. The diaphragmatic injuries were repaired by laparoscopic endosuture and all the patients presented a satisfactory recovery

Tireoidite de Hashimoto e neoplasma maligno da tireóide / Hashimoto's thyroiditis and malignant neoplasms of the thyroid

A tireoidite de Hashimoto é uma doença tireoidiana comum. Sua associaçao com neoplasmas malignos da tireóide é citada na literatura como de 0,5 a 32 por cento , maior em nódulos frios solitários. A dificuldade em diagnosticar esta associaçao faz com que a conduta diante da tireoidite de Hashimoto seja controversa. Revisamos os dados de 30 doentes com diagnóstico de tireoidite de Hashimoto com nódulos tireoidianos tratados de abril de 1984 a agosto de 1992 no Departamento de Cirurgia da Faculdade de Ciências Médicas da Santa Casa de Sao Paulo. Destes, sete (23,3 por cento ) apresentavam neoplasmas malignos da tireóide, sendo um linfoma (14,3 por cento ), dois carcinomas foliculares (28,6 por cento ) e quatro papilíferos (57,1 por cento ). Com base nestes dados e em outros de literatura, achamos que apesar da tireoidite de Hashimoto ser afecçao de tratamento clínico, todo paciente com este diagnóstico e que apresente na sua evoluçao o aparecimento de nódulo hipo ou normocaptante, deve ser submetido a tratamento cirúrgico