Vólvulo de ciego / Volvulus of the caecum

Valvulus of the caecum constitutes an uncommon cause of surgical obstructive acute abdomen. It is originated in the torsion of a mobile segment of the colon, surrounding its mesenteric axis. The caecum is the second most frequent localization, after the sigmoid colon. The usual picture of volvulus of the caecum is of an acute, complete intestinal obstruction with enormous abdominal distention. Patients who develop this form of volvulus possess a caecum and ascending colon with a free mesenterium. Unless this entity is early recognized, it can progress to a colonic ischemia, perforation, sepsis and death. The definitve surgical treatment is the right hemicolectomy. An illustrative case is reported, with a complete description of the clinical features and the surgical management performed.

Leiomioma duodenal. Tratamiento quirúrgico de urgencia por perforación post-ecoendoscopía / Duodenal leiomyoma: emergency surgical management after endoscopic ultrasonography

Duodenal leiomyomas are unfrequent gastrointestinal submucosal tumors. Endoscopic ultrasonography is an important procedure for the differential diagnosis of these type of tumors of the digestive system. A female patient presenting a duodenal submucosal tumor is presented. She was submitted to emergency surgical management because of a perforation following a duodenal endoscopic ultrasonography. The surgical procedure performed is detailed and the result is commented.