Priapismo como manifestación de leucemia mieloide cronica / Priapism as a sign of chronic myeloid leukaemia

En base a un caso clínico se realiza una revisión bibliográfica acerca de las recomendaciones formuladas en el diagnóstico y manejo de los pacientes con priapismo. Se describe lo fundamental en lo que respecta a la distinción entre un priapismo de alto o bajo flujo y al tratamiento de instauración precoz a fin de optimizar el pronóstico de potencia sexual a largo plazo. En la revisión de la literatura, destaca el escaso número de casos descritos por lo que aún se requiere mayor experiencia y seguimiento para definir y precisar el mejor protocolo terapÚutico en pacientes leucÚmicos con priapismo. Se insiste en la importancia de una historia clínica exhaustiva con el propósito de distinguir factores etiológicos y la utilidad del hemograma como herramienta económica en el diagnóstico diferencial.

Cáncer de la vesícula biliar: manejo de pacientes con invasión de la túnica muscular / Management of gallbladder cancer with invasion of the muscular layer

Background: Gallbladder cancer is the leading cause of death of cancer among women in Chile. Detection of early forms of the disease during the pathological study of the cholecystectomy specimen is common. The management of these cases, specially those with invasion of the muscular layer is under discussion. Aim: To analyze the clinical features of patients with gallbladder cancer and muscular layer invasion and their prognosis after a simple cholecystectomy. Patients and methods: We studied a series of 46 patients with gallbladder cancer and invasion of the muscular layer. In the majority of cases diagnosis was performed at the moment of specimen study. Eleven patients underwent reoperation. Of these, ten underwent lymphadenectomy and liver resection while one patient underwent resection of the cystic duct stump. Results: During follow up, five patients died as a consequence of gallbladder cancer. Overall survival was 78 percent, with no differences between patients subjected or not a new operation. Conclusions: Gallbladder cancer with muscular infiltration has a good prognosis, independent of the type of therapy.