Sialocele post-trauma sin lesión penetrante / Sialocele post-trauma without penetrating injury

El sialocele es una colección de saliva en los tejidos que rodean al conducto de la glándula o del parénquima sin un drenaje adecuado. Su causa más común es la extravasación de saliva producto a una disrupción del parénquima o conducto parotídeo secundario a un trauma cortante. Si el tratamiento del sialocele no se realiza en forma oportuna se puede generar una fístula externa, cicatrices faciales e infecciones secundarias. Un hombre de 24 años ingresado al Hospital con múltiples fracturas faciales sin trauma cortante. Luego de la disminución del edema, continuó el aumento de volumen en la región geniana en forma localizada, fluctuante, ovalada. La piel se encontraba distendida, asintomática, sin secreciones, con alteración de la función motora y sensorial en la región geniana derecha. Se realizó la aspiración del contenido del aumento de volumen. Después de 2 días recidivó. Se solicitó una Tomografía computarizada y se volvió a realizar aspiración del contenido para enviarlo a cultivo citológico. Se hizo el diagnóstico de sialocele post-trauma de la parótida y se realizó un vaciamiento del contenido y drenaje tipo penrose intraoral. Se controló al siguiente día sin recidivas y se retiró el drenaje a los 2 meses. Es importante tener en cuenta que se puede generar un sialocele post-trauma sin necesariamente ser cortante.

Sialocele is a collection of saliva in the tissues surrounding the duct of the gland or parenchyma without proper drainage. The most common cause is the extravasation of saliva product to a disruption of the parenchyma or parotid duct secondary to a cutting trauma. If sialocele treatment is not performed in a timely manner it can generate an external fistula, facial scars and secondary infections. Male admitted to hospital with multiple facial fractures. After the reduction of edema, continued increased volume in the preauricular region localized, fluctuating, oval. The skin was asymptomatic, without secretions, with impairment of motor and sensory function in the right genial region. The aspiration of the increase in volume under a hypothesized hematoma was performed. After 2 days recurred. A tomography scan was requested and returned to realize the aspiration of which was sent to cytological exam. The diagnosis was post-trauma sialocele parotid and was performed emptying the contents and drainage type penrose intraoral. Was control the next day without relapses and the drain was removed after 2 months. It ́s important to know that can generate a post-trauma sialocele without necessarily cutting trauma.

A New Approach to the Surgical Treatment of Olecranon Bursitis.

Aims: To describe a new approach to the surgical treatment of the nonseptic olecranon bursitis. Methods: The study included 14 patients (13 men, 1 woman; age range 51-77 years) treated in a 10-year period. Patients with a systemic inflammatory disease were excluded. All patients had already been treated with bursal aspiration associated with multiple punctures of the cyst wall and compressive dressing. Clinical features, ultrasonography and analysis of the aspirated bursal fluid were indicative of a nonseptic olecranon bursitis. The new approach included surgical incision to drain the bursa and the use of a Penrose drain tube for post-operative drainage for an average of 5 days. The wound was treated by secondary closure. No antibiotics were used. Results: Eleven patients showed rapid secondary healing of the wound which reached 7 to 14 days following the Penrose drain removal. Wound healing was delayed in 3 patients and required approximately a month. The long-term follow-up ranged from 2 to 10 years. No recurrences or complications were encountered. Conclusion: This novel approach proves that excision of the bursa is not a mandatory step in the surgical treatment of olecranon bursitis. It is worthwhile to consider this new approach as the first step in the surgical management of the, non-responsive to conservative treatment, nonseptic olecranon bursitis.