Estudio comparativo del dolor abdominal en las culturas maya Tzeltal, maya Tzotzil y maya Q ́eqchi ́y el uso de Ageratina ligustrina para su tratamiento / Comparative study of abdominal pain in the Mayan cultures Tzeltal, Maya Tzotzil and Maya Q ́eqchi´ and use of Ageratina ligustrina for the treatment

El presente estudio es una comparación del dolor abdominal producido por trastornos gastrointestinales, aliviado por Ageratina ligustrina , entre los grupos maya Tzeltal, Tzotzil y Q ́eqchi ́, el cual integró un enfoque etnomédico, etnobotánico y transcultural, comparando estudios previos con el presente trabajo de campo. Para evaluar la eficacia de Ageratina para aliviar el dolor abdominal, se realizó un inventario de las moléculas reportadas en esta especie, así como de su actividad farmacológica, a través de una revisión bibliográfica. Los resultados mostraron que la epidemiología del dolor producido por TGI, su etnobotánica y el modelo explicativo del dolor abdominal fueron similares entre grupos étnicos. Asimismo, se identificaron 27 moléculas con efectos antiinflamatorios y antinociceptivos, lo que podría explicar por qué esta especie es culturalmente importante para los pobladores maya Tzeltal, Tzotzil y Q ́eqch i ́ para el alivio del dolor abdominal, mientras que, desde el punto de vista biomédico, es una especie con potencial para inhibir el dolor visceral.

The current study is a comparison of the abdominal pain conception produced by gastrointestinal disorders, relieved by Ageratina ligustrina , among inhabitants of the Mayan Tzeltal, Tzotzil, and Q'eqchi' groups ethnomedical, ethnobotanical, and cross -cultural approaches were used to compare previous studies with the present field work. To evaluate the efficacy of A. ligustrina to relieve pain, also through a bibliographic review an inventory of the molecules present in this species was performed, as well as their pharmacological activity. The results showed that the epidemiology of pain produced by GID, its ethnobotany, and the explanatory model of abdominal pain are similar among ethnic groups. Likewise, 27 molecules with anti-inflammatory and anti-nociceptive effects were identified, which could explain why this species is culturally important for the Mayan Tzeltal, Tzotzil, and Q'eqchi' groups for the relief of abdominal pain, while, from a biomedical point of view, it is a species with potential to inhibit visceral pain.

Toxina botulínica y neumoperitoneo secuencial en el manejo de hernia inguinoescrotal gigante: Reporte de caso / Botulinum toxin and sequential pneumoperitoneum in the management of giant inguinoscrotal hernia: Case report

Introducción. Las hernias gigantes con pérdida de domicilio son aquellas cuyo saco herniario alcanza el punto medio del muslo en bipedestación y su contenido excede el volumen de la cavidad abdominal. Estas hernias son un reto quirúrgico dada la difícil reducción de su contenido y del cierre primario de la fascia. Tienen mayor riesgo de complicaciones asociadas al síndrome compartimental abdominal, así como mayor tasa de recurrencia y morbilidad en los pacientes. Caso clínico. Paciente masculino de 81 años, reconsultante por hernia inguinoescrotal derecha gigante, de dos años de evolución, sintomática, con índice de Tanaka de 24 %. Se decidió aplicar el protocolo de neumoperitoneo secuencial (hasta 11.000 ml en total en cavidad) además de toxina botulínica en pared abdominal (dos sesiones). Resultados. Se logró la corrección exitosa de la hernia inguinoescrotal gigante, sin recaídas de su patología abdomino-inguinal. El paciente manifestó satisfacción con el tratamiento un año después del procedimiento. Conclusiones. El protocolo de neumoperitoneo secuencial es una alternativa en casos de hernias complejas, con alto riesgo de complicaciones, que requieren técnicas reconstructivas adicionales. La aplicación previa de toxina botulínica es un adyuvante considerable para aumentar la probabilidad de resultados favorables. Sin embargo, debe incentivarse la investigación en esta área para evaluar su efectividad.

Introduction. Giant hernias with loss of domain are those whose hernial sac reaches the midpoint of the thigh in standing position and whose content exceeds the volume of the abdominal cavity. These hernias are a surgical challenge given the difficult reduction of their contents and the primary fascial closure, with a higher risk of complications associated with abdominal compartment syndrome, as well as a higher rate of recurrence and morbidity in patients. Clinical case. A 81-year-old male patient with comorbidity, reconsulting due to a symptomatic giant right inguinoscrotal hernia of two years of evolution, with a Tanaka index of 24%, eligible for a sequential pneumoperitoneum protocol (up to a total of 11,000 cc in cavity) plus application of botulinum toxin (two sessions) in the abdominal wall. Results. Successful correction of the patient's giant inguinoscrotal hernia was achieved using this protocol, without recurrence of his abdomino-inguinal pathology and satisfaction with the procedure after one year. Conclusion. The sequential pneumoperitoneum protocol continues to be an important alternative in cases with a high risk of complications that require additional reconstructive techniques, while the previous application of botulinum toxin is a considerable adjuvant to further increase the rate of favorable results. However, research in the area should be encouraged to reaffirm its effectiveness.

Reconstrução mamária com TRAM: avaliação tomográfica abdominal / Breast reconstruction with TRAM: abdominal tomographic evaluation

Introdução: O retalho transverso do músculo reto abdominal (TRAM) é um método de reconstrução mamária com bons resultados estéticos e dispensa o uso de próteses de silicone para melhor contorno corporal. Foi originalmente descrito por Holmstrom em 1979, como uma elipse de pele e gordura com base em um músculo isolado no seu pedículo vascular. A reconstrução sistematizada do defeito da parede instalado após a transposição do retalho com o uso de tela de polipropileno foi descrita em estudo prévio por Cunha. O artigo tem como objetivo avaliar as alterações na parede abdominal, após a sistematização da colocação da tela de polipropileno durante a cirurgia de reconstrução com TRAM. Método: É um trabalho de coorte retrospectivo que avalia as possíveis alterações da parede abdominal de pacientes submetidos ao retalho TRAM com tomografia computadorizada de abdome pré e pós-operatórias. Resultados: Foi evidenciada uma redução do tamanho da cavidade abdominal de, em média, 14,5% e 14,2% na espessura da parede abdominal submetidas ao TRAM. A maior redução da espessura da parede abdominal foi de um paciente submetido ao retalho bipediculado, com 50,7%. As complicações apresentadas foram hérnia umbilical, seroma tardio, fibrose peritela e granuloma de fio. Conclusão: Nesse estudo, a tomografia após a cirurgia demonstrou a redução no volume da cavidade abdominal e espessura da parede abdominal, o que não influenciou estatisticamente no aparecimento de hérnia abdominal, abaulamentos, extrusão da malha ou outras deformidades.

Introduction: The transverse rectus abdominis muscle flap (TRAM) is a method of breast reconstruction with good aesthetic results and does not require the use of silicone implants for better body contouring. It was originally described by Holmstrom in 1979 as an ellipse of skin and fat based on an isolated muscle on its vascular pedicle. The systematic reconstruction of the wall defect installed after flap transposition using polypropylene mesh was described in a previous study by Cunha. The article aims to evaluate changes in the abdominal wall, after the systematization of polypropylene mesh placement during TRAM reconstruction surgery. Method: This is a retrospective cohort study that evaluates possible changes in the abdominal wall of patients undergoing the TRAM flap with preand postoperative abdominal computed tomography. Results: A reduction in the size of the abdominal cavity of, on average, 14.5% and 14.2% in the thickness of the abdominal wall subjected to TRAM was evidenced. The greatest reduction in abdominal wall thickness was in a patient who underwent a bipedicled flap, with 50.7%. The complications presented were umbilical hernia, late seroma, perithellal fibrosis, and thread granuloma. Conclusion: In this study, tomography after surgery demonstrated a reduction in the volume of the abdominal cavity and thickness of the abdominal wall, which did not statistically influence the appearance of abdominal hernia, bulging, mesh extrusion, or other deformities.

Siguiendo la trayectoria de la abdominoplastia TULUA ­ Revelación de su evolución e impacto global / Tracing the Trajectory of TULUA Abdominoplasty ­ Unveiling its Evolution and Global Impact

La técnica de abdominoplastia TULUA, fue concebida por el Dr. Francisco Villegas en Colombia, su acrónimo en inglés refleja sus principios fundamentales: plicatura Transversal, Sin despegamiento, Liposucción sin restricción que incluye la línea media y flancos, Neo umbilicoplastia, ubicación baja de cicatriz y libre posición del ombligo. A lo largo de los últimos 12 años, la técnica TULUA ha ganado espacio en América Latina, Norteamérica, la zona árabe e India. Destacando su relevancia, se ha propuesto la publicación de un libro monográfico, programado para 2024, que abarcará desde los principios fundamentales hasta las experiencias internacionales con la técnica. Las indicaciones de la abdominoplastia TULUA han evolucionado, incluyendo casos estéticos, secundarios, hernias, cicatrices previas, pérdida masiva de peso, alta definición, aumento muscular y combinaciones con otras plicaturas. Ha sido aplicada con éxito en cierre del abdomen donante de reconstrucción mamaria. A través de investigaciones especializadas y revisiones de pares, la TULUA ha sido reconocida por su aplicabilidad y beneficios, especialmente en la realización segura de liposucción en abdominoplastias. Se sugieren estudios adicionales para evaluar los resultados y posibles complicaciones, abriendo oportunidades para una mayor comprensión y refinamiento. El futuro de la abdominoplastia TULUA parece prometedor, anticipando trabajos prospectivos, indicaciones adicionales y un enfoque gradual para cirujanos en formación. En última instancia, la técnica se presenta como una adición al repertorio de procedimientos estéticos abdominales, contribuyendo al avance de la cirugía abdominal estética.

The TULUA abdominoplasty technique, conceived by Dr. Francisco Villegas in Colombia, its acronym in English reflects its fundamental principles: Transverse plication, no Undermined flap above the umbilicus, Liposuction without restrictions including midline and flanks, Neo umbilicoplasty, low scar placement, and free umbilical positioning. Over the past 12 years, the TULUA technique has gained acceptance in Latin America, North America, the Arab region, and India. Highlighting its relevance, the publication of a monographic book has been proposed, its launch is scheduled for 2024, covering from fundamental principles to international experiences with the technique. Indications for TULUA abdominoplasty have evolved, including aesthetic cases, secondary cases, hernias, previous scars, massive weight loss, high definition, muscle augmentation, and combinations with other plications. It has been successfully applied in closing the donor abdomen for breast reconstruction. Through specialized research and peer reviews, TULUA has been recognized for its applicability and benefits, especially in safely performing liposuction during abdominoplasties. Additional studies are suggested to evaluate results and potential complications, opening opportunities for greater understanding and refinement. The future of TULUA abdominoplasty appears promising, anticipating prospective works, additional indications, and a gradual approach for surgeons in training. Ultimately, the technique presents itself as an addition to the repertoire of abdominal aesthetic procedures, contributing to the advancement of aesthetic abdominal surgery.

Divertículo de Meckel complicado. Experiencia de 15 años en un hospital interzonal / Complicated Meckel's diverticulum. Fifteen years of experiencein an interzonal hospital in the Province of Buenos Aires

Introducción: el divertículo de Meckel es la anomalía congénita más frecuente del tracto gastrointestinal. Puede presentarse con hemorragia, obstrucción intestinal o diverticulitis, complicaciones que disminuyen con la edad, por lo que en el adulto el diagnóstico suele ser incidental. El tratamiento de las complicaciones es quirúrgico, mediante diverticulectomía o resección segmentaria del intestino delgado, dependiendo de sus características morfológicas. Objetivo: analizar nuestra experiencia en el manejo del divertículo de Meckel complicado en un período de 15 años. Diseño: estudio descriptivo, observacional, transversal, retrospectivo. Material y métodos: se revisaron las historias clínicas de los pacientes operados por divertículo de Meckel complicado en el Servicio de Cirugía General del Hospital San Roque durante el periodo 2007-2022. Se registraron datos demográficos, presentación clínica, diagnóstico preoperatorio, tratamiento quirúrgico, complicaciones postoperatorias y hallazgos histopatológicos. Resultados: se incluyeron 25 pacientes, 21 (84%) hombres, 3 menores de 18 años. La presentación clínica fue un síndrome de fosa iliaca derecha en el 80% de los casos, obstrucción intestinal en el 16% y hemorragia en el 4%. En solo 2 casos se realizó el diagnóstico preoperatorio, confirmado mediante tomografía computada. Se realizó diverticulectomía en el 68% de los pacientes y resección segmentaria el 32%. El abordaje fue laparotómico en el 64%, principalmente en el periodo inicial y laparoscópico en el 36%. Hubo una complicación IIIb de Clavien-Dindo en un paciente pediátrico tratado con drenaje percutáneo. En un solo paciente (4%), que se presentó con hemorragia digestiva masiva, se encontró epitelio de tipo gástrico y páncreas ectópico en el divertículo. Conclusiones: En nuestra experiencia el divertículo de Meckel complicado se presentó predominantemente en hombres. La complicación más frecuente en el adulto fue la diverticulitis. El diagnóstico preoperatorio fue infrecuente y realizado por tomografía computada. La diverticulectomía es suficiente en la mayoría de los casos. Actualmente, la laparoscopia es una herramienta segura, rentable y eficiente que permite el diagnóstico y tratamiento oportunos de esta entidad. (AU)

Introduction: Meckel's diverticulum is the most common congenital malformation of the gastrointestinal tract. It can present with bleeding, intesti-nal obstruction or diverticulitis, complications that decrease with age, so in adults the diagnosis is usually incidental. Treatment of complications is surgical, through diverticulectomy or segmental resection of the small intestine, depending on its morphological characteristics. Objective: to analyze our experience in the management of complicated Meckel's diverticulum over a period of 15 years. Design: descriptive, observational, cross-sectional, retrospective study. Materials and methods: the medical records of patients operated on for complicated Meckel's diverticulum in the General Surgery Service of the San Roque Hospital during the period 2007-2022 were reviewed. Demo-graphic data, clinical presentation, preoperative diagnosis, surgical treatment, postoperative complications, and histopathological findings were recorded. Results: twenty-five patients were included, 21 (84%) men, 3 under 18 years of age. The clinical presentation was a right iliac fossa syndrome in 80% of cases, intestinal obstruction in 16% and hemorrhage in 4%. In only 2 cases was the preoperative diagnosis made, confirmed by computed tomography. Diverticulectomy was performed in 68% of patients and segmental resection in 32%. The approach was by laparotomy in 64%, mainly in the initial period, and by laparoscopy in 36%. There was a Clavien-Dindo IIIb complication in a pediatric patient treated with percutaneous drain-age. In only one patient (4%), who presented with massive gastrointestinal bleeding, gastric-type epithelium and ectopic pancreas were found in the diverticulum. Conclusions: In our experience, complicated Meckel's diverticulum occurred predominantly in men. The most frequent complication in adults was diverticulitis. Preoperative diagnosis was infrequent and was made by computed tomography. Diverticulectomy is sufficient in most cases. Currently, laparoscopy is a safe, profitable and efficient tool that allows for the timely diagnosis and treatment of this entity. (AU)

Reparação da parede abdominal com membranas acelulares de pericárdio bovino - Parte I - Achados clínicos e radiológicos / Abdominal wall repair with acellular bovine pericardial membranes - Part I - Clinical and radiological findings

Introdução: Reduzindo os índices de recidiva de forma impactante, o emprego de biomateriais como "telas de reforço" na reparação de diferentes defeitos da parede abdominal tornou-se rotina quase obrigatória para o sucesso dessas reparações. A partir da década de 1990 houve a introdução de matrizes biológicas acelulares, iniciando-se assim uma nova era na reparação dos defeitos da parede abdominal. O objetivo é avaliar a funcionalidade do pericárdio bovino acelularizado em reparações da parede abdominal. Método: Trinta pacientes foram submetidos a reparação de defeitos da parede abdominal, com biopróteses acelulares de pericárdio bovino, perfazendo um total de 40 implantes anatomicamente individualizados. O seguimento médio foi de 31 meses, sendo os pacientes avaliados clinicamente e radiologicamente. Em três casos foram feitas biópsias das áreas implantadas permitindo análise histológica do material. Resultados: Não se observou recidiva das herniações em nenhum dos casos, tanto clinica como radiologicamente. Também não houve registro de hematomas, infecções ou qualquer fenômeno de natureza reacional local ou sistêmica. Radiologicamente, não foi possível visualizar as matrizes no local de implantação em qualquer dos períodos de pós-operatório analisados. Conclusão: As matrizes mostraram similaridade às demais membranas biológicas descritas na literatura internacional. Representando uma importante atualização e evolução conceitual, as membranas acelulares de pericárdio bovino podem ser incorporadas ao arsenal terapêutico nas reparações de parede abdominal.

Introduction: Reducing recurrence rates significantly, the use of biomaterials as "reinforcement meshes" in the repair of different abdominal wall defects has become an almost mandatory routine for the success of these repairs. From the 1990s onwards, acellular biological matrices were introduced, thus beginning a new era in the repair of abdominal wall defects. The objective is to evaluate the functionality of the acellularized bovine pericardium in abdominal wall repairs. Method: Thirty patients underwent repair of abdominal wall defects using acellular bovine pericardium bioprostheses, making a total of 40 anatomically individualized implants. The average follow-up was 31 months, with patients being evaluated clinically and radiologically. In three cases, biopsies were taken from the implanted areas, allowing histological analysis of the material. Results: No recurrence of herniations was observed in any of the cases, both clinically and radiologically. There were also no records of bruises, infections or any phenomenon of a local or systemic reaction nature. Radiologically, it was not possible to visualize the matrices at the implantation site in any of the postoperative periods analyzed. Conclusion: The matrices showed similarity to other biological membranes described in the international literature. Representing an important update and conceptual evolution, acellular bovine pericardial membranes can be incorporated into the therapeutic arsenal in abdominal wall repairs.

Reparação da parede abdominal com membranas acelulares de pericárdio bovino - Parte II - Análises histológicas e morfométricas / Repair of the abdominal wall with acellular bovine pericardial membranes - Part II - Histological and morphometric analyses

Introdução: Análise histológica é a principal ferramenta de avaliação de biopróteses acelulares, em sua maioria em caráter experimental. O objetivo é analisar histologicamente a matriz acelular de pericárdio bovino em reparações de parede abdominal implantada em humanos. Método: De uma série de 30 reparações com a membrana, 3 pacientes foram submetidas a revisão cirúrgica não relacionada aos implantes, aos 13, 22 e 23 meses de pós-operatório, obtendo-se biópsias das áreas previamente implantadas. Além da avaliação dos aspectos básicos de biocompatibilidade e neoformação tecidual, as lâminas foram digitalizadas e submetidas a análise computadorizada com o software ImageJ para quantificação da cinética de degradação das membranas, associada à análise da dimensão fractal das amostras. Os valores obtidos para porcentagens de membrana residual tiveram suas médias comparadas por análise de variância (ANOVA) e pelo teste T de Student não pareado, também utilizado para os valores da quantificação da dimensão fractal. Resultados: Foi demonstrada a biocompatibilidade do material, com neoformação tecidual, deposição de colágeno e tecido celularizado de aspecto normal, sem reações locais importantes. Fragmentos residuais da membrana foram quantificados em 40%±7% aos 13 meses, em 20%±6% aos 22 meses e em 17%±6% aos 23 meses de pós-operatório, com a análise da dimensão fractal indicando uma progressiva degradação dos implantes, com significância estatística entre 13 meses e as amostras tardias. Conclusão: Os resultados atestaram a funcionalidade do pericárdio bovino acelular sob diferentes níveis de estresse mecânico nas reparações da parede abdominal em humanos.

Introduction: Histological analysis is the main tool for evaluating acellular bioprostheses, mostly on an experimental basis. The objective is to histologically analyze the acellular matrix of bovine pericardium in abdominal wall repairs implanted in humans. Method: From a series of 30 repairs with the membrane, 3 patients underwent surgical revision unrelated to the implants at 13, 22, and 23 months postoperatively, obtaining biopsies of the previously implanted areas. In addition to evaluating the basic aspects of biocompatibility and tissue neoformation, the slides were digitalized and subjected to computerized analysis with the ImageJ software to quantify the kinetics of membrane degradation associated with the analysis of the fractal dimension of the samples. The values obtained for percentages of residual membrane had their means compared by analysis of variance (ANOVA) and the unpaired Student's T test, also used for the fractal dimension quantification values. Results: The biocompatibility of the material was demonstrated, with tissue neoformation, collagen deposition, and cellularized tissue with a normal appearance without important local reactions. Residual fragments of the membrane were quantified at 40%±7% at 13 months, at 20%±6% at 22 months, and at 17%±6% at 23 months postoperatively, with the analysis of the fractal dimension indicating a progressive degradation of implants, with statistical significance between 13 months and late samples. Conclusion: The results confirmed the functionality of the acellular bovine pericardium under different levels of mechanical stress in abdominal wall repairs in humans.

Herramientas para el tamizaje de aneurisma de aorta abdominal / Tools for abdominal aortic aneurysm screening

Introducción. El aneurisma de la aorta abdominal (AAA) es la dilatación de la aorta abdominal mayor de 1,5 veces el diámetro esperado. Su prevalencia es variable, con tasas reportadas de hasta el 12,5 %. Se considera como causa de muerte de más de 10.000 personas al año en los Estados Unidos. El objetivo de esta revisión de la literatura fue describir los factores de riesgo y las herramientas de tamizaje de AAA. Métodos. Se realizó una búsqueda de la literatura utilizando dos ecuaciones en bases de datos electrónicas, empleando términos seleccionados de "Medical Subject Heading" (MeSH) y "Descriptores en Ciencias de la Salud" (DeCS). Se evaluó la calidad de los estudios con la herramienta STROBE (Strengthening the Reporting of Observational Studies in Epidemiology). Resultados. Se recolectaron 40 artículos y a partir de ellos se construyó el texto de revisión, identificando en estos, los factores de riesgo asociados al desarrollo de AAA, tales como sexo masculino, tabaquismo, hipertensión arterial, antecedente familiar y obesidad, entre otros. La diabetes mellitus parece actuar como factor protector. Dentro de los instrumentos de tamizaje, el ultrasonido abdominal es uno de los más usados. Conclusión. El AAA es una patología multifactorial. En la actualidad la ultrasonografía de aorta es el método de elección para el tamizaje, permitiendo la detección precoz. El tamizaje de AAA con métodos no invasivos, como el ultrasonido, es útil sobre todo en zonas con prevalencia alta de la patología y en pacientes con determinados factores de riesgo.

Introduction. Abdominal aortic aneurysm (AAA) is a dilation of the abdominal aorta greater than 1.5 times the expected diameter. Its prevalence is variable, with reported rates of up to 12.5%. It is considered the cause of death of more than 10,000 people a year in the United States. The objective of this literature review was to describe risk factors and screening tools for AAA. Methods. A literature search was conducted using two equations in electronic databases, using terms selected from "Medical Subject Heading" (MeSH) and "Descriptors in Health Sciences" (DeCS). The quality of the studies was evaluated with the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) tool. Results. Forty articles were collected and from them the review text was constructed, identifying the risk factors associated with the development of AAA, such as male sex, smoking, high blood pressure, family history and obesity, among others. Diabetes mellitus seems to act as a protective factor. Among the screening instruments, abdominal ultrasound is one of the most used. Conclusion. AAA is a multifactorial pathology. Currently, aortic ultrasonography is the method of choice for screening, allowing early detection. Screening for AAA with non-invasive methods, such as ultrasound, is useful especially in areas with a high prevalence of this pathology and in patients with certain risk factors.

Teratoma mesentérico maduro en una mujer adulta: reporte de caso y revisión de la literatura / Mature mesenteric teratoma in an adult women: Case report and literature

Introducción. Los teratomas son neoplasias que surgen a partir de células germinales pluripotenciales y derivan de dos o más capas de células. Se clasifican en tumores maduros, que contienen tejidos bien diferenciados, o inmaduros, que contienen estructuras inmaduras y embrionarias. Su localización más frecuente son las gónadas; la ubicación mesentérica es infrecuente y se han descrito aproximadamente 40 casos en la literatura mundial. Dentro del abordaje diagnóstico y terapéutico, se emplea la tomografía computarizada y la resonancia magnética nuclear para caracterizar la lesión, evaluar la extensión intraabdominal y la relación con otras estructuras. El diagnóstico debe confirmarse mediante el examen histopatológico. Caso clínico. Paciente femenina de 56 años, con antecedente de carcinoma ductal infiltrante de mama izquierda en remisión, en estudios de seguimiento con hallazgo incidental en tomografía de abdomen de lesión abdominopélvica dependiente del mesenterio, contornos lisos y nivel grasa-líquido. Estudios de extensión con marcadores tumorales negativos. Resultados. Por la alta sospecha clínica e imagenológica de teratoma, fue llevada a resección quirúrgica de la lesión. El examen histopatológico confirmó el diagnóstico de teratoma quístico maduro del mesenterio. Conclusión. El teratoma mesentérico es una entidad clínica rara, que debe ser considerado como uno de los diagnósticos diferenciales de una masa abdominal con efecto compresivo. El diagnóstico se basa principalmente en el examen clínico y los hallazgos imagenológicos. La escisión quirúrgica temprana es el pilar del tratamiento; el abordaje laparoscópico o abierto depende de las características clínicas y la experiencia del cirujano.

Background. Teratomas are neoplasms that arise from pluripotent germ cells, derived from two or more layers of germ cells. They are classified as mature tumors (cystic or solid), which contain well-differentiated tissues, or as immature tumors, which contain immature and embryonic structures. Its most frequent location is the female and male gonads; the mesenteric location is rare and approximately 40 cases have been described in the world literature. Within the diagnostic and therapeutic approach, computed tomography and magnetic resonance imaging are used to characterize the lesion, assess intra-abdominal extension and the relationship with other structures. The diagnosis must be confirmed by histopathological examination. Clinical case. A 56-year-old female patient with a history of infiltrating ductal carcinoma of the left breast in remission. In follow-up studies, incidental abdominal tomography finding of an abdominopelvic lesion dependent on the mesentery at the level of the mesogastrium, smooth contours with fat-liquid level. Extension studies with negative tumor markers. Results. Due to high clinical and imaging suspicion of teratoma, the patient was taken to resection of the lesion. Histopathological examination confirmed the diagnosis of mature cystic teratoma of the mesentery. Conclusion. Mesenteric teratoma is a rare clinical entity and is considered one of the differential diagnoses of an abdominal mass with a compressive effect. Diagnosis is mainly based on clinical examination and imaging findings. Early surgical excision is the mainstay of treatment; laparoscopic or open approach depends on the clinical characteristics and the experience of the surgeon.

Cohorte descriptiva de pacientes adultos con hipertensión portal en una institución de tercer nivel en Colombia / Descriptive cohort of adult patients with portal hypertension at a tertiary care institution in Colombia

Introducción. La hipertensión portal (HTP) se define como una elevación anormal de la presión venosa en el sistema portal que lleva al desarrollo de vías colaterales para desviar el flujo sanguíneo de la zona. Dentro de su etiología están las relacionadas con la cirrosis hepática y otras causas denominadas no cirróticas. El objetivo de este estudio fue evaluar los principales hallazgos demográficos, clínicos y paraclínicos en un grupo de pacientes con HTP, y determinar el uso de ayudas invasivas y no invasivas, y su disponibilidad para el diagnóstico y seguimiento de los pacientes en los centros que no cuentan con laboratorio de hemodinamia hepática, reflejando la dinámica de múltiples escenarios en Colombia. Metodología. Se realizó un estudio descriptivo de corte transversal, retrospectivo, en pacientes atendidos en una institución de tercer nivel del sur de Colombia, entre enero del año 2015 y diciembre del año 2020. Resultados. Se obtuvo una muestra de 61 pacientes en donde la mayoría de casos correspondían a hombres en la séptima década de la vida, procedentes del área urbana. La principal causa de consulta fue el sangrado digestivo (39,3 %), asociado a la presencia de telangiectasias (arañas vasculares) en el 37,2 %, seguido de circulación colateral (31,3 %) e ictericia (19,7 %). En la ecografía abdominal (realizada en el 57,4 % de los pacientes) predominaron la cirrosis (68 %) y la presencia de esplenomegalia (14,2 %), y en lospacientes con Doppler portal (realizado en el 16,4 %) se encontró hígado cirrótico (80 %) y dilatación portal (40 %). Con respecto a los hallazgos en la esofagogastroduodenoscopia predominó la presencia de várices esofágicas y gastritis crónica. Conclusión. El principal motivo de consulta fue el sangrado digestivo, en tanto que la cirrosis fue el antecedente y el hallazgo imagenológico más frecuente, seguido de las várices esofágicas. Se encontró que el uso de paraclínicos, ecografía abdominal, ecografía con Doppler portal y esofagogastroduodenoscopia fueron los más utilizados en el contexto clínico de los pacientes con el diagnóstico de HTP.

Introduction. Portal hypertension (PHT) is defined as an abnormal elevation of venous pressure in the portal system that leads to the development of collateral pathways to divert blood flow from the area. Within its etiology are those related to liver cirrhosis and other so-called non cirrhotic causes. The aim of this study was to evaluate the main demographic, clinical and paraclinical findings in a group of patients with PHT, and to determine the use of invasive and non-invasive aids, and their availability for the diagnosis and follow-up of patients in centers that do not have a hepatic hemodynamics laboratory, reflecting the dynamics of multiple scenarios in Colombia. Methodology. A descriptive, retrospective, cross-sectional, retrospective study was conducted in patients attended in a third level institution in Southern Colombia, between January 2015 and December 2020. Results. A sample of 61 patients was obtained where the majority of cases corresponded to men in the seventh decade of life, from the urban area. The main cause of consultation was digestive bleeding (39.3%), associated with the presence of telangiectasias (spider veins) in 37.2%, followed by collateral circulation (31.3%) and jaundice (19.7%). In abdominal ultrasound (performed in 57.4% of the patients), cirrhosis (68%) and the presence of splenomegaly (14.2%) predominated, and in patients with portal Doppler (performed in 16.4%), cirrhotic liver (80%) and portal dilatation (40%) were found. With respect to the findings in the esophagogastroduodenoscopy, esophageal varices and chronic gastritis were predominant. Conclusion. The main reason for consultation was gastrointestinal bleeding, while cirrhosis was the most frequent history and imaging finding, followed by esophageal varices. It was found that the use of paraclinics, abdominal ultrasound, ultrasound with portal Doppler and esophagogastroduodenoscopy were the most used in the clinical context of patients diagnosed with PHT.

Alteraciones de la pared abdominal: onfalocele / Abdominal wall defects: omphalocele

Introducción: los defectos de la pared son malformaciones congénitas con herniación de algunos órganos de la cavidad abdominal, como es el onfalocele. La prevalencia calculada es 1/10.000 nacimientos en países occidentales, en Colombia se desconoce. El diagnóstico es pre o posnatal requiriendo una serie de exámenes clínicos sistémicos, evaluación diagnóstica secundaria y búsqueda de anomalías asociadas; el tratamiento ha mejorado las tasas de supervivencia entre 70 y 95%. Objetivo: dar a conocer la patología y correlacionar los hallazgos genéticos, ambientales, clínicos y exámenes complementarios para el diagnóstico oportuno, derivando así al paciente a un tratamiento óptimo con disminución de la mortalidad. Materiales y métodos: revisión actualizada de la literatura utilizando buscadores Pubmed, UpToDate y ClinicalKey con énfasis en revisiones sistemáticas, casos clínicos y principales guías clínicas internacionales. Después se envió al jefe del departamento de cirugía pediátrica y a la división de publicaciones para su conocimiento, revisión y aprobación. Resultados: se analizaron 17 artículos publicados en los últimos 5 años, seleccionando los más relevantes y con evidencia clínica actual. Discusión y conclusiones: los estudios recientes han evidenciado nuevos hallazgos que han mejorado la supervivencia y reducido la mortalidad en los últimos 50 años.

Introduction: abdominal wall defects are congenital malformations associated with herniated abdominal organs, such as omphalocele. Its estimated prevalence is 1 per 10.000 live births in western countries. In Colombia the prevalence of omphalocele remains unknown. Omphalocele may be pre or postnatally diagnosed. A series of systemic clinical exams, secondary diagnostic evaluation and assessment for accompanying anomalies, are necessary. Treatment has improved survival rate to 70 and 95%. Objective: to increase awareness of this anomaly and correlate genetic, environmental and clinical findings and complementary exams to enable the early diagnosis and referral of these patients to receive optimal treatment which will reduce mortality. Materials and methods: updated literature review using Pubmed, UpToDate and ClinicalKey search engines, focused on systematic reviews, clinical cases and main international clinical practice guidelines. Found data was submitted to the head of the pediatric surgery department and to the publications division for their information, review and approval Results: 17 articles published in the last 5 years including the most relevant which contained current clinical evidence, were selected. Discussion and conclusions: recent studies have evidenced new findings that have improved survival and reduced mortality in the last 50 years.

The squat exercise recruits core muscles as much as localized exercises / O exercício de agachamento recruta músculos do tronco tanto quanto exercícios localizados

Abstract Introduction In the context of resistance training, which encompasses both strengthening and rehabilitation, the incorporation of global range exercises demands intense activation of the trunk muscle groups, which play a primary role in body stabilization. The squat, notorious for its complexity and effectiveness in activating stabilizers during execution, raises a central question: whether this exercise recruits the muscles more significantly compared to localized exercises, such as push-ups and trunk exten-sions. Objective To identify the degree of activation of the trunk muscles during squats and compare it with localized exercises for the trunk muscles: lumbar and abdominal. Methods Using surface electromyography, the activation of the iliocostalis, multifidus, internal oblique, external oblique and rectus abdominis muscles was evaluated. The sample included 16 physically active volunteers of both sexes. A repeated measures t-test (α < 0.05) was used as an analysis method. Results The iliocostalis, multifidus and internal oblique muscles showed similar levels of activation both in the squat and in their respective isolated exercises, while the rectus abdominis and external oblique muscles showed greater activity during trunk flexion. Conclusion It is possible to infer that squats are an effective exercise for training the iliocostalis, multifidus and internal oblique muscles, while localized exercises are more suitable for strengthening the external oblique and rectus abdominis muscles. Such conclusion can contribute to optimizing the planning of exercise sessions by replacing isolated trunk exercises with squats.

Resumo Introdução No contexto do treinamento resistido, que engloba tanto o fortalecimento quanto a reabilitação, a incorporação de exercícios de alcance global demanda uma intensa ativação dos grupos musculares do tronco, os quais desempenham um papel primordial na estabilização corporal. O agachamento, notório por sua complexidade e eficácia na ativação dos estabilizadores durante a execução, suscita uma questão central: se o agachamento recruta de forma mais acentuada a musculatura do tronco comparativamente a exercícios localizados, tais como flexões e extensões do tronco. Objetivo Identificar o grau de ativação dos músculos do tronco durante o agachamento e confrontá-lo com exercícios localizados para a musculatura do tronco: lombar e abdominal. Métodos Através da aplicação da eletromiografia de superfície, avaliou-se a ativação dos músculos iliocostal, multífido, oblíquo interno, oblíquo externo e reto abdominal. A amostra englobou 16 voluntários de ambos os gêneros, fisicamente ativos. Empregou-se um teste t de medidas repetidas (α < 0,05) como método de análise. Resultados Os músculos iliocostal, multífido e oblíquo interno manifestaram níveis semelhantes de ativação tanto no agachamento quanto em seus respectivos exercícios isolados, enquanto os músculos reto abdominal e oblíquo externo apresentaram maior atividade durante a flexão do tronco. Conclusão É possível inferir que o agachamento se configura como um exercício eficaz para o treinamento do iliocostal, multífido e oblíquo interno, enquanto os exercícios localizados se revelam mais indicados para o fortalecimento do oblíquo externo e dos músculos reto abdominais. Tais conclusões podem contribuir para a otimização do planejamento de sessões de exercícios, mediante a substituição de exercícios isolados de tronco pelo agachamento.

Recto-sigmoïdite induite par administration de purgatifs à propos d'un cas / Recto-sigmoiditis induced by purgative administration: a case report

Il s'agit d'un patient de 25 ans reçu pour hématochézie de grande abondance et douleurs abdominales après utilisation par voie orale et rectale d'un purgatif à base de graines de Jatropha curcas ou pignon d'Inde appelée en bambara (langue locale du Mali) « Bagani ¼ et de Scoparia dulcis appelée en bambara « timitimini ¼. La coloscopie réalisée a permis de retrouver une nécrose du colon descendant. Le patient est décédé dans un tableau de choc septique par perforation colique.

This 25-year-old patient was presented with profuse hematochezia and abdominal pain following oral and rectal use of a purgative based on Jatropha curcas or "pignon d'Inde" seeds, known in Bambara (the local language of Mali) as "Bagani", and Scoparia dulcis, known in Bambara as "timitimini". Colonoscopy revealed necrosis of the descending colon. The patient died of septic shock due to colonic perforation

Establishment of a rat model of myocardial hypertrophy by a modified abdominal aortic coarctation method / 解剖学报

Objective To compare effectiveness between the modified and traditional pressure-overload myocardial hypertrophy(POMH) model by abdominal aorta coarctation (AAC) method. Methods Totally 45 rats were divided into three groups(n = 15 per group), sham group, traditional group, and modified group. In the traditional group, the diameter ol the abdominal aorta was narrowed to 0. 70 mm through a midline incision for 4 weeks; in the modified group, the diameter of the abdominal aorta was narrowed above the left kidney to 0. 45 mm for 1 week, and then the narrowing was lifted postoperatively. The cardiac index, heart weight (HW) /body weight (BW) and left ventricular index, left ventricular weight (LVW)/BW were measured from the heart specimens, and the cross-sectional area of cardiac myocytes, myocardial collagen area, and myocardial collagen area Iraction were measured in the pathological sections by HE staining and Masson staining. Results Compared with the sham group, the differences in end-systolic interventricular septum thickness (IVSs), left ventricular end-systolic posterior wall thickness (LVPWs), HW/BW, LVW/BW, cardiomyocyte cross-sectional area, myocardial collagen area, myocardial collagen area fraction, and brain natriuretic peptide (BNP) expression levels were statistically significant (P0. 05). Conclusion The modified abdominal aortic constriction method used in this experiment is time-saving, stable, homogeneous and easy to replicate, and is a more ideal approach to establish a rat model of POMH.

Effect of LncRNA p21 regulating Hippo-YAP signaling pathway on formation of abdominal aortic aneurysm in mice and its mechanism / 中国药理学通报

Aim To investigate the effect of long non- coding RNA p21 (LncRNA p21) regulating Hippo- Yes-associated protein (Hippo-YAP) signaling pathway on the formation of abdominal aortic aneurysm (AAA) in mice. Methods C57BL/6 ApoE

Application of endocrine indices and ultrasound examination in the early diagnosis of pediatric pancreatic injury / 临床肝胆病杂志

The incidence rate of abdominal trauma is increasing year by year in pediatric trauma， and traumatic pancreatic injury should be taken seriously by clinicians. The pancreas is located behind the peritoneum， and it is difficult to make an early diagnosis of pancreatic injury， especially in children with grade ‍Ⅰ‍/Ⅱ injury. Through a literature review， this article analyzes the application value of endocrine indices and abdominal ultrasound in the early diagnosis of pediatric pancreatic injury， so as to improve the rate of early diagnosis and avoid the onset of related complications. Changes of the endocrine indices such as serum insulin and C Peptide have certain advantages in diagnosing and evaluating the degree of pediatric pancreatic injury and can thus be used as early warning indices for pediatric pancreatic injury. Ultrasound elastography provides a new method for the diagnosis and differentiation of pancreatic injury； contrast-enhanced ultrasound， which has no radioactive damage， has relatively high specificity and sensitivity in identifying pediatric pancreatic injury， and therefore， it is expected to become an alternative to CT examination.

Algoritmo diagnóstico y terapéutico de las lesiones esplácnicas provocadas durante la inserción de sondas pleurales / Diagnostic and Therapeutic Algorithm for Splanchnic Injuries Caused during Chest Tube Insertions

Introducción: La colocación de sondas pleurales es un procedimiento quirúrgico frecuente que puede tener graves complicaciones, las cuales dependen en la mayoría de los casos de la experiencia del operador, el tamaño del tubo y el uso de imágenes para guiar la inserción. Objetivo: Describir las principales lesiones esplácnicas provocadas durante la inserción de sondas pleurales y presentar algoritmos para el diagnóstico precoz y el tratamiento oportuno de estas iatrogenias. Métodos: Se realizó una revisión descriptiva narrativa durante el primer trimestre del año 2023. Se utilizaron las bases de datos electrónicas PubMed, LILACS, EBSCO y Cochrane. Se revisaron artículos publicados desde 1984 hasta el 2022. Se procuró que la mayoría de la información se enmarcara en un período no mayor de 10 años de antigüedad. Desarrollo: De las lesiones esplácnicas de la cavidad torácica, la de pulmón es la más frecuente y puede conducir a sangrado o fuga aérea persistente. Las lesiones vasculares son graves y pueden provocar la muerte si no se toman las medidas pertinentes. Se han descrito lesiones de órganos huecos de la cavidad abdominal que suelen ser parte de una hernia diafragmática. Dentro de las lesiones esplácnicas en el abdomen más frecuentes están la hepática y la esplénica. Conclusiones: Estas lesiones son prevenibles y se debe tener en cuenta su mecanismo de producción para evitarlas. Para este fin recomendamos una selección cuidadosa del sitio de inserción, realizar una confirmación adecuada de la posición de la sonda, manipularla cuidadosamente y monitorear constantemente al paciente(AU)

Introduction: Chest tube insertion is a frequent surgical procedure that can have serious complications, which depend mostly on the practitioner's experience, the tube's size and the use of imaging to guide the insertion. Objective: To describe the main splanchnic injuries caused during chest tube insertion, as well as to present algorithms for early diagnosis and timely treatment of these types of iatrogeny. Methods: A descriptive narrative review was performed during the first quarter of the year 2023. The electronic databases PubMed, LILACS, EBSCO and Cochrane were used. Articles published from 1984 to 2022 were reviewed. Most of the information was secured to be framed within a period of no more than 10 years. Development: Among the splanchnic injuries within the thoracic cavity, lung injury is the most frequent and may lead to bleeding or persistent air leak. Vascular injuries are severe and can lead to death if appropriate measures are not taken. Injuries to hollow organs of the abdominal cavity have been described to be usually part of a diaphragmatic hernia. Among the most frequent splanchnic lesions within the abdomen are the hepatic and splenic injuries. Conclusions: These lesions are preventable and their mechanism of production should be taken into account in order to avoid them. To achieve this, we recommend that the insertion site be carefully selected and that the tube's position be adequately confirmed, as well as the careful handling of the tube and the constant monitoring of the patient(AU)

Trombosis venosa mesentérica y portal como causa infrecuente de obstrucción e isquemia intestinal en paciente joven. Reporte de caso / Mesenteric and Portal Venous Thrombosis as an infrequent cause of intestinal Obstruction and Ischemia in young patients. A case report

Resumen La isquemia mesentérica aguda se asocia a una mortalidad de entre el 50 y el 100%, la causa más rara de esta es la trombosis venosa de los vasos mesentéricos (5%) y portal (1%). Las manifestaciones clínicas son diversas, siendo el dolor abdominal el principal síntoma. La tomografía computarizada con contraste intravenoso en fase portal es la imagen más precisa para el diagnóstico. El tratamiento en fase aguda se basa en anticoagulación, fluidos intravenosos, antibióticos profilácticos, descanso intestinal y descompresión. La laparotomía de control de daños, incluida la resección intestinal y el abdomen abierto, pueden estar justificados en última instancia para pacientes con necrosis intestinal y sepsis. Caso clínico: Hombre de 35 años, sin antecedentes de importancia, solo tabaquismo desde hace 15 años. Refirió que 5 días previos comenzó a presentar dolor en el epigastrio tipo cólico, de intensidad moderada, posteriormente refirió que el dolor se generalizó y aumentó de intensidad, acompañado de náusea, vómito, intolerancia a la vía oral y alza térmica. Al examen físico tuvo datos de respuesta inflamatoria sistémica, estaba consciente y orientado, con abdomen doloroso a la palpación superficial y profunda a nivel generalizado, pero acentuado en el flanco derecho, rebote positivo con resistencia, timpanismo generalizado, peristalsis ausente. Se ingresó a quirófano a laparotomía exploradora, encontrando lesión a intestinal isquémica-necrótica a 190-240 cm del ángulo de Treitz, y 400 cc de líquido hemático; se realizó resección de la parte intestinal afectada, con entero-enteroanastomosis término-terminal manual. Se envió pieza a patología, y se reportó un proceso inflamatorio agudo con necrosis transmural y congestión vascular. Ante estos hallazgos se realizó angiotomografía abdominal que reportó defecto de llenado en la vena mesentérica superior, secundario a trombosis que se extendía hasta la confluencia y la vena porta. Conclusión: La trombosis venosa mesentérica y portal es una patología muy infrecuente en pacientes jóvenes sin factores de riesgo en los que se presenta dolor abdominal. El diagnóstico es complejo debido a que los datos clínicos y de laboratorio son poco específicos. Sin embargo, debemos tenerla en cuenta en el diagnóstico diferencial de etiologías de dolor abdominal.

Abstract Acute Mesenteric Ischemia is associated with a mortality rate between 50% and 100%; the rarest cause of this is venous thrombosis of the mesenteric (5%) and portal (1%) vessels. The clinical manifestations are diverse, with abdominal pain being the main symptom. Computed tomography with intravenous contrast in the portal phase is the most accurate image for diagnosis. Treatment in the acute phase is based on anticoagulation, intravenous fluids, prophylactic antibiotics, intestinal rest, and decompression. Damage control laparotomy, including bowel resection and open abdomen, may ultimately be warranted for patients with bowel necrosis and sepsis. Clinical case: 35-year-old man, with no significant history, only smoking for 15 years. For 5 days before, he reported crampy epigastric pain of moderate intensity. He subsequently reported that the pain became generalized and increased in intensity, accompanied by nausea, vomiting, oral intolerance, and temperature rise. The physical examination showed signs of a systemic inflammatory response, conscious and oriented, abdomen painful on superficial and deep palpation at a generalized level but accentuated on the right flank, positive rebound with resistance, generalized tympanism, absent peristalsis. The operating room was entered for exploratory laparotomy, finding an ischemic-necrotic intestinal lesion at 190 - 240 cm from the angle of Treitz, and 400cc of blood fluid. Resection of the affected intestinal part is performed, with entire manual terminal end anastomosis. The specimen was sent to pathology, reporting an acute inflammatory process with transmural necrosis and vascular congestion. Given these findings, abdominal CT angiography was performed, which reported a filling defect in the superior mesenteric vein, secondary to thrombosis that extended to the confluence and the portal vein. Conclusion: Mesenteric and portal venous thrombosis is a very rare pathology in young patients without risk factors in whom abdominal pain occurs. The diagnosis is complex because the clinical and laboratory data are not very specific. However, we must take it into account in the differential diagnosis of abdominal pain etiologies.

Procedural and long-term outcomes of elective endovascular abdominal aortic aneurysm repair in octogenarians / Resultados perioperatorios y a largo plazo de la reparación electiva endovascular del aneurisma de aorta abdominal en octogenarios

Abstract Objective: The aim of the study was to compare the immediate and long-term outcomes of endovascular aneurysm repair (EVAR) between patients under and over the age of 80 with abdominal aortic aneurysm (AAA). Methods: From 2011 to 2017, we conducted a retrospective cohort study with AAA patients who received elective EVAR. Primary outcomes included hospital mortality, length of stay, acute kidney injury, and the need for re-interventions. Secondary outcomes included aneurysm-related mortality, acute myocardial infarction, stroke, acute limb ischemia, and prolonged mechanical ventilation. Results: A total of 77 (62.6%) patients under the age of 80 years old and 46 (37.4%) octogenarians were included in the study. The male gender and AAA diameter did not differ among groups (92.2% vs. 82.6%, p = 0.11 and 5.4 cm [4.9-6.2 cm] vs. 5.4 cm [5-6 cm], p = 0.53, respectively). The younger patients had a higher prevalence of tobacco use (72.7% vs. 41.7%, p = 0.01). There were no deaths during the index hospitalization. The incidence of reinterventions (5.3% vs. 15.2%, p = 0.11) and acute kidney injury (14.3% vs. 23.9%, p = 0.18) did not differ between groups, but the length of stay was longer for octogenarian patients (3 days [2-4] vs. 2 days [2-3, p = 0.04]). Endoleaks were the most common cause for re-interventions (81.8%), with a prevalence of 34% across the entire cohort. There were no differences in any of the secondary outcomes between groups. Conclusion: In octogenarian patients with AAA, EVAR represents a safe procedure both during the index hospitalization and during long-term follow-up.

Resumen Objetivo: Comparar los resultados inmediatos y a largo plazo de la reparación endovascular del aneurisma de aorta abdominal (REVA) entre pacientes menores de 80 años y octogenarios. Método: Cohorte retrospectiva que incluyó pacientes con aneurisma de aorta abdominal (AAA) sometidos a REVA electiva desde 2011 hasta 2017. Se evaluaron como punto finales primarios la mortalidad hospitalaria, la duración de la estadía hospitalaria, la incidencia de insuficiencia renal aguda y el requerimiento de reintervenciones. Los puntos finales secundarios incluyeron la mortalidad asociada al aneurisma, infarto agudo de miocardio, accidente cerebrovascular, isquemia arterial aguda de las extremidades y ventilación mecánica prolongada. Resultados: Se incluyeron 77 (62.6%) pacientes menores de 80 años y 46 (37.4%) octogenarios. La prevalencia de sexo masculino y el diámetro del AAA no difirieron entre ambos grupos (92.2% vs. 82.6%, p = 0.11 y 5.4 cm [4.9-6.2 cm] vs. 5.4 cm [5-6 cm], p = 0.53, respectivamente). Los pacientes más jóvenes presentaron una mayor prevalencia de tabaquismo (72.7% vs. 41.7%, p = 0.01). No se registraron muertes durante la hospitalización índice. La incidencia de reintervenciones (5.3% vs. 15.2%, p = 0.11) e insuficiencia renal aguda (14.3% vs. 23.9%, p = 0.18) no difirieron entre ambos grupos, pero la estadía hospitalaria fue más prolongada en pacientes octogenarios (3 días [2-4 días] vs. 2 días [2-3 días], p = 0.04). La causa más frecuente de reintervenciones fue la presencia de endofugas (81.8%), con una prevalencia del 34% en toda la cohorte. No se observaron diferencias en ninguno de los puntos finales secundarios entre ambos grupos. Conclusión: En pacientes octogenarios con AAA, la REVA presentó un buen perfil de seguridad perioperatorio y a largo plazo.