Testis tumor associated to microlithiasis / Tumor de testiculo asociado a la microlitiasis / Tumor de testiculo associado a microlitiase

OBJECTIVE: To discuss the relationship between testicular microlithiasis and testis tumors in children and to consider the chances of testis preserving surgery in specific cases. CASE DESCRIPTION: Pre-adolescent presenting testicular microlithiasis and a larger left testis, corresponding to a cystic testicular tumor. The tumor was excised, with ipsilateral testis preservation. Histology diagnosed a testis dermoid tumor. COMMENTS: The relationship between testis tumors and testicular microlithiasis is ill defined in children. Pediatric urologists need to develop specific follow-up protocols for pre-pubertal children. .

OBJETIVO: Discutir las implicaciones de la microlitíasis testicular en el niño con relación al riesgo oncológico implicado y la posibilidad de cirugía de preservación testicular en casos elegidos. DESCRIPCIÓN DEL CASO: Pre-adolescente presentando aumento microlitíasis testicular y aumento del testículo izquierdo, con lesión tumoral quística. La lesión fue resecada, con preservación del testículo y diagnóstico histológico de tumor dermatoide testicular. COMENTARIOS: La relación entre tumores de testículo y microlitíasis testicular es mal definida en niños y hay la necesidad de desarrollar protocolos de seguimiento específicos para esa franja de edad. .

OBJETIVO: Discutir as implicações da microlitíase testicular na criança com relação ao risco oncológico envolvido e a possibilidade de cirurgia de preservação testicular em casos escolhidos. DESCRIÇÃO DO CASO: Pré-adolescente apresentava microlitíase testicular e aumento do testículo esquerdo, correspondendo a tumor testicular cístico. Ressecou-se o tumor, com preservação do testículo. O diagnóstico histológico foi de tumor dermoide testicular. COMENTÁRIOS: A relação entre tumores de testículo e microlitíase testicular é mal definida em crianças e há a necessidade de desenvolver protocolos de seguimento específicos para essa faixa etária. .

Comparing the efficacy of preoperative magnetic resonance cholangiopancreatography with intra-operative cholangiography in patients suspicious to biliary stones

This study was performed to compare the efficacy of preoperative magnetic resonance cholangiopancreatography [MRCP] and intra-operative cholangiography [IOC] methods in patients suspicious to gall stones. According to previous studies, it is recommended that common bile duct investigation should be done in order to rule out choledocholithiasis in all patients with symptomatic cholelithiasis. IOC is an invasive procedure with probable complications, it would seem that MRCP could replace the direct cholangiography. In a diagnostic clinical trial, Fifty-nine patients with symptomatic biliary stones or cholecystitis were recruited in this study. The included patients had normal size biliary ducts in sonography but high serum alkaline phosphatase level. Preoperative MRCP and IOC were performed for the patients and the obtained results were analyzed and compared. The positive predictive value for IOC was 88% and for MRCP was 43%. The diagnostic accuracy of IOC and MRCP were 98% and 85% respectively, suggesting that IOC is much more diagnostically accurate. There were no significant difference in specificity and sensitivity of these two methods. According to the results, we can conclude that MRCP may not obviate the need for IOC. The suggestion for routine use of MRCP instead of IOC and as a substitution of that procedure needs further investigations on more patients

Update on Endoscopic Management of Main Pancreatic Duct Stones in Chronic Calcific Pancreatitis

Pancreatic duct stones are a common complication during the natural course of chronic pancreatitis and often contribute to additional pain and pancreatitis. Abdominal pain, one of the major symptoms of chronic pancreatitis, is believed to be caused in part by obstruction of the pancreatic duct system (by stones or strictures) resulting in increasing intraductal pressure and parenchymal ischemia. Pancreatic stones can be managed by surgery, endoscopy, or extracorporeal shock wave lithotripsy. In this review, updated management of pancreatic duct stones is discussed.

Litiasis coledociana / Choledocal lithiasis

Se presenta un caso en el que luego de realizar un estudio ecográfico abdominal se diagnosticó litiasis coledociana a un paciente que presentaba antecedentes de litiasis vesicular, dolor en flanco derecho, e ictericia. También se describen algunas características de la enfermedad.

Complicación por fuga de cálculos en colecistectomía laparoscópica / Escape of stones as complication of laparoscopic cholecistectomy

Se presenta el caso de una paciente de 72 años que concurrió al servicio de ecografía del Hospital J. F. Muñiz, de la Ciudad de Buenos Aires, para evaluar una tumoración en la pared abdominal y descartar un derrame pleural. Presentaba como antecedente una cirugía laparoscópica, realizada 15 meses antes, y los resultados ecográficos presentaron colecciones originadas por el derrame de cálculos en la cavidad abdominal.

Santorinicele Containing a Pancreatic Duct Stone in a Patient with Incomplete Pancreas Divisum

Santorinicele, a focal cystic dilatation of the distal duct of Santorini, has been suggested as a possible cause of the relative stenosis of the accessory papilla, is associated with complete pancreas divisum, which results in acute episodes of pancreatitis or pain. This report describes a case of a santorinicele, which was initially detected by upper gastrointestinal endoscopy as a polypoid mass, in a patient with recurrent abdominal pain. The mass was subsequently proved to be a santorinicele containing a pancreatic duct stone associated with incomplete pancreas divisum on endoscopic retrograde pancreatography. To the best of our knowledge this is believed to be the first description of a santorinicele associated with these characteristic findings.

Pancreatic calculi-Radiological features and diagnostic significance

Pancreatic calculi refers to true stones in the duct system of the pancreas. False stones are calcifications in the parenchyma of the gland. According to Mayo Robson pancreatic calculi never forms in a healthy pancreas. It is a diagnostic feature of chronic pancreatitis. and it is rare in acute pancreatitis except as its sequelae in areas of fat necrosis and in the wall of pseudocysts. Pancreatic calculi was first observed and recorded by Graaf in 1667. Later, Morgagni [1765] and Cawley [1788] reported autopsy findings of the stones. Capparelli [1883] is given credit for the first surgical removal of pancreatic calculi

Microlitiasis testicular en pediatria / testicular microlithiasis in pediatric care

La microlitiasis testicular(MT)es una entidad rara,caracterizada ultrasonográficamente por la presencia de múltiples focos ecogénicos pequeños(más de cinco por campo de corte ecográfico)sin sombra acústica,generalmente bilaterales,los cuales corresponden a microcalcificaciones localizadas dentro de los túbulos seminíferos.La MT se ha asociado con patologías benignas,algunos síndromes y tumores de células germinales.Describimos 21 pacientes con Mt detectados entre julio de 1996 y Marzo de 1999,evaluamos los factores predisponentes y tratamos de establecer criterios de seguimiento.Utilizamos transductos de 7.5-10 Mhz.En todos los pacietnes se determinaron niverls de alfa-fetroproteínay betagonadotrofina coriónica humana.En 7 de ellos,se praticó biopsia testicular.Desde el momento del diagnóstico se realizó un seguimiento ecográfico semestral.De los 21 pacientes detectados con criterio ecográficos de MT,de acuerdo a su localización fueron:bilateral(n=16)unilateral(n=1)en testículo único(n=4)Las edades oscilaron entre 6 y 23 años(m=14,4 años)Los antecedentes clínicos que originaron el examen Us se agruparon en:criptoquidia corregida quirurgicamente(n=11)orquiepidimitis(n=2)traumatismo testicular(n=2)sindrómicos(n=2)torsión testicular(n=2)sindrómicos(n=2)tosion testicular operada(n=1)torsión de hidátide operada(n=1)asimetría testicular(n=1)control de leucemia(n=1)Los marcadores tumorales resultaron normales en todos los pacientes.las biopsias realizadas,5 evidenciaron cuerpos calcoficados,lamelados concentricamente,intratubulares,típicos de Mt y 2(los pacientes síndromicos)tumor de células de sertoli grandes calcificadas.La MT es un hallazgo ecográfico de patogenia desconocida.Se ha descripto asociado a tumores malignos.La evolución clínica y ecográfica es incierta.De no existir cambios clínicos evidentes,es conveniente un seguimiento ecográfico anual de los pacientes,con el fin de detectar cambios morfológicos que justifiquen la biopsia.En los casos sindromáticos,en los cuales hay asociación conocida con tumores,se debe realizar biopsia y control semestral

Giant prostatic calculus associated with giant urethral calculus

We report 2 cases of giant prostatic calculi associated with giant renal calculi. Both patients were advanced in age and had a long history of urethral strictures and urinary tract infection. They were anemic and their serum creatinine levels were also raised. Diagnosis in both cases was made by rectal examination, and confirmed by plain radiography. Treatment was by suprapubic cystolithotomy preceded by retrograde manipulation of the urethral calculi after control of their urinary tract infection. Both patients made an uneventful recovery, and required regular dilatations of their urethral strictures

Pulmonary alveolar microlithiasis: diagnosed by sputum examination and transbronchial biopsy.

A case of pulmonary alveolar microlithiasis presenting with uncharacteristic radiological features who was diagnosed on the basis of sputum examination and confirmed by transbronchial biopsy, is being reported. Azoospermia resulting in primary infertility and increased lung volumes by helium dilution test were other noteworthy features of the case.

Litiasis intrahepática: aporte de los tratamientos percutáneos / Intrahepatic primitive lithiasis

Se presenta una serie de 82 casos de litiasis intrahepática primitiva. Esta alta cantidad rara en Occidente, se explica por tratarse en su mayoría de pacientes que han quedado con litiasis remanente y enviados para su extracción percutánea. Desde de 1964 hasta la actualidad (5.000 casos). Se analiza la etiopatogenia dando importancia capital a las estenosis prelitiásicas, presentes en el 80 por ciento, que se consiguieron dilatar en todos los casos y no recidivaron. De las 82, 16 fueron difusas, 52 del conducto hepático izquierdo y 14 del derecho. En casi todos la cirugía fue complementada con el tratamiento instrumental. Se hizo tratamiento percutáneo en 79 casos, 73 se realizaron por la vía transfistular y 6 por vía TPH. Se obtuvo un éxito global del 94 por ciento. Las complicaciones fueron del 17 por ciento y la mortalidad del 2,4 por ciento. No se realizó ninguna hepatectomía

Microlitíase testicular associada à neoplasia de células germinativas / Testicular microlithiasis associated with germ cell neoplasy

A calcificaçäo intratubular do testículo, também conhecida como microlitíase testicular, é patologia rara e de etiologia incerta, descoberta durante a investigaçäo de sintomas testiculares inespecíficos. Apresenta padräo ultra-sonográfico característico, diferente daquele observado em outros tipos de calcificaçöes. Sua associaçäo com outras patologias foi descrita, inclusive com tumores testiculares, motivo pelo qual o paciente com microlitíase testicular deve merecer atençäo especial no que diz respeito à investigaçäo

Enterolitíase em paciente com divertículo de Meckel / Enterolithiasis in patients with Meckel's diverticulum

Os autores apresentam um raro caso de enterolitíase em paciente com divertículo de Meckel, a mais comum anomalia congênita do trato gastrintestinal - ocorrendo em 1 por cento a 3 por cento da populaçao. Formaçoes de cálculos no interior dos divertículos sao observaçao muito rara. Discutem os achados clínicos, critérios diagnósticos e o tratamento.

Microlitiasis alveolar pulmonar: Presentación de 5 casos / Pulmonary alveolar microlithiasis: Report of 5 cases

Cinco casos de microlitiasis alveolar pulmonar se describen en este trabajo, integrados por tres pacientes varones y dos pacientes hembras, pertenecientes a dos familias de dos y tres hermanos. El estudio se efectuó en el Hospital Universitario Ruiz y Páez de Ciudad Bolivar, mediante radiografia de tórax biopsia pulmonar, espirometría y estudio genético familiar

Pulmonary alveolar microlithiasis--report of three cases with pulmonary function and exercise studies.

Pulmonary alveolar microlithiasis is a rare disease involving accumulation of calcific concretions in the alveoli of the lungs. Three cases of this disease are reported with their varying and unusual clinical features. Radiologic studies demonstrated presence of diffuse calcific densities in the lungs with varying degrees of emphysematous changes. Bone scans showed diffuse uptake of the tracer in the lungs. Pulmonary functions showed hyperinflation and small airways dysfunction in one case besides the presence of restrictive ventilatory defect. Exercise studies demonstrated arterial oxygen desaturation on exercise.