[V grade renal trauma in patient with union pyeloureteral stenosis not known.] / Traumatismo renal grado v en paciente con estenosis de la unión pieloureteral no conocida.

Paciente de 40 años de edad, sin alergias medicamentosas conocidas y sin antecedentesde interés, que es traído a Urgencias por dispositivo de cuidados críticos por politraumatismo tras accidente de moto...

Paciente de 40 años de edad, sin alergias medicamentosas conocidas y sin antecedentesde interés, que es traído a Urgencias por dispositivo de cuidados críticos por politraumatismo tras accidente de moto...

Traumatismo renal grado v en paciente con estenosis de la unión pieloureteral no conocida / V grade renal trauma in patient with union pyeloureteral stenosis not known

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Traumatismo renal grado IV parenquimatoso con ruptura de la vía y urinoma secundario. Manejo conservador / Renal injury grade IV: Laceration and secondary urinoma. Conservative management

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[Usefulness of antimicrobial prophylaxis with ciprofloxacin prior to flexible cystoscopy]. / ¿Está indicada la profilaxis antibiótica con ciprofloxacino en la realización de cistoscopia flexible?

BACKGROUND: Flexible cystoscopy is a common test in clinical practice done with or without antibiotic prophylaxis. AIM: To evaluate the efficacy of antibiotic prophylaxis with ciprofloxacin to reduce the incidence of urinary infection. MATERIAL AND METHODS: Prospective, non-randomized observational study that included 60 patients divided into two groups. Group 1 received prophylactic ciprofloxacin 500 mg, one hour prior to the procedure and group 2 did not receive prophylaxis. The presence of bacteriuria, symptoms or signs of urinary infection or attending Emergency rooms or primary care for these symptoms were recorded during the seven days after the cystoscopy. RESULTS: In groups 1 and 2, four and one patients had a positive urine culture, respectively. Only one patient in group 1 consulted in primary care for symptoms. No significant differences in symptoms or signs of urinary infection between groups were observed. CONCLUSIONS: In this group of patients, antibiotic prophylaxis with ciprofloxacin 500 mg prior to cystoscopy had no benefit.

¿Está indicada la profilaxis antibiótica con ciprofloxacino en la realización de cistoscopia flexible? / Usefulness of antimicrobial prophylaxis with ciprofloxacin prior to flexible cystoscopy

Background: Flexible cystoscopy is a common test in clinical practice done with or without antibiotic prophylaxis. Aim: To evaluate the efficacy of antibiotic prophylaxis with ciprofloxacin to reduce the incidence of urinary infection. Material and Methods: Prospective, non-randomized observational study that included 60 patients divided into two groups. Group 1 received prophylactic ciprofloxacin 500 mg, one hour prior to the procedure and group 2 did not receive prophylaxis. The presence of bacteriuria, symptoms or signs of urinary infection or attending Emergency rooms or primary care for these symptoms were recorded during the seven days after the cystoscopy. Results: In groups 1 and 2, four and one patients had a positive urine culture, respectively. Only one patient in group 1 consulted in primary care for symptoms. No significant differences in symptoms or signs of urinary infection between groups were observed. Conclusions: In this group of patients, antibiotic prophylaxis with ciprofloxacin 500 mg prior to cystoscopy had no benefit.

High-flow priapism caused by a pseudoaneurysm and an arteriocavernosal fistula: clinical and radiological approach of 3 cases.

OBJECTIVE: We report three cases of high-flow priapism in three young patients who presented erectile dysfunction after perineal trauma. METHODS: Complete clinical evaluation, blood tests, color Doppler ultrasonography (US), arteriography and selective embolization were performed. RESULTS: The clinical history and physical assessment were compatible with high-flow priapism. Color Doppler US showed a pseudoaneurysm and an arteriocavernosal fistula, which was confirmed and embolized using arteriography. CONCLUSIONS: High-flow priapism has a characteristic clinical presentation and physical examination. The radiologist has an important role in the diagnosis and treatment of this pathology. Color Doppler US and arteriography are essential in the diagnosis and allow embolization of the vascular injury. Prognosis is usually good.

Priapismo arterial por pseudoaneurisma y fístula arteriocavernosa: manejo clínico y radiológico de tres casos / High-flow priapism caused by a pseudoaneurysm and an arteriocavernosal fistula: clinical and radiological approach of 3 cases

OBJETIVO: Describir tres casos de priapismo arterial en pacientes jóvenes que presentaban disfunción eréctil e historia de traumatismo previo. MÉTODOS: Se realizó historia clínica, analítica, ecografía doppler color de cuerpos cavernosos, arteriografía y embolización selectiva lesional. RESULTADOS: La historia y exploración clínicas eran concordantes con un priapismo arterial. En la ecografía doppler color de los tres casos se identificó un pseudoaneurisma y una fístula arteriocavernosa que se confirmó y embolizó mediante arteriografía. CONCLUSIONES: El priapismo de tipo arterial tiene una historia y exploración clínicas características. El papel del radiólogo en el diagnóstico y tratamiento de esta patología es fundamental. La ecografía doppler color y la arteriografía son pruebas diagnósticas de primer orden y permite la embolización selectiva de la lesión vascular de base. El pronóstico generalmente es bueno

OBJECTIVE: We report three cases of high-flow priapism in three young patients who presented erectile dysfunction after perineal trauma. METHODS: Complete clinical evaluation, blood tests, color Doppler ultrasonography (US), arteriography and selective embolization were performed. RESULTS: The clinical history and physical assessment were compatible with high-flow priapism. Color Doppler showed a pseudoaneurysm and an arteriocavernosal fistula, which was confirmed and embolized using arteriography. CONCLUSIONS: High-flow priapism has a characteristic clinical presentation and physical examination. The radiologist has an important role in the diagnosis and treatment of this pathology. Color Doppler US and arteriography are essential in the diagnosis and allow embolization of the vascular injury. Prognosis is usually good

Hemoperitoneo espontáneo por rotura de tumor retroperitoneal / Spontaneous hemoperitoneum secondary to retroperitoneal tumor rupture

OBJETIVO: Describimos un caso de tumor retroperitoneal tipo GIST con rotura espontánea a cavidad abdominal, ocasionando un cuadro de abdomen agudo secundario a hemoperitoneo. MÉTODO Y RESULTADOS: Varón de 84 años que acude a servicio de Urgencias de nuestro hospital por cuadro sincopal, con dolor abdominal difuso y cortejo vegetativo acompañante. Tras la realización de diferentes pruebas complementarias se objetiva una masa retroperitoneal de pendiente de riñón izquierdo de unos 19 cm con sangrado activo y hemoperitoneo secundario, por lo que se realiza una nefrectomía radical izquierda con resultado anatomopatológico de tumor estromal gastrointestinal dependiente de la capsula renal. CONCLUSIONES: El hemoperitoneo espontáneo es una entidad poco frecuente y de una etiología variada estando descrita en muy raras ocasiones en tumores retroperitoneales

OBJECTIVE: To report a case of GIST type retroperitoneal tumor with spontaneous rupture to the abdominal cavity causing acute abdomen secondary to hemoperitoneum. METHODS/RESULTS: We report the case of an 84 year-old man with history of BPH and chronic atrial fibrillation. He presented to the Emergency Department with diffuse abdominal pain, syncope and accompanying vegetative symptoms. Diagnostic work up showed a 19 cm retroperitoneal mass dependent of the left kidney with active bleeding and secondary hemoperitoneum. Left radical nephrectomy was performed with pathology report of gastrointestinal stromal tumor attached to the renal capsule. CONCLUSIONS: Spontaneous hemoperitoneum is a rare entity and it has various etiologies. It is rarely described in retroperitoneal tumors

Hematoma subcapsular de 13 cm en paciente con aneurisma aorta toraco-abdominal de 10 cm y trombo mural / Thirteen centimeter subcapsular haematoma in a patient with thoracoabdominal aortic aneurysm and mural thrombus

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Adrenal cavernous hemangioma: is presurgical diagnosis with imaging test possible.

OBJECTIVE: To describe a case of adrenal cavernous hemangioma in a 67 year old man who presented left lumbar pain. METHODS: Abdominal ultrasound, contrast enhanced ultrasound of the lesion, abdominal-pelvic CT scan, and then left adrenalectomy and pathology were performed RESULTS: Imaging studies showed a large solid-cystic mass with 12 × 11 cm diameters in the left adrenal gland, well defined, with calcifications, which showed peripheral arterial globular contrast enhancement on CT and ultrasound. The lesion displaced neighboring structures without other findings in the abdominopelvic study. The pathology report after adrenalectomy was: cavernous hemangioma with calcifications, ossifications and necrosis. CONCLUSIONS: Cavernous hemangioma is a rare cause of adrenal mass. The globular peripheral contrast uptake and gradual filling of the lesion on dynamic imaging studies (Ultrasound or CT) and phlebolith type calcifications suggest the diagnosis of typical angioma. However, the presence of thrombosis, necrosis and calcifications in large lesions confer an unusual dynamic behavior and force pathology for definitive diagnosis.

Hemangioma cavernoso suprarrenal: ¿es posible un diagnóstico preoperatorio mediante imagen? / Adrenal cavernous hemangiona: is presurgical diagnosis with imaging tests possible

OBJETIVO: Describir un caso de hemangioma cavernoso suprarrenal en un paciente de 67 años que presentaba dolor lumbar izquierdo. MÉTODOS: Se realizó ecografía abdominal, ecografía de la lesión con ecopotenciador y TC multidetector abdomino-pélvico. Se practicó suprarrenalectomía izquierda y estudio histológico. RESULTADOS: En las pruebas de imagen se apreció en el área suprarrenal izquierda una gran masa sólido-quística de 12 x 11 cm de diámetro, bien delimitada, con calcificaciones groseras, que presentaba realce arterial de contraste y de ecopotenciador de morfología globular en su porción periférica. Dicha lesión desplazaba estructuras vecinas sin infiltrarlas, siendo el resto del estudio abdominopélvico normal. El resultado de la pieza de suprarrenalectomía fue: hemangioma cavernoso con calcificación, osificación y necrosis. CONCLUSIONES: El hemangioma cavernoso es una causa rara de masa suprarrenal. La captación periférica globular de contraste iodado o de ecopotenciador y relleno progresivo de la lesión en el estudio dinámico de imagen (Eco o TC) así como las calcificaciones tipo “flebolitos” sugieren el diagnóstico de angioma típico. Sin embargo la presencia de trombosis-necrosis y calcificaciones en lesiones de gran tamaño le confieren un comportamiento dinámico atípico y obligan al estudio anatomopatológico para establecer un diagnóstico definitivo(AU)

OBJECTIVE: To describe a case of adrenal cavernous hemangioma in a 67 year old man who presented left lumbar pain. METHODS: Abdominal ultrasound, contrast enhanced ultrasound of the lesion, abdominal-pelvic CT scan, and then left adrenalectomy and pathology were performed. RESULTS: Imaging studies showed a large solid-cystic mass with 12 x 11 cm diameters in the left adrenal gland, well defined, with calcifications, which showed peripheral arterial globular contrast enhancement on CT and ultrasound. The lesion displaced neighboring structures without other findings in the abdominopelvic study. The pathology report after adrenalectomy was: cavernous hemangioma with calcifications, ossifications and necrosis. CONCLUSIONS: Cavernous hemangioma is a rare cause of adrenal mass. The globular peripheral contrast uptake and gradual filling of the lesion on dynamic imaging studies (Ultrasound or CT) and phlebolith type calcifications suggest the diagnosis of typical angioma. However, the presence of thrombosis, necrosis and calcifications in large lesions confer an unusual dynamic behavior and force pathology for definitive diagnosis(AU)

Urogenital sinus cyst in a 21-year-old man.

We report a case of a rare congenital malformation, a urogenital sinus cyst in a young patient with non-specific symptoms for several months. A 21-year-old male presented with vague and intermittent abdominal pain. Ultrasound scan showed a retrovesical hypoechoic collection (approximately 6 cm) and left renal agenesis, compatible with a possible congenital malformation. These findings were confirmed by MRI. A laparoscopic excision of the cyst was performed with no complications. Pathology report confirmed a urogenital sinus cyst. The postoperative recovery was uneventful and the patient was discharged within 48 h. Urogenital sinus cysts are rare entities with few cases described in the literature. Imaging techniques such as ultrasound, CT or MRI may help with diagnosis. Therapeutic modalities range from observation to needle aspiration or surgical removal. In our case, we chose a laparoscopic approach to minimize morbidity and achieve an early recovery.