Durability of Concrete with Partial Replacement of Portland Cement by Incorporating Reactive Magnesium Oxide and Fly Ash.

In this research, the durability performance of sustainable concrete with the incorporation of reactive magnesium oxide (MgO) and fly ash (FA) was evaluated. The partial replacement of cement with these two materials is an appealing solution for the construction sector due to sustainability benefits and shrinkage reduction. The incorporation of FA by partial replacement of cement was carried out at 0%, 15% and 30%. The incorporation of MgO in concrete was carried out at 0%, 5%, 10% and 20%. Two types of MgO were used, one from Australia and another of Spanish origin. These two materials were evaluated in terms of their individual incorporation, and then an evaluation was carried out when the two were simultaneously used. In terms of durability, performance losses between 3% and 95% were obtained in all tests (water absorption by capillarity and immersion, carbonation depth and resistance to chloride penetration). However, over time, the difference in performance relative to the reference concrete tends to decrease due to the slow hydration that characterizes these two alternative materials. It was found that, in most of the tests, no overlapping of the negative effects occurred. In other words, the simultaneous incorporation of MgO and FA caused performance losses lower than the sum of the losses of their individual incorporation.

Improvement of the Quality of Recycled Concrete Aggregate Subjected to Chemical Treatments: A Review.

The main factor that alters the quality of recycled concrete aggregate (RCA) is the paste adhered to the natural aggregate (NA). Since it causes weakening of the interfacial transition zone (ITZ) between the aggregate and the cementitious paste, it becomes a determining factor for the mechanical behavior of concrete. It turns out that it is critical to enhance this interface by improving the surface of the aggregate or by removing the paste adhered to the NA. Considering the variety of methods for removing paste adhered to RCA-namely using acids such as hydrochloric acid (HCl), sulfuric acid (H2SO4), and phosphoric acid (H3PO4), among others-this paper presents a review of treatments for the removal of adhered paste using acidic solutions on the RCA, and their influence on the mechanical properties and durability of concrete produced with RCA. Pearson's correlation was used in the statistical analysis to determine the linear relationship of the main factors-for instance, immersion time, acidic solution, and aggregate size-involved in the removal of the paste in the RCA.

As regulamentações de proteção de dados pessoais no Brasil e em Portugal: o tratamento de dados relativos à saúde no âmbito do Projeto "Sífilis Não" / Regulations for the protection of personal data in Brazil and Portugal: the processing of health data under the "No Syphilis" Project / Normativa para la protección de datos personales en Brasil y Portugal: el tratamiento de datos sanitários em el marco del Proyecto "Sífilis Não"

Objetivo: discutir se replicar o Projeto "Sífilis Não", naquilo que se refere ao tratamento de vastas quantidades de dados pessoais relativos à saúde sem o consentimento dos titulares, seria possível em solo português. Metodologia: análise da legislação referente à proteção de dados pessoais brasileira, portuguesa e europeia, tendo o Projeto "Sífilis Não" como o caso em estudo. Resultados: o tratamento de dados pessoais sensíveis sem o consentimento do titular é, em regra, proibido pelo Regulamento Geral de Proteção de Dados, entretanto, o tratamento por motivo de interesse público na área da saúde e para fins de pesquisa científica é autorizado, desde que sejam garantidas as liberdades fundamentais dos titulares. Conclusão: tendo em vista que o Projeto "Sífilis Não" é um projeto de pesquisa que envolve o enfrentamento e erradicação da sífilis em todas as suas formas, hipóteses específicas da legislação portuguesa e europeia autorizam o tratamento de dados pessoais sensíveis mesmo sem o consentimento dos titulares, notadamente o tratamento de dados pessoais por motivos de interesse público no domínio da saúde pública e para fins de investigação científica.

Objective: to discuss whether the reproduction of the "No Syphilis" Project regarding the processing of large scale of personal data related to health without the consent of the holders would be possible in Portugal. Methods: analysis of the Brazilian, Portuguese, and European legislation on personal data protection, with the "No Syphilis" Project as a case study. Results: the processing of sensitive personal data without the consent of the owner is, as a rule, prohibited by the General Data Protection Regulation, however the processing for reasons of public interest in the field of health and scientific research purposes is authorized, provided that the fundamental freedoms of the holders are guaranteed. Conclusion: considering that the "No Syphilis" Project is a research project that involves addressing and eradicating syphilis in all its forms, specific hypotheses of Portuguese and European legislation authorize the processing of sensitive personal data even without the consent of the holders, specifically, the processing of personal data for reasons of public interest in the field of public health and scientific research purposes.

Objetivo: discutir si la reproducción del Proyecto "Sífilis No", con respecto al procesamiento de grandes cantidades de datos personales relacionados con la salud sin el consentimiento de los titulares, sería posible en el terreno portugués. Metodología: análisis de la legislación sobre protección de datos personales brasileños, portugueses y europeos, con el Proyecto "Sífilis No" como caso en estudio. Resultados: el tratamiento de datos personales sensibles sin el consentimiento del titular está, por regla general, prohibido por el Reglamento General de Protección de Datos, sin embargo, el tratamiento por razones de interés público en el ámbito de la salud y con fines de investigación científica está autorizado, siempre que se garanticen las libertades fundamentales de los titulares. Conclusión: considerando que el Proyecto "Sífilis No" es un proyecto de investigación que implica hacer frente y erradicar la sífilis en todas sus formas, hipótesis específicas de la legislación portuguesa y europea autorizan el procesamiento de datos personales sensibles incluso sin el consentimiento de los titulares, en concreto, el tratamiento de datos personales por razones de interés público en el ámbito de la salud pública y con fines de investigación científica.

Eurocode Shear Design of Coarse Recycled Aggregate Concrete: Reliability Analysis and Partial Factor Calibration.

This paper contributes to the definition of design clauses for coarse recycled aggregate concrete. One of the main reasons for scepticism towards recycled aggregate concrete is the perceived notion that the heterogeneity of recycled aggregates may increase the uncertainty of the behaviour of concrete. Therefore, the paper uses structural reliability concepts to propose partial factors for recycled aggregate concrete's design for shear failure. The paper builds upon a previous publication by the authors, in which the model uncertainty of recycled aggregate concrete elements designed for shear, with and without shear reinforcement, was compared with that of natural aggregate concrete elements. In that paper, the statistics of the model uncertainty for recycled aggregate concrete shear design were indeed found to be less favourable than those of natural aggregate concrete. Therefore, a partial factor for recycled aggregate concrete design is needed to ensure safety. This paper presents partial factors calibrated with explicit reliability analyses for different cases of design concerning beams (in the case of shear design of elements with shear reinforcement) and slabs (for the design of elements without shear reinforcement). For full incorporation of coarse recycled concrete aggregates and the design of elements without shear reinforcement, the calibrated partial factor reduces the design value of shear resistance by 10% (design with EN1992) or 15% (design with prEN1992) in comparison to natural aggregate concrete's design. For the shear design of elements with shear reinforcement, the partial factor decreases resistance by 5% but a sensitivity analysis showed that the reduction might be, under pessimistic expectations, of up to 20%.

Performance of Mortars with Commercially-Available Reactive Magnesium Oxide as Alternative Binder.

This paper intends to analyze the performance of mortars with reactive MgO, as a sustainable alternative to cement. Six different MgOs from Australia, Canada, and Spain were used in the production of mortars as partial substitutes for cement, namely 5%, 10%, 15%, 20%, and 25% (by weight). MgOs with different levels of reactivity were used to analyze its influence on the performance of MgO mortars. In order to evaluate the mechanical performance of these mortars, compressive strength, flexural strength, dynamic modulus of elasticity, and ultrasonic pulse velocity tests were performed. Compressive strength tests showed that the use of 25% reactive MgO can cause a decrease of this property of between 28% and 49%. The use of reactive MgO affected the other mechanical properties less. This paper also intends to analyze the durability performance of mortars with reactive MgO. To that effect, water absorption by capillarity was assessed. In this research, the effect of using MgO on the shrinkage was also analyzed. It was found that shrinkage may decrease by more than a half in some cases.

On the Development of a Technical Specification for the Use of Fine Recycled Aggregates from Construction and Demolition Waste in Concrete Production.

The possibility of using recycled aggregates from construction and demolition waste (CDW) in concrete is rather widely agreed upon when it comes to the use of coarse recycled aggregates. However, this is not the case when fine recycled aggregates (FRA) are considered, as it is deemed that these seriously impair the behaviour of concrete. Hence, this work presents a technical specification proposal for the use of FRA from CDW in concrete, to attempt to fill this gap in legislation. The specification is based on a wide collection of experimental results, from which it is shown that for low incorporation ratios (up to 25%), the properties of concrete with FRA from CDW are comparable to those of a reference concrete. The intended international scope of the specification is ensured by the fact that FRA from CDW are typified by composition (percentage of concrete, masonry, glass, etc.) rather than by geographical origin or construction type. It is shown that, after typifying the FRA and assuming, as per design, the acceptable percentage losses (relative to a reference concrete) of mechanical, durability-related and long-term physical properties, if the maximum incorporation ratios proposed of each type of FRA are used, the variation of properties remains within the limits established.

Microstructural Features of Recycled Aggregate Concrete: From Non-Structural to High-Performance Concrete.

The use of concrete-recycled aggregates to produce high-performance concrete is limited by insufficient correlation between resulting microstructure and its influence on mechanical performance reproducibility. This work addresses this issue in a sequential approach: concrete microstructure was systematically analyzed and characterized by scanning electron microscopy and results were correlated with concrete compressive strength and water absorption ability. The influence of replacing natural aggregates (NA) with recycled concrete aggregates (RCA), with different source concrete strength levels, of silica fume (SF) addition and of mixing procedure was tested. The results show that the developed microstructure depends on the concrete composition and is conditioned by the distinct nature of NA, recycled aggregates from high-strength source concrete, and recycled aggregates from low-strength source concrete. SF was only effective at concrete densification when a two-stage mixing approach was used. The highest achieved strength in concrete with 100% incorporation of RCA was 97.3 MPa, comparable to that of conventional high-strength concrete with NA. This shows that incorporation of significant amounts of RCA replacing NA in concrete is not only a realistic approach to current environmental goals, but also a viable route for the production of high-performance concrete.

Probabilistic Conversion of the Compressive Strength of Cubes to Cylinders of Natural and Recycled Aggregate Concrete Specimens.

This paper investigates the effect of recycled coarse aggregate incorporation on the relationship between 150 mm cubic and Փ 150 mm cylindrical compressive strength (the reference strength of standards) by comparing data from recycled and natural aggregate concrete compositions in which both cubes and cylinders were tested. A conversion factor from cubic to cylindrical strength is proposed in two versions: A deterministic and a probabilistic one. Such factor has not been studied before and researchers have been converting cubic data as if natural aggregate concrete were tested. The probabilistic factor is intended for reliability analyses on the structural behaviour of recycled aggregate concrete using data from laboratory cube tests. It was found that the incorporation of recycled coarse aggregates sourced from concrete waste significantly decreases the expected value of the factor but the factor's scatter is relatively unaffected.

Microstructure of Concrete with Aggregates from Construction and Demolition Waste Recycling Plants.

This paper intends to analyze the microstructure of concrete with recycled aggregates (RA) from construction and demolition waste from various Portuguese recycling plants. To that effect, several scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS) analyses were performed. Various concrete mixes were evaluated in order to analyze the influence of the RA's collection point and consequently of their composition on the mixes' characteristics. Afterward all the mixes were subjected to the capillary water absorption test in order to quantitatively evaluate their porosity. Results from the SEM/EDS analysis were compared with those from capillary water absorption test. The SEM/EDS analysis showed that the bond capacity of aggregates to the new cement paste is greatly influenced by the RA's nature. On the other hand, there was an increase in porosity with the incorporation of RA.

Increased Durability of Concrete Made with Fine Recycled Concrete Aggregates Using Superplasticizers.

This paper evaluates the influence of two superplasticizers (SP) on the durability properties of concrete made with fine recycled concrete aggregate (FRCA). For this purpose, three families of concrete were tested: concrete without SP, concrete made with a regular superplasticizer and concrete made with a high-performance superplasticizer. Five volumetric replacement ratios of natural sand by FRCA were tested: 0%, 10%, 30%, 50% and 100%. Two natural gravels were used as coarse aggregates. All mixes had the same particle size distribution, cement content and amount of superplasticizer. The w/c ratio was calibrated to obtain similar slump. The results showed that the incorporation of FRCA increased the water absorption by immersion, the water absorption by capillary action, the carbonation depth and the chloride migration coefficient, while the use of superplasticizers highly improved these properties. The incorporation of FRCA jeopardized the SP's effectiveness. This research demonstrated that, from a durability point of view, the simultaneous incorporation of FRCA and high-performance SP is a viable sustainable solution for structural concrete production.

Microstructural characterization of concrete prepared with recycled aggregates.

Several authors have reported the workability, mechanical properties, and durability of concrete produced with construction waste replacing the natural aggregate. However, a systematic microstructural characterization of recycled aggregate concrete has not been reported. This work studies the use of fine recycled aggregate to replace fine natural aggregate in the production of concrete and reports the resulting microstructures. The used raw materials were natural aggregate, recycled aggregate obtained from a standard concrete, and Portland cement. The substitution extent was 0, 10, 50, and 100 vol%; hydration was stopped at 9, 24, and 96 h and 28 days. Microscopy was focused on the cement/aggregate interfacial transition zone, enlightening the effect of incorporating recycled aggregate on the formation and morphology of the different concrete hydration products. The results show that concretes with recycled aggregates exhibit typical microstructural features of the transition zone in normal strength concrete. Although overall porosity increases with increasing replacement, the interfacial bond is apparently stronger when recycled aggregates are used. An addition of 10 vol% results in a decrease in porosity at the interface with a corresponding increase of the material hardness. This provides an opportunity for development of increased strength Portland cement concretes using controlled amounts of concrete waste.

Gastrobronchial fistula after sleeve gastrectomy and gastric bypass: endoscopic management and prevention.

Gastrobronchial fistula (GBF) is a serious complication following bariatric surgery, whose treatment by thoracotomy and/or laparotomy involves a high morbidity rate. We present the outcomes of endoscopic management for GBF as a helpful technique for its healing process. This is a multicenter retrospective study of 15 patients who underwent gastric bypass (n = 10) and sleeve gastrectomy (n = 5) and presented GBF postoperatively (mean of 6.7 months). Ten patients developed lung abscess and were treated by antibiotic therapy (n = 10) and thoracotomy (n = 3). Abdominal reoperation was performed in nine patients for abscess drainage (n = 9) and/or ring removal (n = 4) and/or nutritional access (n = 6). The source of the GBF was at the angle of His (n = 14). Furthermore, 14 patients presented a narrowing of the gastric pouch treated by 20 or 30 mm aggressive balloon dilation (n = 11), stricturotomy or septoplasty (n = 10) and/or stent (n = 7). Fibrin glue was used in one patient. We performed, on average, 4.5 endoscopic sessions per patient. Endotherapy led to a 93.3% (14 out of 15) success rate in GBF closure with an average healing time of 4.4 months (range, 1-10 months), being shorter in the stent group (2.5 × 9.5 months). There was no recurrence during the average 27.3-month follow-up. A patient persisted with GBF, despite the fibrin glue application, and decided to discontinue it. GBF is a highly morbid complication, which usually arises late in the postoperative period. Endotherapy through different strategies is a highly effective therapeutic option and should be implemented early in order to shorten leakage healing time.

Atividade mioelétrica do intestino delgado de cães submetidos à oclusão parcial da veia porta / Myoelectric activity of the small bowel of dogs submitted to partial occlusion of the portal vein

RACIONAL: A oclusão temporária da veia porta causa estase esplâncnica e pode causar dismotilidade intestinal. OBJETIVO: Avaliar as alterações da atividade mioelétrica e da histologia do intestino delgado, além da pressão arterial média (PAM), frequência cardíaca (FC), pressão venosa central (PVC) e pressão portal (PP), na fase de pré-oclusão e de oclusão portal. MÉTODO: Realizou-se anestesia geral em seis cães, seguido de monitorização da PAM, FC e PVC, laparotomia, aferição da PP, fixação de três pares de eletrodos na parede intestinal, biópsias jejunais e oclusão parcial da veia porta, sendo programado aumento da PP entre 2,5 e 3 vezes. Os eletrodos foram conectados a um microcomputador com software de aquisição para armazenamento e análise da atividade mioelétrica, cujo registro ocorreu nos 30 minutos da fase de pré-oclusão e nos 60 minutos de oclusão. Determinouse a variância e a média do RMS (root mean square) da atividade mioelétrica. RESULTADOS: Na fase de oclusão, houve diminuição significativa da média do RMS e aumento da frequência de hemorragia da lâmina própria, sendo proporcional ao tempo de estase.Infiltrado inflamatório, dilatação vascular e desprendimento epitelial não apresentaram diferença entre as duas fases. Durante a estase, PAM, FC e PVC diminuíram (p=0,326; 0,375 e 0,008; respectivamente), e PP aumentou (p=0,015). CONCLUSÃO: A oclusão parcial da veia porta de cães promoveu diminuição da atividade mioelétrica e aumento da frequência percentual da hemorragia da lâmina própria, além de queda da PVC.

BACKGROUND: Temporary occlusion of the portal vein causes splancnic venous stasis and intestinal disfunction, that can produce alterations in the motility, and this fact is not vastly known. AIM: To evaluate the small bowel myoelectric activity and histology in the six dogs, also covering mean arterial blood pressure (AP), pulse rate (PR), central venous pressure (CVP) e portal pressure (PP), in two phases: pre-occlusion and occlusion. METHODS: It was done general anesthesia, invasive monitorization of the AP, PR e CVP, laparotomy, measure of the PP, fixation of the three pairs of electrodes in the intestinal wall, jejunal biopsy and parcial occlusion of the portal vein, being programmed the increase of the PP between 2.5 and 3 times baseline. Electrodes were connected to a computer system that captured electrical signals from the intestine. The computer has a software of acquisition to store and analyse the myoelectric activity after registering, what happened in 30 minutes of the pre-occlusion phase and in 60 minutes of occlusion. The variance and the mean RMS(root mean square) of the myoeletric activity were determined. The statistical analysis was done with Friedman, Dunn, Cochran and Students t tests. RESULTS: Mean RMS of myoeletric activity showed significant decrease in the phase of portal occlusion, in comparison to preocclusion phase. The frequency of hemorrhage of the lamina propria was major during occlusion. It was proportional at stasis time, with significant difference between the preocclusion and the occlusion of 60 minutes. Inflammatory infiltration, vascular dilation and epithelial detachment did not show any differences between two phases. During the stasis, AP, PR and CVP decreased (p=0,326; 0,375 e 0,008, respectively), and PP increased(p=0,015). CONCLUSIONS: Parcial occlusion of the portal vein produced reduction of the myoeletric activity and elevation of the percentage frequency of hemorrhage in lamina propria, and a fall of CVP, with relative hemodynamic stabilization.

Small erosion of adjustable gastric band: endoscopic removal through incision in gastric wall.

The erosion of a laparoscopic adjustable gastric band (LAGB) can cause pain that is not controlled by analgesics. In such cases, early endoscopic removal may be indicated, but only when gastric penetration is greater than 50%. We report the case of a patient with severe shoulder pain due to a small area of LAGB erosion, which was treated with early endoscopic removal through an incision in the gastric wall. The pain worsened after eating and gastroscopy revealed slight gastric erosion of the band under the cardia. The gastric wall covering the LAGB was incised using an endoscopic needle knife. In a second upper endoscopy performed 7 days later at the endoscopy suite, endoscopic scissors were used to cut the thread and part of the band lock. The open band was then removed orally. This novel endoscopic incision in the gastric wall hastened band erosion and avoided abdominal reoperation.

Treatment of ring slippage after gastric bypass: long-term results after endoscopic dilation with an achalasia balloon (with videos).

BACKGROUND: Silastic rings are used in gastric bypass procedures for the treatment of obesity, but ring slippage may lead to gastric pouch outlet stenosis (GPOS). Conventional management has been ring removal through abdominal surgery. OBJECTIVE: To describe a novel, safe, minimally invasive, endoscopic technique for the treatment of GPOS caused by ring slippage after gastric bypass. DESIGN: Case series. SETTING: Federal University of Pernambuco and São Paulo University. PATIENTS: This study involved 39 consecutive patients who were screened for inclusion. INTERVENTION: Endoscopic dilation with an achalasia balloon. MAIN OUTCOME MEASUREMENTS: Technical success and safety of the procedure. RESULTS: Among the 39 patients, 35 underwent endoscopic dilation at the ring slippage site for the relief of GPOS. The 4 patients who did not undergo endoscopic dilation underwent surgical removal of the ring, based on the exclusion criteria. The endoscopic approach was successful in 1 to 4 sessions in 100% of cases with radioscopic control (n = 12). The duration of the procedures ranged from 5 to 30 minutes, and the average internment was 14.4 hours. Dilation promoted either rupture (65.7%) or stretching (34.3%) of the thread within the ring, thereby increasing the luminal diameter of the GPOS. Complications included self-limited upper digestive tract hemorrhage (n = 1) and asymptomatic ring erosion (n = 4). There were no recurrences of obstructive symptoms during the follow-up period (mean of 33.3 months). LIMITATIONS: This was not a randomized, comparison study, and the number of patients was relatively small. CONCLUSION: The technique described promotes the relief of GPOS with low overall morbidity and avoids abdominal reoperation for ring removal.

Laparoscopic greater curvature plication: initial results of an alternative restrictive bariatric procedure.

BACKGROUND: Vertical sleeve gastrectomy (VSG) is a surgical technique that involves resection of a significant portion of the stomach. This surgery is sometimes associated with gastric leaks, which can be difficult to treat. The present study reports findings from laparoscopic greater curvature plication (LGCP), which is an alternative bariatric procedure similar to VSG but without the need for gastric resection. METHODS: A prospective study was carried out, following LGCP in 42 morbidly obese patients (30 female/12 male) with a mean age of 33.5 years (23 to 48) and mean BMI of 41 kg/m(2) (35 to 46). Through a five-port approach, the stomach was reduced by dissecting the greater omentum and short gastric vessels, as in VSG, and the greater curvature was then invaginated using multiple rows of non-absorbable suture performed over a 32-Fr bougie to ensure a patent lumen. RESULTS: All procedures were completed laparoscopically. Mean operative time was 50 min (40 to 100 min) and mean hospital stay was 36 h (24 to 96). Patients returned to their regular activities at an average of 7 days (4 to 13) following surgery. No intra-operative complications occurred. All patients experienced excess weight loss (EWL) of at least 20% after 1 month. Mean EWL was 62% (45% to 77%) in nine patients after 18 months. There has been no record of weight regain in any patient to date. CONCLUSIONS: LGCP is feasible, safe, and effective for at least 18 months when performed on morbidly obese patients. Longer follow-up and prospective comparative trials are needed.

Translumenal endoscopic drainage of abdominal abscess due to early migration of adjustable gastric band.

We describe the case of early band migration that developed into intraabdominal infection treated by natural orifice translumenal endoscopic surgery. A 40-year-old man was seen 4 years after gastric band placement. He complained of epigastric pain and fever. Gastroscopy revealed minimal gastric fundus erosion and a bulging of the antrum wall. Abdominal CT scan showed perigastric abscess surrounding the band tube. Antibiotic therapy was initiated, and endoscopic transgastric abscess drainage was performed. The endoscope was guided into the abscess cavity, and the band tubing was brought into the gastric lumen to serve as a stent to drain the infection, which ceased 5 days later. During the follow-up, the mucosa covering the band was incised in two more sessions to hasten the erosion process. Endoscopic removal was done 7 months after the drainage.

Endoscopic removal of eroded adjustable gastric band: lessons learned after 5 years and 78 cases.

BACKGROUND: One of the complications of laparoscopic adjustable gastric banding is intragastric erosion, leading to a revisional procedure to remove the band. Our aim was to present the procedure and results of endoscopic band removal in a 5-year multicenter experience from the Gastro Obeso Center and Universidade de São Paulo, São Paulo, and Universidade Federal de Pernambuco, Recife, Brazil. METHODS: From 2003 to 2008, 82 patients were diagnosed with band erosion. The clinical data concerning the endoscopic procedure were prospectively recorded and retrospectively reviewed. RESULTS: The average preoperative body mass index was 43.2 kg/m(2) (range 34-50). At the diagnosis of intragastric erosion, the body mass index was 24-41 kg/m(2) (average 31.8). The erosion occurred an average of 16.3 months (range 6-36) postoperatively. The symptoms included pain in 25 (31%), port infection in 21 patients (27%), and weight regain in 20 (25%), and 12 patients (15%) were asymptomatic. Endoscopic removal was possible for 78 patients (95%). In 85% of patients, the band was removed in the first session, with an average duration of 55 minutes (range 25-150). Five cases of pneumoperitoneum occurred after the procedure. Of these, 3 were treated conservatively, 1 was treated by laparoscopy, and 1 was treated by abdominal puncture using the Veress needle. CONCLUSION: Endoscopic removal of eroded laparoscopic adjustable gastric banding is safe and effective. It can be used as a first choice procedure in clinical practice.

Diverticulite em adolescente com Síndrome de Williams: relato de caso / Diverticulitis in adolescent with Williams Syndrome: case report

A Síndrome de Williams é uma doença genética rara, atribuída a deleção do gene da elastina no cromossomo 7. É caracterizada por estenose de aorta, divertículos de bexiga, constipação, retardo mental leve, fácies dismórfica, fraqueza da parede da bexiga e do cólon que levam ao surgimento de divertículos. Relata-se um caso de diverticulite aguda em paciente de 18 anos, o resultado do tratamento clínico durante 5 anos e o diagnóstico diferencial de abdome agudo nesta doença. A indicação de colectomia eletiva é discutida, considerando o pouco conhecimento da história natural da diverticulite nesta síndrome.

The Syndrome of Williams is a rare genetic illness, attributed the deletion of the gene of the elastin in chromosome 7. It is characterized by aortic stenosis, bladder diverticula's, constipation, light mental retardation, dysmorphic facies, weakness of the wall of the bladder and colon that they lead to the sprouting of diverticula. A case of acute diverticulitis in patient of 18 years is told, the result of the clinical treatment during 5 years and the differential diagnosis of acute abdomen in this illness. The indication of elective colectomy is argued, considering the unfamiliarity of the natural history of the diverticulitis in the syndrome.