ABSTRACT
INTRODUCCIÓN: la ecoendoscopia permite el diagnóstico histológico de lesiones renales radiológicamente indeterminadas, aunque existen pocas series disponibles. OBJETIVOS: describir el procedimiento, rendimiento y complicaciones de las punciones renales guiadas por ecoendoscopia. MATERIAL Y MÉTODOS: serie de casos retrospectiva sobre una base prospectiva que incluye consecutivamente las ecoendoscopias de marzo/2014-agosto/2018. Recogimos complicaciones, evolución y seguimiento. Definimos punción exitosa si permitió realizar un diagnóstico histológico. Se consideraron lesiones malignas aquellas confirmadas quirúrgicamente (en pacientes no quirúrgicos se asumió el diagnóstico histológico); la benignidad requirió estabilidad radiológica ≥ 12 meses. RESULTADOS: identificamos a ocho pacientes con una edad mediana de 61,6 años (57,3-71,9), cinco (62,5 %) mujeres, cinco punciones de riñón derecho y tres de riñón izquierdo. Se emplearon agujas de citología de 22G. La punción fue diagnóstica en el 100 %, sin complicaciones. CONCLUSIONES: la punción guiada por ecoendoscopia puede resultar una herramienta efectiva y segura en el diagnóstico de lesiones renales de origen incierto
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Subject(s)
Humans , Male , Female , Middle Aged , Endoscopic Ultrasound-Guided Fine Needle Aspiration/methods , Kidney Diseases/diagnosis , Kidney Diseases/pathology , Retrospective Studies , Endoscopic Ultrasound-Guided Fine Needle Aspiration/adverse effects , Tertiary Care Centers , Kidney Neoplasms/diagnosis , Kidney Neoplasms/pathology , Statistics, Nonparametric , Risk FactorsABSTRACT
INTRODUCTION: endoscopic ultrasound (EUS) allows the histological diagnosis of radiologically undetermined renal lesions, although few series have been described. OBJECTIVES: to describe the procedure, yield and complications of EUS-guided renal fine-needle aspiration (FNA). MATERIAL AND METHODS: a retrospective case series in a prospective database was used that consecutively included EUS procedures from March 2014 to August 2018. Data on complications, outcome and follow-up were collected. A successful FNA was defined as any FNA that allowed a histological diagnosis. Lesions were considered as malignant when surgically confirmed as such (the histological diagnosis was used for non-surgical patients) and benign when radiographically stable for ≥ 12 months. RESULTS: eight patients were identified with a median age of 61.6 years (57.3-71.9), and five (62.5 %) were female. Five FNA procedures involved the right kidney and three involved the left kidney. 22G cytology needles were used. Renal FNA was diagnostic in all cases, with no complications. CONCLUSIONS: EUS-guided FNA may represent an effective, safe procedure for the diagnosis of renal lesions of an uncertain origin.
Subject(s)
Endoscopic Ultrasound-Guided Fine Needle Aspiration , Kidney Diseases , Endosonography , Female , Humans , Kidney , Kidney Diseases/diagnosis , Middle Aged , Needles , Retrospective StudiesSubject(s)
Catheter Ablation/methods , Endosonography , Gastrointestinal Stromal Tumors/diagnostic imaging , Gastrointestinal Stromal Tumors/surgery , Stomach Neoplasms/diagnostic imaging , Stomach Neoplasms/surgery , Ultrasonography, Interventional , Diagnosis, Differential , Humans , Male , Middle AgedABSTRACT
BACKGROUND: Few cases have been reported in children and adolescents of sigmoid diverticulitis. Most of the case reports in medical literature are associated with true congenital diverticula and genetic diseases of collagen synthesis. CLINICAL CASE: 13 year-old female who was admitted to General and Endoscopic Surgery service with diagnosis of complicated appendicitis. Laparotomy was performed finding complicated sigmoid diverticular disease. Lavage, sigmoidectomy and primary anastomosis were performed. The histopathological findings reported a perforated pseudo-diverticulum of the sigmoid colon with peritonitis. The patient was discharged 72 hours after surgery and no complications were reported. CONCLUSION: There are only case reports about colonic diverticulitis in children and adolescents, and its etiology has not yet been well established. This patient had sigmoid pseudo-diverticula and did not present genetic concomitant disease. This case is an exception to data reported on literature about diverticular disease in this population.
Antecedentes: la enfermedad diverticular colónica en niños y adolescentes es poco frecuente y sólo existen reportes de casos aislados en la bibliografía. La mayoría de los casos reportados se asocian con divertículos verdaderos congénitos y enfermedades genéticas de producción de la colágena. Caso clínico: paciente femenina de 13 años de edad, que ingresó a la División de Cirugía General y Endoscópica con diagnóstico de apendicitis aguda complicada. En la laparotomía se encontró enfermedad diverticular complicada de colon sigmoides. Se le practicó sigmoidectomía y colorrecto-anastomosis. El reporte histopatológico evidenció perforación de pseudodivertículo de colon sigmoides y peritonitis. La paciente fue dada de alta del hospital 72 horas posteriores a la cirugía, sin complicaciones. Conclusión: existen sólo reportes de casos aislados de niños y adolescentes con diverticulitis colónica, y su etiología no ha sido aún debidamente establecida. Esta paciente tuvo diverticulitis de sigmoides, similar a la enfermedad en adultos, sin padecimientos genéticos concomitantes. El caso es una excepción a lo reportado en la bibliografía de las diverticulitis en niños y adolescentes.
