ABSTRACT
Acroangiodermatitis (AAD) is often seen in association with various vascular anomalies such as venous insufficiency, vascular syndromes, and conditions associated with thrombosis. This is the first case reported in the literature associated with arteriovenous fistula stenosis in a patient with chronic kidney disease on hemodialysis. This case is being described for its rarity and to familiarize the clinicians with this unusual complication, especially, to prevent them from thinking of this condition as an infectious complication. It is essential to recognize the uniqueness of the pathophysiology of this disease and to do a clear distinction with that of a venous ulcer. With this work we also aim to help health practitioners with proper management of the condition. As we've seen, surgical treatment in appropriately selected cases corrects the reflux of the venous system and successfully improves the appearance of the verrucous lesion. Our patient was successfully treated by correcting the arteriovenous fistula stenosis with near-complete subsidence of the verrucous lesion within days of the procedure. Acroangiodermatitis management must be conducted with a multidisciplinary approach (dermatology, vascular surgery, and internal medicine). It is essential the comprehensive management of these patients, to ensure prompt recovery and avoid chronic effects, as well as to guarantee the quality of life in the future.
Subject(s)
Acrodermatitis/etiology , Arteriovenous Shunt, Surgical/adverse effects , Graft Occlusion, Vascular/etiology , Hand Dermatoses/etiology , Renal Dialysis , Renal Insufficiency, Chronic/therapy , Acrodermatitis/diagnosis , Adult , Diagnosis, Differential , Graft Occlusion, Vascular/diagnosis , Graft Occlusion, Vascular/physiopathology , Graft Occlusion, Vascular/surgery , Hand Dermatoses/diagnosis , Hemodynamics , Humans , Male , Renal Insufficiency, Chronic/diagnosis , Reoperation , Skin Diseases, Infectious/diagnosis , Soft Tissue Infections/diagnosis , Treatment Outcome , Wound HealingABSTRACT
El angiomiolipoma es un tumor benigno del hígado poco frecuente. Se presenta el caso de una paciente de 32 años de edad, a quien se le realizó ultrasonido abdominal por sospecha de embarazo, detectándose masa hiperecoica en el lóbulo izquierdo del hígado, misma que se corroboró por tomografía. La biopsia percutánea reportó neoplasia maligna compatible con liposarcoma, por lo que se decidió realizar laparotomía exploradora, efectuando resección hepática, que evolucionó sin complicaciones. El informe anatomopatológico fue de angiomiolipoma de hígado. Este caso demuestra la dificultad para realizar el diangóstico preoperatorio de lesiones grasas en hígado, por lo que se revisó la literatura y se discutió el diagnóstico, así como el tratamiento de estas lesiones
