ABSTRACT
La piometra es una acumulación de pus en la cavidad endometrial. Aparece cuando existe una estenosis del orificio cervical debida a procesos malignos de cuerpo uterino o de cérvix, tras tratamientos con cirugía o radioterapia y por atrofia senil. Se presenta el caso de una paciente de 84 años remitida al Servicio de Urgencias Hospitalarias del Hospital Universitario Basurto, en Bilbao, España por el médico de la residencia donde se encuentra institucionalizada debido a que presentaba fiebre mantenida desde hacía dos semanas, sin focalidad aparente, diagnosticada como infección urinaria y tratada con amoxicilina-clavulánico. Por los exámenes imagenológicos se diagnosticó piometra en útero bicorne. Fue sometida al drenaje del piometra por vía vaginal, bajo anestesia general, tras dilatación mecánica del canal cervical. Se puso tratamiento con ertapenen. La evolución fue satisfactoria. Por lo poco común del caso se decidió su presentación.
Pyometra is an accumulation of pus in the endometrial cavity. It occurs when there is a stenosed cervical os as a result of malignant growths in the uterus or cervix, surgery or radiation therapy and senile atrophy. We present the case of an 84-year-old female patient referred to the Emergency Service of the Basurto University Hospital in Bilbao, Spain by the doctor of the nursing home where she is institutionalized because of a two-week history of continued fever without apparent cause. She was diagnosed with urinary tract infection and treated with amoxicillin/clavulanate. Based on the imaging tests, a pyometra in bicornuate uterus was diagnosed. She underwent drainage of the pyometra via the vaginal route, under general anesthesia, after mechanical dilation of the cervical canal. Treatment with ertapenen was prescribed. Progression was satisfactory. Given the rarity of this case, we decided to present it.
ABSTRACT
La gangrena gaseosa de la mama es una enfermedad rara y potencialmente mortal descrita como consecuencia de un traumatismo, por complicaciones infecciosas de la cirugía o por una trombosis venosa. También se ha relacionado ocasionalmente con otras causas tales como la diabetes mellitus, el envenenamiento con monóxido de carbono o la cirugía plástica. Presentamos un caso de gangrena gaseosa de mama en una mujer diabética de 74 años. Esta rara infección representa una emergencia médico-quirúrgica(AU)
Gas gangrene of the breast is a rare and potentially lethal disease following trauma, as a result of infectious complications from surgery or venous thrombosis. Other rare etiologies, such as diabetes mellitus, carbon monoxide poisoning, and plastic surgery, have also been reported as related to this illness. A case of gas gangrene of the breast found in a 74-year-old diabetic woman was presented in this paper. This rare infection is a medical and surgical emergency situation(AU)
Subject(s)
Humans , Female , Aged , Breast Diseases/diagnosis , Gas Gangrene/pathology , Mastectomy/methodsABSTRACT
La vasa previa es una afección rara asociada a una elevada mortalidad perinatal. Los vasos sanguíneos fetales cruzan por encima del orificio cervical interno y son el resultado de una inserción velamentosa del cordón umbilical. Se presenta un caso de sufrimiento fetal agudo letal causado por rotura de un vaso previo durante el segundo periodo del parto. Se comenta la etiología y el manejo clínico de esta afección.
Vasa previa is a rare condition associated with high perinatal mortality. Fetal blood vessels cross over the internal os and they are the result of an insertion cord velamentous. We report a case of fatal acute fetal distress caused by rupture of a vessel in the second period before delivery. We discuss the etiology and clinical management of this condition.
ABSTRACT
Objetivo. El número de pacientes ancianas con cáncer de mama está en aumento y, una proporción elevada de estas pacientes mayores no recibe el tratamiento convencional. Analizamos las características clínicas y biológicas de los tumores a esta edad y la supervivencia en función del tratamiento local o sistémico. Material y método. Estudiamos retrospectivamente a 96 pacientes consecutivas de 80 o más años con cáncer primario de mama diagnosticadas en nuestra Unidad entre enero del 2002 y septiembre del 2008. De ellas, 54 se sometieron a cirugía con o sin tratamiento hormonal adyuvante y 42 recibieron hormonoterapia primaria. Resultados. Las pacientes de más de 80 años tuvieron tumores con características biológicas más favorables, incluyendo tumores que expresaban receptores esteroideos y ausencia de expresión de c-erb B2. La supervivencia global fue de 50 meses para el grupo sometido a cirugía y 44 meses para el grupo no sometido a cirugía. La supervivencia libre de recaída local en el grupo operado fue de 44 meses, mientras que la supervivencia libre de progresión local fue de 18 meses en el grupo no operado. Conclusiones. En una cohorte de mujeres octogenarias, la supervivencia fue similar en las que recibieron tratamiento hormonal o quirúrgico, aunque las primeras tuvieron un período de supervivencia libre de progresión o recidiva local menor(AU)
Background. The number of elderly patients with breast cancer is increasing, and a large proportion of these older patients do not receive conventional treatment. Clinical and biological characteristics of tumours at this age and survival according to local or systemic therapy were analysed. Material and method. A total of 96 consecutive early breast cancer patients over 80 years of age diagnosed in our Unit between January 2002 and September 2008 were retrospectively investigated. Of them, 54 underwent surgery with or without adjuvant hormonal treatment, and 42 received primary hormonal therapy. Results. Tumours of patients 80 years old or older had more favourable biological characteristics, including expression of steroid receptors, and absence of c-erb B2 expression. Overall survival was 50 months for the group subjected to surgery, and 44 months for the group who did not undergo surgery. The survival free of local recurrence in the surgery group was 44 months, whereas it was 18 months in the non-surgery group. Conclusion. In a cohort of patients aged 80 years and older, survival was similar in those who received hormonal or surgical therapy, although the former had a shorter period of progression-free survival or local recurrence(AU)
Subject(s)
Humans , Female , Aged , Aged, 80 and over , Breast Neoplasms/diagnosis , Breast Neoplasms/therapy , Hormones/therapeutic use , Radio Waves/therapeutic use , Aromatase Inhibitors/therapeutic use , Retrospective Studies , Comorbidity , Cohort Studies , Quality of LifeABSTRACT
BACKGROUND: The number of elderly patients with breast cancer is increasing, and a large proportion of these older patients do not receive conventional treatment. Clinical and biological characteristics of tumours at this age and survival according to local or systemic therapy were analysed. MATERIAL AND METHOD: A total of 96 consecutive early breast cancer patients over 80 years of age diagnosed in our Unit between January 2002 and September 2008 were retrospectively investigated. Of them, 54 underwent surgery with or without adjuvant hormonal treatment, and 42 received primary hormonal therapy. RESULTS: Tumours of patients 80 years old or older had more favourable biological characteristics, including expression of steroid receptors, and absence of c-erb B2 expression. Overall survival was 50 months for the group subjected to surgery, and 44 months for the group who did not undergo surgery. The survival free of local recurrence in the surgery group was 44 months, whereas it was 18 months in the non-surgery group. CONCLUSION: In a cohort of patients aged 80 years and older, survival was similar in those who received hormonal or surgical therapy, although the former had a shorter period of progression-free survival or local recurrence.
Subject(s)
Breast Neoplasms/therapy , Aged, 80 and over , Breast Neoplasms/mortality , Breast Neoplasms/pathology , Female , Humans , Neoplasm Staging , Retrospective Studies , Survival RateABSTRACT
La aparición de úlceras genitales en niñas y mujeres jóvenes, de aparente origen no venéreo, es una entidad infrecuente, descrita ya a principios del siglo pasado, conocida como úlcera vulvar aguda o de Lipschütz. Es una entidad de incidencia baja, por lo que es poco conocida y genera confusión cuando se presenta. La falta de una etiología clara y su presentación en una población a caballo entre la población pediátrica y mujeres jóvenes aumentan esta confusión. Detallamos un caso a continuación (AU)
The development of genital ulcers, of apparently non-venereal origin, in adolescents and young girls is a rare entity known as acute genital ulcer or Lipschütz ulcer. Because of their low incidence, these ulcers are little known and can cause confusion when they occur. This confusion is increased by the lack of a clear cause and the occurrence of these ulcers in an age group that falls between the pediatric and young adult populations. We describe a case of Lipschütz ulcer treated in our hospital (AU)
Subject(s)
Humans , Female , Child , Adolescent , Genital Diseases, Female/complications , Genital Diseases, Female/diagnosis , Genitalia, Female/injuries , Ulcer/complications , Ulcer/diagnosis , Vulva/injuries , Adrenal Cortex Hormones/therapeutic use , Hematologic Tests/methods , Hematologic Tests , Gangrene/complications , Gangrene/therapyABSTRACT
La evisceración intestinal a través de la vagina después de una histerectomía es una complicación rara. Se presenta el caso de mujer posmenopáusica que presentó una evisceración transvaginal del intestino delgado después de que se le realizara una histerectomía abdominal. Se revisa la epidemiología, causas, diagnóstico y tratamiento(AU)
Transvaginal intestinal evisceration after hysterectomy is a uncommon complication. This is the case of a postmenopausal women presenting with transvaginal evisceration of the small intestine after a abdominal hysterectomy. Epidemiology, causes, diagnosis and treatment are analyzed(AU)
