ABSTRACT
La lesión aislada del nervio axilar asociada a la posición quirúrgica del paciente es una complicación muy poco frecuente, y en la mayoría de los casos está asociada al prono durante una cirugía de columna. La presentación de esta patología en relación con cirugías de otra índole es excepcional, existiendo solo unos pocos casos en la literatura científica.Presentamos el caso de una paciente que desarrolló clínica de parálisis aislada del nervio axilar izquierdo tras someterse a una lipoabdominoplastia y reducción mamaria, en la que se alternaron la posición en prono y en supino. La utilización de una solución de infiltración con lidocaína y adrenalina pudo contribuir a la aparición de la lesión en este caso único. Finalmente, el cuadro clínico se resolvió en su totalidad gracias al tratamiento conservador (AU)
Isolated injury to the axillary nerve associated with the patient́s surgical position is a very rare complication, and in most cases it is associated with the prone during spinal surgery. The presentation of this pathology in relation to surgeries of another nature is exceptional, with only a few cases in the scientific literature.We present the case of a patient who developed symptoms of isolated left axillary nerve palsy after undergoing lipoabdominoplasty and breast reduction, in which the prone and supine positions were alternated. The use of an infiltration solution with lidocaine and epinephrine could have contributed to the appearance of the lesion in this unique case. Finally, the clinical picture was fully resolved thanks to conservative treatment (AU)
Subject(s)
Humans , Female , Adult , Lipoabdominoplasty/adverse effects , Paralysis/etiology , Axilla/innervation , Conservative TreatmentABSTRACT
Isolated injury to the axillary nerve associated with the patient's surgical position is a very rare complication, and in most cases it is associated with the prone during spinal surgery. The presentation of this pathology in relation to surgeries of another nature is exceptional, with only a few cases in the scientific literature. We present the case of a patient who developed symptoms of isolated left axillary nerve palsy after undergoing lipoabdominoplasty and breast reduction, in which the prone and supine positions were alternated. The use of an infiltration solution with lidocaine and epinephrine could have contributed to the appearance of the lesion in this unique case. Finally, the clinical picture was fully resolved thanks to conservative treatment.
Subject(s)
Brachial Plexus , Lipectomy , Humans , Lipectomy/adverse effects , Paralysis/etiologyABSTRACT
The SARS-CoV-2 pandemic is giving rise to a wide range of clinical manifestations, which can affect all organs and systems. Due to the enormous and constantly growing number of infected people, even the rarest complications will be observed in a very high number of patients. Late periprosthetic seroma of the breast has gained importance since the description of Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL), but this entity is not the only cause. Among the causes of non-BIA-ALCL late seroma, we can include those of mechanical origin and those of non-mechanical origin. Within the latter, the common denominator is the triggering of an aberrant immune reaction that generates an inflammatory exudate from the periprosthetic capsule that gives rise to the seroma. We present two cases of late breast seroma as a manifestation of SARS-CoV-2 infection. Level of evidence: Level V, diagnostic study.
ABSTRACT
Isolated injury to the axillary nerve associated with the patientÌs surgical position is a very rare complication, and in most cases it is associated with the prone during spinal surgery. The presentation of this pathology in relation to surgeries of another nature is exceptional, with only a few cases in the scientific literature. We present the case of a patient who developed symptoms of isolated left axillary nerve palsy after undergoing lipoabdominoplasty and breast reduction, in which the prone and supine positions were alternated. The use of an infiltration solution with lidocaine and epinephrine could have contributed to the appearance of the lesion in this unique case. Finally, the clinical picture was fully resolved thanks to conservative treatment.
ABSTRACT
RESUMEN La enfermedad de Dieterich o necrosis avascular de la cabeza de los metacarpianos es una enfermedad muy poco frecuente, con poco más de 50 casos reportados en la literatura. De etiología desconocida, clínicamente se puede manifestar de forma variable, desde asintomática hasta con evidente inflamación y limitación funcional dolorosa de la articulación metacarpofalángica afectada. Presentamos el caso de un paciente de 82 anos que presentaba dolor a nivel de la articulación metacarpofalángica del tercer dedo de la mano derecha, de un año de evolución, sin causa aparente. La exploración física no evidenciaba limitación funcional, ni dolor; tampoco se objetivó eritema, tumefacción o efecto masa. Se realizó un estudio radiológico con diagnóstico de enfermedad de Dieterich avanzada, estableciendo tratamiento conservador con antiinflamatorios no esteroideos con mejoría clínica significativa.
ABSTRACT Dieterich's disease, or avascular necrosis of the metacarpal head, is a very rare disease, with just over 50 cases reported in the literature. Of unknown aetiology, it can manifest clinically in a variable way, from asymptomatic to obvious inflammation and painful functional limitation of the affected metacarpophalangeal joint. The case is presented of an 82-yearold patient who presented with pain at the level of the metacarpophalangeal joint of the third finger of the right hand of 1 year of duration without apparent cause. The physical examination showed no functional limitation or pain. Furthermore, no erythema, swelling, or mass effect was observed. A radiological study was carried out, leading to a diagnosis of advanced Dieterich's disease. Conservative treatment was started with nonsteroidal anti-inflammatory drugs, with a significant clinical improvement.
Subject(s)
Humans , Male , Aged, 80 and over , Osteonecrosis , Disease , Rare Diseases , Diagnosis , Conservative Treatment , Head , Metacarpophalangeal JointABSTRACT
El uso de silicona fluida para el aumento mamario tuvo su auge entre los años cuarenta y setenta del siglo XX. Debido a su alta tasa de complicaciones, su utilización fue finalmente prohibida por la FDA a principios de los años noventa. Presentamos el caso de una mujer con múltiples nódulos mamarios y mastodinia de repetición secundarias a la inyección de silicona fluida en ambas mamas. Las inyecciones de silicona fueron realizadas en su país de origen con objetivo estético. Se realizó estudio mediante resonancia magnética de la mama, que demostró distribución difusa de la silicona en todo el espesor mamario y en especial bajo el complejo aréola-pezón (CAP). Se procedió a la realización de una mastectomía subcutánea bilateral incluyendo el CAP. Intraoperatoriamente se objetivó afectación difusa del espesor muscular del pectoral mayor, además de la ya conocida afectación de todo el parénquima glandular
The use of fluid silicone for breast augmentation reached a peak between the 1940s and 1970s. Due to the high rate of complications, its use was finally banned by the FDA in the early 1990s. We present the case of a woman with multiple mammary nodules and recurrent mastodynia due to the injection of fluid silicone in both breasts. The silicone injections were performed in her country of origin for cosmetic reasons. Magnetic resonance imaging of the breast showed diffuse distribution of the silicone throughout the breast thickness and especially under the nipple-areola complex (NAC). A bilateral subcutaneous mastectomy was performed, including the NAC. Intraoperatively, diffuse muscular thickness of the pectoralis major was affected, in addition to the well-known involvement of the entire glandular parenchyma
Subject(s)
Humans , Female , Aged , Granulomatous Mastitis/chemically induced , Silicones/adverse effects , Mastectomy/methods , Long Term Adverse Effects , Risk FactorsABSTRACT
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