ABSTRACT
There are few reports on intracardiac fungal masses, especially in the pediatric population. We present the case of an extremely premature patient who, after being hospitalized since birth in an intensive care unit, developed fungal masses in the right atrium, which, due to their size, location and resistance to medical treatment, required surgical excision. For this reason, at the slightest suspicion of systemic candidiasis in pediatric patients, it is mandatory to include an echocardiogram in the defocalization examinations to rule out endocarditis and thus avoid the development of intracardiac fungal masses. Therefore, early detection for timely medical management may avoid the surgical approach associated with a high risk of morbidity and mortality in extremely premature patients.
ABSTRACT
The health care system in Peru treats 15,000 dialysis patients annually. Approximately 45% of patients receive therapy using catheters. The incidence of catheter-induced superior vena cava (SVC) occlusion is increasing along with its associated significant morbidity and vascular access dysfunction. One of the unusual manifestations of this complication is bleeding "downhill" esophageal varices caused by reversal of blood flow through esophageal veins around the obstruction to the right atrium. Herein is presented the case of an 18-year-old woman on hemodialysis complicated by SVC occlusion and bleeding esophageal varices who underwent successful endovascular recanalization of the SVC. Bleeding from "downhill" esophageal varices should be considered in the differential diagnosis of dialysis patients exposed to central venous catheters. Aggressive endovascular treatment of SVC occlusion is recommended to preserve upper extremity access function and prevent bleeding from this complication.
Subject(s)
Esophageal and Gastric Varices , Superior Vena Cava Syndrome , Adolescent , Esophageal and Gastric Varices/diagnostic imaging , Esophageal and Gastric Varices/etiology , Esophageal and Gastric Varices/therapy , Female , Gastrointestinal Hemorrhage/diagnostic imaging , Gastrointestinal Hemorrhage/etiology , Gastrointestinal Hemorrhage/therapy , Humans , Renal Dialysis , Superior Vena Cava Syndrome/diagnostic imaging , Superior Vena Cava Syndrome/etiology , Superior Vena Cava Syndrome/therapy , Treatment Outcome , Vena Cava, SuperiorABSTRACT
Se presentan dos casos de bocio retroesternal que fueron resecados a través de incisión cervical y esternotomía mediana. Se discuten las alternativas para el abordaje quirúrgico y se hace una revisión de la literatura.
Subject(s)
Humans , Male , Middle Aged , Female , Goiter, Substernal , MediastinumABSTRACT
Se presentan 5 casos consecutivos de pacientes con Síndrome de Marfan y disección de aorta toráxico ascendente, quienes fueron tratados quirúrgicamente con reemplazo de raíz aórtica (operación modificada de Bentall). Todos los pacientes tuvieron plena recuperación y al seguimiento post alta realizan actividades de la vida diaria sin problemas.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aorta, Thoracic/surgery , Dissection , Marfan Syndrome/surgeryABSTRACT
La timectomía es una opción terapéutica en el manejo de la miastenia gravis (MG). Aunque existe controversia sobre las indicaciones quirúrgicas y el mejor momento para operar, la timectomía se mantiene como un procedimiento seguro y efectivo para el tratamiento de MG. Aquí revisamos nuestra experiencia con esta operación en pacientes con esta enfermedad, y comparamos nuestros resultados con aquellos publicados en la literatura.
