ABSTRACT
BACKGROUND: There are different surgical procedures for the treatment of advanced haemorrhoidal disease, being described by Milligan and Morgan as well as closed haemorrhoidectomy published by Ferguson. Haemorrhoidopexy with circular stapler was used since 1998 and nowadays is a widely accepted procedure and more institutes confirm its efficiency and safety. OBJECTIVES: Initial one year experience is presented in patients selected for haemorrhoidopexy with stapler, evaluating post-operatory pain, early and delayed complications, day-in hospital stay and reintegration to daily activities. MATERIAL AND METHODS: Patients operated with haemorrhoidopexy with circular Ethicon Endo Surgery Inc. PPH 03 33 mm (Cincinnati, OH) were included prospectively in the period between November 1st 2004 and October 30th 2005 in Mexico's ABC Medical Center. RESULTS: Thirtynine patients were included in this study, of which 17 (44%) presented a III degree haemorrhoidal disease and 22 (56%) with IV degree. Post-operatory bleeding was observed in 3 patients (8%); post-operatory pain was evaluated with Mankoski scale. After day five, every patient reintegrated to its daily activities, and none required re-intervention. CONCLUSION: Haemorrhoidopexy has shown to be a safe and effective procedure. If this technique was once questioned and controversial, today is recognized by the vast majority of colorectal surgeons.
Subject(s)
Hemorrhoids/surgery , Surgical Staplers , Adult , Aged , Equipment Design , Female , Humans , Male , Middle Aged , Postoperative Complications/epidemiology , Prospective StudiesABSTRACT
Colon and rectum hemangioma is a rare disease, and even more so when it presents as cavernous subtype; few of these hemangioma have been confirmed by pathology reports. The main presentation of this disease is observed by transrectal painless bleeding; other manifestations are less frequent. Diagnosis implies high index of suspicion and proper diagnostic workup; this entity has been frequently misdiagnosed as other more common entities. We present the case of a 15-year-old female patient with a cavernous hemangioma of the sigmoid colon; her principal complaint was abdominal pain. Diagnosis was suspected due to the finding of phleboliths in plain abdominal film and diagnostic findings in colonoscopy. The patient was treated by means of segmental resection of the colon and experienced a satisfactory postoperatory recovery. According to the literature, these hemangiomas originate from embryologic sequestrations of mesodermal tissue, while clinically they usually present between the ages of 5 and 25 years, most commonly with painless transrectal bleeding and less frequently with intestinal obstruction, tenesmus, urgency, abdominal pain or mass, and anemia. The majority of these hemangiomas are localized in rectosigmoid region of the colon and may infiltrate surrounding tissues; 26-50% show phleboliths in plain abdominal film. Colonoscopy is considered by many authors the best diagnostic tool; angiography, computed tomography (CT) scan and scintigraphy may be also useful. The only effective treatment of this disease is complete surgical resection, for which there have been many proposals regarding best method and approach.
Subject(s)
Colonic Neoplasms/diagnosis , Hemangioma, Cavernous/diagnosis , Adolescent , Colectomy , Colon/pathology , Colon/surgery , Colonic Neoplasms/surgery , Colonoscopy , Female , Hemangioma, Cavernous/surgery , Humans , Postoperative Complications , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Hombre de 44 años de edad con tumoración dolorosa en la región mamaria derecha, de seis meses de evolución, con secreción serohemática por el pezón en dos ocasiones. En la exploración física se encontró un tumor de 3 cm localizado en el cuadrante superoexterno de la mama derecha, de consistencia dura y no fijo a planos profundos. Se realizó mastrografía en la que se observó tumoración de bordes regulares con presencia de microcalcificaciones amorfas. El ultrasonido confirmó la presencia de lesión sólida con calcificaciones: la modalidad Doppler color demostró existencia de vascularidad. Se realizó biopsia excisional, el resultado de histopatología fue adenocarcinoma ductal infiltrante. Posteriormente se efectuó mastectomía radical modificada; la evolución postoperatoria fue buena. Actualmente se encuentra con quimioterapia
Subject(s)
Humans , Male , Middle Aged , Breast Neoplasms/classification , Breast Neoplasms/diagnosis , Breast Neoplasms/therapyABSTRACT
Informamos un caso de carcinoma escamoso primario de hígado en un paciente masculino de 38 años de edad. Se realizó una revición de la literatura mundial encontrando únicamente 12 casos reportados y todos ellos en pacientes masculinos; no encontramos reportes de este tumor en la literatura mexicana. El pronóstico de estas lesiones es malo y la sobrevida promedio no es mayor de seis meses
