ABSTRACT
With the aim of obtaining a map which is useful as a diagnostic tool and therapeutical orientation, complementing the written report of duplex ultrasound venous study, Latin-American Scientific Societies of Phlebology, Vascular Surgery and Vascular Imaging were invited to participate, through their regional representatives, to the First Consensus of Superficial and Perforating Venous Mapping. A consensus process using a modified Delphi method was carried out. An International Working Group was formed, which developed a Prototype of the Venous Mapping that worked as a starting point for consensus, and was presented in a first virtual meeting of 54 experts (societies' representatives) when the methodology was explained. For the consensus process, two rounds of self-administrated questionnaires with feedback were used. In the first questionnaire a 100% consensus was obtained in the 15 statements (an agreement range of 85.2% to 100%) In the analysis of qualitative data, three categories according to the actions to implement were identified - actions which involved no action, minor changes and major changes. This analysis was used to build the second questionnaire, which reached a consensus in its six statements (agreement range of 87.1% to 98.1%). A final consensus on every field proposed was established with the approval of all the experts consulted and it was presented at a third online meeting. The document of the superficial and perforating venous mapping reached by consensus is presented hereafter.
Subject(s)
Ultrasonography, Doppler, Duplex , Veins , Humans , Consensus , Latin America , Veins/diagnostic imaging , Ultrasonography, Doppler, Duplex/methods , Vascular Surgical ProceduresABSTRACT
Although pseudoaneurysms are a rare complication of chronic pancreatitis, they are potentially serious both because of the events they can lead to and the diagnostic challenges they may pose. Historically, they used to be treated surgically, through ligation and/or resection; it was not until the last decade that scarcely invasive percutaneous endovascular procedures were introduced. This article reports the case of a patient with chronic pancreatitis presenting with severe upper digestive hemorrhage caused by the rupture of a pseudoaneurysm of the gastroduodenal artery. The patient was successfully treated using selective embolization.
Subject(s)
Aneurysm, False/etiology , Aneurysm, Ruptured/etiology , Duodenum/blood supply , Pancreatitis, Alcoholic/complications , Pancreatitis, Chronic/complications , Stomach/blood supply , Aged , Aneurysm, False/diagnosis , Aneurysm, False/therapy , Aneurysm, Ruptured/diagnosis , Aneurysm, Ruptured/therapy , Arteries , Embolization, Therapeutic , Endoscopy, Gastrointestinal , Gastrointestinal Hemorrhage/etiology , Humans , Male , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
La ruptura del quiste hidático (QH) pulmonar puede provocar una hidatidosis secundaria (local, siembra bronquial, pleural secundaria). Es por ello que clásicamente se consideraba que un QH en sufrimiento era una urgencia quirúrgica. La experiencia ha demostrado que más peligroso que la ruptura, es operar un paciente con una neumonitis periquística. En el acto operatorio no se podrá realizar la broncorrafia desgarrando el parenquima pulmonar friable. Ello llevará a una aerostasis defectuosa, sangrado, reexpansión pulmonar incompleta, con el consiguiente peligro de complicaciones postoperatorias. Un enérgico tratamiento preoperatorio de la neumonitis es obligatorio no importando el estado de sufrimiento del quiste. La TAC no documentará el estado del pulmón. El objetivo de este trabajo es mostrar dos pacientes operados con una preparación correcta, donde se logró evitar complicaciones y un postoperatorio de pocos días. Por lo que concluimos que no se justifica una cirugía de urgencia, sin una preparación adecuada del parenquima pulmonar, con el fin de evitar la ruptura de un QH de pulmón
