Evaluación ecográfica de la orquiepididimitis complicada / Ultrasound findings in complicated orchiepididymitis

Para describir los hallazgos ecográficos de la orquiepididimitis aguda complicada diseñamos un estudio descriptivo retrospectivo de casos entre 2006-2013. Registramos 75 casos de orquiepididimitis aguda severa, presentando complicaciones 15 pacientes (20%). La media de edad fue 54 años (rango 15-84). Las principales manifestaciones clínicas fueron dolor escrotal y edema testicular, encontrando: orquiepididimitis crónica, absceso escrotal, absceso intratesticular, piocele, isquemia testicular y atrofia testicular en el contexto de una orquitis crónica. Fue preciso realizar cirugía en 9 casos. La ecografía identifica lesiones específicas cuyo manejo precoz permite el tratamiento conservador y un seguimiento del proceso sin recurrir a exploraciones quirúrgicas innecesarias. Se revisan los datos clínicos y su correlación con los patrones ecográficos encontrados en nuestro estudio. La orquiepididimitis es un problema habitual que puede derivar en complicaciones de variada gravedad. El conocimiento de los signos ecográficos nos permitirá establecer un diagnostico precoz y fiable, eligiendo el tratamiento adecuado (AU)

A retrospective descriptive study was conducted on patients diagnosed between 2006 and 2013, in order to describe the ultrasound findings in complicated acute orchiepididymitis (orchitis). There have been 75 cases of severe acute orchitis, with 15 (20%) of them having complications. The mean age was 54 years (range 15-84), and the main clinical manifestations were scrotal pain and testicular swelling. Other findings included, chronic orchitis, scrotal abscess, intra-testicular abscess, pyocele, testicular ischaemia, and testicular atrophy. Surgery was performed in 9 cases. Ultrasound can reliably identify specific lesions, for which early treatment that includes conservative management and monitoring of the process without resorting to unnecessary surgical exploration. Clinical data and its correlation with the main ultrasound patterns found in the study were reviewed. The diagnosis of orchitis is a common problem that can lead to complications of varying severity. Knowledge of the ultrasound signs of these conditions will allow us to establish a reliable early diagnosis and the choice of appropriate conservative or surgical treatment (AU)

Hallazgos ecográficos asociados al cáncer de vesícula biliar / Ultrasound findings associated to gallbladder carcinoma

OBJETIVO: Revisar los hallazgos ecográficos más relevantes asociados al cáncer de vesícula biliar. MATERIAL Y MÉTODO: Estudio descriptivo y retrospectivo de las características clínicas y estudios de imagen en pacientes con neoplasia de vesícula biliar en el periodo 2000-2011 en el Hospital General Reina Sofía de Murcia. RESULTADOS: Fueron hallados 15 casos de cáncer vesicular, de los que 9 eran mujeres. La edad media fue 77 años (rango 61-96). El dolor fue el principal motivo de consulta. Presentaban colelitiasis 13 casos, tabaquismo 2 casos y obesidad 3 casos. La ecografía comprobó engrosamiento de la pared vesicular (> 4 mm) en 8 casos, masa intraluminal en 4, vesícula escleroatrófica en 2 y masa que reemplaza la vesícula en uno. Solo en 4 casos hubo la sospecha preoperatoria de carcinoma vesicular. Siguiendo la estadificación pTNM, 4 pacientes presentaban un carcinoma in situ (Tis), un caso T1a, 6 casos T2, 3 casos T3 y un caso T4. En 7 casos, la única prueba radiológica preoperatoria fue la ecografía y en otros 8 se completó el estudio con una TC abdominal. CONCLUSIÓN: El diagnóstico precoz del cáncer vesicular es raro. La orientación diagnóstica por ecografía es limitada; solo el engrosamiento parietal localizado coexistente con litiasis vesicular parece significativo en estadios tempranos. La imagen de masa y cálculo ocupando la vesícula se asocia a etapas avanzadas de la enfermedad

OBJECTIVE: This article reviews the most relevant ultrasound findings associated with gallbladder cancer. MATERIALS AND METHODS: A descriptive and retrospective study was made of clinical features and imaging studies in patients subjected to surgery for gallbladder neoplasm in the Reina Sofía General University Hospital (Murcia) during the time period 2000-2011. RESULTS: A total of 15 cases of gallbladder cancer were found during the study period, 9 of whom were women. The mean age was 77 years (range 61-96). Pain was the principal complaint. The patients had cholelithiasis in 13 cases, smoking in 2 cases, and obesity in 3 cases. The ultrasound showed gallbladder wall thickening (> 4 mm) in 8 cases, intraluminal mass in 4, scleroatrophic gallbladder in 2, and mass replacing the gallbladder in one. Only in 4 cases was the suspicion of gallbladder carcinoma established preoperatively. According to the pTNM staging, 4 patients were carcinoma in situ (Tis), one case T1a, 6 cases T2, 3 cases T3 and one case T4. In 7 cases, the only evidence was the preoperative ultrasound, and in 8 the study was completed with an abdominal CT. CONCLUSION: Early diagnosis of gallbladder cancer is rare. The ultrasound diagnostic approach is difficult; only a localized thickening coexisting with gallstones seems to be significant, and requires a biopsy. The image of a mass and a stone occupying the gallbladder is associated with later stages of the disease

Ultrasound findings associated to gallbladder carcinoma.

OBJECTIVE: This article reviews the most relevant ultrasound findings associated with gallbladder cancer. MATERIAL AND METHOD: A descriptive and retrospective study was made of clinical features and imaging studies in patients subjected to surgery for gallbladder neoplasm in the Reina Sofía General University Hospital (Murcia) during the time period 2000-2011. RESULTS: A total of 15 cases of gallbladder cancer were found during the study period, 9 of whom were women. The mean age was 77 years (range 61-96). Pain was the principal complaint. The patients had cholelithiasis in 13 cases, smoking in 2 cases, and obesity in 3 cases. The ultrasound showed gallbladder wall thickening (>4mm) in 8 cases, intraluminal mass in 4, scleroatrophic gallbladder in 2, and mass replacing the gallbladder in one. Only in 4 cases was the suspicion of gallbladder carcinoma established preoperatively. According to the pTNM staging, 4 patients were carcinoma in situ (Tis), one case T1a, 6 cases T2, 3 cases T3 and one case T4. In 7 cases, the only evidence was the preoperative ultrasound, and in 8 the study was completed with an abdominal CT. CONCLUSION: Early diagnosis of gallbladder cancer is rare. The ultrasound diagnostic approach is difficult; only a localized thickening coexisting with gallstones seems to be significant, and requires a biopsy. The image of a mass and a stone occupying the gallbladder is associated with later stages of the disease.