RESUMEN
A woman in her 50s was admitted to the emergency department with a 3-day history of abdominal pain, mainly in the right hypochondrium, radiating to the back, associated with postprandial vomiting and dysphagia. The abdominal ultrasound study found no abnormalities. Laboratory tests showed increased C-reactive protein levels, creatinine and high white blood cell count without a left shift. Abdominal computed tomography scan exhibited mediastinal herniation, twist and perforation of the gastric fundus associated with air-fluid levels in the lower mediastinum. The patient underwent diagnostic laparoscopy requiring laparotomy conversion due to hemodynamic instability related to the pneumoperitoneum. During the intensive care unit (ICU) stay, thoracoscopy with pulmonary decortication was performed to treat complicated pleural effusion. After ICU and standard infirmary bed recovery, the patient was discharged from the hospital. This report illustrates a case of perforated gastric volvulus as the cause of nonspecific abdominal pain.
RESUMEN
Congenital cutaneous pyogenic granuloma is a rare benign vascular tumor with clinical and histopathological features similar to infantile hemangioma. It usually presents as a red, pedunculated and highly friable papule. On histopathological analysis, one can see a capillary vessel proliferation with lobular pattern and endothelial proliferation. The differential diagnosis is based on negativity of glucose transporter 1 (GLUT1) immunochemistry studies. We report two infants with congenital pyogenic granuloma, one with a unique cutaneous lesion and the other with multiple lesions affecting both skin and mucosal surfaces. These two cases highlight the importance of the differential diagnosis based on the GLUT1 immunochemistry analysis considering the distinct treatments required to these infant vascular tumors.