Nephrogenic fibrosing dermopathy: report of two cases.

Nephrogenic fibrosing dermopathy is a recently described fibrosing disorder that emerges in different settings of renal insufficiency. The degree and cause of the underlying renal impairment seem not to be related to the severity of the nephrogenic fibrosing dermopathy. Lesions are typically symmetrical and usually develop on the limbs and trunk. These are characterized by skin-coloured to erythematous papules that coalesce into plaques markedly thickened in texture. Flexion contractures of the joints may be a feature of the disease. There is no consistently effective therapy for nephrogenic fibrosing dermopathy. We report here 2 Brazilian patients in connection with a short review. Remission was recorded in one case after plasmapheresis.

Necrose da mucosa esofágica como complicação da cardiomiotomia à heller para tratamento de megaesôfago chagásico / Necrosis of esophageal mucosa as a heller cardiomyotomy complication in the treatment of achalasia in chagas' disease

This article presents a complication of the laparoscopic technique for Heller cardiomyotomy and anterior fundoplication. This procedure is safe and provides excellent relief of disphagia in esophageal achalasia. Nevertheless, there are rare but dangerous complications, such as late active digestive bleeding, presented in this paper which was resistant to conservative treatment and led to hypovolemic shock. Urgent laparotomy performed to identify and control bleeding, revealed necrosis of esophageal mucosa with a bleeding gastric vessel. Inadequate exposure of the gastroesophageal junction and an incision very close to the lesser curvature might have damaged the esophageal branches of the left gastric artery, leading to ischemic necrosis of the mucosa and exposure of the gastric wall and its vessels.