Assuntos
Angioplastia Coronária com Balão/métodos , Estenose Coronária/diagnóstico por imagem , Estenose Coronária/epidemiologia , Refluxo Gastroesofágico/epidemiologia , Refluxo Gastroesofágico/cirurgia , Comorbidade , Estenose Coronária/terapia , Fundoplicatura/métodos , Refluxo Gastroesofágico/diagnóstico , Humanos , Segurança do Paciente , Complicações Pós-Operatórias/prevenção & controle , Cuidados Pré-Operatórios/métodos , Radiografia , Medição de Risco , Resultado do TratamentoRESUMO
Colonic diverticula are very common and may be associated with symptoms or complicated by diverticulitis and its associated problems. Many of the traditional concepts relating to the pathophysiology, prevention, and management of these entities have been questioned recently based on findings from high-quality prospective studies. Although dietary fiber may protect against symptoms and complications, its impact on the formation of diverticula may be limited. It is now evident that the risk for an episode of diverticulitis in an individual with diverticula is lower than previously thought. Furthermore, the necessity for antibiotic use in uncomplicated diverticulitis has been questioned and serious doubt cast upon the belief that surgery should be performed when a second attack occurs. Although data are far from conclusive, there is some evidence to suggest that diverticulosis may be associated with chronic abdominal symptoms, with or without underlying chronic inflammatory changes in the involved segment of the colon. In addition, colonoscopy is not routinely required after an attack of acute uncomplicated diverticulitis, as the risk of cancer in this population is not much higher than in the general population.
Assuntos
Endoscopia Gastrointestinal , Prática Profissional , Colangiopancreatografia Retrógrada Endoscópica/economia , Colonoscopia/economia , Educação Médica Continuada , Educação de Pós-Graduação em Medicina , Endoscopia Gastrointestinal/economia , Endoscopia Gastrointestinal/educação , Prática de Grupo , Humanos , Reembolso de Seguro de SaúdeRESUMO
BACKGROUND: Rectal duplication cyst (RDC) is a rare congenital anomaly representing 1% to 8% of all intestinal duplications. The case presented here is the first report of the laparoscopic resection of an RDC. METHODS: We report the case of a 49-year-old white woman in whom a retrorectal cystic mass measuring 5 x 5.3 x 6 cm was diagnosed. The mass was completely resected by means of laparoscopic techniques. RESULTS: Pathologic findings revealed a cystic structure partially lined with squamous as well as respiratory- and gastrointestinal-type epithelium. Muscularis propria was identified in the outer portions of the wall of the specimen. No atypia or malignancy was identified. The overall findings were consistent with an RDC. CONCLUSIONS: Laparoscopic resection constitutes an excellent and patient-friendly approach to the management of large adult cystic duplication of the rectum.
