RESUMO
INTRODUCTION: Bowel obstruction is one of the principal non-traumatic causes of general surgery emergencies, both in Brazil and worldwide. This condition can be classified according to the degree (complete or incomplete), clinical course (acute or chronic) or nature (mechanical, vascular or functional) of the obstruction. CASE REPORT: ESS, a 62-year old Brazilian woman from Rio de Janeiro, was admitted to the emergency department complaining of constipation of two weeks' duration. She also reported fever and fecal vomiting in the preceding two days.A syndromic diagnosis of bowel obstruction was made, and the patient was referred for CT. The sigmoid colon, descending colon, transverse colon, ascending colon, the cecum and the terminal ileum were resected. DISCUSSION: Colorectal cancer is one of the most common forms of cancer in the elderly, perforation of the cecum occurs in only around 3-8% of cases. 15 This can be explained by the fact that patients with colorectal cancer present with wasting syndrome before the bowel lumen becomes completely obstructed. In a literature review conducted for this study, only one publication was found in which rupture of the cecum was associated with colorectal cancer. CONCLUSION: Although rupture of the cecum associated with colorectal cancer is a rare pathology, it constitutes a surgical emergency; therefore, all surgeons should be aware of the possibility.
RESUMO
The foramen venosum (FV) is an anatomical structure situated at the base of the skull, generally posteromedial to the foramen rotundum and anteromedial to the foramen ovale. Its prevalence and patency may be related to the shape of the skull. The objective of this study was to verify the prevalence and patency of the FV and its association with the different skull types. Overall, 143 dry skulls were screened. Of these, 84 were considered to be in an adequate state of conservation and were included in the analysis, which was conducted through a cross-sectional view of the skullcap. The transverse (T) and anteroposterior (AP) diameters of the skull were evaluated by pachymetry and the skull type was classified according to the cephalic index (CI) (CI = T/AP x 100). The presence and patency of the FV were evaluated. Overall, 25 % of the skulls were dolichocephalic, 21.4 % sub-dolichocephalic, 26.2 % mesaticephalic, 16.7 % sub-brachycephalic and 10.7 % brachycephalic. Overall, the FV was found in 41.6 % of the skulls (n=35), with this prevalence being greater in the mesaticephalic skulls (50 %; n=11). Patency was 25 % (n=21). A positive correlation was found between the CI and the presence of the FV in dolichocephalic skulls (on the right-hand side only) and in sub-brachycephalic skulls (bilaterally). In conclusion, the prevalence of the FV was considerable in the sample analyzed and was directly associated with the CI in dolichocephalic and sub-brachycephalic skulls.
El foramen venoso (FV) es una estructura anatómica situada en la base del cráneo, en general, posteromedial al foramen redondo y anteromedial al foramen oval. Su prevalencia y permeabilidad pueden estar relacionados con la forma del cráneo. El objetivo de este estudio fue verificar la prevalencia y permeabilidad del FV y su asociación con los diferentes tipos de cráneo. Se estudiaron 143 cráneos secos. De éstos, 84 fueron considerados en estado adecuado de conservación y se incluyeron en el análisis, realizado mediante la visualización de una sección transversal del cráneo. Los diámetros transversal (T) y anteroposterior (AP) del cráneo se evaluaron mediante paquimetría y el tipo de cráneo se clasificó de acuerdo con el índice cefálico (IC) (IC = T/AP x 100). Se evaluó también la presencia y permeabilidad del FV. El análisis mostró que 25 % de los cráneos eran dolicocefálicos, 21,4 % subdolicocéfalicos, 26,2 % mesaticéfalos, 16,7 % sub-braquicéfalos y 10,7 % de braquicéfalos. El FV se encontró en 41,6 % de los cráneos (n=35), con prevalencia mayor en los cráneos mesaticéfalos (50 %, n=11). La permeabilidad fue del 25 % (n=21). Se encontró una correlación positiva entre el IC y la presencia del FV en cráneos dolicocéfalicos (sólo en el lado derecho) y en sub-braquicéfalos (bilateral). En conclusión, la prevalencia del FV fue considerable en la muestra analizada y se asocia directamente con el IC en cráneos dolicocéfalicos y sub-braquicéfalos.
