Carcinoma papilar de tiroides sobre conducto tirogloso persistente / Papillary thyroid carcinoma arising in a thyroglossal duct cyst

La malignización de los quistes del conducto tirogloso es infrecuente y corresponde fundamentalmente, a carcinomas papilares del tejido tiroideo que los constituye. En este trabajo se describe un carcinoma papilar que se asienta sobre el conducto tirogloso en una mujer de 40 años intervenida previamente de bocio multinodular que tenía una biopsia con aguja fina preoperatoria de carcinoma papilar de tiroides (AU)

Malignant transformation of thyroglossal duct cysts is uncommon and usually corresponds to papillary carcinoma of the thyroid tissue constituting the cyst. We report a case of papillary thyroid carcinoma originating in a thyroglossal duct cyst in a 40-year-old woman who had previously undergone surgery for goitre with a prior diagnosis of papillary carcinoma by fine needle punch biopsy (AU)

Computed tomography, angiography, and endoscopic retrograde cholangiopancreatography in the nonoperative management of hepatic and splenic trauma.

There is a marked trend toward nonoperative management of abdominal trauma. This has been possible thanks to the advances in imaging and interventional techniques. In this work we review in which way computed tomography (CT) abdominal scans, angiography, and endoscopic retrograde cholangiopancreatography (ERCP) can guide the nonoperative management of hepatic and splenic trauma. The CT abdominal scan with intravenous contrast is the "departure imaging" of choice for the nonoperative management of hepatic and splenic trauma in the hemodynamically stable patient. It is the most accurate test for detecting, defining, and characterizing these injuries, the associated hemoperitoneum, and other abdominal abnormalities (the hollow viscus injuries missed on the CT scan were detected by clinical parameters and had no negative consequences in the outcome). It has an accuracy of more than 95% for these injuries, but CT grading alone cannot decide which patient can be treated conservatively and which patient requires surgery. Its usefulness for follow-up seems challenging. Angiography can be therapeutic, thereby avoiding surgery (some report that angiography can be performed even in patients with active bleeding as damage control); if vessel injury, active bleeding or hemobilia are suspected on the basis of a CT scan in a stable patient, angiography should be carried out. ERCP should be performed in patients with suspected injury to the biliary tree, even with normal iminodiacetic acid radionuclide scanning (HIDA) if symptoms persist. A biliary stent can be placed. Indications for angiography and ERCP remain unclear.

Orthotopic liver transplantation for alpha-1-antitrypsin deficiency: an experience in 29 children and ten adults.

Thirty-nine patients (29 children and ten adults) underwent OLT for liver disease associated with A1AD from March 1980 to March 1986. Thirty of thirty-six patients (83%) with available data were homozygous phenotype PiZZ. The other six were Pi heterozygotes, being either PiMZ or PiSZ. The mean A1A activity in homozygous and heterozygous patients was 38.8 mg/dL and 114.3 mg/dL respectively. Eight patients died during the first 3 months after OLT (20%). The 5-year actuarial survival is 83% and 60% in pediatric and adult recipients respectively. Today 30 (76%) of the recipients are alive, with follow-ups of 8 to 64 months (average 27 months). The quality of life in the surviving patients is excellent.