Assuntos
Lesões Encefálicas/complicações , Hematoma Epidural Craniano/etiologia , Hipotensão Intracraniana/etiologia , Tomografia Computadorizada por Raios X , Derivação Ventriculoperitoneal/efeitos adversos , Acidentes de Trabalho , Adulto , Abscesso Encefálico/complicações , Abscesso Encefálico/cirurgia , Lesões Encefálicas/cirurgia , Transtornos da Consciência/etiologia , Craniotomia , Descompressão Cirúrgica , Drenagem , Hematoma Epidural Craniano/diagnóstico por imagem , Hematoma Epidural Craniano/cirurgia , Humanos , Hidrocefalia/etiologia , Hidrocefalia/cirurgia , Masculino , Pneumocefalia/diagnóstico por imagem , Pneumocefalia/etiologiaRESUMO
A safe protocol for conscious sedation and control during placement (or extraction) of an intragastric balloon in massively obese patients is described.
Assuntos
Cirurgia Bariátrica/métodos , Sedação Consciente , Balão Gástrico , Hipnóticos e Sedativos/uso terapêutico , Midazolam/uso terapêutico , Piperidinas/uso terapêutico , Cirurgia Bariátrica/instrumentação , Humanos , Hipnóticos e Sedativos/administração & dosagem , Midazolam/administração & dosagem , Obesidade Mórbida/cirurgia , Piperidinas/administração & dosagem , RemifentanilRESUMO
La enfermedad de Crohn limitada al apéndice es una entidad clínica poco frecuente que se asemeja a un cuadro de apendicitis aguda. Afecta principalmente a individuos jóvenes, y el diagnóstico definitivo es anatomopatológico. Presentamos una serie de 7 casos de enfermedad de Crohn apendicular intervenidos en nuestro servicio de cirugía en los últimos 12 años. Los 7 pacientes presentaron dolor en la fosa ilíaca derecha y, con sospecha de apendicitis aguda, se intervinieron quirúrgicamente; en todos ellos se realizó apendicectomía. El diagnóstico se confirmó con estudios anatomopatológicos. Un enfermo fue diagnosticado en el postoperatorio de enfermnedad de Crohn cólica y en la actualidad evoluciona favorablemente con tratamiento médico. Aunque la enfermedad de Crohn limitada al apéndice es una entidad clínica rara, debe considerarse en el diagnóstico diferencial preoperatorio de pacientes con dolor en la fosa ilíaca derecha y un curso preoperatorio tórpido que se asemeja a una apendicitis aguda. La recurrencia de la enfermedad en otro lugar del tracto digestivo es poco frecuente (AU)
Crohn's disease limited to the appendix is uncommon. Clinically, it is likely to mimic acute appendicitis. It is more frequent in young people and definitive diagnosis is histological. We present a series of seven cases of Crohn's disease of the appendix that were treated in our surgery service over the past 12 years. The seven patients had pain in the lower right quadrant. In all patients, the preoperative diagnosis was acute appendicitis and appendectomy was performed. Histopathological evaluation was required for diagnosis. In the postoperative course, one patient was diagnosed with colonic Crohn's disease, and outcome was favorable with medical treatment. Although isolated Crohn's disease of the appendix is a rare entity, it should be considered in the preoperative differential diagnosis of patients with right lower quadrant pain and a protracted preoperative course mimicking acute appendicitis. Disease recurrence elsewhere in the alimentary tract is uncommon (AU)
Assuntos
Masculino , Feminino , Adulto , Humanos , Doença de Crohn/diagnóstico , Doença de Crohn/cirurgia , Apendicectomia/métodos , Diagnóstico Diferencial , Apendicite/diagnóstico , Apendicite/cirurgia , Leucocitose/diagnóstico , Leucocitose/cirurgia , Colonoscopia/métodos , Recidiva , Apendicite/fisiopatologia , Doença de Crohn/complicações , Abdome/patologia , Abdome/cirurgia , Abdome , Actinomicose/complicações , Neoplasias do Apêndice/diagnóstico , Neoplasias do Apêndice/cirurgia , Células Gigantes de Langhans/patologiaRESUMO
Crohn's disease limited to the appendix is uncommon. Clinically, it is likely to mimic acute appendicitis. It is more frequent in young people and definitive diagnosis is histological. We present a series of seven cases of Crohn's disease of the appendix that were treated in our surgery service over the past 12 years. The seven patients had pain in the lower right quadrant. In all patients, the preoperative diagnosis was acute appendicitis and appendectomy was performed. Histopathological evaluation was required for diagnosis. In the postoperative course, one patient was diagnosed with colonic Crohn's disease, and outcome was favorable with medical treatment. Although isolated Crohn's disease of the appendix is a rare entity, it should be considered in the preoperative differential diagnosis of patients with right lower quadrant pain and a protracted preoperative course mimicking acute appendicitis. Disease recurrence elsewhere in the alimentary tract is uncommon.
