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11.
Reumatol. clín. (Barc.) ; 9(4): 239-242, jul.-ago. 2013. ilus
Artigo em Espanhol | IBECS | ID: ibc-113681

RESUMO

En los últimos años se ha extendido el uso de técnicas de cementación vertebral, vertebroplastia y cifoplastia, para el tratamiento del dolor asociado a fracturas vertebrales osteoporóticas. Se han descrito diferentes complicaciones relacionadas con dichos procedimientos, siendo las más frecuentes derivadas de la fuga del material de cementación. El cemento puede extravasarse al sistema venoso vertebral y a través del sistema ácigos y la vena cava alcanzar la circulación pulmonar, produciendo embolismo por cemento. Esta complicación es frecuente, ocurriendo hasta en 26% de los pacientes sometidos a vertebroplastia, pero dado que generalmente no produce repercusión hemodinámica ni clínica este evento suele pasar inadvertido. Sin embargo, se han descrito algunos casos graves e incluso fatales. Presentamos un paciente varón de 74 años, sometido a vertebroplastia por dolor persistente asociado a una fractura vertebral osteoporótica en L3, que presentó una fuga de cemento hacia la vena cava y la arteria pulmonar derecha. Aunque desarrolló un embolismo pulmonar por cemento, el paciente permaneció asintomático y sin complicaciones durante el seguimiento (AU)


In recent years, the use of vertebral cementing techniques for vertebroplasty and kyphoplasty has spread for the treatment of pain associated with osteoporotic vertebral compression fractures. This is also associated with the increased incidence of complications related with these procedures, the most frequent being originated by leakage of cementation material. Cement can escape into the vertebral venous system and reach the pulmonary circulation through the azygous system and cava vein, producing a cement embolism. This is a frequent complication, occurring in up to 26% of patients undergoing vertebroplasty but, since most of the patients have no clinical or hemodynamical repercussion, this event usually goes unnoticed. However, some serious, and even fatal cases, have been reported. We report the case of a 74-year-old male patient who underwent vertebroplasty for persistent pain associated with osteoporotic L3 vertebral fracture and who developed a cement leak into the cava vein and right pulmonary artery during the procedure. Although he developed a pulmonary cement embolism, the patient remained asymptomatic and did not present complications during follow-up (AU)


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Embolia Pulmonar/complicações , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/terapia , Osteoporose/complicações , Osteoporose/diagnóstico , Traumatismos da Coluna Vertebral/complicações , Traumatismos da Coluna Vertebral/diagnóstico , Cimentação/efeitos adversos , Embolia Pulmonar/fisiopatologia , Embolia Pulmonar , Vertebroplastia/efeitos adversos , Cifoplastia , Radiografia Torácica/métodos , /métodos
12.
Reumatol Clin ; 9(4): 239-42, 2013.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-23481509

RESUMO

In recent years, the use of vertebral cementing techniques for vertebroplasty and kyphoplasty has spread for the treatment of pain associated with osteoporotic vertebral compression fractures. This is also associated with the increased incidence of complications related with these procedures, the most frequent being originated by leakage of cementation material. Cement can escape into the vertebral venous system and reach the pulmonary circulation through the azygous system and cava vein, producing a cement embolism. This is a frequent complication, occurring in up to 26% of patients undergoing vertebroplasty but, since most patients have no clinical or hemodynamical repercussion, this event usually goes unnoticed. However, some serious, and even fatal cases, have been reported. We report the case of a 74-year-old male patient who underwent vertebroplasty for persistent pain associated with osteoporotic L3 vertebral fracture and who developed a cement leak into the cava vein and right pulmonary artery during the procedure. Although he developed a pulmonary cement embolism, the patient remained asymptomatic and did not present complications during follow-up.


Assuntos
Cimentos Ósseos/efeitos adversos , Complicações Pós-Operatórias/etiologia , Embolia Pulmonar/etiologia , Vertebroplastia , Idoso , Humanos , Masculino
13.
Clin Imaging ; 37(1): 163-6, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23206626

RESUMO

A 67-year-old female ex-smoker was referred to our hospital after chest radiographs revealed a nonresolving opacity in the right lower lung. Her past medical history was significant for laryngeal cancer. A whole-body positron emission tomography/computed tomography (CT) confirmed an ill-defined fluorodeoxyglucose-avid peribronchial opacity in the right middle and inferior lobes. The CT component of the study showed focal areas of low attenuation within the lung opacity; these focal areas followed fat signal intensity on a magnetic resonance study, confirming the suspicion of exogenous lipoid pneumonia. The patient admitted to applying petroleum jelly (Vaseline) to her tracheostomy in order to moisturize the area around the stoma.


Assuntos
Laringectomia , Imageamento por Ressonância Magnética/métodos , Imagem Multimodal/métodos , Vaselina/efeitos adversos , Pneumonia Lipoide/induzido quimicamente , Pneumonia Lipoide/diagnóstico , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios X , Traqueostomia/efeitos adversos , Corticosteroides/efeitos adversos , Idoso , Feminino , Humanos , Pneumonia Lipoide/tratamento farmacológico , Resultado do Tratamento
14.
Gastroenterol. hepatol. (Ed. impr.) ; 34(9): 619-623, Nov. 2011.
Artigo em Espanhol | IBECS | ID: ibc-98653

RESUMO

La colangiopatía portal es el conjunto de alteraciones que pueden aparecer en la vesícula y en la vía biliar en relación con la existencia de una trombosis crónica de la vena porta y el desarrollo de circulación colateral. La obstrucción crónica de la vena porta es una causa frecuente de hemorragia digestiva por varices esofágicas, pero su posible repercusión sobre la vía biliar es menos conocida. Presentamos el caso clínico de un varón con un cuadro de ictericia secundaria a colangiopatía portal, analizando posteriormente la patogenia de esta entidad, los métodos diagnósticos y las diferentes posibilidades terapéuticas disponibles (AU)


Portal cholangiopathy encompasses a group of abnormalities of the biliary system and gallbladder that occur secondary to chronic portal vein thrombosis and collateral venous circulation. Chronic obstruction of the portal vein is a frequent cause of gastrointestinal variceal bleeding, but data on biliary tract abnormalities are limited. We report the case of a male patient with obstructive jaundice secondary to portal cholangiopathy. We describe the pathogenesis of this entity, and the various diagnostic and therapeutic options available


Assuntos
Humanos , Masculino , Colangite/etiologia , Hipertensão Portal/complicações , Icterícia Obstrutiva/etiologia , Trombose/etiologia , Insuficiência Venosa/complicações , Colangiopancreatografia por Ressonância Magnética
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