Invaginación íleo-colónica en un paciente adolescente con fibrosis quística / Ileocolonic intussusception in an adolescent patient with cystic fibrosis

La invaginación intestinal ocurre cuando un segmento proximal de intestino se repliega dentro de la luz de un segmento distal adyacente y provoca obstrucción intestinal. Es una causa común de abdomen agudo en los dos primeros años de la vida, pero raro en niños mayores. Un varón de 16 años, con diagnóstico de fibrosis quística, se presentó con un cuadro compatible con síndrome de oclusión intestinal distal. Consultó a la clínica con dolor abdominal y una masa palpable en el hipocondrio derecho. Se realizó ecografía abdominal y tomografía de abdomen contrastada, que demostraron invaginación íleo-colónica con signos de isquemia intestinal, necrosis y neumatosis de la pared intestinal. Fue intervenido: se realizó resección del íleon terminal y hemicolon derecho, y se detectó una tumoración en ciego. La invaginación íleo-colónica es una causa rara de abdomen agudo en pacientes adolescentes con fibrosis quística y puede estar asociada a una causa orgánica subyacente.

Intestinal intussusception occurs when a proximal segment of the intestine telescopes into the lumen of an adjacent distal segment, causing intestinal obstruction. It is a common cause of acute abdomen in the first two years of life, but rare in older children. A 16-year-old male with a diagnosis of cystic fibrosis presented with symptoms compatible with distal intestinal occlusion syndrome. He came at the cystic fibrosis clinic with a 5-day evolution of abdominal pain and a palpable mass in the right hypochondrium. Abdominal ultrasound and abdominal contrasted tomography were performed demonstrating ileo-colonic invagination with signs of intestinal ischemia, necrosis and pneumatosis of the intestinal wall. He underwent surgery with resection of the terminal ileum and right hemicolon, ana tumor in the caecum was found. This is a rare cause of acute abdomen in young patients with cystic fibrosis and may be associated with an underlying organic cause.

[Ileocolonic intussusception in an adolescent patient with cystic fibrosis]. / Invaginación íleo-colónica en un paciente adolescente con fibrosis quística.

Intestinal intussusception occurs when a proximal segment of the intestine telescopes into the lumen of an adjacent distal segment, causing intestinal obstruction. It is a common cause of acute abdomen in the first two years of life, but rare in older children. A 16-year-old male with a diagnosis of cystic fibrosis presented with symptoms compatible with distal intestinal occlusion syndrome. He came at the cystic fibrosis clinic with a 5-day evolution of abdominal pain and a palpable mass in the right hypochondrium. Abdominal ultrasound and abdominal contrasted tomography were performed demonstrating ileocolonic invagination with signs of intestinal ischemia, necrosis and pneumatosis of the intestinal wall. He underwent surgery with resection of the terminal ileum and right hemicolon, and a tumor in the caecum was found. This is a rare cause of acute abdomen in young patients with cystic fibrosis and may be associated with an underlying organic cause.

La invaginación intestinal ocurre cuando un segmento proximal de intestino se repliega dentro de la luz de un segmento distal adyacente y provoca obstrucción intestinal. Es una causa común de abdomen agudo en los dos primeros años de la vida, pero raro en niños mayores. Un varón de 16 años, con diagnóstico de fibrosis quística, se presentó con un cuadro compatible con síndrome de oclusión intestinal distal. Consultó a la clínica con dolor abdominal y una masa palpable en el hipocondrio derecho. Se realizó ecografía abdominal y tomografía de abdomen contrastada, que demostraron invaginación íleo-colónica con signos de isquemia intestinal, necrosis y neumatosis de la pared intestinal. Fue intervenido: se realizó resección del íleon terminal y hemicolon derecho, y se detectó una tumoración en ciego. La invaginación íleo-colónica es una causa rara de abdomen agudo en pacientes adolescentes con fibrosis quística y puede estar asociada a una causa orgánica subyacente.

Perineural spread-susceptible structures: a non-pathological evaluation of the skull base.

Perineural spread adenoid cystic carcinoma can alter the dimension of foramina and canals of the skull base. The objective of this study was to determine the range of normal variation of the foramina and canals of both hemicranium. We analyzed 200 individuals with no alterations of the skull base in a retrospective manner using high-resolution computed tomography. We measured the short and long axis diameters of the foramen rotundum (FR), foramen ovale (FO), stylomastoid foramen (SMF), pterygoid canal (PTC), internal auditory canal (IAC), and the facial nerve canal in its labyrinthine portion (LPFC) to calculate the area in each hemicranium, compare them and obtain the normal range of asymmetry. Parametric and non-parametric comparison tests were realized. The structures that had the lowest range of asymmetry were the LPFC (0.00-0.79 mm2) and the FR (0.00-2.12 mm2). The one that had the highest asymmetry range was the FO (0.00-9.16 mm2). Significant differences were found in the FO (p = 0.01) and the IAC (p = 0.00) in the gender comparison. We determined a normal asymmetry range of the susceptible foramina and canals of the skull base. This study reports a useful and objective measure to differentiate anatomical from pathological variations of the foramina and canals of the skull base by age and gender. Our results establish a basis for future studies that evaluate this range as a diagnostic tool of metastasis in the skull base as a complement of other imaging techniques.