Vólvulo del ángulo esplénico del colon / No disponible

No disponible

Cirugía laparoscópica en pacientes con sistemas de derivación ventriculoperitoneal / Laparoscopic surgery in patients with a ventriculoperitoneal shunt

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Laparoscopic colectomy for primary colonic lymphoma.

Primary colorectal lymphoma is an infrequent disease of unknown origin and with a growing incidence. Differentiation be-tween primary lymphoma and secondary colorectal involvement is of great therapeutic and prognostic importance. The diagnosis must always be based on histological findings. Different forms of presentation have been described, though all are nonspecific. While full agreement on the best management approach for colorectal lymphoma is lacking, surgical resection is usually the treatment of choice. The role of chemotherapy has not been defined. This study reports on a case of primary lymphoma in the cecum, with clinical manifestations in the form of meteorism and early satiety. The diagnosis was established by colonoscopy and biopsy. The absence of lymph-node involvement, tumor size, existing cardiopulmonary risk factors, and the fact that a full resection of the malignancy proved possible, with tumor-free resection margins, led us to exclude adjuvant chemotherapy. After one year of follow-up the patient remains disease-free.

Tratamiento del linfoma primario de colon mediante colectomía laparoscópica / Laparoscopic colectomy for primary colonic lymphoma

El linfoma primario colorrectal es una enfermedad muy infrecuente,de causa desconocida y con una incidencia en aumento.Diferenciar entre el linfoma primario y la afectación colorrectal secundariaen el linfoma sistémico es de elevada importancia terapéuticay pronóstica. El diagnóstico ha de ser siempre histológico.Se han descrito diferentes formas de presentación, pero todasellas inespecíficas. No existe un total acuerdo sobre cuál es el mejortratamiento del linfoma colorrectal. La resección quirúrgicasuele ser el procedimiento de elección, sin haberse definido el papelde la quimioterapia. Presentamos un caso de linfoma primariolocalizado en el ciego, cuyas manifestaciones clínicas fueron meteorismoy saciedad precoz, siendo diagnosticado mediante colonoscopiay biopsia. La resección asistida por laparoscopia fue eltratamiento de elección. La no afectación ganglionar, tamaño tumoral,resección completa con márgenes libres, así como los factoresde riesgo cardiopulmonares del paciente, llevaron a desestimarla quimioterapia adyuvante. Tras un año de seguimiento elpaciente se encuentra libre de enfermedad

Primary colorectal lymphoma is an infrequent disease of unknownorigin and with a growing incidence. Differentiation betweenprimary lymphoma and secondary colorectal involvement isof great therapeutic and prognostic importance. The diagnosismust always be based on histological findings. Different forms ofpresentation have been described, though all are nonspecific.While full agreement on the best management approach for colorectallymphoma is lacking, surgical resection is usually the treatmentof choice. The role of chemotherapy has not been defined.This study reports on a case of primary lymphoma in the cecum,with clinical manifestations in the form of meteorism and earlysatiety. The diagnosis was established by colonoscopy and biopsy.The absence of lymph-node involvement, tumor size, existing cardiopulmonaryrisk factors, and the fact that a full resection of themalignancy proved possible, with tumor-free resection margins,led us to exclude adjuvant chemotherapy. After one year of follow-up the patient remains disease-free

Laparoscopically treated duodenal hamartoma of Brunner's glands.

Hamartomas of Brunner's glands are extremely rare lesions, with only about 100 cases reported to date in the world literature; of these, fewer than 25 correspond to growths >2 cm in diameter. We report the case of a patient with a large (6-cm diameter) duodenal hamartoma of Brunner's glands treated by laparoscopic surgery. A review of the literature revealed no other cases via this approach.

[Porto-cholecysto-duodenal fistula as an infrequent cause of upper gastrointestinal hemorrhage]. / Fístula porto-colecisto-duodenal como causa poco frecuente de hemorragia digestiva alta.

A case of porto-cholecysto-duodenal fistula which caused a severe upper gastrointestinal haemorrhage is presented. The difficulties involved in diagnosis and surgical treatment are discussed.