RESUMO
El abdomen agudo comprende un amplio grupo de enfermedades con alta incidencia en la práctica quirúrgica habitual. Se presenta el caso de un paciente masculino, de 23 años, con cuadro abdominal agudo, cuyo diagnóstico preoperatorio fue compatible con una apendicitis aguda; al efectuar la laparotomía exploratoria se constató torsión primaria y segmentaria del omento mayor. Esta es una afección de difícil diagnóstico preoperatorio, generalmente diagnosticada durante el acto quirúrgico porque fácilmente se confunde con otras enfermedades del abdomen agudo quirúrgico. Lo indicado en estos pacientes es la remoción del segmento involucrado por lo que se realizó omentectomía parcial y apendicectomía complementaria; el paciente presentó una evolución clínica favorable.
Acute abdomen comprises a wide group of diseases with a high incidence in routine surgical practice. We present a 23-year-old male patient with acute abdominal symptoms, whose preoperative diagnosis was compatible with acute appendicitis; primary and segmental torsion of the greater omentum was found when performing the exploratory laparotomy. This condition is difficult to diagnose preoperatively; it is generally evident during surgery because it is confused with other diseases of the acute surgical abdomen. The removal of the involved segment is indicated in these patients that is why partial omentectomy and complementary appendectomy were performed; the patient had a favourable clinical evolution.
Assuntos
Omento , Dor Abdominal , Abdome AgudoRESUMO
Current findings show some brain regions consistently related to performance of the Wisconsin Card Sorting Test (WCST). An increase of local cerebral blood flow or metabolic demands has been detected in those regions. Functional integration of the neuronal circuits that subserve the task performance, based upon the identification of the oscillations and their distributed cerebral sources, has not been accomplished previously. The event-related tonic oscillations within a period of 2,000 msec after the stimulus onset and the probable neural substrate were evaluated in healthy volunteers by variable-resolution brain electrical tomography (VARETA). The WCST induced a significant increase of delta, theta, beta-2, and gamma oscillations, but decrease of alpha. Areas such as the frontal subregions, temporal, cingulate, parahippocampal, parietal, occipitotemporal cortex, and occipital poles showed modified activity during the task, with EEG spectral band selectivity as well as some overlapping among them. Frontal and temporal regions generated the delta/theta oscillations. Additionally, the occipitotemporal and parietal regions were the source of the delta activity, lacking theta activation. The parietal region also showed tonic alpha, beta-2 and gamma changes. These data imply that different processes have been simultaneously mediated during task performance. Relationships among the individual bands, the neural substrata and the specific cognitive process that support the task were established. The selectively distributed delta, theta, alpha, beta-2 and gamma oscillations reflect communication networks through variable populations of neurons, with functional relations to the working memory functions and the information processing that subserve the WCST performance.
