RESUMO
The incidence of bronchiectasis has declined markedly in developed countries with improvement in health care, antibiotics, vaccines and control of tuberculosis (<0.6/1000 persons), but is still high in developing countries. Early complete resection of affected lung segment remains the mainstay of treatment as it causes maximum improvement in symptoms, minimum deterioration of lung function and prevents disease progression. Surgery is indicated in unsuccessful medical treatment and complications of bronchiectasis e.g. haemoptysis, lung abscess, lung masses and pneumothorax. Bronchiectasis with multiple broncholithiasis is a very rare presentation and very few cases have been reported in literature so far. This article presents here, the symptoms and signs, operative and perioperative management and literature review of a case of bronchiectasis with multiple bronchial stones.
Assuntos
Bronquiectasia/complicações , Bronquiectasia/diagnóstico , Cálculos/complicações , Cálculos/diagnóstico , Litíase/complicações , Litíase/diagnóstico , Toracotomia , Bronquiectasia/cirurgia , Cálculos/cirurgia , Tosse/etiologia , Drenagem/métodos , Febre/etiologia , Humanos , Incidência , Litíase/cirurgia , Masculino , Pessoa de Meia-Idade , Radiografia Torácica , Toracotomia/métodos , Resultado do TratamentoRESUMO
Port-site metastasis (PSM) is often encountered during laparoscopic surgery in patients with malignancy. We report a 45-year-old woman who presented with a single PSM from papillary adenocarcinoma after undergoing laparoscopic cholecystectomy for calculus cholecystitis. Post cholecystectomy, a diagnosis of chronic cholecystitis was confirmed on histopathology. The patient presented with a mass at the site of epigastric port 28 months after surgery. PSM was suspected on clinical examination, which was supported by findings on computed tomography and further confirmed by fine-needle aspiration cytology of the lump. The patient underwent surgical clearance of the mass, and histopathological examination proved the lesion to be papillary adenocarcinoma. The site of the primary tumour was not detected even after thorough examination. Based on the histopathology report following local surgical clearance, the patient was started on chemotherapy. This case is unusual because of the long delay prior to the presentation of PSM and the unknown primary malignancy.
