Estudio de las complicaciones de la cirugía bariátrica por tomografía computarizada multidetector con contraste intravenoso / Studying the complications of bariatric surgery with intravenous contrast-enhanced multidetector computed tomography

Objetivo. Revisar las complicaciones de la cirugía bariátrica y su diagnóstico mediante tomografía computarizada multidetector con contraste intravenoso (TCMDcCIV). Material y métodos. Estudio retrospectivo de los pacientes intervenidos mediante by-pass gástrico o gastrectomía tubular en nuestro centro durante 2013 y 2014. Las complicaciones se dividieron en precoces (durante el primer mes) y tardías. Resultados. Se revisaron 155 casos y se diagnosticaron 24 complicaciones en 22 pacientes: 16 precoces (7 hematomas intraperitoneales, 5 dehiscencias anastomóticas, 2 obstrucciones intestinales y 2 hernias externas) y 8 tardías (3 hernias internas, 3 perforaciones intestinales y 2 úlceras en boca anastomótica). Dos pacientes fallecieron. Todas las complicaciones se diagnosticaron mediante TCMDcCIV, excepto una que requirió un tránsito baritado. Conclusión. La tasa de complicaciones en la cirugía bariátrica es elevada y su mortalidad no es despreciable. Deben reconocerse los hallazgos normales en estos pacientes para identificar rápidamente las posibles complicaciones, diagnosticadas en su mayoría mediante TCMDcCIV

Objective. To review the complications of bariatric surgery and their diagnosis with intravenous contrast-enhanced multidetector computed tomography (MDCT). Material and methods. We retrospectively studied all patients who underwent gastric bypass or sleeve gastrectomy at our center during 2013 or 2014. We classified complications into early complications (appearing within 30 days of the intervention) and late complications. Results. We reviewed 155 cases and found 24 complications in 22 patients: 16 early complications (7 intraperitoneal hematomas, 5 anastomotic dehiscences, 2 intestinal obstructions, and 2 external hernias) and 8 late complications (3 internal hernias, 3 intestinal perforations, and 2 marginal ulcers). Two patients died. All of these complications were diagnosed with intravenous contrast-enhanced MDCT, except one, which required a barium transit study. Conclusion. The rate of complications in bariatric surgery is high and the associated mortality is not negligible. Radiologists need to know the normal findings in these patients so they can quickly identify possible complications, most of which can be diagnosed with intravenous contrast-enhanced MDCT

Studying the complications of bariatric surgery with intravenous contrast-enhanced multidetector computed tomography. / Estudio de las complicaciones de la cirugía bariátrica por tomografía computarizada multidetector con contraste intravenoso.

OBJECTIVE: To review the complications of bariatric surgery and their diagnosis with intravenous contrast-enhanced multidetector computed tomography (MDCT). MATERIAL AND METHODS: We retrospectively studied all patients who underwent gastric bypass or sleeve gastrectomy at our center during 2013 or 2014. We classified complications into early complications (appearing within 30 days of the intervention) and late complications. RESULTS: We reviewed 155 cases and found 24 complications in 22 patients: 16 early complications (7 intraperitoneal hematomas, 5 anastomotic dehiscences, 2 intestinal obstructions, and 2 external hernias) and 8 late complications (3 internal hernias, 3 intestinal perforations, and 2 marginal ulcers). Two patients died. All of these complications were diagnosed with intravenous contrast-enhanced MDCT, except one, which required a barium transit study. CONCLUSION: The rate of complications in bariatric surgery is high and the associated mortality is not negligible. Radiologists need to know the normal findings in these patients so they can quickly identify possible complications, most of which can be diagnosed with intravenous contrast-enhanced MDCT.

[Persistent left superior vena cava. Implications in central venous catheterisation]. / Vena cava superior izquierda persistente. Implicaciones en la cateterización venosa central.

The placement of central catheters through the subclavian and jugular venous path can be complicated by the cannulation of an artery or an aberrant venous path. The most frequent anomaly of the embryological development of the caval vein is the persistence of the left superior vena cava (LSVC). The implantation of catheters in the LSVC can be suspected by its anomalous route in thorax radiography. Gasometry and the pressure curve of the vessel make it possible to rule out an arterial catheterisation. Diagnostic confirmation is obtained through angiography, echocardiography, computerised tomography or cardiac resonance. The doctor who regularly implants central venous catheters must be familiar with the anatomy of the venous system and its variants and anomalies, since their presence might influence the handling of the patient.

Severe exophthalmos in trigeminal plexiform neurofibroma involving the orbit and the infratemporal fossa.

Trigeminal plexiform neurofibromas involving the orbit and the infratemporal fossa are rare tumours. An uncommon case of a plexiform neurofibroma of the trigeminal nerve occurring in a 53-year-old female patient with severe cosmetic deformity is reported. The clinical findings, neuroradiographic features, surgical management, postoperative results and follow-up of trigeminal plexiform neurofibromas are reviewed.

Displasia renal multiquística segmentaria: hallazgos radiológicos y diagnóstico / diferencial / Segmental multicystic renal dysplasia: radiological findings and differential diagnosis

La displasia renal multiquística constituye la segunda causa más frecuente de masa renal en neonatos tras la hidronefrosis y la causa más frecuente de masa quística en la infancia. Presentamos un caso de una masa quística renal en un lactante cuyo diagnóstico anatomopatológicodefinitivo fue de displasia quística segmentaria. Esta entidad, en su forma segmentaria es rara, ya que habitualmente la displasia quística renal se presenta como una afectación unilateral de todo el riñón. Revisamos la etiopatogenia de esta entidad, los hallazgos radiológicos y su principal diagnóstico diferencial con el fin de establecer un correcto diagnóstico y su diferenciación con otras lesiones focales quísticas renales de la infancia

Multicystic dysplasia of the kidney is the second most common cause of renal masses in newborns after hydronephrosis and the most frequent cause of cystic masses in childhood. We present the case of acystic renal mass in an infant that was definitively diagnosed at histological examination to be segmental cystic dysplasia. Cystic renal dysplasia usually involves an entire kidney, and segmental multicystic renal dysplasia is rare. We review the etiology and pathogenesis of this entity, the radiological findings, and the main differential diagnoses with the aim of establishing the correct diagnosis and differentiatingthis entity from other focal cystic kidney lesions affecting children

[Segmental multicystic renal dysplasia: radiological findings and differential diagnosis]. / Displasia renal multiquística segmentaria: hallazgos radiológicos y diagnóstico diferencial.

Multicystic dysplasia of the kidney is the second most common cause of renal masses in newborns after hydronephrosis and the most frequent cause of cystic masses in childhood. We present the case of a cystic renal mass in an infant that was definitively diagnosed at histological examination to be segmental cystic dysplasia. Cystic renal dysplasia usually involves an entire kidney, and segmental multicystic renal dysplasia is rare. We review the etiology and pathogenesis of this entity, the radiological findings, and the main differential diagnoses with the aim of establishing the correct diagnosis and differentiating this entity from other focal cystic kidney lesions affecting children.