Assuntos
Assistentes Médicos/classificação , Cirurgiões/classificação , Pensamento/fisiologia , Anatomia , Conscientização/fisiologia , Humanos , Conhecimento , Patologia , Avaliação de Resultados da Assistência ao Paciente , Segurança do Paciente , Assistentes Médicos/psicologia , Cirurgiões/estatística & dados numéricosRESUMO
Linitis plastica refers to the diffuse submucosal spread of scirrhous carcinoma in a hollow organ, resulting in constriction and inelasticity of the organ. It is best known to occur in the stomach. Linitis plastica of the colon is rare, and more commonly occurs in the rectum and sigmoid colon from metastatic gastric or breast cancer. We report a case of linitis plastica of the ascending colon in a 69-year-old female as the initial presentation of ovarian carcinoma. Luminal narrowing, poor distension, and rigidity at colonoscopy, in the absence of other causes, should alert the clinician to the potential for an underlying submucosal process, and prompt biopsy techniques that enable submucosal tissue sampling.
RESUMO
Thoracotomy is acknowledged as one of the most painful procedures in surgical practice, with the potential to result in significant acute and chronic sequelae, which become especially relevant in high-risk patient populations. Certain pathologies necessitate this surgical approach, and in those circumstances we must aim to mitigate postoperative complications by employing surgical techniques that decrease the risk of nerve injury, rib fracture, and unnecessary soft tissue trauma. We describe an approach to thoracotomy that incorporates evidence-based strategies to lessen the risk of these potential complications, which resulted in rapid postoperative recovery in a nonagenarian.