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1.
Cir Cir ; 92(3): 399-402, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38862120

RESUMO

Massive bleeding due to rupture of hypogastric artery pseudoaneurysm is an exceptional complication of colorectal anastomotic leakage. A 41-year-old woman with history of rectal cancer surgery, who debuted with massive rectorrhagia and hypovolemic shock due to rupture of a hypogastric artery pseudoaneurysm as a late complication of a colorectal anastomosis leak. The ruptured hypogastric artery pseudoaneurysm should be taken into account in the differential diagnosis of patients with massive rectorrhagia and history of colorectal anastomosis leak. Endovascular embolization is considered the first-line treatment.


La hemorragia masiva por rotura de un pseudoaneurisma de la arteria hipogástrica es una complicación muy rara de la fuga anastomótica colorrectal. Mujer de 41 años con antecedentes de cirugía por cáncer de recto, que debutó con un cuadro de rectorragias masivo y shock hipovolémico secundario a la rotura de un pseudoaneurisma de la arteria hipogástrica como complicación tardía de una fuga de la anastomosis colorrectal. La rotura de un pseudoaneurisma de la arteria hipogástrica se debe tener presente en el diagnostico diferencial de pacientes con rectorragia masiva y antecedentes de dehiscencia de anastomosis colorrectal. La embolización endovascular es actualmente el tratamiento de elección.


Assuntos
Fístula Anastomótica , Falso Aneurisma , Choque Hemorrágico , Humanos , Falso Aneurisma/etiologia , Feminino , Adulto , Fístula Anastomótica/etiologia , Choque Hemorrágico/etiologia , Aneurisma Roto/cirurgia , Reto/cirurgia , Neoplasias Retais/cirurgia , Colo/cirurgia , Colo/irrigação sanguínea , Anastomose Cirúrgica
4.
Abdom Radiol (NY) ; 44(11): 3674-3682, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31332499

RESUMO

PURPOSE: To analyze changes in MRI diagnostic accuracy in main rectal tumor (T) evaluation resulting from the use of diffusion-weighted imaging (DWI), according to the degree of experience of the radiologist. METHODS: This is a cross-sectional study of a database including one hundred 1.5 T MRI records (2011-2016) from patients with biopsy-proven rectal cancer, including primary staging and post-chemoradiotherapy follow-up. All cases were individually blindedly reviewed by ten radiologists: three experienced in rectal cancer, three specialized in other areas, and four residents. Each case was assessed twice to detect perirectal infiltration: first, evaluating just high-resolution T2-weighted sequences (HRT2w); second, evaluation of DWI plus HRT2w sequences. Results were pooled by experience, calculating accuracy (area under ROC curve), sensitivity and specificity, predictive values, likelihood ratios, and overstaging/understaging. Histology of surgical specimens provided the reference standard. RESULTS: DWI significantly improved specificity by experienced radiologists in primary staging (63.2% to 75.9%) and, to a lesser extent, positive likelihood ratio (2.06 to 2.87); minimal changes were observed post-chemoradiotherapy, with a slight decrease of accuracy (0.657 to 0.626). Inexperienced radiologists showed a similar pattern, but with slight enhancement post-chemoradiotherapy (accuracy 0.604 to 0.621). Residents experienced small changes, with increased sensitivity/decreased specificity in both primary (69% to 72%/67.2% to 64.7%) and post-chemoradiotherapy (68.1% to 73.6%/47.3% to 44.6%) staging. CONCLUSIONS: Adding DWI to HRT2w significantly improved specificity for the detection of perirectal infiltration at primary staging by experienced radiologists and also by inexperienced ones, although to a lesser extent. In the post-neoadjuvant treatment subgroup, only minimal changes were observed.


Assuntos
Quimiorradioterapia , Imagem de Difusão por Ressonância Magnética/métodos , Neoplasias Retais/diagnóstico por imagem , Neoplasias Retais/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Colonoscopia , Estudos Transversais , Feminino , Humanos , Interpretação de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante , Invasividade Neoplásica , Estadiamento de Neoplasias , Valor Preditivo dos Testes , Neoplasias Retais/patologia , Estudos Retrospectivos , Sensibilidade e Especificidade
7.
Rev. derecho genoma hum ; (17): 99-124, jul.-dic. 2002.
Artigo em Es | IBECS | ID: ibc-34191

RESUMO

La selección del sexo y especialmente su regulación, es un asunto controvertido. El autor examina los problemas actuales que rodean a la selección del sexo desde sus comienzos, e ilustra su punto de vista con un caso reciente y controvertido en el que una mujer a quien le fue permitido someterse a inseminación artificial, se le ofreció la posibilidad de elegir el sexo del niño. El autor también expone las posibles soluciones y las regulaciones penales y administrativas del asunto, además de examinar la decisión del tribunal en este caso en concreto (AU)


No disponible


Assuntos
Feminino , Humanos , Recém-Nascido , Pré-Seleção do Sexo/métodos , Legislação Médica , Ética Médica , Inseminação Artificial/legislação & jurisprudência , Inseminação Artificial/métodos , Espanha
8.
Rev Derecho Genoma Hum ; (16): 59-69, 2002.
Artigo em Espanhol | MEDLINE | ID: mdl-12379981

RESUMO

Gender selection, and particularly its regulation, is a controversial issue. The author discusses the current problems surrounding gender selection from the very beginnings, and illustrates his views with an actual and controversial case in which a woman allowed to undergo artificial insemination was given the possibility of choosing the sex of her child. The author also discusses possible solutions and the penal, administrative regulation of the issue, as well as examining the court's decision in this particular case.


Assuntos
Pré-Seleção do Sexo/ética , Engenharia Genética/legislação & jurisprudência , Humanos , Espanha
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