RESUMO
Background: The umbilicus detachment and reinsertion in umbilical float mini-abdominoplasty results in its lower position with or without shape distortion. This event creates a stigmatizing look, elongating the upper abdomen and creating variable grades of infra umbilical/pubis bulging. This lack of proportion causes an unpleasant, artificial look, and is very difficult to fix. The study aimed to describe a sequence of abdominoplasty and combined upper abdomen horizontal muscle plications to correct umbilicus malposition after a mini-abdominoplasty. Methods: Over a period of 24 months, 12 patients underwent a liposuction (suction-assisted liposuction) and abdominoplasty with horizontal supraumbilical muscle plication. All patients underwent objective measurements before and after the procedure, using digital image measurements by Mirror Image software, version 6.0 (Fairfield, N.J.). The follow-up evaluation was performed 12 months postoperatively. Statistical analysis was performed using IBM SPSS Statistics V26. Results: Over 24 months, 12 patients (100%), who underwent abdominoplasty combined with horizontal plication in the upper abdominal wall, have shown adequate umbilicus elevation (2.98 ± 0.242 cm; 95% confidence level), restoring the abdominal muscle wall proportion at 12 months follow-up. One patient (8%) had a seroma, and one (8%) had a small muscular hernia (1.5 cm) in the lower abdomen. Conclusions: The combination of abdominoplasty and upper horizontal muscle plication can fix the malpositioned umbilicus, restoring the aesthetic and anatomic proportions in those patients who underwent an umbilical float mini-abdominoplasty.
RESUMO
O cisto de colédoco é definido como dilataçäo das vias biliares, sendo uma entidade patológica rara, principalmente em adultos ocidentais, e com maior prevalência no oriente. Suspeita-se do diagnóstico pela tríade clínica de dor abdominal, massa palpável em hipocôndrio direito e icterícia. É freqüente em crianças e rara em adultos, sendo o diagnóstico confirmado por exames de imagem como: ultra-sonografia, tomografia computadorizada e colângio-ressonância. Esses cistos säo classificados em seis tipos e tratados conforme essa classificaçäo. É importante levar-se em conta que esta entidade é considerada como um fator de risco para o colangiocarcinoma. É descrito um caso de cisto de colédoco gigante em adulto jovem do sexo feminino, aliado a uma revisäo da literatura existente e posterior análise dos principais meios diagnósticos e tratamentos para essa rara patologia.
