RESUMO
BACKGROUND: Spiegelian hernia is an uncommon entity and occurs as a result of a defect in the linea semilunaris located in the lateroventral abdominal wall. CLINICAL CASE: We report the case of a 44-year-old female with a history of progressive abdominal swelling. Clinical history included a previous blunt trauma to the abdomen. A Spiegelian hernia with a large aponeurotic defect (7 × 12 cm) and sac (15 × 15 cm) was diagnosed. A literature review of similar topics was performed. CONCLUSION: Weakness presented in the linea semilunaris in Spiegelian hernia may be caused either spontaneously or as a consequence of factors that increase intra-abdominal pressure. Otherwise, it is important to unify the terms related to the size of this entity in order to establish a correct classification.
Assuntos
Traumatismos Abdominais/complicações , Hérnia Ventral/etiologia , Ferimentos não Penetrantes/complicações , Adulto , Feminino , HumanosRESUMO
BACKGROUND AND AIM: Recurrent biliary pancreatitis is described as episodes of new abdominal pain after diagnosis of pancreatitis. Few studies have analyzed the abdominal pain before the diagnosis of acute pancreatitis. Our study aimed to analyze factors associated with previous abdominal pain episodes in patients with biliary pancreatitis, and elucidate its possible pancreatic origin. METHODS: Data from direct interrogation and medical records was analyzed from 48 hospitalized female patients with diagnosis of acute biliary pancreatitis. RESULTS: Mean age of our patients was 31.6 years (SD +/- 13.9). Forty one (85.4%) patients gave history of at least one previous abdominal pain episode. During the episode 37 (90.2%) patients received H2 receptor antagonist or proton pump inhibitors as treatment; 26 (63.4%) had epigastric pain; 23(56.1%) gave association with cholecystokinetic food; 21 (51.2%) complained of nausea and/or vomiting; 23 (56.1%) had jaundice, acholia and/or dark urine; and 20 (48.9%) patients had microlithiasis and/or biliary sludge. CONCLUSIONS: Previous abdominal pain episodes had similar characteristics to a pancreatic episode in a high percentage of our patients. These characteristics suggest that these episodes are often undiagnosed pancreatic attacks.
Assuntos
Dor Abdominal/epidemiologia , Bile , Pancreatite/epidemiologia , Dor Abdominal/diagnóstico , Dor Abdominal/etiologia , Adulto , Colangiopancreatografia Retrógrada Endoscópica , Feminino , Seguimentos , Humanos , Incidência , México/epidemiologia , Pancreatite/complicações , Pancreatite/diagnóstico , Recidiva , Estudos RetrospectivosAssuntos
Aneurisma/complicações , Paraganglioma Extrassuprarrenal/complicações , Feocromocitoma/complicações , Artéria Renal , Neoplasias Vasculares/complicações , Adolescente , Aneurisma/cirurgia , Humanos , Excisão de Linfonodo , Masculino , Nefrectomia , Paraganglioma Extrassuprarrenal/cirurgia , Feocromocitoma/cirurgia , Recidiva , Artéria Renal/cirurgia , Reoperação , Neoplasias Vasculares/cirurgia , Procedimentos Cirúrgicos VascularesRESUMO
BACKGROUND: Bladder and surrounding tissue resection followed by creation of a continent urinary reservoir is the gold standard treatment for invasive bladder cancer. In recent years, the da Vinci robot has played a major role in this procedure. Our objective was to describe our surgical technique, a robot-assisted laparoscopic radical cystoprostatectomy and totally intrabdominal ortothopic ileal neobladder construction (Studer). CLINIC CASE: We present the case of a 79-year-old male patient with a diagnosis of transitional cell bladder carcinoma. The patient underwent radical cystoprostatectomy with urinary diversion. The procedure was performed with the use of the da Vinci Surgical System (Intuitive Surgical, Sunnyvale, CA). Total operative time was 7 h, and the estimated blood loss was 500 ml. There were no intra- or postoperative complications, and the patient's hospitalization was 7 days. At early follow-up, oncological and functional results were favorable. CONCLUSIONS: Robot-assisted cystoprostatectomy and urinary diversion are feasible techniques, although their role in management of infiltrative bladder cancer is not well defined.