Peritonealized urachal remnant and obstructive congenital peritoneal band. A case report. / Remanente uracal peritonizado y banda peritoneal congénita obstructiva. Reporte de caso.

INTRODUCTION: Intestinal obstruction as a result of congenital peritoneal bands is rare in surgical practice. It typically compromises the small bowel, and it also has been reported to involve the appendix or a Meckel's diverticulum. However, peritonealized urachal remnant as part of a congenital band is highly infrequent. CASE REPORT: 5-year-old boy presenting with intestinal obstruction related to a peritoneal band from the mesentery to the appendix and a peritonealized urachal remnant, associated with an incidental finding of a Meckel's diverticulum. Diagnosis was achieved laparoscopically. The peritoneal band, the urachal remnant, and the Meckel's diverticulum were resected. DISCUSSION: Kerkeni's congenital band classification consists of 4 independent groups. This case combines both a band stemming from an embryological remnant and an idiopathic band.

INTRODUCCION: La obstrucción intestinal por bandas peritoneales congénitas es poco común en la práctica quirúrgica. Su ubicación más frecuente compromete el intestino delgado y existen reportes que involucran el apéndice y el divertículo de Meckel, pero que un remanente uracal peritonizado haga parte de una banda congénita es verdaderamente singular. CASO CLINICO: Niño de 5 años de edad con cuadro de obstrucción intestinal en el que confluyen una banda peritoneal, que va del mesenterio al apéndice y que se une a un remanente uracal peritonizado, asociado al hallazgo incidental de un divertículo de Meckel. El diagnóstico se definió por medio de una laparoscopia y como tratamiento se realizó la resección de la banda peritoneal, del remanente uracal y del divertículo de Meckel. DISCUSION: La clasificación de bandas congénitas de Kerkeni comprende 4 grupos independientes, en este caso confluyen una banda derivada de un remanente embriológico junto con el tipo idiopático.

Remanente uracal peritonizado y banda peritoneal congénita obstructiva. Reporte de caso / Peritonealized urachal remnant and obstructive congenital peritoneal band. A case report

Introducción: La obstrucción intestinal por bandas peritoneales con-génitas es poco común en la práctica quirúrgica. Su ubicación más fre-cuente compromete el intestino delgado y existen reportes que involucranel apéndice y el divertículo de Meckel, pero que un remanente uracal pe-ritonizado haga parte de una banda congénita es verdaderamente singular.Caso clínico: Niño de cinco años de edad con cuadro de obstruc-ción intestinal en el que confluyen una banda peritoneal, que va delmesenterio al apéndice y que se une a un remanente uracal peritonizado,asociado al hallazgo incidental de un divertículo de Meckel. El diag-nóstico se definió por medio de una laparoscopia y como tratamientose realizó la resección de la banda peritoneal, del remanente uracal ydel divertículo de Meckel.Discusión: La clasificación de bandas congénitas de Kerkenicomprende 4 grupos independientes, en este caso confluyen una bandaderivada de un remanente embriológico junto con el tipo idiopático.

Introduction. Intestinal obstruction as a result of congenital peri-toneal bands is rare in surgical practice. It typically compromises thesmall bowel, and it also has been reported to involve the appendix ora Meckel’s diverticulum. However, peritonealized urachal remnant aspart of a congenital band is highly infrequent.Case report: 5-year-old boy presenting with intestinal obstructionrelated to a peritoneal band from the mesentery to the appendix and aperitonealized urachal remnant, associated with an incidental findingof a Meckel’s diverticulum. Diagnosis was achieved laparoscopically.The peritoneal band, the urachal remnant, and the Meckel’s diverticulumwere resected.Discussion: Kerkeni’s congenital band classification consists of 4independent groups. This case combines both a band stemming froman embryological remnant and an idiopathic band.

Factors predictive of adherence to tuberculosis treatment, Valle del Cauca, Colombia.

BACKGROUND: Early diagnosis and treatment are fundamental to tuberculosis (TB) control. Nevertheless, the effectiveness of TB management continues to be influenced by treatment adherence. OBJECTIVE: To determine which factors are predictive of adherence to TB treatment at the time of diagnosis in Colombia. METHODS: A cohort of 300 patients newly diagnosed with TB was followed up over 26 weeks. Treatment adherence was measured by determining whether the patient took all or part of the 84 doses in the 26 weeks of treatment. A logistic analysis was carried out and the predictive power of the final variables was determined by means of a receiving operator curve analysis. RESULT: A high incidence of partial completion of treatment (65.6%) was found. Significant associated factors were 1) living away from the family, 2) overcrowding at home (> or =2 persons per bedroom), 3) lack of family support, 4) living >10 min away from the treatment facility and 5) not having used the services of the treatment facility before. CONCLUSION: Several factors can be measured on PTB diagnosis that would help identify those patients at higher risk for treatment non-adherence. The predictive value of each of these factors alone was weak, but if associated their predictive value was high.