Gallbladder perforation after closed thoracoabdominal trauma, diagnosed and treated by ERCP.

Single gallbladder injury after abdominal trauma is a rare finding. Early diagnosis of this disease is often difficult due to the variability of symptoms and unspecific results in the usual radiological tests. The usual management in patients with vesical trauma is surgery. We report a case of a patient with a gallbladder perforation after closed thoracoabdominal trauma diagnosed and treated with ERCP and a conservative management with good clinical evolution.

Ectopia tiroidea retroperitoneal / Ectopic retroperiotoneal thyroid gland

La ectopia tiroidea subdiafragmática es un hallazgo muy infrecuente, del cual hemos identificado únicamente 15 casos tras una revisión de la literatura médica. Su manejo no se encuentra establecido, si bien es frecuente su extirpación por la sospecha de enfermedad neoplásica. Presentamos el caso de una mujer de 76 años que presenta una ectopia tiroidea mesentérica en forma de masa retroperitoneal extirpada quirúrgicamente y que evolucionó de manera favorable (AU)

The presence of subdiaphragmatic thyroid tissue is a very rare finding. We reviewed the literature and found only 15 published cases. The most appropriate management of this entity has not been established, but surgical removal is common to exclude malignancy. We present the case of a 76-year-old woman with an ectopic mesenteric thyroid gland forming a retroperitoneal mass that was surgically removed. Outcome was favorable (AU)

[Ectopic retroperitoneal thyroid gland]. / Ectopia tiroidea retroperitoneal.

The presence of subdiaphragmatic thyroid tissue is a very rare finding. We reviewed the literature and found only 15 published cases. The most appropriate management of this entity has not been established, but surgical removal is common to exclude malignancy. We present the case of a 76-year-old woman with an ectopic mesenteric thyroid gland forming a retroperitoneal mass that was surgically removed. Outcome was favorable.

Z-line examination by the PillCam SB: prospective comparison of three ingestion protocols.

AIM: To evaluate the Z-line visualization by the PillCam SB2 using three different ingestion protocols. METHODS: Ninety consecutive patients undergoing small bowel capsule endoscopy (SBCE) between January and May 2008 were included in the study. They swallowed the capsule in the standing (Group A = 30), supine (Group B = 30) and right supine positions (Group C = 30). Baseline patient characteristics, difficulties in capsule ingestion, esophageal transit times (ETT) and Z-line visualization were noted. RESULTS: No significant differences were found between the groups with regard to baseline patient characteristics, ingestion difficulties and complete SB examinations (P > 0.05). At least 1 frame of the Z-line was detected in 15.8%, 46.7% and 90% of patients in groups A, B and C, respectively (P < 0.001). The average number of Z-line images was 0.21 +/- 0.53, 3.23 +/- 6.59 and 5.53 +/- 7.55 and the mean % of the Z-line detected was 71.3, 25.1 and 8.3, in groups A, B and C, respectively (both P < 0.001). ETT times were longer in the supine group followed by the right supine and the standing groups (median of 237 s vs 64 s and 39 s, respectively; P < 0.001). CONCLUSION: Z-line visualization in patients undergoing SBCE can be accurately achieved in most cases when the capsule is swallowed in the right supine position.