RESUMEN
The case of a 65 year old woman presented symptoms of acute abdomen secondary to full torsion of the greater omentum is presented, diagnosed preoperatively by CT, thus avoiding emergency surgery due to good evolution with conservative attitude. This disease is a rare cause of abdominal pain, but we include it in the differential diagnosis of acute abdomen. Currently imaging techniques allow preoperative diagnosis to avoid emergency surgery, and maintain an expectant attitude to act on patient evolution. In our case, we chose conservative attitude and the patient is asymptomatic 7 months later.
Asunto(s)
Infarto/diagnóstico por imagen , Epiplón/irrigación sanguínea , Enfermedades Peritoneales/diagnóstico por imagen , Anciano , Colonoscopía , Femenino , Humanos , Infarto/terapia , Epiplón/diagnóstico por imagen , Enfermedades Peritoneales/terapia , Tomografía Computarizada por Rayos XRESUMEN
No disponible
Asunto(s)
Femenino , Humanos , Persona de Mediana Edad , Epiplón/patología , Epiplón , Dolor Abdominal/etiología , Dolor Abdominal , Leucocitosis/complicaciones , Leucocitosis , Infarto/complicaciones , Infarto , Leucocitosis/cirugía , Radiografía Abdominal/instrumentación , Radiografía Abdominal/métodos , Laparotomía/métodosRESUMEN
Simultaneous gastric and pancreatic ductal adenocarcinoma is an exceptional situation with short literature review. The accumulated risk throughout life in women is 0.8% for gastric cancer and 0.6% for pancreas cancer. We report a case where both tumors are demonstrated. The patient was surgically intervened removing both tumors and achieving total recovery, with no signs of tumor recurrence after four months. This is to remind us that simultaneous tumors do exist, especially when suggestive images of neoplasia appear in a patient previously diagnosed of tumor in another location.
Asunto(s)
Adenocarcinoma/cirugía , Carcinoma Ductal Pancreático/cirugía , Neoplasias Pancreáticas/cirugía , Neoplasias Gástricas/cirugía , Adenocarcinoma/diagnóstico por imagen , Carcinoma Ductal Pancreático/diagnóstico por imagen , Endosonografía , Femenino , Humanos , Imagen por Resonancia Magnética , Persona de Mediana Edad , Neoplasias Pancreáticas/diagnóstico por imagen , Neoplasias Gástricas/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
No disponible
Asunto(s)
Femenino , Humanos , Persona de Mediana Edad , Adenocarcinoma/complicaciones , Adenocarcinoma/cirugía , Adenocarcinoma , Neoplasias Ductales, Lobulillares y Medulares/complicaciones , Carcinoma Ductal Pancreático/complicaciones , Carcinoma Ductal Pancreático/cirugía , Carcinoma Ductal Pancreático , Gastrectomía/métodos , Gastrectomía/tendencias , Carcinoma Ductal Pancreático/fisiopatología , Dehiscencia de la Herida Operatoria/complicaciones , Dehiscencia de la Herida Operatoria/cirugía , Diagnóstico Diferencial , Calidad de VidaRESUMEN
BACKGROUND: Low grade fibromyxoid sarcoma or tumor Evans is a variety of soft tissue sarcoma that represents 1% of all malignancies. More common in limbs and trunk (50%), we present 3 new cases of retroperitoneal reviewing their characteristics and performing a literature review. CLINICAL CASE: In the retroperitoneal location highlights the poor specificity of clinical symptoms, demonstrating, according to their growth and size, as an abdominal tumor, usually painless, or by compression and/or invasion of nearby structures. In cases that present the most important finding was the presence of a palpable abdominal tumor without other symptoms despite remarkable infiltration of other organs that should be included in surgical resection. CONCLUSIONS: We emphasize the difficulty of correct diagnosis preoperatively because preoperative studies are inconclusive and only the histological and immuno-histo-typing chemistry allow precise identification.
Antecedentes: el sarcoma fibromixoide de bajo grado o tumor de Evans es una variedad de sarcoma de partes blandas que representa el 1% de todos los tumores malignos. Más frecuente en extremidades y tronco (50%), presentamos tres nuevos casos de localización retroperitoneal. Se revisan sus características y se realiza actualización bibliográfica. Casos clínicos: en su localización retroperitoneal destaca lo inespecífico de su sintomatología clínica, se manifiesta en función de su crecimiento y tamaño, como una tumoración abdominal, habitualmente indolora, o por la compresión y/o invasión de estructuras próximas. Los casos presentados se manifestaron, por la presencia de tumoración abdominal, sin otra sintomatología; a pesar de infiltrar a otros órganos. Conclusiones: el diagnóstico preoperatorio es difícil, y debe tenerse la presunción clínica para solicitar el estudio histológico, con tipificación inmuno-histo-química para su dentificación precisa.
Asunto(s)
Fibrosarcoma/patología , Neoplasias Retroperitoneales/patología , Adulto , Biomarcadores de Tumor/análisis , Terapia Combinada , Diagnóstico Diferencial , Resultado Fatal , Femenino , Fibrosarcoma/diagnóstico , Fibrosarcoma/terapia , Humanos , Leiomiosarcoma/secundario , Leiomiosarcoma/cirugía , Neoplasias Hepáticas/cirugía , Masculino , Persona de Mediana Edad , Miofibroblastos/patología , Recurrencia Local de Neoplasia/cirugía , Neoplasias Primarias Secundarias/patología , Neoplasias Primarias Secundarias/cirugía , Neoplasias Retroperitoneales/diagnóstico , Neoplasias Retroperitoneales/terapia , Sarcoma/clasificación , Neoplasias Uterinas/patología , Neoplasias Uterinas/cirugíaRESUMEN
OBJECTIVE: to analyse the characteristics of colorectal cancer in elderly patients and to assess the outcomes of treatment. MATERIAL AND METHODS: the study included 1,924 patients diagnosed with colorectal cancer during a 22 year period (1985-2007). We analysed patient clinical and demographic characteristics as well as their treatment and its outcome. RESULTS: there was an increase in emergency surgery with age, increasing from 13% among patients under 80 years of age to 47% in those over 90 years of age (p = 0.0001). On the other hand, the overall percentage of patients who underwent surgical treatment decreased from 96% in patients younger than 80 years of age, to 85% and 59% in octogenarians and nonagenarians, respectively (p = 0.0001), and there was a similar pattern in the rates of curative surgery among patients who underwent surgery. The overall mortality of patients who underwent surgery was 8% (141 out of 1,769), increasing from 4% in patients younger than 70 years of age to 25% in those over 90 (p = 0.0001). Multivariate analysis showed that the factors associated with mortality were the emergency nature of the surgery (p = 0.001), the ASA grade (p = 0.0001), and the presence of systemic complications (p = 0.0001), the weight of age decreasing significantly with respect to the univariate analysis (p = 0.013). CONCLUSIONS: there is an increase in the rate of complicated forms of colorectal cancer with increasing age of patients. In addition, there is a dramatic decrease in the rate of curative tumour resection with increasing age. Intraoperative mortality for colorectal cancer in octogenarians and nonagenarians is more closely related to the nature and intent of the surgery (elective or emergency; palliative or curative), the perioperative risk (ASA grade), and severe systemic complications, than to age.
Asunto(s)
Neoplasias Colorrectales/cirugía , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Factores de Tiempo , Resultado del TratamientoRESUMEN
Objetivo: analizar las características del cáncer colorrectal en pacientes ancianos y evaluar los resultados de su tratamiento. Material y métodos: 1.924 pacientes diagnosticados por cáncer colorrectal un periodo de 22 años (1985-2007). Se analizan parámetros del paciente, clínicos, tratamiento y resultados del mismo. Resultados: hay un incremento de la cirugía de urgencia con la edad, pasando del 13% en pacientes menores de 80 años al 47% en pacientes mayores de 90 (p = 0,0001). El porcentaje de pacientes sometidos a tratamiento quirúrgico desciende del 96% en los pacientes menores de 80 años, al 85% en los octogenarios y al 59% en los nonagenarios (p = 0,0001), así como de la tasas de cirugía curativa entre los pacientes sometidos a tratamiento quirúrgico. La mortalidad global de pacientes sometidos a cirugía ha sido del 8% (141 de 1.769), ascendiendo del 4% en pacientes menores de 70 años al 25% en los de 90 años o más (p = 0,0001). En el análisis multivariante, los factores relacionados con la mortalidad han sido el carácter urgente de la cirugía (p = 0,001), el grado ASA (p = 0,0001), y la presencia de complicaciones sistémicas (p = 0,0001), disminuyendo el peso de la edad de forma significativa (p = 0,013). Conclusiones: hay un incremento de las formas complicadas de presentación del cáncer colorrectal según avanza la edad de los pacientes. Hay un descenso dramático de resección tumoral curativa en relación al incremento de la edad. La mortalidad operatoria por cáncer colorrectal, de pacientes octogenarios y nonagenarios, depende más que de la edad, del carácter electivo o urgente de la cirugía, de que esta sea con intención curativa o paliativa, con el riesgo perianestésico (grado ASA), y con la aparición de complicaciones sistémicas graves(AU)
Objective: to analyse the characteristics of colorectal cancer in elderly patients and to assess the outcomes of treatment. Material and methods: the study included 1,924 patients diagnosed with colorectal cancer during a 22 year period (1985-2007). We analysed patient clinical and demographic characteristics as well as their treatment and its outcome. Results: there was an increase in emergency surgery with age, increasing from 13% among patients under 80 years of age to 47% in those over 90 years of age (p = 0.0001). On the other hand, the overall percentage of patients who underwent surgical treatment decreased from 96% in patients younger than 80 years of age, to 85% and 59% in octogenarians and nonagenarians, respectively (p = 0.0001), and there was a similar pattern in the rates of curative surgery among patients who underwent surgery. The overall mortality of patients who underwent surgery was 8% (141 out of 1,769), increasing from 4% in patients younger than 70 years of age to 25% in those over 90 (p = 0.0001). Multivariate analysis showed that the factors associated with mortality were the emergency nature of the surgery (p = 0.001), the ASA grade (p = 0.0001), and the presence of systemic complications (p = 0.0001), the weight of age decreasing significantly with respect to the univariate analysis (p = 0.013). Conclusions: there is an increase in the rate of complicated forms of colorectal cancer with increasing age of patients. In addition, there is a dramatic decrease in the rate of curative tumour resection with increasing age. Intraoperative mortality for colorectal cancer in octogenarians and nonagenarians is more closely related to the nature and intent of the surgery (elective or emergency; palliative or curative), the perioperative risk (ASA grade), and severe systemic complications, than to age(AU)