RESUMEN
Spillage of gallstones during laparoscopic cholecystectomy is not a rare event. We present a patient with spilled calculi causing an incarcerated hernia.
Asunto(s)
Colecistectomía Laparoscópica/efectos adversos , Hernia Inguinal/etiología , Hernia Inguinal/cirugía , Complicaciones Intraoperatorias , Colecistectomía Laparoscópica/métodos , Colelitiasis/cirugía , Estudios de Seguimiento , Hernia Inguinal/patología , Humanos , Masculino , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
A very large incisional hernia measuring 59 x 35 cm was repaired in four stages after preoperative creation of a pneumoperitoneum using a Tenckoff catheter to facilitate reduction of the contents of the sac into the peritoneal cavity. Initially, three large sheets of 2-mm-thick expanded polytetrafluoroethylene (ePTFE, GORE-TEX Soft Tissue Patch) were used to bridge the defect. Two subsequent procedures further tightened the abdominal wall by excising several inches of the central part of the patch. During the fourth operation, the remaining ePTFE was explanted and replaced with two 15 x 19 pieces of macroporous ePTFE sheet (GORE-TEX Mycro Mesh), overlapping the lateral edges of healthy fascia to prevent herniation from the sides. Postoperative complications included a small draining sinus that cleared after the final operation and a seroma that resolved in several weeks. The patient has recovered and walks normally, which she was unable to do earlier.
Asunto(s)
Hernia Ventral/cirugía , Neumoperitoneo Artificial , Politetrafluoroetileno/uso terapéutico , Anciano , Femenino , Humanos , Prótesis e Implantes , Recurrencia , Procedimientos Quirúrgicos Operativos/métodos , Técnicas de SuturaAsunto(s)
Síndrome de Inmunodeficiencia Adquirida/complicaciones , Taponamiento Cardíaco/etiología , Taponamiento Cardíaco/cirugía , Neoplasias Cardíacas/complicaciones , Derrame Pericárdico/etiología , Derrame Pericárdico/cirugía , Técnicas de Ventana Pericárdica , Sarcoma de Kaposi/complicaciones , Adulto , Humanos , Masculino , PericardioRESUMEN
The presence of noncaseating granulomas in salivary tissue is a specific feature of sarcoidosis. We document the case of a healthy woman who presented with a sarcoid ranula of the sublingual salivary gland without any other manifestations of the disease. This sarcoid ranula subsequently progressed to symptomatic widespread sarcoidosis in a span of 7 months. An asymptomatic sarcoid ranula may thus possibly represent a precursor to widespread sarcoidosis.