RESUMEN
Necrotising fasciitis is a life-threatening condition characterised by inflammation, affecting the soft tissues, which spreads within a fascial plane. Skin changes can be delayed and can often go unnoticed. The condition arises from a bacterial infection, commonly being of polymicrobial aetiology. We describe an uncommon case of necrotising fasciitis caused by Finegoldia magna, an anaerobic coccus, in a 40-year-old patient with diabetes. F. magna is a Gram-positive anaerobic coccus, which was previously known as Peptostreptococcus magnus The bacteria is found in the normal flora of the urogenital tract. The bacteria is associated with severe infections such as native valve endocarditis, paravalvular abscess around a bioprosthetic valve, purulent pericarditis complicated by mediastanitis, meningitis after pneumonia and necrotising pneumonia complicated by pyopneumothorax. There have been no cases in the literature describing necrotising fasciitis of the abdominal wall caused by F. magna.
Asunto(s)
Fascitis Necrotizante/diagnóstico , Pared Abdominal , Adulto , Fascitis Necrotizante/microbiología , Firmicutes/aislamiento & purificación , Humanos , MasculinoRESUMEN
OBJECTIVE: To evaluate the breast imaging changes after fat grafting and its impact on cancer follow up. METHODS: This is a retrospective observational study conducted on patients who underwent fat grafting for breast reconstruction. We reviewed mammographic and ultrasound images of patients. Fisher's exact test was used to analyze results. The level of significance was set at P < 0.05. RESULTS: A total of ninety patients with breast cancer had fat grafting. Fifty eight patients for defects following post mastectomy reconstruction and 32 for wide local excision defects. The mean follow up was 37.4 months. Benign lumps were identified in 23/90 cases (25 percent). Mammograms were reported as BI-RADS I in 21/32 cases (72 percent) and BI-RADS II in 8/32 cases (28 percent). BI-RADs III score was reported in two patients on further follow up imaging, both were re-classified as BI-RADS II after biopsy. A total of eight patients (8.9 percent) required biopsy. No local recurrences or new cancers were observed in any patients. CONCLUSION: Our study suggests radiological changes after fat grafting are almost always benign with no adverse outcome on cancer follow up.
RESUMEN
The treatment of complex fistulae-in-ano is challenging and often includes a number of operations due to high rates of recurrence. We report the successful treatment of three consecutive patients with long-standing cryptoglandular fistula-in-ano with a novel combination of mucosal advancement flap and adipose-tissue derived regenerative cells (ADRCs) from the stromal vascular fraction (SVF) obtained from a simple lipoaspiration procedure, using Celution technology. There was no operative morbidity; one patient who had a colostomy for faecal diversion has since undergone restoration of bowel continuity. All thee fistulae remain healed at 2-3-year follow-up. Lipofilling of cryptoglandular fistulae-in-ano with ADRC-enhanced lipofilling appears feasible and safe, and may add to the range of procedures that can be used to treat this difficult problem.
Asunto(s)
Tejido Adiposo/citología , Canal Anal/cirugía , Fístula Rectal/terapia , Regeneración , Células Madre Adultas , Células Endoteliales , Femenino , Humanos , Inyecciones , Mucosa Intestinal/cirugía , Lipectomía , Macrófagos , Masculino , Persona de Mediana Edad , Miocitos del Músculo Liso , Fístula Rectal/cirugía , Colgajos QuirúrgicosRESUMEN
BACKGROUND: Idiopathic omental pseudocysts occur very rarely in adults. Pseudocyst patients usually have a history of either trauma (e.g. seat belt injuries) or other related intra-abdominal pathology (e.g. pancreatitis, malignancy). They may result in a range of complications, from frequent abdominal pains with inconclusive diagnosis mimicking acute appendicitis, acute cholecystitis, or twisted ovarian cysts, to intestinal obstruction and peritonitis. CASE REPORT: A rare case of omental pseudocyst presenting as an acute intestinal obstruction in a 64-year-old woman without any previous history of significant abdominal pain, relevant medical problems, or trauma is reported. On plain abdominal x-ray, the cyst with dystrophic calcifications appeared as a dermoid cyst with multiple teeth. The optimal diagnostic methods, such as CT scanning and ultrasound imaging, which may show a well-circumscribed soft tissue mass are discussed. Uncomplicated and stable patients with established diagnosis can be treated conservatively. Surgical management includes resection of the cyst by either laparoscopy or laparotomy. CONCLUSIONS: Prognosis is good since omental cysts shows no documented tendency for malignant degeneration or recurrence. Optimal surgical management requires complete excision of these lesions.