RESUMEN
Chylous fistula is a complication related to thoracic duct injury, appearing in upper abdominal, thoracic and neck surgery. Occurrence of chylous fistula is very rare after modified radical mastectomy. We encountered a chylous fistula case after breast cancer surgery and successfully treated it conservatively. It is important that all surgeons dealing with breast surgery should be aware that, altough rarely, a chylous fistula can develop after axillary dissection. Experience related to the occurrence of this complication and its management when it occurs is quite restricted.
Asunto(s)
Neoplasias de la Mama/cirugía , Carcinoma/cirugía , Quilo , Fístula/etiología , Enfermedades Linfáticas/etiología , Mastectomía Radical Modificada , Complicaciones Posoperatorias/etiología , Conducto Torácico/lesiones , Anciano , Neoplasias de la Mama/patología , Carcinoma/patología , Femenino , Fístula/terapia , Humanos , Escisión del Ganglio Linfático , Enfermedades Linfáticas/terapia , Estadificación de Neoplasias , Nutrición Parenteral Total , Complicaciones Posoperatorias/terapiaRESUMEN
Aneurysm of the portal venous system, a localized fusiform or saccular dilatation, is a rare clinical abnormality. Most aneurysms are located in the extrahepatic segment and rarely in intrahepatic branches. Portal vein aneurysms are usually uncomplicated and asymptomatic and detected incidentally during diagnostic work-up. We describe a case of a bleeding intrahepatic portal vein aneurysm studied with ultrasonography, color Doppler, computed tomography, and percutaneous transhepatic portography in a noncirrhotic patient. Although there are 43 published cases of portal vein aneurysm in the English-language literature, neither rupture and spontaneous thrombosis of an intrahepatic portal vein aneurysm nor its nonsurgical conservative treatment has been reported.
Asunto(s)
Aneurisma/diagnóstico , Diagnóstico por Imagen , Vena Porta , Trombosis/diagnóstico , Diagnóstico Diferencial , Femenino , Humanos , Persona de Mediana Edad , Rotura EspontáneaRESUMEN
We present an 18-year-old man with painless rectal bleeding, hematuria and diffuse cavernous hemangioma of the rectum and sigmoid colon. Thirty units of blood were transfused during the interval preceding definitive surgery. Low anterior resection and partial cystectomy were performed. During the postoperative period no rectal bleeding occurred, but he died of massive intracerebral bleeding 10 months after the operation.
Asunto(s)
Hemorragia Gastrointestinal/etiología , Hemangioma Cavernoso/patología , Neoplasias del Recto/patología , Neoplasias del Colon Sigmoide/patología , Adolescente , Angiografía , Transfusión Sanguínea , Resultado Fatal , Hemorragia Gastrointestinal/terapia , Hemangioma Cavernoso/complicaciones , Hemangioma Cavernoso/cirugía , Humanos , Masculino , Neoplasias del Recto/complicaciones , Neoplasias del Recto/cirugía , Neoplasias del Colon Sigmoide/complicaciones , Neoplasias del Colon Sigmoide/cirugía , Tomografía Computarizada por Rayos XRESUMEN
UNLABELLED: Sixty-three lymph node aspirates were screened and 32 aspirates revealing granulomatous lymphadenitis with or without caseation necrosis were re-evaluated. The most characteristic morphological features among these cases were epithelioid cell clusters with or without caseation necrosis. When clusters were thick, careful observation of the periphery of the clusters helped to find epithelioid cells. Caseation necrosis revealed a typical macroscopic and microscopic appearance. Ziehl-Neelsen staining was negative in all smears and histological sections. Polymerase chain reaction (PCR) amplification technique was applied to 23 of the cases in which the cytological diagnoses were consistent with tuberculosis. Mycobacterium tuberculosis was demonstrated in 19 (82.60%) cases. IN CONCLUSION: (i) it is necessary to perform several aspirations from different sites of the enlarged lymph node; (ii) the diagnosis of 'granulomatous lymphadenitis, consistent with tuberculosis' can be given, even though the acid-fast stains are negative; (iii) additional techniques such as PCR give supportive information; (iv) an open biopsy is recommended if there is a discrepancy with the clinical impression.