RESUMEN

Duodenal atresia is associated with Down's syndrome, malrotation, and congenital cardiac defects. Idiopathic intestinal perforations in a newborn, which are not associated with necrotizing enterocolitis (NEC), have been described. The authors report on a full-term neonate who had multiple perforations of the proximal jejunum distal to duodenal atresia. To the best of the authors knowledge, the combination of idiopathic intestinal perforation and duodenal atresia has not been reported previously.

Asunto(s)

Obstrucción Duodenal/congénito , Obstrucción Duodenal/complicaciones , Atresia Intestinal/complicaciones , Perforación Intestinal/complicaciones , Enfermedades del Yeyuno/complicaciones , Obstrucción Duodenal/diagnóstico , Humanos , Recién Nacido , Atresia Intestinal/diagnóstico , Perforación Intestinal/diagnóstico , Enfermedades del Yeyuno/diagnóstico , Masculino

RESUMEN

BACKGROUND: The diagnosis of abdominal wall endometriomas is often confused with other surgical conditions. METHODS: A retrospective study was made of 12 patients presenting with an abdominal wall mass, which proved to be endometrioma. RESULTS: Of a total of 297 patients of endometriosis treated in our hospital over a 7-year period, 12 (4%) had isolated abdominal wall endometriomas. Their mean age was 29.4 years. The presenting symptoms were abdominal mass (n = 12), cyclical (n = 5) or noncyclic pain (n = 7), dyspareunia and dysmenorrhea (n = 1). All patients had a history of gynecologic operations and presented, after an average of 1.9 years, with a tender mass (average 4 cm) at the previous incision site. Preoperative diagnosis was correct in 4 patients (33%) who presented with a cyclically painful abdominal mass. The others were diagnosed as incisional hernia (n = 4), "abdominal wall tumor" (n = 2), and inguinal hernia (n = 2). All patients underwent wide excision of their endometrioma; 2 required polytetrafluoroethylene patch grafting for the resulting fascial defect. The diagnosis was confirmed at frozen section or conventional histological examination in all patients. At follow-up, ranging from 4 months to 3 years, there was no recurrence of endometrioma. CONCLUSIONS: Scar endometrioma commonly presents as an abdominal mass with noncyclical symptoms. Imaging techniques are nonspecific and needle biopsy may confirm the diagnosis. Wide excision is the treatment of choice for abdominal wall endometrioma as well as for recurrent lesions.

Asunto(s)

Pared Abdominal/patología , Cicatriz/diagnóstico , Endometriosis/diagnóstico , Enfermedades Musculares/diagnóstico , Dolor Abdominal/diagnóstico , Dolor Abdominal/etiología , Dolor Abdominal/cirugía , Pared Abdominal/cirugía , Adulto , Cesárea , Cicatriz/cirugía , Diagnóstico Diferencial , Dismenorrea/diagnóstico , Dismenorrea/etiología , Dismenorrea/cirugía , Dispareunia/diagnóstico , Dispareunia/etiología , Dispareunia/cirugía , Endometriosis/complicaciones , Endometriosis/cirugía , Femenino , Humanos , Enfermedades Musculares/etiología , Enfermedades Musculares/cirugía , Complicaciones Posoperatorias , Embarazo , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , Resultado del Tratamiento

RESUMEN

BACKGROUND: The abdominal wall is the commonest site of extrapelvic endometriosis, which usually develops in association with a prior surgical scar. CASE: A 28-year-old woman with two endometriomas in the recti abdominis, which developed in a scarless abdomen. CONCLUSIONS: Abdominal wall endometrioma can develop spontaneously in the absence of prior surgical scar and should be considered in the differential diagnosis of abdominal wall masses.

Asunto(s)

Pared Abdominal , Endometriosis/diagnóstico , Adulto , Endometriosis/patología , Femenino , Humanos , Imagen por Resonancia Magnética

RESUMEN

The concept of transluminal treatment of vascular obstruction by the percutaneous approach was introduced by Dotter and Judkins, in 1964. Percutaneous transluminal angioplasty (PTA) developed rapidly into an extremely important therapeutic modality for relieving symptomatic obstructions in major arteries. However, it was not until 1969 that Dotter reported the successful placement of coiled stainless steel wire endarterial tube grafts, with the aid of a catheter, into the popliteal arteries of dogs. This procedure stimulated the worldwide development and clinical application of endovascular stenting.

Asunto(s)

Angioplastia , Arteriopatías Oclusivas/cirugía , Enfermedades Vasculares Periféricas/cirugía , Stents , Diseño de Equipo , Humanos

RESUMEN

The entity of delayed splenic rupture represents an initially missed injury, a delayed presentation of the latter, or an actually delayed development of an initially latent, minor, splenic injury. Having encountered a number of patients presenting with splenic rupture days after what was considered a minor abdominal trauma we review our experience with this entity. This is a retrospective study. During the past 6 years 26 patients were treated at our level II trauma center for blunt splenic injuries. The 8 patients who presented 48 h or more after injury are the focus of this communication. All patients had an underlying medical condition: five were drug addicts (one was HIV positive) and the other three were affected by cirrhosis, sickle cell disease, and HIV. The mechanisms of injury were as follows: blunt assault in 5 patients, a fall in 2 patients, and unknown in 1 patient. The patients presented to our hospital after a mean lag time of 5 days after injury (range, 2-10 days). One patient presented in shock and underwent laparotomy after a positive diagnostic peritoneal lavage. Four presented with a clinical acute abdomen, and three presented with abdominal pain and anemia. Abdominal computed tomography (CT) was performed in the seven hemodynamically stable patients demonstrating hemoperitoneum in all: five had a grade III injury and two had a grade II injury. All patients survived after an emergency splenectomy. Delayed presentation of splenic injury after minor abdominal trauma is not uncommon in our indigenous population. It may be associated with drug abuse and HIV.

Asunto(s)

Rotura del Bazo/diagnóstico , Heridas no Penetrantes/diagnóstico , Adulto , Comorbilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Esplenectomía , Rotura del Bazo/epidemiología , Rotura del Bazo/cirugía , Factores de Tiempo

RESUMEN

We present two cases of a rare form of intraductal carcinoma of the breast, "cystic hypersecretory carcinoma of the breast." The clinical and pathologic characteristics of the lesion are discussed, along with a review of the literature.