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Presentamos el caso de una paciente de 32 años que desarrolló ceguera legal posterior a liposucción y mamoplastia de aumento, evolucionando con anemia transitoria y disminución progresiva de la agudeza visual del ojo izquierdo (20/200). A pesar de la corrección de la anemia y la mejoría del estado general, continuó durante 2 meses con sintomatología ocular. Se estableció diagnóstico de neuropatía óptica isquémica anterior no arterítica (NOIA) de acuerdo con los hallazgos oftalmológicos. Revisamos las publicaciones previas para neuritis óptica isquémica anterior después de liposucción y las recomendaciones para prevenir dicha patología

We present the case of a 32-year-old woman who developed legal blindness posterior to liposuction and augmentation mammoplasty, with postoperative anemia and decreased vision of the left eye (20/200). Despite the correction of the anemia and improvement of the general status, the patient continued with vision loss for 2 months. According to ophthalmologic studies we could establish the diagnosis of non-arteritic ischemic optic neuropathy (NAION). We review the previous reports in the literature for anterior ischemic optic neuritis after liposuction and the recommendations to prevent this complicatio

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Introducción y Objetivo: Es un hecho que la Cirugía Plástica es la parte más artística de la Medicina, y aunque está constituida por la Cirugía Reconstructiva y la Cirugía Estética, no existe un límite entre ambas. Una de las técnicas que mayormente realizamos dentro de nuestra especialidad es la rinoplastia, y de la misma manera, aunque dogmáticamente existen diferencias entre una rinoplastia estética y una reconstructiva o funcional, ambas pueden beneficiarse del mismo manejo. Algunos procedimientos empleados con buen resultado en la reparación de deformidades congénitas o adquiridas, pueden utilizarse en pacientes cuya morfología nasal es normal, sólo con fines estéticos. Material y método: Realizamos una revisión de los procedimientos quirúrgicos reconstructivos nasales que pueden aplicarse de acuerdo a las subunidades estéticas, destacando los realizados en dorso, paredes laterales y punta, explicando el cómo y porqué del uso de injertos cartilaginosos o compuestos. Resultados: Dichas técnicas acumulan la experiencia de los últimos 18 años del autor principal en cirugía nasal, tanto reconstructiva como estética. Es importante hacer notar que la correcta selección de los pacientes y el análisis preoperatorio serán siempre un instrumento valioso para lograr un buen resultado. Conclusiones: La integración de procedimientos propios de la Cirugía Reconstructiva aplicados en la Cirugía Estética de la nariz, pueden proporcionar resultados óptimos en diferentes tipos de pacientes previamente seleccionados

Background and Objective: It is a fact that Plastic Surgery is the most artistic specialty in Medicine and even though Reconstructive Surgery and Aesthetic Surgery constitute it, there is no limit between them. One of the techniques that we mostly perform within the specialty is rhinoplasty and in the same way, although dogmatically there are differences between an aesthetic rhinoplasty and a reconstructive or functional rhinoplasty, both can benefit from the same management. Some procedures used with good results in the repair of congenital malformations or acquired deformities, can be used in patients whose nasal morphology is normal and for cosmetic purposes only. Methods: In order to describe the function of reconstructive rhinoplasty procedures applied to aesthetic rhinoplasty, a review of reconstructive surgical procedures that can be applied according to the aesthetics subunits was carried out, highlighting those performed on the dorsum, the lateral walls and the tip, explaining how cartilages or composite grafts are used. Results: These techniques accumulate the experience of the last 18 years of the main author with the management of nasal surgery, both in the reconstructive and aesthetic field. It is important to consider that the selection of patients and the preoperative analysis will always be an invaluable tool to achieve a good result. Conclusions: The integration of reconstructive surgery procedures applied in the aesthetic surgery of the nose can provide optimal results in different types of patients, previously selected

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BACKGROUND: Fecal incontinence is defined as an involuntary bowel movement through the anal canal in inadequate time and place. There are different types of therapies for the management of fecal incontinence, being biofeedback therapy one of the most effective techniques. The aim of this study was to evaluate the necessary number of sessions of biofeedback electromyographyc therapy to achieve the maximum sphincteric complex contraction. METHODS: Descriptive, retrospective and longitudinal study. 65 patients with fecal incontinence were included. Weekly electromyographyc biofeedback therapies were applied, with a maximum of 6, in which the sphincteric complex contraction was measured. A two ways Friedman analysis was made to determine the significant differences between the sessions. RESULTS: A total of 65 patients were evaluated for fecal incontinence. The values for pelvic floor contraction were significantly higher in the third session, and did not show any significant difference in posterior sessions. CONCLUSION: The maximum contraction of the sphicnteric complex was achieved in the third weekly biofeedback session, without any significant differences in the posterior sessions.

Introducción: el origen anómalo de la arteria coronaria izquierda del seno coronario derecho (ACAOS) se caracteriza porque la arteria coronaria principal izquierda se origina anómalamente del seno de valsalva aórtico coronario derecho y cuyo trayecto puede seguir cuatro diferentes caminos hacia el lado izquierdo del corazón. Caso clínico: masculino de 73 años de edad, que ingresó al hospital por dolor precordial de tipo opresivo, intensidad 10/10 con irradiación a brazo izquierdo y cuello, acompañado de diaforesis y nausea. El diagnóstico fue de un síndrome isquémico coronario agudo sometido a terapia trombolítica Su evolución posterior fue no satisfactoria debido a diferentes complicaciones que lo llevaron a la muerte. Conclusiones: el diagnóstico del origen anómalo de la arteria coronaria izquierda del seno opuesto (ACAOS), se establece únicamente a través de métodos de diagnósticos como la angiotomografía computada cardiaca o un cateterismo cardiaco como parte del abordaje de un síndrome isquémico coronario agudo que permiten establecer las características morfológicas de las arterias coronarias como las diferentes variantes anatómicas y sus características particulares respecto a las estructuras adyacentes.

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INTRODUCTION: Appendiceal diverticulosis is a rare entity, with a global incidence between 0.004% and 2.1% of all appendectomies. It has been related with an elevated risk of perforation in comparison to acute appendicitis, as well as an increased risk for synchronic appendicular cancer in 48% of the cases, and colonic cancer in 43%. The incidence of chronic appendicitis has been reported in 1.5% of all appendicitis cases. PRESENTATION OF CASE: We present a 73-year-old female, with no relevant familial history, who presented due to a four-month-long oppressive, moderate pain in the lower right abdominal quadrant without irradiation or any other accompanying symptoms. DISCUSSION: The documented incidence of appendiceal diverticula and chronic appendicitis by themselves is low; therefore the presence of both entities at the same time is extremely rare. CONCLUSION: We present a case in which both diagnoses concurred in the same patient. The relevance of this case relies on the importance of the adequate knowledge of these pathologies, so we can approach them correctly. Although it does not represent an absolute surgical emergency, appendectomy represents the first therapeutic option.

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INTRODUCTION: Intussusception in adult patients represents 5% of all intussusceptions and 1-5% of bowel obstructions in adults. In contrast to pediatric patients, 90% of the time, in adults, it's caused by well-established pathologic mechanisms, such as carcinoma, polyps, diverticula, Meckel diverticula, stenosis, or benign neoplasms. Small intestine intussusceptions are more frequent, but colonic intussusceptions are caused 50% of the time by malignant neoplasms, especially adenocarcinoma. PRESENTATION OF CASE: We present a 70-year-old woman, with no relevant familial history, who presented with a 3-day symptomatology consisting of epigastric, colic, diffuse, abdominal pain of moderate intensity, which progressed till reaching a severe intensity, also referring abdominal distension, nausea, and gastrointestinal-content vomits. DISCUSSION: In adult patients, the exact mechanism of intussusception is unknown in 8-20% of the cases, however, secondary intussusception can occur with any lesion of the intestinal wall or any irritant factor in its lumen that alters normal peristaltic activity and that could serve as a trigger to start an intussusception of one bowel segment over another the most common site is the small intestine. CONCLUSION: Intussusception represents an unusual problem in adult patients; it requires a high clinical suspicion, mainly as a differential diagnosis in patients with intestinal obstruction, and it clinically presents as a subacute or chronic illness. CT represents the most useful diagnostic tool. An attempt to perform reduction procedures in small intestine intussusceptions can be done, however, in ileocolic or colonic intussusceptions, a formal resection of the segment is recommended.