RESUMEN
Herein we describe a case of enterovesical fistula in a patient with Crohn's disease that presented exclusively as urinary symptoms. The patient had no known history of GI disorders. The clinical features, natural history and treatment of enterovesical fistula in Crohn's disease are discussed.
Asunto(s)
Enfermedad de Crohn/complicaciones , Enfermedades del Íleon/etiología , Fístula Intestinal/etiología , Fístula de la Vejiga Urinaria/etiología , Adulto , Femenino , HumanosRESUMEN
Eleven patients, 8 women and 3 men, mean age 69.9 years (range 54-81) were operated with a gallstone ileus during a seven years period. Echography and barium study of small bowel were made in 8 and 2 patients, and gave a diagnostic rate of 37% and 100%, respectively. A preoperative diagnosis was made in 72.2% of cases, simple enterolithotomy was made in 8 cases and in three cases a definitive treatment of biliary pathology was added. There was no mortality and a major complication was observed in 1 patient without biliary surgery (evisceration and recurrence of biliary ileus); no major complications were seen in patients with primary biliary surgery. With a careful, selection, surgery can be made without mortality nor morbidity.
Asunto(s)
Colelitiasis/cirugía , Colestasis/cirugía , Anciano , Anciano de 80 o más Años , Enfermedades de los Conductos Biliares/complicaciones , Enfermedades de los Conductos Biliares/cirugía , Colelitiasis/complicaciones , Colestasis/etiología , Femenino , Humanos , Intestinos/cirugía , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Procedimientos Quirúrgicos Operativos/métodosRESUMEN
Three patients with polycystic liver disease, needing surgical treatment, are reported. In two cases surgical indication was continuous pain and compressive symptoms from an abdominal mass, and in the third case was an infection of the cyst. All patients were treated by fenestration combined with resection of cysts. The postoperative course was uneventful in two patients, but hepatic failure developed in the third case, needing hepatic transplantation. This patient died during this operation. The complications of the disease and its surgical management are revised.
Asunto(s)
Hepatopatías/cirugía , Anciano , Femenino , Hepatectomía , Humanos , Hepatopatías/congénito , Persona de Mediana Edad , Enfermedades Renales Poliquísticas/congénito , Enfermedades Renales Poliquísticas/cirugía , ReoperaciónRESUMEN
A case is presented of a 10-year-old female twin with a cystic liver mass that debuted as a painless epigastric mass. The lesion was excised by hepatectomy of segments II and III, confirming in the review of the cavity the presence of a common mesentery with cecocolonic malposition. The postoperative course was normal and clinical and echographic study of her twin sister disclosed no anomalies. The anatomopathologic study of the lesion revealed a tumor of difficult filiation that presented features of mesenchymal hamartoma together with others of biliary cystadenoma. The amount and nature of the stromal component, together with the patient's age at appearance, made us classify the case as mesenchymal hamartoma. The morphologic findings observed seem to support the histopathologetic theory of a congenital origin.