RESUMO
Sclerosing mesenteritis or panniculitis is a rare condition characterized by inflammation of the mesentery ranging from an acute to a chronic fibrotic process that can resemble an intestinal malignant neoplasm even though it is benign. Its etiology is unknown, although it is thought to be the result of a nonspecific inflammatory response of the mesentery to an allergic, chemical, thermal, infectious, autoimmune or surgical stimulus. Its natural history is benign and in most cases is self-limited. Surgery is reserved only for those cases where there is intestinal obstruction. We report three cases of sclerosing mesenteritis that occurred after abdominal surgery and we present a review of the literature.
Assuntos
Paniculite Peritoneal/diagnóstico , Complicações Pós-Operatórias/diagnóstico , Adulto , Anti-Inflamatórios/uso terapêutico , Colecistectomia , Colecistite/etiologia , Colecistite/cirurgia , Colchicina/uso terapêutico , Colectomia , Terapia Combinada , Diverticulose Cólica/cirurgia , Duodenopatias/etiologia , Duodenopatias/cirurgia , Derivação Gástrica/efeitos adversos , Gastrite/etiologia , Humanos , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia , Laparotomia , Masculino , Metilprednisolona/uso terapêutico , Pessoa de Meia-Idade , Paniculite Peritoneal/tratamento farmacológico , Paniculite Peritoneal/etiologia , Paniculite Peritoneal/cirurgia , Complicações Pós-Operatórias/tratamento farmacológico , Complicações Pós-Operatórias/etiologia , Prognóstico , Reoperação , Aderências Teciduais/complicações , Aderências Teciduais/cirurgiaRESUMO
Sclerosing mesenteritis or panniculitis is a rare condition characterized by inflammation of the mesentery ranging from an acute to a chronic fibrotic process that can resemble an intestinal malignant neoplasm even though it is benign. Its etiology is unknown, although it is thought to be the result of a nonspecific inflammatory response of the mesentery to an allergic, chemical, thermal, infectious, autoimmune or surgical stimulus. Its natural history is benign and in most cases is self-limited. Surgery is reserved only for those cases where there is intestinal obstruction. We report three cases of sclerosing mesenteritis that occurred after abdominal surgery and we present a review of the literature.
Assuntos
Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnóstico , Paniculite Peritoneal/diagnóstico , Anti-Inflamatórios , Colecistectomia , Colecistite , Colectomia , Terapia Combinada , Colchicina/uso terapêutico , Duodenopatias , Derivação Gástrica/efeitos adversos , Diverticulose Cólica/cirurgia , Gastrite/etiologia , Obstrução Intestinal , Metilprednisolona/uso terapêutico , Paniculite Peritoneal , Complicações Pós-Operatórias , Prognóstico , Reoperação , Aderências TeciduaisRESUMO
Traumatic rupture of the thoracic aorta is a near-lethal event presenting on-scene mortality rates of 80% and 60-80% perioperatively with an overall survival rate of 15%. Conventional treatment includes thoracotomy with aortic clamping and aortic replacement but this implies high complication and mortality rates with extended inpatient care. Endoluminal treatment has recently become an attractive treatment option with advantages such as lower death and complication rates as well as shorter inpatient care. We present an 18-year-old female victim of a frontal automobile crash who presented mediastinal enlargement and underwent CT evaluation confirming pericardial effusion, left hemothorax and a contained traumatic rupture of the thoracic aorta. She was sent to our hospital where aortography was performed identifying the injury, and a preperitoneal left iliac artery approach was made to insert a Medtronic Talent 24F endograft. Under fluoroscopic guidance the graft was placed below the subclavian ostium. There was no endoleak after the procedure. A left iliac-femoral bypass was performed and a chest tube was inserted. The patient was managed in the ICU, being later operated by reconstructive and orthopedic surgeons for injuries related to the initial trauma. The patient was released from the hospital on the 10th postoperative day after a satisfactory evolution. We present also a brief review of recent articles.