RESUMO
BACKGROUND: Torsion of appendices epiplocae leads to an ischemic infarct of surrounding adipose tissue, causing a syndrome, called "primary epiploic appendagitis" characterized by acute abdominal pain that can simulate a surgical clinical picture. AIM: To describe the clinical picture, ultrasonographic and computed tomographic features of primary epiploic appendagitis. MATERIAL AND METHODS: A report of patients with acute abdominal pain whose diagnosis was a primary epiploic appendagitis, diagnosed and treated in a period of 48 months. RESULTS: Fifty five patients (45 males) aged 16 to 76 years old are reported. Their clinical presentation was acute abdominal pain in the left abdominal quadrant in 48, pain in the right lower quadrant in 4 and epigastric pain in two. Two had mild fever and 12 had nausea. Ten perform physical activities prior to the onset of pain. Imaging examinations showed a 1.5 to 5 cm diameter, uncompressible small mass of adipose origin, located anteriorly and anterolaterally, between the colon and the abdominal wall. There were inflammatory phenomena surrounding the lesion and thickening of the neighboring parietal peritoneum. In all cases, the mass gradually subsided with medical treatment. CONCLUSIONS: Primary epiploic appendagitis is a relatively frequent cause of spontaneously resolving abdominal pain. It is diagnosed by ultrasound or CT scanning.
Assuntos
Abdome Agudo/diagnóstico por imagem , Dor Abdominal/etiologia , Adolescente , Adulto , Idoso , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
The management of patients with thyroid cancer can be optimized by developing multidisciplinary groups of highly specialized individuals. The completeness of surgery and its morbidity are mostly surgeon-dependent. Similarly, the decisions regarding selection of adjuvant treatments, doses, follow-up schemes, and so forth require depth of knowledge and understanding of the disease; its variables; factors that govern its course; and the values, limitations, and side effects of alternative therapies.
Assuntos
Neoplasias da Glândula Tireoide , Feminino , Humanos , Masculino , Prognóstico , Radioterapia Adjuvante , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/radioterapia , Neoplasias da Glândula Tireoide/cirurgiaRESUMO
Bronchogenic cysts are congenital malformations of the tracheo-bronchial tree usually located intrathoraxically. We report a 44 years old male with a bronchogenic cyst located exceptionally in the pre tracheal anterior cervical region, simulating a thyroid lesion.
Assuntos
Cisto Broncogênico/diagnóstico , Doenças da Glândula Tireoide/diagnóstico , Adulto , Cisto Broncogênico/patologia , Cisto Broncogênico/cirurgia , Diagnóstico Diferencial , Humanos , MasculinoRESUMO
BACKGROUND: Parathyroid scintigraphy with Tc99m Sestamibi, a tracer that is taken up by hyperfunctioning parathyroid tissue, has a high yield in the diagnosis of abnormal parathyroid growths. AIM: To assess the usefulness of parathyroid scintigraphy with Tc99m Sestamibi in patients with suspected hyperparathyroidism. PATIENTS AND METHODS: We analyzed retrospectively 29 patients with suspected hyperparathyroidism, in whom a scintigraphy with Tc99m Sestamibi was performed. RESULTS: Twenty four of 25 patients in whom hyperfunctioning parathyroid tissue was evidenced with scintigraphy, were operated. Histological diagnosis of the excised parathyroid gland, showed 23 adenomas and 1 hyperplasia. Anatomical location disclosed by scintigraphy was concordant with surgical findings in all cases, including a mediastinic adenoma. Of the four patients with negative scintigraphic findings, two had transitory PTH elevations and in two the presence of adenoma or hyperplasia could not be demonstrated with other diagnostic procedures. CONCLUSIONS: Parathyroid scintigraphy with Tc99m Sestamibi had an 86% sensitivity for the detection of hyperfunctioning parathyroid tissue in patients with elevated PTH.
Assuntos
Hiperparatireoidismo/diagnóstico por imagem , Compostos Radiofarmacêuticos , Tecnécio Tc 99m Sestamibi , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cintilografia , Estudos Retrospectivos , Sensibilidade e EspecificidadeRESUMO
A 29 year old woman with type V hyperlipidemia developed acute pancreatitis associated with severe hyper triglyceridemia when she coursed the 28th week of pregnancy. Plasma exchange was performed 3 times and plasma lipids became normal, while the acute pancreatitis subsided. Intravenous and then enteric nutrition followed and a successful cesarean section was performed 30 days after the initial episode.