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Background: Meckel's diverticulum is a rare congenital pathology among newborns. Nevertheless, it is an uncommon abdominal pathology in the adult population. Therefore, we aim to provide a detailed account of our surgical approach in treating 27 cases of Meckel's diverticulum. Methods: This study is a cross-sectional analysis that utilized a database with prospectively collected data from 2004 to 2022. All patients under the age of 18 were excluded from the population. We described the population's demographic characteristics, symptoms, anatomopathological study, surgical technique, complications, morbidity, and mortality. A subgroup analysis was performed between the symptomatic and asymptomatic patients. Results: A total of 27 patients who underwent surgical resection for a posteriorly diagnosed Meckel's diverticulum were included. The male population accounted for 81.4% (n = 22) of the sample size. The symptomatic group consisted of 18 male and four female patients. Abdominal pain was the predominant symptom in 85% of the patients. Out of the 22 symptomatic patients, only 9% had a positive perioperative diagnosis of Meckel's diverticulum. All 27 patients with diverticulum diagnosis received the resection through diverticulectomy (n = 6), small bowel resection with end-to-end anastomosis (n = 6), and small bowel resection with lateral to lateral anastomosis (n = 15). The mean distance between the diverticulum and the ileocecal valve was 63.4â cm. The symptomatic group had an average diverticulum length of 3.54â cm, with an average base width of 2.47â cm. In the other group, the values were 2.75 and 1.61â cm. The average length of hospital stay in the symptomatic group was 7.3 days. Conclusions: Meckel's diverticulum is a rare pathology in the adult population. Its presentation varies from asymptomatic to symptomatic patients, and surgery is the cornerstone treatment for this pathology.
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INTRODUCTION AND IMPORTANCE: Paracoccidioidomycosis (PCM) is a systemic fungal infection, primarily affecting the respiratory tract. Extra pulmonary presentation is rare, representing less than 1% of cases (about 1 in every 200 cases). CASE PRESENTATION: We present a case of a 73-year-old male with acute surgical abdomen secondary to Intestinal Paracoccidioidomycosis requiring intestinal resection and postoperative antifungal therapy. CONCLUSION: Intestinal Paracoccidioidomycosis represents a rare pathology with challenging diagnostic approach due to its frequency and nonspecific clinical manifestations. Extra pulmonary presentation is rare, but it should be considered in endemic regions.
RESUMO
BACKGROUND: Gastroesophageal reflux disease (GERD) is a common disease among patients with obesity, with an associated prevalence of 39 to 61% between the population who attends a bariatric surgery evaluation. Laparoscopic sleeve gastrectomy (LSG) has become a popular and valid option for obesity treatment, even though the literature is ambivalent regarding the increase or decrease in GERD after this surgery. Thus, it is necessary to propose new surgical techniques as a solution to GERD in patients with a concomitant LSG or with a history of it. Therefore, we present a modified technique based on Hill's gastropexy described originally in 1967. OBJECTIVE: Describe and propose a surgical procedure for GERD management based on the Hill technique that can be applied in all patients who undergo an LSG or with a history of it. METHODS: Retrospective observational study with a prospective database in which we described, Hill modified technique in a group of 16 patients with GERD who underwent this procedure concomitantly with an LSG or who presented with GERD after LSG with a 3-year follow-up. The surgical technique is based on an intra-abdominal esophageal length of a minimum of 3 cm and posterior fixation of the gastroesophageal junction to the crus. RESULTS: Postoperative controls have shown satisfactory results in the control and management of GERD symptoms in this group of patients, with very few to no complications associated with the procedure and without reintervention or medication out of the standard protocol. CONCLUSION: Hill modified technique can be used and presented as an option for GERD control in patients with LSG.
Assuntos
Cirurgia Bariátrica , Refluxo Gastroesofágico , Laparoscopia , Obesidade Mórbida , Gastrectomia , Refluxo Gastroesofágico/etiologia , Refluxo Gastroesofágico/cirurgia , Humanos , Obesidade Mórbida/cirurgia , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Este artigo apresenta uma revisão teórica sobre três fatores que podem influenciar no julgamento da atratividade facial: cuidado parental, fatores psicológicos e percepção da dominância, todos relacionados às diferenças individuais. Discute-se se eles afetam os resultados de estudos que envolvam percepção facial, de modo a refutar a hipótese dos hormônios como os maiores influenciadores no julgamento da atratividade. Encontrar as possíveis variáveis que influenciam a atratividade facial pode ajudar a explicar os resultados controversos, além de ampliar o conhecimento sobre a escolha do parceiro. (AU)
This paper is about a review on three factors that may affect the judgment of facial attractiveness: parenting care, psychological factors and dominance. They are all related to individual differences. It is discussed whether they may affect the results of studies involving face perception, refuting the hypothesis that hormones have major influence in attractiveness judgments. Finding possible variables that influence facial attractiveness may help to explain the controversial results in this area broadening our understanding about mate choice. (AU)