RESUMO
We report a rare case of spontaneous catheter knotting in the setting of a suprapubic cystostomy and also review previous reports and the rationale behind this event.
Assuntos
Cistostomia/instrumentação , Cateterismo Urinário/efeitos adversos , Cateterismo Urinário/instrumentação , Idoso , Falha de Equipamento , Humanos , MasculinoRESUMO
OBJECTIVES: The renal graft rupture (RGR) was first described in 1968; it is a severe situation, generally appearing in the immediate post-operative period. OBJECTIVES: To retrospectively analyze the incidence of renal graft rupture in the population of patients who underwent kidney transplant in the Renal Transplant Department of the Angerich Hospital. METHODS: 492 kidney transplants were performed from 1-1-1992 to 7-31-2005. 422 (85.7%) cadaver donor transplants and 70 (14.3%) live related donor transplants. RESULTS: 11 renal ruptures were observed, with a clinical picture characterized by sudden pain in the graft area, hypotension, and hematocrit descent. CT scan confirmed the diagnosis. Seven patients underwent transplant nephrectomy (one of them 24 hours after surgical repair), another two were surgically repaired successfully, and for the other two patients a conservative management with watchful waiting also resulted in graft preservation. All cases where cadaver donor drafts. CONCLUSIONS: 1) The renal graft rupture is a rare (2.8% in our series) severe complication characterized by hemodynamic instability, with no diagnostic doubts about its presentation in most cases. We use ultrasound as the diagnostic test. 2) In our series we were able to preserve 40% of the kidneys with low morbidity. 3) This complication appeared in cadaver donor kidneys in all cases (11/386; 2.8%).
Assuntos
Transplante de Rim , Complicações Pós-Operatórias , Adolescente , Adulto , Feminino , Humanos , Incidência , Masculino , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , RupturaRESUMO
Nephroblastoma or Wilms tumor is the most common renal neoplasia in children, representing 1/5 of the malignant tumors in this group. Nevertheless, the incidence of such tumor in adults is much rarer with less than 250 cases reported. Due to the low-frequency of this pathology in adults there is not a world widely accepted treatment modality. Currently, the therapeutic options derive from the National Wilms Tumor Study (NWTS). We report a new case with the radiological images, histologic findings, outcomes and follow-up.
Assuntos
Neoplasias Renais/diagnóstico , Tumor de Wilms/diagnóstico , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Endometriosis is the proliferation of endometrial tissue outside the normal confines of the myometrium or uterine cavity. Endometriosis involving the urinary tract occurs in approximately 1% to 2% of cases. The bladder is affected in 80% of these patients. The diagnosis of vesical endometriosis is difficult, and it should be confirmed by cystoscopy with biopsy. Laparoscopic examination represents the gold standard for the diagnosis of pelvic endometriosis. Urinary bladder endometriosis may be treated surgically or medically with hormone-suppressive therapy. However, medical treatments usually are only palliative, and symptoms generally recur on discontinuation. We report our experience in two patients with vesical endometriosis who were managed successfully with cystoscopy-assisted laparoscopic partial cystectomy.
Assuntos
Cistectomia , Endometriose/cirurgia , Laparoscopia/métodos , Doenças da Bexiga Urinária/cirurgia , Adulto , Endometriose/diagnóstico por imagem , Feminino , Humanos , Tomografia Computadorizada por Raios X , Doenças da Bexiga Urinária/diagnóstico por imagemRESUMO
BACKGROUND: Teratoma is a germ-cell tumor that commonly affects the gonads. Its components originate in the ectoderm, endoderm, and mesoderm. Extragonadal occurrence is rare. Teratomas confined to the adrenal gland are exceptional; only 3 cases have been reported in the English-language literature. We report 2 cases of mature teratomas of the adrenal gland that were laparoscopically excised. METHODS: Two patients (ages 8 and 61 years) were diagnosed with adrenal teratoma at our institution. Radiological examination showed a solid 8-cm adrenal lesion in both cases. Hormonal assessment was normal. Both patients underwent laparoscopic transperitoneal adrenalectomy. RESULTS: Surgical time was 120 minutes and 50 minutes, respectively. One patient was discharged on postoperative day 2, and the other remained hospitalized until day 10. The latter patient required percutaneous drainage of a retroperitoneal collection. Both tumors were identified as mature cystic teratomas. No evidence was present of recurring disease in either patient. CONCLUSIONS: Adrenal teratoma is rare. Laparoscopic transperitoneal adrenalectomy is a feasible, effective technique that enables excellent oncologic results. To our knowledge, this is the first report of laparoscopic adrenalectomy for pure adrenal teratoma.