Background: Fournier fasciitis (FF) severity is traditionally assessed by the Fournier gangrene severity index (FGSI), as it is an internationally accredited index, which consists of some clinical and laboratory parameters. However, the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have shown to be useful as predictors of severity in different septic and ischemic processes, and a full blood count is sufficient for its application. Objectives: The objectives of this study were to determine if there is a correlation between FF severity measured by NLR and PLR, and the severity measured by the FGSI scale. Materials and methods: We conducted a retrospective, observational, and analytical study to evaluate the usefulness of the NLR and PLR as indicators of severity on Fournier fasciitis. Results: We included 45 cases treated at Hospital General de México "Dr. Eduardo Liceaga", from 2010 to 2016. Forty cases were of anorectal origin and five of them of urological origin. The severity assessment scale was set for FGSI at 9 points, NLR at 7 points, and PLR at 140 points. About 60% of cases deemed severe by NLR, resulted in an FGSI score lower than 9, p = 0.547, without statistical significance. About 72% of cases diagnosed as severe by PLR, yielded an FGSI score lower than 9, p = 0.613, without statistical significance. Conclusions: Additional studies would be required to confirm or rule out these results.
Ligadura interesfintérica de trayecto fistuloso como tratamiento de fístula anorrectal compleja Ligation of intersphinteric fistula tract as treatment of complex anorectal fistula
La poliposis adenomatosa familiar es un trastorno poco frecuente y significa menos de 1% de las causas de cáncer colorrectal. Se caracteriza por presentar miles de adenomas colorrectales con alto riesgo de desarrollar cáncer. Caso clínico: Paciente femenino de 48 años de edad con hematoquecia y pérdida de peso. La colonoscopia muestra más de 100 pólipos y un tumor en colon sigmoides. Cuenta con antecedente de tres familiares directos con cáncer de colon. Conclusión: Es necesario realizar una valoración precoz y evaluación de familia directa para prevenir la aparición de cáncer. La cirugía es la base del tratamiento.
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