Background: Abnormalities of liver morphology are rare, divided into two categories: those resulting from overgrowth of liver tissue, such as the Riedel lobe and other accessory lobes, and those with poor liver development include agenesis, hypoplasia and aplasia of the hepatic lobes.
Presentation of the case: 57-year-old man, subjected to laparoscopic programmed inguinal surgery, finding liver hypoplasia.
Conclusions: Hepatic hypoplasia is rare, has no symptoms or long-term clinical repercussions, is usually an incidental finding during an imaging study or during an abdominal surgical procedure.
Introducción: el trasplante renal es el único tratamiento que mejora la calidad de vida en los pacientes con enfermedad renal crónica, al cierre de 2021 en México se realizaron 1,971 trasplantes. Dentro de las principales complicaciones observadas después del trasplante encontramos infecciones, alteraciones asociadas a la inmunosupresión, recurrencia de enfermedad de base y el rechazo. La incidencia de rechazo reportada a nivel mundial oscila entre 12 y 14%. El diagnóstico de rechazo es histopatológico; sin embargo, no se han reportado marcadores moleculares que nos permitan sospechar el desarrollo de esta entidad antes de que se inicie el deterioro estructural del injerto. Los métodos actuales para monitorizar el rechazo en el injerto son la elevación de creatinina, la presencia de proteinuria y el desarrollo de anticuerpos antidonador específico (ADES). Una biopsia renal implica riesgo de hematuria y hematoma perirrenal (2 a 4%). Antecedentes: existe una gran cantidad de biomarcadores nuevos, no invasi-ABSTRACT Introduction: renal transplantation is the only treatment that improves the quality of life of patients with chronic kidney disease; at the end of 2021, 1,971 transplants were performed in Mexico. Among the main complications observed after transplantation are infections, alterations associated with immunosuppression, recurrence of the underlying disease and rejection. The incidence of rejection reported worldwide ranges between 12 and 14%. The diagnosis of rejection is histopathological; however, no molecular markers have been reported that allow us to suspect the development of this entity before the onset of structural deterioration of the graft. Current methods to monitor graft rejection are creatinine elevation, the presence of proteinuria and the development of specific anti-donor antibodies (ADES). A renal biopsy implies a risk of hematuria and perirenal hematoma (2 to 4%). Background: there are a large number of new, non-
Introduction
Xanthogranulomatous cholecystitis (XGC) is a rare inflammatory disease of the gallbladder(GB). It has been classified as an uncommon variant of chronic cholecystitis with a prevalence of 0.7 to 10%. It is a difficult diagnosis because macroscopic appearance may be confused with gallbladder cancer (GC). Laparoscopic cholecystectomy is the gold standard for the management of benign gallbladder disease. Laparoscopic cholecystectomy in XGC is associated with a high conversion rate to open cholecystectomy with a rate of 10.6 to 80%.
Material and methods
A descriptive, observational, retrospective, and cross-sectional study was carried out over a period of 18 years at a general hospital on Mexico City. Patients with histopathological diagnosis of xanthogranulomatous cholecystitis were included. This study was retrospectively registered and approved by the board of ethical committee in our institution on 2018.
Results
We recorded 142 patients, and 106 surgeries were performed totally laparoscopically (74.6%). 52 were emergency surgeries (49%) and 54 elective (51%). The conversion rate to open cholecystectomy was 3.7% (4 patients). There were 5 post-surgical complications (4.7%) one biloma, one surgical site infection, and 3 pancreatitis.
Conclusions
XGX represents a surgical challenge from diagnosis to surgical management and is associated to a higher number of perioperative complications. Nevertheless, a laparoscopic approach is safe in high volume centers with experience in laparoscopy.
Intestinal malrotation is the failure of the fetal intestine to complete a 270-degree counter clockwise rotation around the superior mesenteric artery, resulting in positional and fixation abnormalities of the small and large intestine. Adult presentation is uncommon with an estimated incidence of 0.2 to 0.5%. There is no consensus on treatment in patients with asymptomatic intestinal malrotation in adults. The aim of this document was to report and review a case of intestinal malrotation conditioning intestinal obstruction in an adult patient with successful laparoscopic management. We conclude that laparoscopic resolution is feasible, reproducible and may ensure a faster recovery in a selected group of patients.
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