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Bilioma é qualquer coleção de bile fora das vias biliares. Geralmente, resulta de complicações cirúrgicas e trauma abdominal. A ocorrência espontânea é rara, ocasionalmente associada a coledocolitíase. Relata-se um caso de bilioma espontâneo, cujo diagnóstico foi confirmado radiologicamente. À laparotomia, observou-se bilioma retroperitoneal. A colangiografia transoperatória não evidenciou fístula. Após drenagem, o paciente teve boa evolução e alta hospitalar.

Complications involving the central nervous system in patients suffering from hepatitis C virus (HCV) infection have been rare. Among them, it appears the transverse myelitis, which has already been reported in likely association with HCV. This paper presents the case study of a 65-year-old woman who developed cervical transverse myelitis linked to chronic HCV infection and anti-HCV antibodies in the spinal fluid, being excluded other etiologies for transverse myelitis. Current evidence has reinforced the likely association between chronic HCV infection and transverse myelitis, especially as recurrent manifestations of the disease. These findings reveal the need for more searching to establish the causal relationship between transverse myelitis and hepatitis C. Key-Words: Central Nervous System, HCV infection, transverse myelitis. The World Health Organization estimates that infection by the hepatitis C virus (HCV) affects around 3% of the world population [1], being one of the main causes of the chronic hepatic disease. In HCV-positive patients, extra-hepatic symptoms are reported in up to 74% of the cases, 10% to 15% of which regarding the neurological changes, mainly in the peripheral nervous system, and in this context associated to the cryoglobulinaemia. Manifestations observed in the central nervous system (CNS) include chronic forms of encephalopathy, epilepsy, normal pressure hydrocephaly, ischemic encephalovascular syndrome, Ekbom syndrome, and encephalomyelitis [2][3][4][5].Transverse myelitis (TM) is a demyelinating disease of the spinal cord. The disease is characterized by the emergence of acute or sub acute signs and symptoms of motor, neurological, and autonomic dysfunction related to the nervous tracts of the spinal cord [6]. TM often occurs due to inflammatory and infectious processes, rheumatologic, neoplastic, iatrogenic, demyelinating, compressive, actinic as well as idioapthic diseases [7,8]. TM associated to HCV infection has recently been reported, and although the causal mechanism has not been fully established yet, it is hypothesized that the virus may act directly in the development of TM, or lead to immune-mediated injury.This paper is a case study of a patient who suffered from cervico-dorsal spinal cord myelitis, In association with updated literature, this study case adds evidence about the association between HCV and TM. Case ReportThe patient was a nulliparous, non-smoker 65-year-old caucasian woman previously alcoholic but abstemious for eight years, with obesity degree 3, hypertension, diabetes mellitus type II, and with a metallic mitral valve for nine months. The patient was from the central region of the state of Rio Grande do Sul, Brazil, and had been taking warfarin, metphormin, glibenclamide, hydrochlothiazide, metoprolol, enalipril, and furosemide at the time of hospital admission.On admission, complaints reported by the patient included strong and progressive thoracolumbar pain for 30 days, which evolved with the loss of strength and sensitivity in lower limbs five days ...

Congenital absence of the inferior vena cava is a rare vascular anomaly, and most cases are asymptomatic. Nevertheless, patients with inferior vena cava malformations may have increased risk of deep venous thrombosis. Particularly, cases of bilateral deep venous thrombosis may arise owing to an insufficient collateral venous drainage from the lower limbs. We hereby describe a case of a previously healthy young male patient presenting with bilateral lower limb deep venous thrombosis as the initial clinical manifestation of congenital inferior vena cava agenesis. We conclude that in young patients presenting with deep venous thrombosis, especially when thrombosis occurs spontaneously, bilaterally, or recurrently, inferior vena cava anomalies should be thoroughly investigated and ruled out as appropriate.

ABSTRACT

A 74-year-old white male who was a retired farmer, a nonsmoker and a former drinker presented with a one-year history of chest pain in the suprasternal notch, accompanied by edema and local erythema. His condition had worsened two weeks prior, aggravated by drainage of purulent material from a fistulous lesion. In addition, he reported evening fever, night sweats and weight loss (25 kg) in the last 12 months. The patient was under outpatient follow-up treatment in various sectors of the Santa Maria University Hospital, due to multiple comorbidities: systemic arterial hypertension; heart failure; mitral valve disease; pulmonary arterial hypertension; hypothyroidism; chronic renal failure; nonspecific colitis; and benign prostatic hyperplasia. He was being treated with furosemide, simvastatin, omeprazole, levothy- IntroductionThe extrapulmonary form of TB involving the sternum is quite rare. The most significant risk factor for the disease is open heart surgery.(1) Other risk factors include intravenous drug abuse, blunt thoracic trauma, closed cardiopulmonary resuscitation, subclavian vein catheterization, diabetes mellitus, HIV infection, alcoholism and BCG vaccination.(1) Sternal TB usually affects young adults living in areas where TB is endemic. Since the advent of modern antituberculous therapy, the number of cases of sternal TB has dramatically decreased, there having been fewer than 20 cases reported in the literature since that time.(2) We report the case of a male patient without active pulmonary disease who was under follow-up treatment at a clinical medicine outpatient clinic when he developed sternal TB. Sternal osteomyelitis caused by AbstractWe report the case of a 74-year-old male patient with a one-year history of chest pain in the suprasternal notch associated with erythema, edema and drainage of purulent material from a fistulous lesion. The patient was HIV-negative with no history of TB. A CT scan of the chest showed an osteolytic lesion in the sternum, and a biopsy revealed caseous granuloma, which, in the microbiological evaluation, was negative for fungi and acid-fast bacilli.The diagnosis of sternal osteomyelitis caused by Mycobacterium tuberculosis was confirmed using PCR.

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Relata-se o caso de um paciente portador da doença de Madelung, definida clinicamente pela presença de múltiplos acúmulos de tecido adiposo não encapsulados, usualmente envolvendo a região cervical e superior do tórax, de distribuição simétrica. O exame de imagem eleito para confirmação do diagnóstico foi tomografia computadorizada, por ser menos dispendiosa e mais acessível, comparando-se à ressonância magnética.