Cecal volvulus is a rare cause of intestinal obstruction, with multifactorial etiologies. This is a case report describing a 52-year-old female with a cecal volvulus diagnosis made during the laparotomy procedure, which was treated with a right hemicolectomy with a side-to-side ileotransverse anastomosis. The aim of this report is to emphasize the importance of a diagnosis and appropriate treatment in this rare pathology in abdominal procedures. In this particular case, the patient benefited from an early surgical intervention without further complications, as well as an adequate postoperative evolution; it is important to acknowledge and consider this pathology during differential diagnosis, and not delay the treatment in patients with cecal volvulus. A critical review of the literature is included and discussed.
ResumenLos mucoceles del seno esfenoidal representan de 1 a 2% de todos los de los senos paranasales. Se han reportado 140 casos de los cuales 95% ocurrieron en adultos, siendo un paciente de 11 años el más joven informado. El objetivo es presentar nuestra experiencia en una paciente de siete años de edad con un mucocele del seno esfenoidal. Los signos y síntomas consistieron en cefalea y rinorrea purulenta escasa. El diagnóstico se realizó mediante TAC y RMN de senos paranasales, así como por los hallazgos histopatológicos. El tratamiento consistió en abordaje endoscópico. El diagnóstico precoz es importante para evitar déficit neurológico permanente o alteraciones visuales y nerviosas por vecindad. Se analizó la etiología, manifestaciones y tratamiento de los mucoceles esfenoidales y se revisa la literatura médica disponible. Palabras clave: mucocele, seno esfenoidal, esfenoides, niños, pediátrico, infancia.Abstract Sphenoid sinus mucoceles represent only 1 to 2% of all paranasal mucoceles. Only 140 cases have been reported so far, 95% in adults and an 11-year-old child is the youngest patient reported. Our objective is to describe our experience in a 7-year-old girl with a sphenoid sinus mucocele. Signs and symptoms consisted of headache and mild purulent rhinorrhea. Paranasal sinus CT and MR imaging, as well, as the histopathologic findings allowed the diagnosis. Patient was treated by endoscopic approach. Because of close proximity with vital structures early diagnosis is essential to prevent permanent neurologic deficit, such as, visual or nerve impairment. Etiology, manifestations and treatment of sphenoid sinus mucoceles and relevant medical literature were reviewed.
Since the first successful use of mesh in hernia surgery, the development and progress in materials, techniques, and procedures have increased exponentially; consequently, surgeons started to use meshes for hiatal hernia repair to prevent postoperative hernia recurrences and complications. Nonetheless, there are alarming reports in literature concerning cardiac tamponade as an apparently rare complication of hiatal mesh placement, especially when fixation is performed with tacks.A 50-year-old female diagnosed with gastroesophageal reflux disease undergoes an elective laparoscopic Nissen fundoplication and hiatal hernia repair with tack fixation of the mesh; on the fourth postoperative day she was readmitted with cardiac tamponade diagnosed via echocardiography, and CT scan showed proximity of the tacks to the pericardium. She underwent a failed attempt of ultrasound guided pericardiocentesis (PC), therefore, a pericardial window was performed.The ideal method for diaphragmatic mesh fixation is still controversial. Some recent articles alert of this potential risk; although the manufacturers contraindicate the use of tacks in the diaphragm, one-third of surgeons prefer this method.
Introducción : El colgajo de Moberg descrito por primera vez en 1964 ha demostrado ser útil para la resolución de defectos que van desde 1cm hasta 2 cm. Caso clínico: Masculino de 19 años que sufrió accidente con sierra eléctrica en punta digital del primer dedo derecho, tratado con cierre primario 10 días antes de su llegada a nuestro hospital por necrosis de la punta digital. Discusión: Aunque este colgajo se utilizan principalmente en situaciones agudas, también se pueden emplear para la reconstrucción de la superficie volar del primer dedo en un segundo tiempo quirúrgico cuando este lo requiera. La elección del diseño del colgajo adecuado para la reconstrucción con estos colgajos ofrece la mejor oportunidad para un resultado exitoso. Conclusión: El colgajo de avance volar de Moberg es una buena opción en defectos de la punta de digital en defectos menor o iguales a 2 cm. En los casos que se presente una longitud mayor a 2 cm, se debe planificar la reconstrucción mediante colgajo Moberg modificado.
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