Introduction
Extrapulmonary tuberculosis may develop in any organ system, including the spine. The affection of spinal cord is called Pott's disease and it is the most frequent set. Pott's disease can present as back pain and be related to complications such psoas muscle abscess.
Case presentation
We report a case of 23-year-old Brazilian woman, natural from Amazonas, presenting with psoas abscess associated to Pott's disease treated with surgical debridement and drainage and extended tuberculosis scheme.
Discussion
Psoas abscess is rare and the main agents related to psoas abscess are
Staphylococcus aureus
, followed by
Streptococcus
and
Escherichia coli
. Retrofascial abscesses usually originate from bone lesions, including spine tuberculosis as our case, or due to contiguity of the retroperitoneal space.
Conclusion
Psoas abscess related to Pott's disease is a difficult diagnosis, requiring high suspicious and proper investigation through good anamnesis, CT scan and culture.
A isquemia mesentérica aguda é um quadro de abdômen agudo vascular em que ocorre obstrução arterial súbita ocasionando má nutrição e hipoxemia de órgãos do trato gastrointestinal. É uma emergência cirúrgica rara com elevadas taxas de morbimortalidade sendo mais comum em mulheres a partir dos 60 anos. Dentre os fatores de risco destaca-se aterosclerose e distúrbios de coagulação. Possui evolução clinica inespecífica, à medida que a doença avança sinais de peritonite e instabilidade hemodinâmica são comuns. Sendo o diagnóstico precoce o melhor método de minimizar complicações, no entanto ainda é um desafio na prática médica. Em 2020 o mundo foi marcado pela pandemia de SARS-CoV-2, em consonância, observa-se o aumento significativo de síndromes isquêmicas na cidade de Manaus, incluindo a isquemia mesentérica aguda. Atualmente são 6.386.787 infectados e 173.817 mortos no Brasil, nesse cenário são apresentados 3 casos de isquemia mesentérica em um hospital da rede pública de Manaus entre julho e agosto de 2020. Salienta-se que esse diagnóstico é raro e não fazia parte da rotina de atendimentos na cidade, destacando a relação entre essas duas patologias.
Introduction
Even though colorectal cancer is one of the most frequent in the world, its simultaneous presence with other neoplasms, such as renal, is still rare in incidence. This article aims to report and expose a literature review of the synchrony of colorectal cancer and renal carcinoma.
Presentation of case
A 57-year-old female patient complaining of diffuse abdominal pain that worsened with food and improved with evacuation, especially in the periumbilical region and right iliac fossa, from moderate to strong intensity, starting 1 year ago, worsening in the last 3 months. An abdominal CT scan was performed, showing a lesion in the right kidney and a narrowing of the ascending colon lumen. Due to the possibility of cure, we opted for right colectomy and right nephrectomy at the same surgery.
Discussion
Synchronous tumors are neoplasms in which the diagnostic interval is up to 6 months, and must be differentiated from metachronic neoplasms and even metastases between tumors. The incidence of synchronous colorectal and renal cancer is rare but appears to be divergent.
Conclusion
The presence of synchronous tumors can be evidenced in imaging tests, such as CT scan, but appropriate diagnostic tests for each neoplasm, such as colonoscopy, should not be ruled out. The treatment of choice must be surgery, when possible, with the options of conventional access, videolaparoscopic and robotic surgery.
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