Rectal tumor as a presentation of primary syphilis In the era of HIV infection there is a resurgence of syphilis. Without a doubt it is still a diagnostic dilemma in various clinical situations such as anorectal syphilis in HIV patients. When a patient HIVpositive presents with a rectal tumor, syphilis must be considered in the differential diagnosis. We present a case report of an HIV positive patient who consulted due to rectal tenesmus associated to rectal bleeding, being diagnosed a rectal tumor and treated secondary to primary syphilis.
giant fecaloma in an adolescent patient *Recibido el 2 de octubre de 2013 y aceptado para publicación el 28 de diciembre de 2013. Los autores no refieren conflictos de interés.
Analysis of predictive factors for conversion to open surgery in laparoscopic colorectal surgeryBackground: Conversion to open surgery of laparoscopic procedures is not in essence a complication, but invalidates the benefi ts of laparoscopy. Aim: To identify the predictive factors for conversion in laparoscopic colorectal surgery. Material and Methods: Revision of medical records of all patients with colorectal disease operated using a laparoscopic approach, from 1998 to 2010. Gender, age, American Society of Anesthesiologists (ASA) score, body mass index (BMI), previous abdominal surgery, elective/urgency procedure, benign/malignant disease, type of resection and surgeon experience were recorded. A logistic regression model was done to determine which variables were predictive for conversion to open surgery. Results: The medical records of 582 patients aged 57 ± 17 years (45% men) were analyzed. The rate of conversion to open surgery was 7.1%. The logistic regression model selected as predictors of conversion a BMI over 25 kg/m
Active and refractory ulcerative proctitis: An update Ulcerative colitis (UC) is a chronic inflammatory disease of unknown etiology that affects a variable length of the colon, starting from the rectum. When the disease is confined to the rectum is called ulcerative proctitis (UP). Several studies have unsuccessfully attempted to determine the factors that determine the extent of involvement. The goals of therapy in UP are to induce and maintain remission of symptoms and disease. Topical treatment with 5-aminosalicylates (5-ASA) is the treatment of choice to induce remission. In the maintenance phase, long-term follow up studies suggest that treatment with 5-ASA is better than placebo, to maintain the disease inactive. For those patients that do not respond to treatment with topical 5-ASA or have a moderate to severe disease, there are additional therapies such as oral 5-ASA, topical or systemic corticosteroids, immunomodulators, biological therapies (Infliximab) and cyclosporine. Surgery is seldom needed.
Bowel obstruction caused by an omphalomesenteric duct remnant.
Report of one caseOmphalomesenteric duct remnant is one of the least common congenital abnormalities due to vitelline sac persistence. Among the five types of this abnormalities, omphalomesenteric band or obliterated omphalomesenteric duct remnant is the least common. We report a 64 years old male presenting with vomiting, abdominal pain and absence of stools. The patient was operated with the diagnosis of intestinal obstruction and a persistent omphalomesenteric duct that caused the bowel obstruction was found. The patient had an uneventful postoperative period as is discharged 24 hours later.Key words: Omphalomesenteric duct, bowel obstruction, vitelline sac.
ResumenEl remanente del conducto onfalomesentérico es una de las anomalías congénitas más raras asociadas con la permanencia del saco vitelino. Dentro de los cinco subtipos que se describen en la literatura, la banda onfalomesentérica o conducto onfalomesentérico obliterado es el de menor frecuencia. Presentamos un caso muy infrecuente de persistencia del conducto onfalomesentérico, que ocasionó una obstrucción intestinal en un paciente adulto y que fue resuelto de forma quirúrgica.Palabras clave: Conducto onfalomesentérico, obstrucción intestinal, saco vitelino.
IntroducciónLa obstrucción intestinal de intestino delgado es una emergencia quirúrgica común y encontrada frecuentemente en laparotomías exploradoras. Es una causa importante de morbilidad y mortalidad en hospitales alrededor del mundo. El remanante del conducto onfalomesentérico es una de las anomalías congénitas más raras asociadas con la permanencia del saco vitelino 1 . Este remanante puede oca-
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