Hombre de 80 años con antecedentes de hipertensión arterial y enfermedad pulmonar obstructiva crónica. Consultó por disnea y angina progresiva de un año de evolución. El ecocardiograma demostró una masa tumoral de 5 por 3 centímetros en la aurícula izquierda, móvil, pediculada y que protruye a través de la válvula mitral hacia ventrículo izquierdo (Figura 1A). La masa tumoral tenía base de implantación en el tabique inter auricular y era compatible con mixoma.Se completó el estudio con coronariografía que demostró enfermedad coronaria; presentaba una lesión crítica en la arteria coronaria descendente anterior y oclusión de la arteria coronaria derecha. En la coronariografía la masa tumoral se contrastaba en forma espontánea ( Figuras 1B y 1C).
Fasciotomy closure technique with vessel loopsAim: Present and describe the progressive fasciotomy closure technique with vessel loops. Methods: Progressive and multicentric study in the period between June of 2007 and June of 2011. Results: In 2007 we initiated the complementary treatment for fasciotomy closure related to compartment syndrome or acute ischemia cases. Progressive closure with vessel loops, the shoelace technique. In 2010's preliminary report, we published a total of 56 fasciotomies closed by this technique, with an average closure time of 9.5 ± 3.31 days. Current report is the result of a 4 years prospective study intending to prove that is possible to associate this technique to the initial management of fasciotomies closure. This final report shows a total of 122 fasciotomies cases closed in 7.9 ± 3.31 days, without skin grafts. Conclusion: The technique is easy to learn, reproducible and not expensive. Results show that this technique is useful in reduce the time for fasciotomy closure.
Thoracic foreign body after penetrating chest trauma We present the case of a 21 year old man with an intra thoracic foreign body after penetrating chest trauma. The foreign body was the blade of a knife. It was removed through the wound, without thoracotomy or video-assisted thoracic surgery (VATS) and the patient evolved without incidents. Intrathoracic foreign bodies secondary to penetrating trauma are rare. They are usually removed through thoracotomy or VATS. Both alternatives allow adequate exploration of the intra-thoracic structures and repair injuries that are potentially lethal. In stable patients and selected cases, they can be removed without surgery (without thoracotomy or VATS); always in an operating room and under general anesthesia, in case that surgical exploration could be needed after the procedure.
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