Introduction: The invagination of one intestinal loop within another rarely occurs in adults and it is usually caused by a polyp or another intraluminal lesion. Intussusceptions occur mostly in children; an organic lesion is not necessary, and colic pain syndrome, rectal bleeding, and a palpable mass (the intussuscepted segment) are characteristics. Justification: To compare data from a tertiary reference hospital with data described in the literature, considering the evolution of such patients is unknown in our field. Objective: To report the case of a patient with distal jejunal intussusception from melanoma metastasis. Method: Information was obtained through medical record reviews, patient interviews, photographic records of the diagnostic methods and the surgery to which patients were subjected, and literature review. Final considerations: The case reported and the publications surveyed bring to light the discussion on the therapeutics of the complex condition that is melanoma metastasis, showing that some patients may present satisfactory and lasting results regarding symptom relief and improvement of quality of life.
Nonbacterial thrombotic endocarditis is an uncommon disease characterized by formation and deposition of sterile fibrin vegetations on heart valves. This condition is more related to states of chronic inflammation, mainly related to malignancy. This report describes the case of a Brazilian woman, 50 years old, smoker, diagnosed with pulmonary adenocarcinoma with pleural and bone metastases after presenting with deep venous thrombosis and pulmonary embolism. During the investigation, a transthoracic echocardiogram was performed, which revealed a mobile echogenic mass in the mitral leaflet. As there were no suggestive signs or laboratory tests that corroborated a systemic bacterial infection, the diagnosis of non-bacterial thrombotic endocarditis was confirmed. Given the poor prognosis related to the disease, suspicion and early treatment were determining factors for the favorable evolution presented.
RESUMOIntrodução: As operações na glândula adrenal são realizadas para determinados cânceres, todas as massas biologicamente ativas, metástases, massas com mais de 4-5 cm encontradas incidentalmente e hiperplasia adrenal primária. Métodos:Estudo transversal e descritivo. Foram analisados os prontuários dos pacientes submetidos a adrenalectomia videolaparoscópica entre agosto de 1994 e novembro de 2014. Resultados:Foram realizadas 146 adrenalectomias videolaparoscópicas. Em 134 casos, foi realizada com sucesso, mas em 12 casos (8,2%), o procedimento foi convertido. Foram 97 pacientes do sexo feminino e 49 do sexo masculino, com idade variando de 9 a 81 anos (média de 46,7 anos). Foram removidas 56 adrenais direitas, 75 esquerdas e 15 bilaterais. O tamanho médio das adrenais foi de 5,7 cm, variando de 0,9 a 15 cm. A mediana do tempo de internação hospitalar pós-operatória foi de 4,5 dias. A mediana do tempo de cirurgia foi de 144 minutos. Houve complicações em 22,5% dos casos (maiores -casos em que houve conversão para cirurgia aberta, necessidade de reinternação hospitalar e óbito-e menores), sendo 10,9% complicações intraoperatórias e 11,6% pós-operatórias. Apenas sete (4,7%) pacientes foram considerados complicações maiores. Conclusão:A cirurgia realizada em nosso serviço está de acordo com o descrito na literatura, com taxas aceitáveis de complicações, com motivos de conversão compatíveis e com as indicações totalmente aceitáveis e condizentes. A adrenalectomia videolaparoscópica é a cirurgia de escolha para patologias cirúrgicas da glândula adrenal, exceto em casos de carcinoma adrenal localmente invasivo com comprometimento de outras estruturas. Palavras-chave: Glândulas suprarrenais; adrenalectomia; laparoscopia ABSTRACTIntroduction: Adrenal gland surgery is performed for some types of cancer, all biologically active masses, metastases, masses larger than 4-5 cm found incidentally, and primary adrenal hyperplasia.
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