Intussusception is the invagination of a bowel segment into another immediately adjacent, causing obstruction, and the etiology can be benign, malignant, or idiopathic. The diagnosis may be obtained by ultrasound scans, or computed tomography imaging that can detect characteristics findings. Small bowel obstruction due to intussusception of inverted Meckel's diverticulum is a rare condition that usually constitutes a challenging diagnosis in adulthood. The surgical management in adults is often performed by en bloc resection without reduction attempts. We report a case of CASE REPORTS a middle-aged man with acute intestinal obstruction due to an ileo-ileal intussusception of inverted Meckel's diverticulum with a lipoma that was managed by laparoscopy. Worthy of note is the very scarce number of case reports on this exceeding uncommon association.
O trauma de laringe constitui-se em uma lesão penetrante na região cervical de grande importância nos atendimentos em emergências. Lesões penetrantes estão associadas a trauma balístico, com maior chance de ruptura endo laríngea. Este relato de caso refere-se a um paciente do sexo masculino vítima de lesão penetrante promovido por arma de fogo em região cervical anterior, com lesão laríngea complexa, grau IV de Legacy Emanuel. Este foi submetido a uma cervicotomia de emergência, com evidência de lesão de cartilagem tireoide, sendo realizado enxerto cartilaginoso proveniente de segunda articulação costocondral direita, tendo o paciente evoluído de maneira satisfatória em pós operatório sem déficits funcionais de fala. Foi evidenciado, que a aplicação da técnica resultou na não rejeição do órgão ao enxerto, com rápida recuperação. Houve uma completa epitelização de face intraluminal do enxerto no quinto dia pós-operatório, evidenciado em broncoscopia e resultando em ganho funcional e estético para o paciente, além de tempo de internação hospitalar reduzido. Esta estratégia adotada gerou bons resultados, sem rejeição de retalho, com boa repercussão estética e sem limitações funcionais no doente, reduzindo o número de abordagens cirúrgicas, tempo hospitalizado e gastos de recursos financeiros com internação hospitalar.
Objective: To identify the sensitivity and specificity of Fine-Needle Aspiration Biopsies (FNAB) performed at Hospital Regional da Asa Norte (HRAN) for the diagnosis of thyroid cancer in patients submitted to thyroidectomy. Methods: This was an observational and analytical study, which analyzed medical records of patients submitted to FNAB at HRAN from April 2015 to December 2021. The data were descriptively analyzed using the SPSS 2.0 program, and using the ROC Curve, considering a p value <0.05 as statistically significant. Results: 699 patients were submitted to FNAB. 62 patients were undergoing biopsy and surgery after. FNAB sensitivity and specificity were 90.32% and 83.87%, respectively (p <0.001). Most patients were females (96.78%), aged > 60 years (32.25%) and were submitted to total thyroidectomy (66.12%). Among the analyzed cytopathological samples, the Bethesda II classification predominated (25.80%), followed by class V (22.58%). In the histopathological analysis, the predominant diagnosis was papillary carcinoma (43.54%) followed by goiter (38.70%). Among classes I and II, only one sample was considered malignant after the histopathological analysis. Among class III samples, 22.22% were, in fact, malignant lesions. Among the samples suspected of malignancy (Bethesda IV, V and VI), there was a progressive increase in the rate of cancer diagnosis, of 62.50%, 85.71% and 100%, respectively. The FNAB results showed an accuracy of 87.09%. Conclusions: The results of this study are compatible with the findings in the literature. Thus, FNAB remains the gold standard for the analysis of thyroid nodules until another more sensitive and specific method is described.
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