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Incidental findings smaller than 4 cm should be followed-up by imaging. Tumors measuring more than 7 cm or those that are symptomatic a surgical approach is mandated. We present the case of a 78-year-old man with an extra-adrenal myelolipoma.The pre-operative differential diagnosis of gastric subepithelial lesions is complex. We can find pathologies with a very different behavior. Some of them, like gastrointestinal (GI) stromal tumors, can present a malignant behavior, and others like schwannomas are practically benign. Schwannomas of the GI tract originate from the Schwann cells of the Auerbach plexus and their most frequent location is the stomach. Selleckchem AZD9291 The definitive diagnosis is made by immunohistochemical analysis of the surgical specimen and its resection is curative. We report two cases of gastric subepithelial lesions with a definitive diagnosis of schwannoma.Las neoplasias del apéndice son un grupo heterogéneo de tumores con una incidencia baja, la presentación clínica es inespecífica, cursando generalmente de forma asintomática, y la tomografía es el estudio de elección para el diagnóstico. El tratamiento dependerá del tipo histológico del tumor.The appendix neoplasms are a heterogeneous group of tumors with a low incidence, the clinical presentation is nonspecific, usually being asymptomatic, tomography is the study of choice for the diagnosis. Treatment will depend on the histological type of the tumor.El pectus excavatum es la deformidad de la caja torácica frecuente, siendo el sexo masculino el mayormente afectado. Presentamos el caso de un varón de 16 años con pectus excavatum e índice de Haller de 4, a quien se somete a cirugía de pectus up con sistema de tracción esternal externa y fijación con tornillos. Se obtuvo una muy buena respuesta funcional y estética en su posoperatorio. La cirugía de pectus up como método poco invasivo da buenos resultados posoperatorios.The pectus excavatum is the most frequent deformity of the rib cage, with the male sex being the most affected. We present the case of a 16-year-old male with the presence of pectus excavatum with a Haller’s index of 4 who undergoes pectus up surgery with an external sternal traction system and screw fixation. A very good functional and aesthetic response was obtained. The pectus up surgery as a less invasive technique has good postoperative results.Los pacientes con crisis hipecalcémica suelen estabilizarse con tratamiento médico y rara vez precisan tratamiento quirúrgico urgente. Se presenta el caso de una mujer con clínica inespecífica de dolor abdominal, diagnosticada tardíamente de crisis hipercalcémica por hiperparatiroidismo primario. El tratamiento médico y la diálisis peritoneal no fueron efectivos, por lo que precisó paratiroidectomía urgente con determinación intraoperatoria de hormona paratiroidea. La localización preoperatoria del adenoma fue concordante para gammagrafía y ecografía. La crisis hipercalcémica por hiperparatiroidismo primario sin respuesta al tratamiento médico precisa paratiroidectomía urgente. El diagnóstico de localización preoperatorio y la hormona paratiroidea intraoperatoria son indispensables para un tratamiento quirúrgico curativo.Patients with hypecalcemic crisis usually stabilize with medical treatment and rarely require urgent surgical treatment. Woman with a nonspecific clinic of abdominal pain, diagnosed late of hypercalcemic crisis due to primary hyperparathyroidism. Medical treatment and peritoneal dialysis were not effective, requiring urgent parathyroidectomy with determination of intraoperative parathormone. The preoperative location of the adenoma was concordant for scintigraphy and ultrasound. Hypercalcemic crisis due to primary hyperparathyroidism without response to medical treatment requires urgent parathyroidectomy. Preoperative adenoma location and intraoperative parathormone are essential for curative surgical treatment.
El trauma en México es un problema mayor de salud pública, siendo una de las principales causas de mortalidad en personas jóvenes. La incidencia reportada de trauma cardiaco varía. El sitio primario de lesión miocárdica es la pared libre del ventrículo derecho.
Se reportan dos casos de pacientes lesionados con un instrumento punzocortante en el tórax, sufriendo lesión miocárdica que requirió tratamiento quirúrgico de urgencia.
Existen diversas incisiones del tórax. La elección dependerá de la situación a tratar, el estado hemodinámico y el número de lesiones. Ante una lesión cardiaca, el abordaje de Spangaro es una prudente elección.
Trauma in Mexico is a major public health problem, being one of the main causes of mortality in young people. The reported incidence of cardiac trauma complications. The primary site of myocardial injury is the free wall of the right ventricle.
Two cases of injured patients with a throbbing instrument in the chest are reported, suffering from myocardial injury that required emergency surgical treatment.
There are various chest incisions. The choice will depend on the entity to be treated, the hemodynamic state, number of injuries. Faced with a heart injury, Spangaro’s approach is a prudent choice.
There are various chest incisions. The choice will depend on the entity to be treated, the hemodynamic state, number of injuries. Faced with a heart injury, Spangaro’s approach is a prudent choice.El situs inversus es una rara anomalía congénita. El primer caso de colecistectomía laparoscópica en un paciente con situs inversus totalis se realizó en 1991. Se presenta el caso de un paciente varón, de 66 años, que presentó litiasis vesicular. Durante el protocolo preoperatorio se documentó situs inversus totalis. Fue intervenido quirúrgicamente de forma electiva y se realizó colecistectomía laparoscópica sin complicaciones. Diversos autores reportan casos en los que realizaron colecistectomía laparoscópica con tres y cuatro trócares, y con diferente posición de los puertos. Es técnicamente demandante realizar una colecistectomía laparoscópica en pacientes con situs inversus totalis, pero es seguro realizarla.Situs inversus totalis is a rare congenital anomaly. The first case of laparoscopic cholecystectomy in a patient with situs inversus totalis was reported in 1991. A 66-year-old male with cholelithiasis. Clinical assessment and radiological investigation diagnosed situs inversus totalis. Laparoscopic cholecystectomy was performed electively without complications.
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