Abdominal aortic aneurysms are defined as vascular dilatations greater than 50% of the normal proximal segment or those that have a maximum diameter above 3 cm. Risk factors include male gender, age over 75 years, history of vascular pathology, hypertension and arteriosclerosis. The Authors describe a case of a 74-year-old man, evaluated in an emergency setting for right lumbar pain lasting 4 days. The pain did not respond to analgesia and became progressively worse. Due to the severity of symptoms, CT angiography was performed, which showed an active rupture of a partially contained aneurysm associated with aortic dissection. Early diagnosis and timely management of aortic aneurysms are essential in preventing complications, namely rupture (50–83% patients die after rupture and before receiving medical care). Acute aortic dissection is a surgical emergency and the risk of rupture is proportional to the size of the aneurysm and its rate of growth.LEARNING POINTSThis article shows how difficult it is sometimes to make the right diagnosis in an emergency department.Although a very common symptom, low back pain should not be regarded as harmless.

MEDICAL MEMORANDA MBILJ cyst was derived from a congenital duplication of the large intestine. The cyst described in this paper and the retroperitoneal cyst of Hughes and Greene bear a close resemblance histologically, the endothelial foam cells and giant cells found in both suggesting a breaking down of fat cells following infection; but, whereas theirs was unilocular and lay on the antimesenteric border of the gut, the one now reported was multilocular and invaded the appendices epiploicae. It is possible that the two cysts may have a similar origin, which may be explained in the way suggested by Hughes and Greene. The importance of this type of cyst is its clinical resemblance to carcinoma of the colon.

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Introducción: la sarcoidosis es una granulomatosis sistémica de etiología desconocida, que se puede manifestar de forma aguda como síndrome de Löfgren en 20 %-50 % de los individuos, la cual, a pesar de tener un curso benigno, exige una vigilancia y acompañamiento cuidadoso de los enfermos. Este síndrome, caracterizado por la triada eritema nodoso, linfadenopatias hilares bilaterales y poliartralgia o poliartritis, no carece de confirmación histológica para el diagnóstico y es más prevalente en mujeres caucasianas hasta los 35 años. Presenta buenos pronósticos y puede tener resolución espontánea de las quejas en el primer año después del aparecimiento. Caso clínico: los autores presentan el caso clínico de una paciente de 20 años que acudió al servicio de urgencia con lesiones nodulares, enrojecidas y dolorosas en los miembros inferiores, acompañadas de malestar general e gonalgias bilaterais com compromiso funcional. Se confirmaron linfadenopatías y hilares bilaterales y aumento de la enzima conversora de la angiotensina sérica. Conclusión: la paciente tuvo respuesta favorable a un ciclo corto de corticoterapia y analgesia con antinflamatorios, no esteroides.