Oblitos en Cirugía. Análisis de casuística y estrategias para su prevenciónForeign body in Surgery. Case analysis and prevention strategiesOblitos em Cirurgia. Análise de caso e estratégias de prevenção ResumenIntroducción: El oblito es un evento de muy baja frecuencia pero que puede generar morbilidad grave. Si bien se han reconocido algunos factores de riesgo y desarrollado sistemas complementarios de detección, continua siendo un gran problema desde el punto de vista sanitario y médico legal.Objetivos: Analizar una casuística del Hospital Maciel, su forma de presentación y complicaciones. Pacientes y métodos: Se presentan 7 pacientes asistidos en los Servicios de Cirugía General y Urología del Hospital Maciel, en el período comprendido del 2013 -2016. Las principales variables que se analizan son la forma de presentación y complicaciones, así como presencia de factores de riesgo.Resultados: El hallazgo fue de compresas en todos los pacientes. En 2 casos el oblito fue asintomático y en otros 5 sintomático. En los últimos, 2 tuvieron una presentación temprana y 3 tardía. El recuento de material fue incorrecto solamente en un caso. Ningún paciente falleció por las complicaciones resultantes.Discusión: El oblito en cirugía es un problema que seguirá existiendo en tanto existan los procedimientos quirúrgicos, por lo que es necesario hacer énfasis en el abordaje sistemático, existiendo también métodos auxiliares de diagnóstico que podrían comenzar a implementarse.Conclusiones: Encontramos casi sin excepción la presencia de factores de riesgo conocidos en nuestra serie, si bien el número de casos es reducido. También la incidencia impresiona ser algo más elevada de la señalada en la literatura. Palabras claveOblito, oblitoma, textiloma, gossypiboma. to be a major problem from a health and medical legal point of view. Objectives: to examine a case study at Hospital Maciel, focusing on clinical presentation and complications.Patients and methods: 7 patients treated at the General Surgery and Urology Departments in Hospital Maciel, between 2013-2016. The main results analized are clinical presentation and complications, as well as the presence of recongnized risk factors.Results: In all patients, the foreign bodies were compresses. In 2 cases the foreign body did not elicit symptoms whereas in five cases it did, 2 had an early and 3 a late presentation. The material count was incorrect in only one case. No patient died from the resulting complications Discussion:Because retained surgical ítems will be a problem as long as surgical procedures are performed, it is necessary to emphasize on a systematic approach accompanied by complementary diagnostic tools that are also available in cases of item miscount.Conclusions: Risk factors were present almost without exception in our case study. Also, the inci-dence seems to be higher than that reported in the literature.
Mucinous biliary cystadenoma (MBC) is a very rare cystic tumour of the liver usually occurring in middleaged women. This condition is difficult to diagnose before surgery; differential diagnosis with hydatid disease of the liver has to be done and is difficult to distinguish from mucinous biliary cystadenocarcinoma. We report two diagnosed and treated cases of intrahepatic MBC.
Introduction: Coronary anomalies, whose incidence is 0.17 to 1.5%, are relevant since they can debut as sudden cardiac death and can determine technical difficulties in interventional procedures such as coronary angiography. This prompted the following study, whose objective is to determine the incidence of anomalies and anatomical variants in the origin and proximal course of the coronary arteries, in a cadaveric population. Materials and methods: 81 hearts were dissected from adult cadavers, of both sexes, previously fixed and preserved in a 10% formaldehyde-based solution. Once the heart was released, the identification and subsequent dissection of the coronary arteries and coronary ostia were carried out. The following data were recorded: number of ostiums, aortic sinus where said ostiums are located, artery that gives origin, route and direction of the same. The data were recorded in tables for later analysis. Results: Of the total of 81 dissected hearts, 45 (55.6%) presented “classic” coronary arteries in origin and proximal path and 36 (44.4%) presented normal anatomical variants and coronary anomalies. Conclusions: Knowledge of coronary anomalies is of the utmost importance, given that between 20% to 90% present with sudden cardiac death and given that when it comes to performing interventional procedures, their ignorance may determine an increase in the duration of the procedures with greater contrast input and radiation exposure for the patient.
ResumenIntroducción: Las complicaciones torácicas secundarias a pancreatitis aguda son excepcionales y más aún la presencia de un pseudoquiste mediastinal.Caso clínico: Hombre de 36 años. Consumidor de marihuana y alcohol. Historia de 6 meses de dolor abdominal y adelgazamiento de 20 kilos. Instalando en la evolución sintomatología respiratoria.Discusión: Se discuten las formas de presentación de esta entidad. Sus etiologías más frecuentes. Se hace énfasis en el rol de la imagenología así como en el análisis del líquido pleural.El enfoque terapéutico es conservador al inicio y en algunos pacientes es quirúrgico en la evolución; con diversas opciones.
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