O prolapso retal é uma patologia relativamente rara que consiste na saída parcial ou completa do reto através do ânus (neste caso, também chamado prolapso retal), mais comum na sétima década de vida de pacientes do sexo feminino. Esta condição apresenta sintomas clínicos variados, tais como proctalgia, incontinência fecal, obstipação, sangramento, descarga de muco, protuberância anal, entre outros. O tratamento desta patologia é cirúrgico, contudo, as terapias não cirúrgicas podem ser utilizadas para combater os sintomas associados. Existem diferentes técnicas cirúrgicas para a correcção do prolapso retal descritas na literatura. Estas técnicas podem ser realizadas pela via perineal ou abdominal, escolhendo a abordagem de acordo com o tipo de prolapso e as condições clínicas do paciente. Este relato pretende apresentar uma complicação que ocorreu após a rectosigmoidectomia perineal com reparação de esfíncteres (técnica de Altemeier) em uma paciente no Hospital PUC-Campinas, SP.

Background: Chronic subdural hematoma (CSDH) tends to occur more commonly in elderly patients, usually develops after mild head trauma and the common treatment is surgical. Objective: To evaluate the effect of treatment with atorvastatin compared to surgical intervention in elderly people with CSDH. Design and setting: we performed an integrative review of studies available in four databases from 2010 to 2020. Methods: Studies were considered eligible for this review if they were randomized controlled trials comparing the use of atorvastatin treatment to surgical treatment associated with drainage trepanation in elderly patients diagnosed with CSDH. Results: titles and abstracts were screened and 20 articles of those were selected to be fully read, of which 4 remained. To Sheng Qui et al (2017) and Chan et al (2016), the use of atorvastatin may be beneficial in the management of CSDH, so that the volume of the hematoma reduced from 48.70 ± 20.38 to 16.64 ± 14.28mL with a sample size of 22 in the first month of oral atorvastatin. Min Xu et al. (2016) and Wang et al. (2013), with a sample of 22, found improvements in 85.7% and 95.7% of patients with CSDH in terms of volume and neurological deficits presented. Conclusion: The treatment with atorvastatin appears to be safe and effective for CSDH compared to surgical intervention in the elderly. However, further studies are necessary to validate the results and, thus, to put the evidence into practice.