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SUMMARY INTRODUCTION: Acute appendicitis (AA) is the most common cause of surgical acute abdomen. Postoperative complications in emergency care are reflections of the surgical procedure and pre- and postoperative factors. OBJECTIVE: Define prognostic factors for patients who underwent appendectomy, comparing them with the literature. METHODS: Descriptive observational study with a cross-sectional design based on data from the emergency/urgency appendectomy records between September 2018 and April 2019. Variables of interest were considered based on intrinsic patient data, clinical status, and perioperative management factors. Primary outcomes considered: postoperative complications from hospital admission discharge and prolonged hospital stay for > 2 days. Secondary outcome: death. The results were evaluated by Fisher's exact test (p <0.05). RESULTS: We identified 48 patients undergoing an appendectomy. Young adults accounted for 68.7%. From the total, 58.3% were males, 6 (12.5%) had hospitalization> 2 days, 4 (8.3%) had complications and no deaths. Among the variables, the stage of AA, the time of complaint up until seeking care, and advanced age were correlated with worse prognosis during hospitalization (p <0.05). The emergence of immediate postoperative complications was correlated with longer hospital stay (p <0.05). DISCUSSION: The descriptive data of the sample converge with the epidemiological profile of patients with AA in the literature, corroborating the applicability of conventional guidelines. The results strengthen the hypothesis that the patient's flow with abdominal manifestations is complicated from the first contact with SUS to the resolution of the condition. CONCLUSION: Knowledge of the epidemiological profile and perioperative predictors that are most related to complications favor the appropriate management of patients.

Experience in the treatment of 150 patients with anorectal disorders and disorders of the sacrococcygeal region who were operated on with local anesthesia at the University Hospital, ABC Medical School, São Bernardo do Campo, SP, Brazil, from March 1995 to March 1998. The anesthesia technique, the operations carried out and the tolerance to the procedure are reported. Intraoperative morbidity was 10.6% (16 patients), and postoperative morbidity was 6% (nine patients). The age of patients was between 15 and 92 years old, with mean age 42 years old; 58% of patients were male and 42% female. Surgical mean time was 45 minutes and the patients remained in the hospital for a mean time of 8 hours. All of patients was instructed about the anesthesia technique, their advantages and disadvantages, and only with their permit the surgery was programmed. Hospitalization was required in five patients (3.3%). The anesthesia technique employed was the same for all patients. Upon survey, 96.7% of the patients stated they did not feel pain during the surgery and that they would go through the procedure again. The authors conclude the surgical treatment of anorectal disorders and disorders of the sacrococcygeal region with local anesthesia is viable and safe, and in addition, is well accepted by the patients.

von Hippel-Lindau syndrome (VHLS) is a rare, autosomal dominant genetic disease with high penetrance and variable phenotypic expression caused by variants in the VHL gene. VHLS is associated with the presence of vascular tumors, often hemangioblastoma of the central nervous system, retina, or spinal cord and, less frequently, pancreatic cystic neoplasm, pancreatic neuroendocrine tumor, clear cell carcinoma of the kidney, endolymphatic sac tumor, pheochromocytoma, and paraganglioma. The authors report a case of a patient with VHLS with a rare pathogenic variant in the VHL gene and with an optic nerve hemangioblastoma, a rare phenotypic expression. Case report: A 49-year-old woman was diagnosed with cystic neoplasm of the pancreas, renal cell carcinoma of the right kidney, and hemangioblastoma of the left optic nerve. The patient's family history revealed siblings with VHLS manifestations. The index case was her mother who died at age 63 of clear cell renal carcinoma. The information was obtained by consulting the patient's medical register and by interviews with the patient and her relatives. The presence of left optic nerve hemangioblastoma was suggested by CT scan of the skull and orbit. The sequencing of the VHL gene was performed in the peripheral blood by the polymerase chain reaction (PCR) technique, and the duplication and deletion research was performed using the multiplex ligation-dependent probe amplification (MPLA) technique. The presence of a rare pathogenic variant c.263G> A (p.Trp88Ter) was observed in heterozygosity in the VHL gene that determined a premature stop codon. CT scan of the skull and orbits suggested the presence of HB in the optic nerve of the left eye. The results of the CT scan of the skull and orbits show thickening with tortuosity of the left optic nerve, with a small area of nodular enhancement. The right optic nerve had a conserved aspect. Conclusion: This is the fourth case described of this rare pathogenic variant of the VHL gene, according to the Human Gene Mutation Database and VHLdb database records and with an optic nerve hemangioblastoma of the optic nerve, a very rare phenotypic expression of the VHLS.

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