RESUMO
OBJECTIVE: This study aims to evaluate the thickness of the femoral quadriceps and biceps brachii and brachialis muscles bilaterally and the adjacent subcutaneous fat in patients undergoing gastric bypass Roux-en-Y before and after surgery, using ultrasound as the diagnostic method of choice. METHODS: We studied 12 patients undergoing this surgical method preoperatively and during the first, third, and sixth postoperative months. During these periods, patients were evaluated by ultrasound to determine the thickness of subcutaneous adipose tissue and muscle of the upper and lower limbs. RESULTS: Postoperatively, these patients showed a reduction in the thickness of the upper and lower extremities muscle and adipose tissue as compared to their preoperative values. There was a significant difference in the loss of muscle thickness in all postoperative months and in the thickness of fatty tissue in the sixth month after surgery, compared to the preoperative muscle and fatty tissue thickness. CONCLUSIONS: Ultrasound can be considered as the diagnostic method of choice when assessment of the fat and lean body mass is required in morbidly obese patients before and after bariatric surgery.
Assuntos
Composição Corporal , Derivação Gástrica , Obesidade Mórbida/diagnóstico por imagem , Obesidade Mórbida/patologia , Músculo Quadríceps/diagnóstico por imagem , Gordura Subcutânea/diagnóstico por imagem , Adulto , Feminino , Seguimentos , Derivação Gástrica/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/cirurgia , Período Pós-Operatório , Período Pré-Operatório , Músculo Quadríceps/patologia , Gordura Subcutânea/patologia , Ultrassonografia , Adulto JovemRESUMO
Psoas abscess (PA) is an infrequent clinical entity and presents diagnostic and therapeutic challenges. Six cases are reported concerning diagnostic and therapeutic considerations. Clinical diagnosis is difficult because of non-specific symptoms. The primary psoas abscess has no definite etiology and is spread by hematogeneous route from a distant occult site. The PA can also be secondary to gastrointestinal pathology through direct infection of adjacent structures. The most common causes are Crohn's disease, appendicitis, diverticulitis and carcinoma. Routine laboratory evaluation is seldom useful for localizing the disease process. Conventional radiological techniques are often unhelpful. Modern imaging diagnosis techniques such as ultrasound and computerized tomography have allowed for a refinement in both the etiologic diagnosis and the treatment by means of CT-guided or ultrasound-guided percutaneous drainage of the abscess, thus avoiding surgical drainage in many cases. Immediately on diagnosis of PA prompt treatment is necessary. Percutaneous drainage should be performed whenever possible and in case of failure, surgical drainage should be practiced as well as intestinal resection, whenever indicated.