RESUMO
The medium arcuate ligament syndrome is a rare disorder that results from luminal narrowing of the celiac artery by the insertion of diaphragmatic muscle or the celiac nerve plexus. The syndrome is characterized by weight loss, postprandial abdominal pain, nausea, vomiting and an epigastric murmur. Surgical management involves the complete division of the medial arcuate ligament. We present two cases satisfactorily treated by laparoscopic surgery. The role of minimally invasive surgery in the treatment of this syndrome is a safe alternative approach to open surgery.
El síndrome de ligamento arcuato medio es un trastorno poco frecuente que resulta del estrechamiento luminal de la arteria celíaca por la inserción de fibras musculares diafragmáticas o bandas fibrosas del plexo nervioso celíaco. El síndrome se caracteriza por pérdida de peso, dolor abdominal posprandial, náuseas, vómitos y un soplo epigástrico. El manejo quirúrgico implica la división completa del ligamento arqueado mediano. Presentamos dos casos tratados satisfactoriamente mediante cirugía laparoscópica. El papel de la cirugía mínimamente invasiva en el tratamiento de este síndrome es una vía de abordaje segura alternativa a la cirugía abierta.
Assuntos
Laparoscopia , Síndrome do Ligamento Arqueado Mediano/cirurgia , Adolescente , Humanos , Masculino , Adulto JovemRESUMO
Resumen Introducción: La perforación esofágica es una posible complicación de la artrodesis cervical anterior. Sin embargo, estas suelen ocurrir intraoperatoriamente o en el posoperatorio precoz. Caso clínico: Mujer de 35 años sometida, 3 años antes, a artrodesis de C3-C5, que tras sufrir un traumatismo leve con latigazo cervical, comienza con disfagia. Se objetiva un absceso retroesofágico por perforación esofágica, causado por rotura de la placa protésica y extrusión de un tornillo.
Introduction: Esophageal perforation is a possible complication after anterior cervical fusion. However, these complications usually appear intraoperatively or in the early postoperative course. Case report: A 35-years-old females, who underwent a C3-C5 anterior cervical fusion 3 years ago, after suffering a mild cervical trauma, she complained of dysphagia. A retroesophageal abscess was observed, caused by esophageal perforation, secondary to plaque rupture and screw extrusion.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Fusão Vertebral/efeitos adversos , Perfuração Esofágica/cirurgia , Perfuração Esofágica/etiologia , Artrodese/efeitos adversos , Imageamento por Ressonância Magnética , Resultado do Tratamento , Perfuração Esofágica/diagnóstico por imagemRESUMO
BACKGROUND: Duodenal carcinoma is very rare. It represents 33-45% of the all tumours of the small bowel. The symptoms are non-specific, and the diagnosis is often accidental. CLINICAL CASE: A 35-year old man was admitted to our hospital with post-prandial abdominal pain. Upper gastrointestinal examination revealed a tumour of the third duodenal portion, which was diagnosed, using endoscopic biopsy, as a tubular adenoma with high grade dysplasia. The computed axial tomography scan, the magnetic resonance imaging, and the endoscopic ultrasound showed the neoplasia of the third duodenal portion with no lymph node or peritoneal metastases. Partial resection of the duodenum was performed. The definitive histopathological diagnosis was primary adenocarcinoma of the third duodenal portion. pT2 N0M0, originated in a tubular adenoma. CONCLUSIONS: Primitive neoplasia of the duodenum is very rare. Duodeno-cephalo-pancreatectomy is recommended in proximally located tumours, while segmental resection of the duodenum is appropriate for distal locations, with the same survival.