RESUMO
Resumen ANTECEDENTES La perforación es la complicación más temida durante la aplicación de un dispositivo intrauterino; cuando esto sucede debe retirarse el dispositivo debido al potencial riesgo de perforación y obstrucción intestinal. CASO CLÍNICO Paciente de 26 años, con trastorno del ciclo menstrual y dispareunia. La radiografía abdominal mostró el dispositivo intrauterino en posición anómala. La tomografía simple de abdomen evidenció el dispositivo en la zona intraluminal del recto, en la pared anterior, a 10 cm del esfínter anal. Se extrajo el dispositivo mediante colonoscopia. Los hallazgos intraoperatorios fueron: migración del dispositivo intrauterino, a 12 cm del margen anal, con adecuada exposición del brazo vertical. La extracción del dispositivo fue exitosa, con evolución satisfactoria de la paciente pues no hubo dolor ni alteraciones intestinales. CONCLUSIÓN La colonoscopia es una técnica diagnóstica y terapéutica efectiva en pacientes con migración del dispositivo intrauterino y afectación intestinal sin perforación, incluso puede considerarse antes de recurrir a la laparoscopia o laparotomía.
Abstract BACKGROUND Perforation is the most important complication during the application of an intrauterine device, which should be removed because of the potential risk of perforation and intestinal obstruction. CASE REPORT Female patient of 26 years of age, who presents menstrual rhythm disorders as well as dyspareunia. The tomography revealed the intrauterine device in the rectum, in the anterior wall, intraluminal, and 10 cm from the anal sphincter. It was scheduled for colonoscopy and device removal. The intraoperative findings were: migration of the intrauterine device, 12 cm from the anal margin, with adequate exposure of the vertical arm. The extraction of the device was successful. The patient had a satisfactory evolution, showed no pain or intestinal alterations. CONCLUSION Colonoscopy is a study of great help in all patients in whom migration of IUD with bowel disease without perforation and related complications is suspected, since it provides diagnostic and even therapeutic support, prior to considering a laparoscopy or laparotomy.
RESUMO
Se presenta un caso de adenocarcinoma de colon en un varón de 10 años, sin factores predisponentes. Clinicámente se manifestó con obstrucción intestinal, consecuencia un avanzado estadío local. La terapeútica quirúrgica y en quimioterapia no modificó por la rápida progresión tumoral por lo que el niño falleció a los 5 meses del diagnóstico.Se comentan los aspectos clinicos,patológicos y evolutivos del cáncer de colon en la edad pediátrica...
Assuntos
Humanos , Criança , Adenocarcinoma/cirurgia , Neoplasias do Colo/cirurgiaRESUMO
Se presenta un caso de adenocarcinoma de colon en un varón de 10 años, sin factores predisponentes. Clinicámente se manifestó con obstrucción intestinal, consecuencia un avanzado estadío local. La terapeútica quirúrgica y en quimioterapia no modificó por la rápida progresión tumoral por lo que el niño falleció a los 5 meses del diagnóstico.Se comentan los aspectos clinicos,patológicos y evolutivos del cáncer de colon en la edad pediátrica... {
Assuntos
Humanos , Criança , Adenocarcinoma/cirurgia , Neoplasias do Colo/cirurgiaRESUMO
BACKGROUND: The prevalence of chronic pancreatitis in Chile is not known and there is no local information about the surgical treatment of this disease. AIM: To review retrospectively the results of surgical treatment of chronic pancreatitis. MATERIAL AND METHODS: The charts of 17 patients (12 male), aged 7 to 65 years old, with chronic pancreatitis that were operated in three different Chilean regions, were reviewed. RESULTS: Seven patients had previous endoscopic therapeutic procedures (papillotomy in 4 and stent placing in 3). Seven patients had been subjected to previous biliary surgical procedures. Indications for surgery were severe pain in 14 patients, the suspicion of a pancreatic carcinoma in 4 patients, an infected pseudocyst in one and massive bleeding of multiple pseudo-aneurysms in a pseudocyst in one patient. Twelve patients were subjected to decompressions and 5 to pancreatic resections. There was no operative mortality and one transient pancreatic fistula. After an average follow up of 22 months, pain improved in 94% of cases, pancreatic cancer was diagnosed in one patient and 79% of subjects gained weight. One patient became insulin dependent, one increased his insulin requirements and one had transient steatorrhea, since she could not afford pancreatic enzyme replacement therapy. CONCLUSIONS: The multidisciplinary approach of patients with chronic pancreatitis, with selective use of surgery, may greatly improve their quality of life.