Divertículo de Meckel necrosado Necrotic Meckel's diverticulum

Se presenta el caso de un paciente que acudió al cuerpo de guardia del CIMEQ en marzo del 2007. Presentaba un cuadro clínico de abdomen agudo quirúrgico y fue intervenido con el diagnóstico de apendicitis aguda complicada. En el transoperatorio se constató la presencia de un gran divertículo de Meckel, que inicialmente se inflamó (diverticulitis aguda) y posteriormente evolucionó hasta la necrosis, por lo que afectó la irrigación de un segmento intestinal en el íleon terminal, el ciego y el tercio inferior del colon ascendente. El apéndice no tenía ninguna alteración, por lo que se realizó una hemicolectomía derecha. El paciente evolucionó favorablemente y fue dado de alta a los 10 días, con una evolución favorable.This is the case presentation of a patient treated in Emergency Department in March 2007 presenting with a clinical picture of surgical acute abdomen and operated on due to complicated acute appendicitis. At transoperative period presence of a Meckel's diverticulum was verified that initially becomes inflamed (acute diverticulitis) and later process evolved until necrosis affecting the blood stream of an intestinal segment in terminal ileum, cecum ant the lower third of ascending colon. Appendix was not altered and a hemicholectomy was performed. Patient had a favorable course and was discharged at 10 days

GHSI EMERGENCY RADIONUCLIDE BIOASSAY LABORATORY NETWORK: SUMMARY OF THE SECOND EXERCISE

The Global Health Security Initiative (GHSI) established a laboratory network within the GHSI community to develop collectivesurge capacity for radionuclide bioassay in response to a radiological or nuclear emergency as a means of enhancingresponse capability, health outcomes and community resilience. GHSI partners conducted an exercise in collaboration withthe WHO Radiation Emergency Medical Preparedness and Assistance Network and the IAEA Response and AssistanceNetwork, to test the participating laboratories (18) for their capabilities in in vitro assay of biological samples, using a urinesample spiked with multiple high-risk radionuclides (90Sr, 106Ru, 137Cs, and 239Pu). Laboratories were required to submittheir reports within 72 h following receipt of the sample, using a pre-formatted template, on the procedures, methods and techniquesused to identify and quantify the radionuclides in the sample, as well as the bioassay results with a 95% confidenceinterval. All of the participating laboratories identified and measured all or some of the radionuclides in the sample. However,gaps were identified in both the procedures used to assay multiple radionuclides in one sample, as well as in the methods ortechniques used to assay specific radionuclides in urine. Two-third of the participating laboratories had difficulties in determiningall the radionuclides in the sample. Results from this exercise indicate that challenges remain with respect to ensuringthat results are delivered in a timely, consistent and reliable manner to support medical interventions. Laboratories within thenetworks are encouraged to work together to develop and maintain collective capabilities and capacity for emergency bioassay,which is an important component of radiation emergency response