Tumor desmoide extraabdominal en rodilla: a propósito de un caso

Los tumores desmoides o fibromatosis agresiva son neoplasias de partes blandas muy poco frecuentes. Son localmente agresivos y recurrentes, aunque carecen de potencial metastásico. La forma extraabdominal es la más infrecuente y asienta habitualmente sobre la cintura pélvica o escapular. Presentamos el caso de una paciente a la que se le diagnosticó un tumor desmoide extraabdominal en la rodilla izquierda que se manifestó inicialmente como una tumoración dolorosa.Desmoid tumours or aggressive fibromatosis are rare neoplasm of soft tissues. They are locally aggressive and recurrent, although they have no metastatic potential. The extra-abdominal appearance is the less common and tumors are frequently located around pelvic or scapular vicinity. We report a case of a patient who suffered an extra-abdominal desmoid tumor in her left knee that arose as a painful bump

Rotura del núcleo de polietileno en cotilo no cementado

La rotura del componente de polietileno de los cotilos en la prótesis total de cadera, es una complicación raramente descrita, sobre todo en artroplastias no cementadas. Presentamos un caso de rotura del polietileno en una prótesis total de cadera no cementada, revisando los 15 casos previamente publicados. Nuestro propósito es alertar sobre la posibilidad de esta infrecuente complicación.Fracture of the polyethylene liner of uncemented acetabular components is rarely mentioned in the literature. One case of fracture of the polyethylene liner is uncementeed his arthroplasty is described and we review 15 cases previously reported. The purpose of the report is to alert about this rare complication

Global attitudes in the management of acute appendicitis during COVID-19 pandemic: ACIE Appy Study

Background: Surgical strategies are being adapted to face the COVID-19 pandemic. Recommendations on the management of acute appendicitis have been based on expert opinion, but very little evidence is available. This study addressed that dearth with a snapshot of worldwide approaches to appendicitis. Methods: The Association of Italian Surgeons in Europe designed an online survey to assess the current attitude of surgeons globally regarding the management of patients with acute appendicitis during the pandemic. Questions were divided into baseline information, hospital organization and screening, personal protective equipment, management and surgical approach, and patient presentation before versus during the pandemic. Results: Of 744 answers, 709 (from 66 countries) were complete and were included in the analysis. Most hospitals were treating both patients with and those without COVID. There was variation in screening indications and modality used, with chest X-ray plus molecular testing (PCR) being the commonest (19\ub78 per cent). Conservative management of complicated and uncomplicated appendicitis was used by 6\ub76 and 2\ub74 per cent respectively before, but 23\ub77 and 5\ub73 per cent, during the pandemic (both P < 0\ub7001). One-third changed their approach from laparoscopic to open surgery owing to the popular (but evidence-lacking) advice from expert groups during the initial phase of the pandemic. No agreement on how to filter surgical smoke plume during laparoscopy was identified. There was an overall reduction in the number of patients admitted with appendicitis and one-third felt that patients who did present had more severe appendicitis than they usually observe. Conclusion: Conservative management of mild appendicitis has been possible during the pandemic. The fact that some surgeons switched to open appendicectomy may reflect the poor guidelines that emanated in the early phase of SARS-CoV-2