Esplenectomia: perfil epidemiológico, indicações e complicações pós-operatórias em hospital do Rio Grande do Sul

Objetivo: descrever o perfil epidemiológico, as indicações e complicações pós-operatórias de pacientes submetidos à esplenectomia. Método: trata-se de um estudo transversal, realizado por meio de coleta de dados em prontuários de pacientes submetidos a esplenectomia entre 2015 e 2019 em um hospital terciário. Resultados: a amostra foi composta por 57 pacientes, com idade média de 33,4 anos (+-19,9), a maioria crianças/adolescentes (33,3%), do sexo masculino (57,9%), solteiros (57,9%), de religião católica (80,7%), atuantes no setor terciário do mercado de trabalho (43,9%), ensino fundamental incompleto (42,1%), procedentes de outras cidades, que não Passo Fundo (66,7%). A principal indicação para esplenectomia foi o acometimento de Púrpura Trombocitopênica Idiopática (33,3%) e a principal alteração pós-operatória associada foi a leucocitose persistente (25%). Conclusões: a esplenectomia é mais comum em crianças/adolescentes, sexo masculino e tem como principal indicação o Púrpura Trombocitopênica Idiopática conforme maioria dos estudo e apresenta alterações pouco frequentemente e, quando presentes, estão relacionadas a leucocitose persistente

True adrenal cyst mimicking renal cancer in a young woman: a case report

The adrenal cyst is a rare disease that represents approximately 5% of discovered adrenal lesions, which are usually discovered incidentally. True adrenal cysts originate to cells from mesothelium. The potential of cyst adrenal to become malignant has been reported to be 7% and a radical excision of a potentially malignant mass are indicate. We report a case of a 48 year old woman that presented with pain in left hypochondrium and epigastrium, nausea, vomiting, weight loss and microscopic hematuria. After the diagnosis suspicion surgery was performed with a monoblock resection of left kidney and left adrenal gland because of kidney cancer diagnosis as considered. The microscopically analysis of surgical specimen, diagnosed a true epithelial cyst of adrenal gland

Terapia endoscópica a vácuo:

Objetivos: este relato de experiência, busca demonstrar a eficácia do tratamento de uma fístula gástrica com a terapia endoscópica a vácuo. Método: criamos um dispositivo de terapia endoscópica a vácuo com materiais simples e disponíveis em qualquer hospital de baixa complexidade. Resultados e discussões: evidenciamos uma eficácia semelhante à dos dispositivos comerciais vendidos no mercado com preços muito mais elevados. Conclusão: este fato torna a terapia endoscópica à vácuo mais acessível e disponível no nosso país

An evaluation of the protective effect of an infusion of chilled glucosesolution on thermal injury of the bile ducts caused by radiofrequency ablation of the liver

PURPOSE: To evaluate the protective effects of chilling the bile ducts with cold (5°C) 5% glucose solution (GS) during radiofrequency (RF) administration. METHODS: Twenty male pigs (3 mos. old; 25-30 kg) were subjected to RF delivery with chilling (experimental group, N=10) or without chilling (control group, N=10). Half of the animals in each group were euthanized immediately after the operation, and half were euthanized one week later. The following histological variables in relation to the bile ducts were evaluated by a pathologist (blind examiner): degenerative changes to the epithelium; epithelial necrosis; ulceration, regenerative changes of the epithelium; polymorphonuclear neutrophil infiltration; and thermal effects. RESULTS: The experimental group (88 bile ducts examined) showed reduced thermal damage relative to the control group (86 bile ducts examined) as demonstrated by significant differences in the following histopathological parameters: epithelial detachment of biliary epithelium (84.1% vs. 59.3%; p<0.006); elongation/palisade arrangement of nuclei (65.1% vs. 87.5%; p<0.001); pseudo-goblet cells (32.9% vs. 56.8%; p<0.001). CONCLUSION: Infusion of 5% glucose solution (5°C) has a protective effect on bile duct subjected to heat (95-110°C, 12 min) from radiofrequency thermal ablation device.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Federal University of São PauloUniversidade Federal de São Paulo (UNIFESP) Department of PathologyUniversidade Federal de São Paulo (UNIFESP) Department of SurgeryAlbert Einstein Israelite Hospital Department of Image DiagnosticUNIFESP School of MedicineUNIFESP, Department of PathologyUNIFESP, Department of SurgeryUNIFESP, School of MedicineSciEL

Impacto Das Complicações Pós-Transplante Simultâneo Pâncreas-Rim Sobre O Custo Da Internação Hospitalar

Objective: To Evaluate The Financial Impact Of Postoperative Complications In The Simultaneous Pancreas-Kidney Transplantation During Hospitalization. Methods: In The Study, Were Retrospectively Analyzed The Clinical And Financial Data Of The Hospitalization Of Patients Submitted Consecutively To The Simultaneous Pancreas-Kidney Transplantation From January 2008 To December 2014 At Hospital Rim/Fundação Oswaldo Ramos. The Main Variables Studied Were Reoperation, Graft Pancreatectomy, Death, Postoperative Complications (Surgical, Infectious, Clinical And Immunological) And The Financial Data Of Hospitalization For Transplantation. Results: The Sample Consisted Of 179 Transplants. In The Analysis Of The Data, 58.7% Of The Patients Had Some Postoperative Complications And 21.8% Required Reoperation, 12.3% Of Graft Pancreatectomy And 8.4% Evolved To Death. The Characteristics Of Donors And Recipients Were Similar In Patients With And Without Complications. The Average Real Cost Of Hospitalization Was Us$18,516.0Objetivo: Avaliar O Impacto Financeiro Das Complicações Pós-Operatórias No Transplante Simultâneo Pâncreas-Rim Durante A Internação Hospitalar. Métodos: Foram Analisados Retrospectivamente Os Dados Clínicos E Financeiros Da Internação Hospitalar Dos Pacientes Submetidos Consecutivamente Ao Transplante Simultâneo Pâncreas-Rim No Período De Janeiro De 2008 A Dezembro De 2014 No Hospital Do Rim/Fundação Oswaldo Ramos. As Principais Variáveis Estudadas Foram A Reoperação, Enxertectomia, Óbito, Complicações Pós-Operatórias (Cirúrgicas, Infecciosas, Clínicas E Imunológicas) E Os Dados Financeiros Da Internação Para O Transplante. Resultados: A Amostra Foi Composta De 179 Transplantes. Na Análise Dos Dados, 58,7$ 18,516.02. ADados abertos - Sucupira - Teses e dissertações (2018

Principais controvérsias do tratamento não operatório das lesões contusas do baço

Introduction: The nonoperative management of traumatic spleen injuries is the modality of choice in patients with blunt abdominal trauma and hemodynamic stability. However, there are still questions about the treatment indication in some groups of patients, as well as its follow-up. Aim: Update knowledge about the spleen injury. Method: Was performed review of the literature on the nonoperative management of blunt injuries of the spleen in databases: Cochrane Library, Medline and SciELO. Were evaluated articles in eng and por, between 1955 and 2014, using the headings "splenic injury, nonoperative management and blunt abdominal trauma". Results: Were selected 35 articles. Most of them were recommendation grade B and C. Conclusion: The spleen traumatic injuries are frequent and its nonoperative management is a worldwide trend. The available literature does not explain all aspects on treatment. The authors developed a systematization of care based on the best available scientific evidence to better treat this condition.Surgical Gastroenterology Division, Department of Surgery, School of Medicine, Federal University of São Paulo (EPM/UNIFESP), São Paulo, SP, BrazilDisciplina de Gastroenterologia Cirúrgica, Departamento de Cirurgia, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, SP, BrasilWeb of Scienc

Primary malignant neoplasms of the cecal appendix: unusual findings in acute appendicitis

Introduction: To evaluate the prevalence of appendix neoplasia correlating withpatient profile, histological types and frequency.Methods: Data collection was performed in the Pathology Department of a GeneralHospital, with the objective of identifying patients diagnosed with malignant cecalappendix tumors by histopathologic study of specimens from acute appendicitis.Results: The prevalence of malignant primary epithelial neoplasia of the appendixwas 1%. Fifty percent of the cases were neuroendocrine tumors, 35% were mucinous,and 15% were adenocarcinomas. The mean age at diagnosis was 41.3 (SD, 20.4)years (range16-81), with a women/men ratio of 3:1.Discussion: Appendiceal neoplasms are rare and should be suspected manlyin women over 40 years of age with suggestive symptoms of acute appendicitis.The size, location, extent, margins and presence of mucin are essential findings forthe treatment of these patients

Primary malignant neoplasms of the cecal appendix: unusual findings in acute appendicitis

Introduction: To evaluate the prevalence of appendix neoplasia correlating withpatient profile, histological types and frequency.Methods: Data collection was performed in the Pathology Department of a GeneralHospital, with the objective of identifying patients diagnosed with malignant cecalappendix tumors by histopathologic study of specimens from acute appendicitis.Results: The prevalence of malignant primary epithelial neoplasia of the appendixwas 1%. Fifty percent of the cases were neuroendocrine tumors, 35% were mucinous,and 15% were adenocarcinomas. The mean age at diagnosis was 41.3 (SD, 20.4)years (range16-81), with a women/men ratio of 3:1.Discussion: Appendiceal neoplasms are rare and should be suspected manlyin women over 40 years of age with suggestive symptoms of acute appendicitis.The size, location, extent, margins and presence of mucin are essential findings forthe treatment of these patients