André Figueiredo Accetta

Doença inflamatória intestinal - Doença de Crohn e gravidez: relato de caso

The Crohns disease, a form of inflammatory bowel disease, is frequent in women of childbearing age. Its management requires greater attention during pregnancy. We report a case of refractory Crohns disease in a pregnant patient that evolued to ileocolectomy at puerperium. The literature regarding pregnant patients with Crohns disease was reviewed, including counseling of patients and investigation of active disease, and the existing data was summarized on the safety of medications used to treat Crohns disease in pregnancy and breastfeeding.

Endometrioma de parede abdominal

BACKGROND: The exact incidence of endometriosis in the general population is unknown. Confirmation of this disease is only possible by histopathological analysis of a fragment obtained by some invasive procedure, because there is so far, no clinical secure marker. AIM: To report the experience with the clinical manifestations and surgical treatment in patients with abdominal wall endometrioma. METHODS: Retrospective analysis of patients operated for abdominal wall endometrioma with emphasis on data relating to age, symptoms, previous cesarean, relation of symptoms with the menstrual cycle, physical examinations and additional surgical treatment, postoperative course and histopathological results of specimens. RESULTS: Forteen patients were operated during the study period, aged between 28 and 40 years. The presence of local mass and pain that worsened during menstruation were the main complaints. Ultrasound and CT examinations were important to precisely localize the disease. Surgical excision was a wide excision of the tumor and affected tissues. The patient progressed satisfactorily and histopathology confirmed the diagnosis of abdominal wall endometrioma in all cases. CONCLUSION: Exists a clear relationship between cesarean operation and abdominal wall endometrioma; ultrasound studies and CT scans help to plan the surgical resection allowing resection of tumor and all affected adjacent tissues.

Análise da resposta ao biofeedback nos pacientes com incontinência fecal

Fecal incontinence is a disabling condition with relevant social costs. Many therapies are described. Objective: To evaluate the response to biofeedback and epidemiological profile, describing the used technique. Methods: A retrospective study in 3 years (June 2005 - June 2008). Results: Thirty patients, 26 women and 4 men, with an average age of 66. The number of normal pregnancies and births varied from none to six and hysterectomy was present in nine. Hypotonia in manometry was present in all patients. Eighteen patients were satisfied, ten were partially met, none was completely dissatisfied, and two have abandoned the therapy. Conclusion: The clinical therapy to biofeedback can be effective for incontinence, but the comprehension by patient appears to be the most important. Diabetes mellitus, anorectal surgery and hysterectomy were related to complaints of incontinence.

Apendicite epiplóica com comprometimento da serosa e estreitamento da luz do sigmóide: relato de caso

Os autores relatam o caso de um paciente de 34 anos, submetido a laparotomia de urgencia com quadro de abdomen agudo ocasionado por apendicite epiploica. Foi dado enfase a manifestacao intensa dos sinais e sintomas, assim como sua apresentacao pouco usual no ato cirurgico, uma vez que comprometia o sigmoide sugerindo tratar-se de doenca de Crohn.