Francisco Reyna-Sepúlveda

Neonatal Sleeve Gastrectomy for Multiple Gastric Perforations: A Case Report

Neonatal gastric perforation (NGP) may be spontaneous, secondary to necrotizing enterocolitis (NEC), or due to distal obstruction. A 27-week old premature male newborn presented with pneumoperitoneum. A single perforation of stomach was found at surgery. Primary repair and gastrostomy were performed. On fifth postoperative day, pneumoperitoneum was again detected. At reoperation, multiple gastric perforations of the greater curvature were found. Sleeve gastrectomy was performed. The patient responded well to the treatment.

Epidemiología de las lesiones por proyectil de arma de fuego en el Hospital Universitario “Dr. José Eleuterio González” de la Universidad Autónoma de Nuevo León

Resumen Antecedentes La incidencia de heridas y muertes por herida por proyectil de arma de fuego merece una atencion especial en su epidemiologia, protocolos de manejo y tratamiento. Objetivos Determinar las caracteristicas epidemiologicas de las heridas por proyectil de arma de fuego. Material y metodos Entre 2005 y 2015 se analizaron todos los pacientes con diagnostico de heridas por proyectil de arma de fuego. Se estudiaron multiples variables de su atencion hospitalaria. Resultados Se obtuvo un total de 605 casos, los cuales se analizaron como universo total de pacientes y, ademas, se tomo una muestra de 314 casos, para un analisis mas detallado. Se obtuvo una mortalidad total de 7.9%. Se realizaron 324 laparotomias, 124 incisiones de la pared toracica, y 72 exploraciones vasculares. Dentro del grupo de resultados especificos se obtuvo un 16.9% y 42% de laparotomias y exploraciones vasculares, respectivamente, sin evidencia de lesion. Discusion La morbimortalidad aumenta significativamente en pacientes con 2 o mas heridas, multiples transfusiones y con requerimiento de estancia en la unidad de cuidados intensivos. Conclusiones Se propone la incorporacion de un formato de evaluacion fisica de los pacientes con heridas por proyectil de arma de fuego, por parte de los servicios involucrados en su atencion, que promueva la generacion de trabajos de investigacion mas detallados.

Identificación de flora bacteriana en cultivos de bilis y pared de vesícula biliar de pacientes sometidos a colecistectomía laparoscópica en el Hospital Universitario «Dr. José Eleuterio González»

BACKGROUND Through experience it has been accepted that bile in normal conditions remains sterile. Bactibilia is a common finding in individuals at high risk or with complicated cholecystolithiasis, however few data prevails about the prevalence of bactibilia in patients operated on for uncomplicated laparoscopic cholecystectomy. There is s common usage of preoperative and postoperative antibiotics in the different patients without the existence of any actual bacteriologic and epidemiologic evidence. MATERIAL AND METHODS 183 patients with diagnosis of cholecystolithiasis postoperated of laparoscopic cholecystectomy had their bile sent to bacteriology. RESULTS Bactibilia was identified in 31.95% of the cultures of mild cholecystitis and in 35.71% for moderate (p<.0001). A total of 125 negative cultures were obtained (68.3) and 58 positive (31.69%) with a prevalence of enterobacteria group (43.10%) and Enterococcus (27.58). CONCLUSIONS Comparing the groups according to severity there is a significant difference with regard to the presence of bactibilia, in addition to the bacterial groups cultivated. Fluoroquinolones and metronidazole is an option for the treatment of patients with the suspicion of bactibilia. The use of antibiotics is not justified in patients at low risk.