Covered intestinal endoprosthesis for the management of enteroatmospheric fistula, case report and review of the literature.

The management of fistulas is a challenge for surgeons, the enteroatmospheric fistulas are characterized by being superficial, high debit and surrounded by viscera or granulation tissue, with poor control of its excretion due to their anatomy. We describe an alternative approach to the management of enteroatmospheric fistulas, in a patient with a hostile abdomen and massive intestinal resection, selected for placement of a stent, as a rescue measure. Use of intestinal stent allowed fistula control and enteric feeding capacity, that substantially improves the quality of life.

[Use of intraoperative enteroscopy as a diagnostic method in patients with obscure gastrointestinal bleeding. Initial experience].

Background: Bleeding of dark origin is a rare entity and it is reserved for cases in which exploration of the small intestine has already been performed (endoscopic / radiological) without finding the cause. Currently, the gold standard is the videocapsule which has been described as a safe, useful and effective technique for the diagnosis and treatment of diseases of the small intestine.

Objective: The objective was to describe demographic variables, indications, findings, explored segment, treatment and time of the surgical procedure of the intraoperative enteroscopy in 15 patients with a diagnosis of gastrointestinal bleeding of dark origin.

Evaluación del desempeño diagnóstico del Índice de Riesgo de Malignidad II en mujeres con diagnóstico de masa anexial en un hospital de tercer nivel.

Objetivo: Evaluar la exactitud diagnóstica del Índice de Riesgo de Malignidad II (IRM II) en 100 pacientes con diagnóstico de masa anexial.

MÉtodo: En una muestra de 100 pacientes con diagnóstico de masa anexial se cuantificaron variables demográficas y se aplicó el IRM II. Mediante una tabla 2 × 2 se obtuvieron la sensibilidad, la especificidad, el valor predictivo positivo, el valor predictivo negativo y la exactitud diagnóstica, y se compararon con el resultado histopatológico.

Ictericia obstructiva intermitente o síndrome de Lemmel: reporte de caso y revisión de la literatura.

Se presenta el caso de una paciente de 68 años con un cuadro de colangitis recurrente y presencia de divertículo duodenal que comprime la vía biliar. El síndrome de Lemmel es una afección infrecuente en la literatura, debido a que los divertículos duodenales rara vez presentan síntomas (10%) y en general se diagnostican de manera incidental. El 75% de estos divertículos son periampulares.