Lusiadas Scientific Journal

Acromial Metastasis: Diagnosis by Magnetic Resonance Imaging

2023-09-05T07:48:46-07:00

Poroqueratose: Uma Entidade Rara

2024-02-08T03:16:58-08:00

Skills in Ambulatory Surgery: Do We All Have Them?

2023-09-27T13:53:29-07:00

Second-Look Surgery in Intestinal Volvulus Caused by Meckel’s Diverticulum – A Case Report

2023-10-26T10:58:50-07:00

Meckel's diverticulum is the most common manifestation of yolk duct anomalies. The most common forms of presentation are painless gastrointestinal bleeding, intestinal obstruction, and diverticulitis. A previously healthy 19-month-old boy was admitted on the emergency department due to septic and hypovolemic shock. The patient underwent exploratory laparotomy which revealed a Meckel's diverticulum anchored to the mesentery by a fibrous band, causing a volvulus and ischemia. A second-look approach was chosen. He underwent relaparotomy on postoperative day 7, which revealed an improvement of intestinal perfusion. Segmental ileal resection containing Meckel's diverticulum and ileostomy were performed. Few cases are described in the literature for intestinal ischemia secondary to volvulus and, those that do exist, are in the context of intestinal malrotation and not in the presence of a Meckel's diverticulum. With this approach, we were able to preserve a significant amount of bowel, without increasing the risk of short intestine syndrome.

A good surprise of a radiological appendicular mucocele

2023-11-20T08:52:39-08:00

This case report presents a 42-year-old female patient with chronic right lower abdominal quadrant pain, extending to the mid-inguinal region, persisting for two years. Her medical history included right-sided kidney stones and treated atrial fibrillation. Family history included breast cancer on her mother's side. Comprehensive clinical evaluation revealed persistent abdominal pain without physical signs of tenderness or irritation.

Imaging tests initially suggested an appendicular mucocele but lacked definitive confirmation. Subsequent computed tomography scans and laboratory tests indicated a peritoneal inclusion cyst, presenting diagnostic challenges. After multidisciplinary consultation, surgical excision was recommended. Laparoscopy revealed a peritoneal cyst intimately associated with the ileocecal appendix, leading to their simultaneous removal. Pathological examination confirmed a benign mesenteric cyst.

This case highlights the diagnostic challenges posed by mesenteric cysts and appendiceal mucoceles, which share similar clinical and radiological presentations. Differential diagnosis requires a comprehensive approach involving patient history, physical examination, and imaging. Mesenteric cysts typically necessitate complete surgical excision, while appendiceal mucoceles require appendectomy, considering the potential for malignancy. In this case, initial suspicion of an appendiceal mucocele led to simultaneous resection of the ileocecal appendix and cyst during laparoscopy, with subsequent pathology confirming a benign mesenteric cyst and normal appendix. Early diagnosis and proper management of mesenteric cysts are vital for optimizing patient outcomes and quality of life.

Body composition, growth, and physical development in young people aged 11 to 13 old according to the metabolic load capacity model

2024-02-12T06:23:52-08:00

As young people undergo the dynamic phase of physical development, their body composition experiences significant changes, marked by the interplay of growth spurts, hormonal fluctuations, and the development of muscle and bone structures, collectively shaping the foundation for their overall well-being.

Objective: This study aimed to compare physical development according to body composition characteristics of the load-capacity model expressed through the ratio between lean body mass (LBM) and fat mass (FBM).

Methods: The sample consisted of 580 participants (283 girls and 297 boys) aged 11-13 yrs. The evaluations included height, body mass index (BMI), total LBM, total FBM, whole-body bone mineral density less head (WBLH BMD) determined by DXA, tibia and radius speed of sound (SoS) measured by ultrasound, somatic maturity through the age of peak height velocity (PHV), and handgrip strength evaluated with a dynamometer. The sample, separated by sex, was divided into two groups according to the LBM/FBM ratio: group A with low LBM/FBM and group B without low LBM/FBM (Z-score > -1). For comparison purposes between these groups, the bone variables and handgrip strength were standardised according to sex and age group (Z-score) using the sample as a reference.

Results: In both sexes, group A revealed a higher BMI, LBM and FBM indexes (p<0.001), an earlier age at which PHV occurred (p<0.001) and lower tibial bone strength (p=0.001), with no differences in radial bone strength. In group A, a shorter predicted adult height was also observed in girls (p=0.024) and a higher WBLH BMD in boys (0.029) than in group B.

Conclusion: A lower metabolic capacity/load in both sexes is associated with increased BMI and seems to compromise the lower limbs more than the upper limbs, particularly in skeletal mineralization, despite promoting earlier somatic maturity.

Ambulatory Surgery in Private Sector- Multidisciplinary Free-standing Hospital

2024-03-13T07:12:16-07:00