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The description of anastomosis of the phrenic nerve has been little studied and even controversial at present. Classical authors such as Testut have briefly described this anastomosis. 13 anatomical preparations formalized at 10% were used, identifying 26 phrenic nerves from their location in the neck and being dissected to their terminal distribution in the diaphragm muscle. A distribution of the phrenic nerve was observed in 3 terminal branches, anterior, lateral and posterior. These branches penetrate the muscle and run initially between the muscle fibers and then on the underside of the muscle and the fascia. In monitoring the anterior branch of the phrenic nerve, it was found that it divided into several branches. 2 constantly stood out, one anterior towards the sternum and another medial that borders the pericardium, which was of interest to us. In 38% of the cases, anastomoses were found between the right and left phrenic nerves, located mainly anterior to the pericardium, which would indicate a justification for reinnervation due to damage to the phrenic. This anatomical description is of utmost importance in cases of bilateral injury to the phrenic nerve and explains the recovery of the denervated diaphragm. [ABSTRACT FROM AUTHOR]

Leakage of the esophagojejunostomy (LEY) is one of the most serious complications after total gastrectomy, as it is associated with increased surgical morbidity and mortality. The optimal management of LEY is still controversial, with increasing minimally invasive options, especially endoscopic ones. The aim of this review is to compare the published and updated scientific evidence regarding the medical, endoscopic and surgical treatment of LEY and its short and long-term results, in addition to propose a management algorithm that allows guiding clinical practice. Finally, the national experience is presented in relation to the advances presented in recent years regarding clinical management of LEY. [ABSTRACT FROM AUTHOR]

This case report describes the surgical repair of a total traumatic rupture of the membranous urethra in a 5 years old, mixed-breed male canine patient who was hit three days earlier by a car. In this procedure, the technique described by Fossum (2019) was used with modifications made by the surgical experience of the authors, where a prostatic fixation point was used, allowing to reduce the tension forces exerted by the bladder and the size of the defect. In cases of abdominal trauma, comorbidities are associated with a worse prognosis, in this case, the uroabdomen was treated immediately. The patient remains in the postoperative period for 4 weeks and 14 months later presents a perfect function of the lower urinary tract with normal urine flow, considering that the technique was successful. Systemic antibiotics and anti-inflammatories were administered, and the wound was completely closed three weeks later. The objective of this work is to present a minimally invasive technique without intraoperative complications in which the conservative procedure is modified, generating a successful result without the need for a pubic osteotomy which, in addition to being highly invasive with the tissues, is quite painful for the patient. [ABSTRACT FROM AUTHOR]

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Colorectal cancer is the third most common malignant tumor in the world, generating great costs for health systems. Treatment should be oriented to the characteristics of the cancer, preventing the greatest number of complications. Objectives: In the present case report, a patient operated on for suspected colorectal cancer is described, who presents difficulty in reconstituting intestinal transit, due to avoidable surgical complications. Clinical case: A 70-year-old female patient, with a significant medical history, admitted for surgical resolution of colorectal cancer, performing anterior rectal resection with protective ileostomy. At the 2-month follow-up, stenosis was observed at the ileostomy level. Endoscopic dilations are performed, but perforation is suspected in the fourth consultation, which requires surgical management, this being very laborious due to intraoperative results not reported in the clinical record. Discussion: There are several complications related to colorectal anastomosis, including anastomotic leak, anastomotic stenosis, and pelvic sepsis, which can be prevented by salvage procedures such as ileostomy, which is not free of complications. The objective of avoiding complications is to be able to perform a traffic reconstruction without incidents and therefore the patient has the lowest possible morbidity and mortality rate. [ABSTRACT FROM AUTHOR]

Objective: To demonstrate the efficacy and safety of self-expanding metal stents for endoscopic management of esophageal fistulas. Materials and methods: Retrospective case series between 2007 and 2017. A total of 11 patients were treated with self-expanding metal stents for esophageal fistula management, after being diagnosed based on symptoms, upper endoscopy, and/or radiological studies in the gastroenterology unit of the Hospital Universitario San Ignacio (HUSI) in Bogotá D.C, Colombia. Results: The most common initial symptom was dyspnea in 27.3% of cases, followed by cough in 18.2%. The most frequent finding during follow-up was pleural effusion in 36.4% of the cases, of which 45.5% received a diagnosis of fistula through esophagogram. The most reported lesion was esophagoenteric anastomotic leak with 45.5%, followed by esophagopleural injury with 36.4%; these patients were those who received self-expanding metal stent management. Technical success was achieved in 100% of the cases, and the defect was resolved in in 72.7% of them. The only complication reported was stent migration in 27.3%, requiring 3 changes in 1 patient. The average hospital stay was 41.5 days. Conclusions: Endoscopic management of esophagogastric fistulas with self-expanding metal stents is effective and safe, with a low complication rate. [ABSTRACT FROM AUTHOR]

Copyright of Acta Médica Peruana is the property of Colegio Medico del Peru and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The case report of a 27 years patient is presented, with history of conventional cholecystectomy for 10 months due to apparent cholecystitis who went to Luis Vernaza Hospital in Guayaquil, Ecuador, presenting jaundice and abdominal pain. Taking into account the clinical, laboratory and imaging findings a sepsis of abdominal focus, cholangitis and choledocolithiasis was diagnosed. During the surgical intervention the presence of 2 Ascaris lumbricoides and cholesterol calculi in the bile duct was observed, reason why a bilioenteric bypass was carried out. After some complications such as breathing failure and hemodynamic upset, the patient was discharged from the institution 25 days after the surgery, with follow up in outpatient clinics during 2 months. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Gastroenterología del Perú is the property of Sociedad de Gastroenterologia del Peru and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ginecología y Obstetricia de México is the property of Federacion Mexicana de Ginecologia y Obstetricia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A canine puppy came in for consultation showing the following symptoms: acute respiratory failure, cyanosis of mucous membranes, inspiratory stridor, orthopnea posture, mouth open at all times, and inspiratory dyspnea, indicating a reduction in the upper airway clearance. The animal arrived with an x-ray showing a suspected diagnosis of tracheal collapse, but during the physical examination, it collapsed and had syncope. When an endotracheal tube was placed, there was resistance to the tube passage. Then it was decided to use a modified tracheoscopy technique. Images compatible with an endotracheal mass obstructing 75% of the organ light were observed, and it was decided to perform its tracheal resection and anastomosis, meeting the surgical criteria of the technique. Three tracheal rings and the dorsal membrane along with the mass were resected and sent to the histopathology laboratory which confirmed the osteochondral dysplasia diagnosis. The animal was kept for eight days with a muzzle, neck bandage and a suture from the muzzle to the bandage to prevent the neck from extending. After 10 days, the suture was removed and the animal was released from the hospital, maintaining the quality of breathing from the first day of surgery. [ABSTRACT FROM AUTHOR]

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista ADM is the property of Asociacion Dental Mexicana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: The main indications for a loop ileostomy are to protect a distal anastomosis or to management of an anastomotic leak. However, it is a procedure with complications arising from its confection, function or closure. There are sparse local data on this topic. Objective: To describe the global morbidity from loop ileostomies. Method: Patients who underwent a loop ileostomy between January 2009 and January 2012 were retrospectively included. Demographics, indications, complications from the making, function and closure of the ileostomy was recorded. Results: The series consists of 64 patients. The total percentage of complications was 40.3%. Complications arising from the confection, function and closure were 4.7%, 18.7% and 16.9% respectively. Two patients were readmitted for dehydration with a total of 4 readmissions. Four patients were reoperated for morbidity of ileostomy closure, two intestinal obstructions, one leak and one enterotomy. Conclusion: In this study, loop ileostomy complications are present in a substantial proportion of patients. It should be take in consideration at the moment of making it. [ABSTRACT FROM AUTHOR]

Introduction. Various treatments have been described for complex aneurysms, one of which is revascularization with the superficial temporal artery (STA) to the middle cerebral artery (MCA) bypass. Case report. A 39-year-old woman presented with sentinel headache 24 h prior to arrival, left hemiplegia, bradipsiquia and bradilalia. A head CT scan showed a rounded hyperdense lesion of 31x32 mm in the right sylvian valley with little perilesional edema and discreet mass effect. The angiography reported a giant, partially thrombosed MCA aneurysm. STA-MCA bypass was performed. The patient presented a satisfactory postoperative outcome and she was discharged to have physical rehabilitation. At 6 month-follow-up the patient was readmitted with minimal motor deficit for the placement of preformed plate cranioplasty with methylmethacrylate. Conclusion. The neurosurgeon should be familiar with the bypass revascularization technique, since it represents an excellent procedure for the management of complex vascular lesions, tumors and potentially for the treatment of some cases of acute cerebrovascular disease. [ABSTRACT FROM AUTHOR]

We present the association between bladder neck stricture and migration of a titanium clip into the urethrovesical anastomosis after a neuropreservative laparoscopic radical prostatectomy in a patient suffering of recurrent acute urinary retention and the eventual resolution after extracting endoscopically the foreign body from the scarred tissue. [ABSTRACT FROM AUTHOR]

Introduction: Wilkie's syndrome, a partial obstruction of the third portion of the duodenum by extrinsic compression of the superior mesenteric artery. It is a rare condition, described approximately 400 cases. Case description: This is 15 years male patient with a history of frequent vomiting since childhood, consultation difficulty walking with a time of 15 days duration illness presenting generalized vesicular lesions. On physical examination, evidence cachectic patient with paresthesia in the lower limbs, distended abdomen, decreased tendon reflexes; The laboratory reports hypokalemia (2,6mEq), nitrogenous retention, hyperchloremia. Evidenced performed gastroscopy gastric dilatation and megaduodenum camera third level stenosis portion thereof and be told + Gastro operative resolution type jejunum side anastomosis. Discussion: This study emphasizes the rarity of the syndrome Wilkie as early diagnosis, improve the quality of life of these patients. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cirugía Oral y Maxilofacial is the property of Sociedad Espanola de Cirugia Oral y Maxilofacial (SECOM) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Fusarium mexicanum has been described as the causal agent of mango malformation in several producing areas in Mexico. Isolates of F. mexicanum obtained from mango trees with malformation disease in Jalisco were characterized according to vegetative compatibility groups (VCGs). Isolates were cultured on minimal medium - supplemented with potassium chlorate (KClO3), NO3-, and L-asparagine, to generate spontaneous nitrate nonutilizing (nit) mutants. Mutants are detected as mycelia sectors chlorate-resistant, which are not able to utilize nitrate as a nitrogen source due to mutations at loci associated with the nitrate-assimilation pathway. F. mexicanum isolates generated 239 chlorate-resistant sectors of mycelia, out of 62.3 % were nit mutants. Phenotypic characterization detected 36.91 % mutants nit1, 28.18 % mutants nit3, 19.46 % mutants NitM and 14.76 % mutants nnu. Compatibility pairing tests amongst the mutants detected two VCGs in isolates of F. mexicanum from Jalisco. Isolates in one VCG from Jalisco were compatible with isolates of a previously identified VCG of F. mexicanum from Michoacan. A total of three VCGs were detected in the central Pacific region of Mexico. [ABSTRACT FROM AUTHOR]

The reconstruction of the digestive tract with a Roux-en-Y anastomosis has been performed more frequently in the last years mainly due to the overgrowth in the surgical treatment of obesity by gastric bypass in Roux-en-Y. The obesity pandemic is also associated with an increase in both the preoperative and postoperative diagnosis of gallstones in this population. Bearing in mind the greater complexity of endoscopic retrograde cholangiopancreatography in these circumstances, the authors have reviewed the various endoscopic approaches available, evaluating 249 articles published between 1990 and 2010 obtained from Medline, Cochrane and Scielo, excluding case reports and articles outside the specific scope of this study. Endoscopic techniques with high success rates include the use of enteroscope, colonoscope, enteral and transgastric access combined with surgery. Even with the technological progress already made, further development of the instruments used will be necessary if greater comfort and safety is to be achieved with this procedure. [ABSTRACT FROM AUTHOR]

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

It has been described that the superficial palmar arterial arch is formed by the terminal branch of the ulnar artery when it communicates with the radiopalmar artery, terminal branch of the radial artery, forming a flexible arch with distal concavity. The arch has different anatomical variants which lead to certain confusion about its nomenclature. Objective: To describe the different anatomical variants of the palmar superficial arch in order to propose specific criteria for the standardization of the different concepts of arcus. Material and methods: An observational study was carried out in 112 upper limbs to identify the different anatomical dispositions of the superficial palmar arch. For this study an original technique of dissection was implemented. Results: In 85 cases (75%) the disposition of the blood vessels corresponded to the ulnar type, with the following variants: a) in 58 cases (51.8%) as arcuata artery, b) in 20 (17.8%) as arcus settae (arch in the form of a saddle) and c) in 7 (6.3%) as anastomosis (communication among two blood vessels). In 21 cases (18.7%) the disposition of the superficial palmar arch was radioulnar type. In 4 cases (3.6%) it corresponded to medium-ulnar type. Conclusions: We believe that the present study can be a useful anatomical reference, where criteria are proposed to try to define more clearly the diverse types of communications, thus same standardized concepts of arcus. [ABSTRACT FROM AUTHOR]