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Extragastrointestinal stromal tumors are rare mesenchymal neoplasms that can occur in the omentum and mesentery. A clinical case of an elderly person from Cuenca is presented, the patient has symptoms like: pain, abdominal distension, lack of elimination of gases and feces of 24 hours of evolution, the physical examination showed a distended abdomen, diffuse palpation pain, increased hydro noise. The patients was surgically intervened, a tumor was found 80 cm from the mesoenterium-dependent ileocecal valve, approximately 7x6 cm that involved intestinal loops; histopathology reported a CD 117 positive extra gastrointestinal stromal tumor; patient evolved favorably, ambulation began at 24 hours and liquid diet at 72 hours with good tolerance, medical discharge was decided on the fifth day after surgery. Start oncological treatment at 4 months after surgery with imatinib 400mg, currently a patient with favorable evolution without recurrence.

Introduction: laparoscopic cholecystectomy is currently the treatment of choice for biliary pathology, such as cholecystolithiasis and acute cholecystitis, both in elective and emergency surgery; This procedure is not exempt from complications, due to technical difficulties that may hinder the performance of this surgical procedure. Objective: to determine the prevalence of difficult laparoscopic cholecystectomy and associated factors, in the "Hospital José Carrasco Arteaga", during the year 2017. Materials and methods: cross-sectional analytical study, including patients undergoing laparoscopic cholecystectomy. With infinite universe, 95% confidence level, a total sample of 369 patients was obtained. Analysis of the statistical variables (age, gender, obesity, antecedent of abdominal surgery, degree of acute cholecystitis, cholecystolithiasis, antecedent of endoscopic retrograde cholangiopancreatography, acute biliary pancreatitis) was performed in the SPSS version 23 and EPIDAT 3.1 program. RP (95% CI) and chi square (p <0.05) were used for statistical significance. Results: the prevalence of difficult laparoscopic cholecystectomy was 8.7%. The associated factors were: advanced age (RP 3.85, IC95% 1.85-8.02, p 0.00), male gender (RP 2.39, IC95% 1.22-4.69, p 0.00), antecedent of abdominal surgery (RP 2.18, IC95% 1.04 -4.57, p 0.04) mild acute cholecystitis (RP 2.18, 95% CI 1.04-4.57, p 0.04), moderate acute cholecystitis (RP 6.58, 95% CI 3.56-12.1, p 0.00), severe acute cholecystitis ( RP 11.2, IC95% 6.73-18.7, p 0.00). Conclusions: difficult laparoscopic cholecystectomy is significantly related to all grades of acute cholecystitis, history of abdominal surgery, male gender and advanced age.

Background: The decrease in calcium and parathyroid hormone levels are related to clinical manifestations in patients undergoing total thyroidectomy and can vary from hours to days, from paresthesias to tetany. Hypocalcemia can also be assessed biochemically with blood levels of calcium and parathormone. Objective: To determine the levels of calcemia and paratohormone related to clinical manifestations of hypocalcemia in the postoperative period of total thyroidectomy. Methods and materials: observational analytical cross-sectional cohort study conducted at the Hospital José Carrasco Arteaga between 2013-2016. The studied population was formed by the universe 300 patients. Clinical records of patients with total thyroidectomy were included; information on sex, age, paresthesias, Chvostek's sign and Trousseau was collected; type of thyroidectomy, operative time, calcium and parathyroid hormone levels. Association, OR and bivariate analysis were determined. Results: Clinical manifestations were found in 29% (87 patients). The most committed age group was 40 to 64 years old. The women were the most affected. The operative time was not associated with clinical manifestations OR 0.66 (95% CI: 0.23-1.84 p value 0.42). Total thyroidectomy with ganglionic dissection of level VI was associated with hypocalcemic symptoms OR 2.22 (95% CI: 1.25-3.93 p-value 0.005). There was also an association between having clinical manifestations of hypocalcemia with: low levels of calcium and parathyroid hormone OR 2.23 (95% CI: 1.33-3.74 p-value 0.002), OR 3.75 (95% CI: 2.19-6.40 p-value 0.000) respectively. Conclusion: The decrease in the values of calcemia and paratohormone if they are related to the clinical manifestations of hypocalcemia

While spirometry test as assessment of pulmonary function does not provide exact boundaries from which a patient will undergo surgery can be considered inoperable, but provides data to divide into groups of high and low risk surgical. From the results obtained in our study, it appears that not all surgical patient spirometry merits, but in those with a risk factor of pulmonary or extrapulmonary that increases your chance of developing respiratory compliaciones, this can be considered a test of support , inexpensive and easy to apply, to achieve a better preoperative assessment of the patient, allowing us to foresee the risk lung and take appropriate precautions before surgery, consideration should be taken into account especially in people who are to be operated abdominal or pelvic level, which are types of surgery have greater impact on pulmonary ventilation and especially if general anesthesia is used, as we have seen is another condition that determines major changes on respiratory function