Servicio de Cirugia General

Lugo, Spain

Servicio de Cirugia General

Lugo, Spain
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Vigilante A.,Servicio de Cirugia General | Saleg P.,Servicio de Cirugia General | Orozco M.,Hospital Privado Of Cordoba | Alcaraz A.,Servicio de Cirugia General | Obeide L.R.,Servicio de Cirugia General
Acta Gastroenterologica Latinoamericana | Year: 2017

Groove pancreatitis is a segmental chronic pancreatitis characterized by the presence of fibrous scars in the anatomic space between the dorsocranial part of the head of the pancreas, the duodenum and the common bile duct. Being this disease unusual and difficult to diagnose, we report a case of a 64-year-old man with history of severe smoking and alcoholism who presented recurrent epigastric pain for 6 months. Blood tests, including tumour markers, only revealed slight elevation of serum pancreatic enzyme levels. Nuclear magnetic resonance detected a solid mass in the groove area, which was hypointense relative to the pancreatic parenchyma on T 1 and T 2 -weighted images, which supports the diagnosis of groove pancreatitis. Duodenal biopsies were negative for malignancy. The patient was treated conservatively. Until now, the patient is free of symptoms and images have improved. Even though it is a rare disease, it should be reminded when we make the differential diagnosis of pancreatic mass, particularly pancreatic head carcinoma, as both treatment and prognosis differ greatly. © 2017, Sociedad Argentina de Gastroenterologia. All rights reserved.


Roca-Rivada A.,Institute Investigacion Sanitaria Of Santiago Idis | Roca-Rivada A.,CIBER ISCIII | Bravo S.B.,Institute Investigacion Sanitaria Of Santiago Of Compostela Idis | Perez-Sotelo D.,Institute Investigacion Sanitaria Of Santiago Idis | And 9 more authors.
Scientific Reports | Year: 2015

In the context of obesity, strong evidences support a distinctive pathological contribution of adipose tissue depending on its anatomical site of accumulation. Therefore, subcutaneous adipose tissue (SAT) has been lately considered metabolically benign compared to visceral fat (VAT), whose location is associated to the risk of developing cardiovascular disease, insulin resistance, and other associated comorbidities. Under the above situation, the chronic local inflammation that characterizes obese adipose tissue, has acquired a major role on the pathogenesis of obesity. In this work, we have analyzed for the first time human obese VAT and SAT secretomes using an improved quantitative proteomic approach for the study of tissue secretomes, Comparison of Isotope-Labeled Amino acid Incorporation Rates (CILAIR). The use of double isotope-labeling-CILAIR approach to analyze VAT and SAT secretomes allowed the identification of location-specific secreted proteins and its differential secretion. Additionally to the very high percentage of identified proteins previously implicated in obesity or in its comorbidities, this approach was revealed as a useful tool for the study of the obese adipose tissue microenvironment including extracellular matrix (ECM) remodeling and inflammatory status. The results herein presented reinforce the fact that VAT and SAT depots have distinct features and contribute differentially to metabolic disease. © 2015, Nature Publishing Group. All rights reserved.


Romero Pinos M.,Servicio de Cirugia General
Clinica e Investigacion en Ginecologia y Obstetricia | Year: 2016

Introduction: Krukenberg tumors consist of the presence of metastatic nodules in the ovaries. The most common primary source is gastric cancer, which causes 50-70% of cases. The incidence of these tumors is approximately 5-10% of ovarian neoplasms in the United States and 15-20% in Asia. These tumors are usually bilateral, solid masses. Their size varies, although metastases from gastric cancer are usually smaller than metastatic tumors from the intestine. Symptoms in patients with Krukenberg tumors are exclusively ovarian. Case report: A 67-year-old woman with a prior history of gastric cancer presented with 2 hyperechoic, solid, encapsulated pelvic masses, measuring 3-cm in diameter, and with a hypoechoic subcapsular ring. The tumoral borders were well-defined. Color doppler identified abundant vascularization branching toward the center of the lesion. velocimetry showed intratumoral circulation of low resistance. Discussion: Approximately 5-10% of malignant ovarian tumors are metastatic lesions. The presence of large, asymmetric, encapsulated masses with variable intratumoral echogenicity and ascites should lead to suspicion of Krukenberg tumor. The echoic structure of these tumors is generally hyperechoic, with abundant internal vascularization due to a main peripheral vessel that penetrates the lesion and branches internally. Doppler velocimetry usually shows low impedance, which is attributed to the rapid angiogenesis of these tumors. Their prognosis is poor, with a 5-year survival rate of 12%. © 2013 Elsevier España, S.L.U.


PubMed | Institute Investigacion Sanitaria Of Santiago Of Compostela Idis, Servicio de Cirugia General and CIBER ISCIII
Type: | Journal: Endocrine | Year: 2016

The secretion of the hepatokine alpha-2-Heremans-Schmid glycoprotein/Fetuin A, implicated in pathological processes including systemic insulin resistance, by adipose tissue has been recently described. Thus, we have recently identified its presence in white adipose tissue secretomes by mass spectrometry. However, the secretion pattern and function of adipose-derived alpha-2-Heremans-Schmid glycoprotein are poorly understood. The aim of this study is to evaluate the expression and secretion of total and active phosphorylated alpha-2-Heremans-Schmid glycoprotein by adipose tissue from visceral and subcutaneous localizations in animals at different physiological and nutritional status including anorexia and obesity. Alpha-2-Heremans-Schmid glycoprotein expression and secretion in visceral adipose tissue and subcutaneous adipose tissue explants from animals under fasting and exercise training, at pathological situations such as anorexia and obesity, and from human obese individuals were assayed by immunoblotting, quantitative real-time polymerase chain reaction and enzyme-linked immunosorbent assay. We reveal that visceral adipose tissue expresses and secretes more alpha-2-Heremans-Schmid glycoprotein than subcutaneous adipose tissue, and that this secretion is diminished after fasting and exercise training. Visceral adipose tissue from anorectic animals showed reduced alpha-2-Heremans-Schmid glycoprotein secretion; on the contrary, alpha-2-Heremans-Schmid glycoprotein is over-secreted by visceral adipose tissue in the occurrence of obesity. While secretion of active-PhophoSer3212HSG by visceral adipose tissue is independent of body mass index, we found that the fraction of active-alpha-2-Heremans-Schmid glycoprotein secreted by subcutaneous adipose tissue increments significantly in situations of obesity. Functional studies show that the inhibition of adipose-derived alpha-2-Heremans-Schmid glycoprotein increases insulin sensitivity in differentiated adipocytes. In conclusion, visceral adipose tissue secretes more alpha-2-Heremans-Schmid glycoprotein than subcutaneous adipose tissue and this secretion is more sensitive to nutritional and physiological changes. The over-secretion of alpha-2-Heremans-Schmid glycoprotein by visceral adipose tissue, the increased secretion of the active phosphorylated form by subcutaneous adipose tissuein obese animals, and the adipose-derived alpha-2-Heremans-Schmid glycoprotein capacity to inhibit the insulin pathway suggest the participation of adipose-derived alpha-2-Heremans-Schmid glycoprotein in the deleterious effects of obesity.


The solid pseudopapillary tumor of the pancreas is a rare neoplasm, representing 0.13% to 2.7% of all pancreatic tumors. This neoplasm is more common in young women between the third and fourth decade of life. It may produce nonspecific symptoms and in many cases is asymptomatic, being diagnosed incidentally. A 28-year-old woman with no previous medical history presented epigastric pain for the last 3 months. Physical examination was normal. When an upper gastrointestinal endoscopy was performed, a submucosal lesion was observed in the posterior wall of the stomach. A computed tomography and a magnetic resonance imaging were done and both showed a 2.8 cm-diameter tumor in the body of the pancreas. She underwent a spleen-preserving distal pancreatectomy (Warshaw surgery), evolved favourably and was discharged at the sixth postoperative day. The pathological diagnosis of the surgical specimen was a solid pseudopapillary tumor of the pancreas. Surgery is the gold-standard treatment for this condition, given the facts that no other treatment have proven being effective and often surgical treatment is curative because of the tumor's low malignant potential.


Galvan-Montano A.,Hospital General Dr Manuel Gea Gonzalez | Guzman-Martinez S.,Hospital General Dr Manuel Gea Gonzalez | Lorenzana-Sandoval C.,Servicio de Cirugia General | Recinos-Carrera E.,Hospital General Dr Manuel Gea Gonzalez
Cirugia y Cirujanos | Year: 2011

Background: Duplications of the alimentary tract are a group of rare malformations occurring in about 1/5,000 live births. These may be either spherical or tubular and may communicate with the intestinal tract. Duplications of the cecum are very uncommon. Clinical case: A 14-year-old female was admitted to the emergency department with a 1-day history of abdominal pain, vomiting, constipation and abdominal distension. Abdominal examination revealed distension and tenderness around the umbilicus. Plain abdominal radiography showed dilated colon. The patient underwent surgical management with diagnosis of sigmoid volvulus. Laparotomy revealed spherical duplication from the cecum. Hemicolectomy was done and alimentary continuity was restored by end-to-end anastomosis. Pathological report was a spherical communicated duplication from the cecum (22 by 32 cm). Conclusions: Duplication of the cecum is extremely rare and is seen in 0.4% of duplications of the alimentary tract. The majority of cases (85%) are diagnosed before age 2 years. It is rare at 14 years of age. Diagnosis is difficult and volvulus, intussusception or appendicitis should be considered in the differential diagnosis. Ultrasonography and tomography are the imaging studies of choice. Plain abdominal x-ray is not specific. Resection of the duplication with restoration of alimentary continuity is the treatment of choice.


Aliaga F.D.,Servicio de Cirugia General | Larsson J.C.,Servicio de Cirugia General | Ballario F.,Servicio de Cirugia General | Garcia S.,Servicio de Cirugia General | Granero L.,Servicio de Cirugia General
Acta Gastroenterologica Latinoamericana | Year: 2013

Mesenteric panniculitis is a rare entity of benign features that affects the intestinal mesenteric fat tissue and can progress in different ways, from spontaneous resolution to fibrosis. The etiology is still uncertain, probably caused by trauma, infection or surgery. We report a case of a 64-year-old male patient who suddenly began with abdominal pain and leukocytosis. Diagnosis of mesenteric panniculitis was made by a CT scan and the patient evolved with spontaneous resolution within two months.


PubMed | Servicio de Nutricion Clinica and Servicio de Cirugia General
Type: Case Reports | Journal: Nutricion hospitalaria | Year: 2015

Hyperemesis gravidarum is a state of severe nausea and vomiting during pregnancy, leading to dehydration, electrolyte and acid-base disorders, malnutrition and weight loss (> 5%). The prevalence of hyperemesis gravidarum is 0.3-2.3% of all pregnancies.To demonstrate the effectiveness of nutritional support in a case of a complicated hyperemesis gravidarum. A case of a 25 years old woman with hyperemesis gravidarum, who had weight loss of 17.7%, dehydration, electrolyte disorders and arrhythmias, managed with enteral and parenteral nutrition at home until week 26 of gestation reaching to cover 70% of her caloric requirements orally, getting a healthy product and a stable nutritionally mother in late pregnancy.The multidisciplinary management and specialized nutritional management in such cases it is compulsory to carry the patient and the product at the end of pregnancy in optimal conditions.


PubMed | Servicio de Cirugia General
Type: Case Reports | Journal: Acta gastroenterologica Latinoamericana | Year: 2013

The solid pseudopapillary tumor of the pancreas is a rare neoplasm, representing 0.13% to 2.7% of all pancreatic tumors. This neoplasm is more common in young women between the third and fourth decade of life. It may produce nonspecific symptoms and in many cases is asymptomatic, being diagnosed incidentally. A 28-year-old woman with no previous medical history presented epigastric pain for the last 3 months. Physical examination was normal. When an upper gastrointestinal endoscopy was performed, a submucosal lesion was observed in the posterior wall of the stomach. A computed tomography and a magnetic resonance imaging were done and both showed a 2.8 cm-diameter tumor in the body of the pancreas. She underwent a spleen-preserving distal pancreatectomy (Warshaw surgery), evolved favourably and was discharged at the sixth postoperative day. The pathological diagnosis of the surgical specimen was a solid pseudopapillary tumor of the pancreas. Surgery is the gold-standard treatment for this condition, given the facts that no other treatment have proven being effective and often surgical treatment is curative because of the tumors low malignant potential.


PubMed | Servicio de Cirugia General
Type: Case Reports | Journal: Acta gastroenterologica Latinoamericana | Year: 2014

Mesenteric panniculitis is a rare entity of benign features that affects the intestinal mesenteric fat tissue and can progress in different ways, from spontaneous resolution to fibrosis. The etiology is still uncertain, probably caused by trauma, infection or surgery. We report a case of a 64-year-old male patient who suddenly began with abdominal pain and leukocytosis. Diagnosis of mesenteric panniculitis was made by a CT scan and the patient evolved with spontaneous resolution within two months.

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