Reativação da retocolite ulcerativa com o uso de droga anti-inflamatória não esteróide: relato de caso e revisão da literatura

The case of a patient with ulcerative colitis and isolated sacro-ileitis is presented. She suffered reactivation of the intestinal disease with diclofenac. The patient was allergic to sulfasalazine and was using fish oil fatty acid. The possible mechanisms of reactivation of the inflammatory bowel disease with non-steroidal anti-inflammatory drugs are discussed. It is suggested when necessary the utilization of non-steroidal anti-inflammatory drugs that inhibits the lipoxygenase in these patients.

Rim esponja medular, litiase, hipercalciuria e hiperuricosuria em crianca. Relato de um caso e evolucao

The medullary sponge kidney is rare in children and may present it self with hematuria and nephrolithiasis. We report a case of medullary sponge kidney in a child with nephrolithiasis, hypercalciuria, hyperuricosuria and prolonged treatment which avoided the recurrence of nephrolithiasis.

Ectima gangrenoso: Relato de caso

Report of a case of ecthyma gangrenosum with septicemia by Pseudomonas aeruginosa with favorable evolution in a 3-month-old boy. This disease is relatively rare, potentially lethal and the early diagnosis and treatment has an important role in the clinical evolution.

Tinea nigra: Relato de caso e revisao da literatura brasileira

The authors present a clinical case of palmar Tinea nigra in a 19-year-old young woman. The Brazilian literature concerning Tinea nigra is discussed as well as the reports presented in Brazilian Congresses from 1985 to 1995. The data show that 63.3% of the cases occurred in patients younger than 20-years-old, they were more frequent among females and 90.5% were localized on the palms; among the cases reported in the Brazilian Congresses those of atypical localization as the back and the genital area are worth noticing.

Histoplasmose do esôfago: Relato de caso

The authors report a case of a patient with complaint of progressive disphagia. Stenoses of lower third of esophagus was revealed by radiological and endoscopic examinations. Fungi were showed in biopsy of lesion, with demonstration of Histoplasm capsulate by tissue culture. Endoscopic dilatation was performed because especific medical treatment failed but esophageal rupture was observed. Partial esophagectomy was performed with symptoms remission.

Carcinoma basaloide - Escamoseo de cebeça: relato de 4 casos

Basaloid squamous carcinoma is an aggressive subtype of squamous carcinoma of superior aerodigestive tract. This tumor has been recently described and it seems to have higher incidence in tongue, hypopharynx and supraglottis. It has more agressive biological behavior than pure type of squamous cell carcinoma. We report 4 cases of this tumor and we present a review of the literature.

Sindrome das bandas ou constricoes amnioticas: Relato de caso

The authors present a case of constriction band syndrome in a 20-year-old male. There were constriction rings in the interphalangeal joints of hands and in the thigh, shortening of the lower limb and atrophic left gastrocnemius muscle. These findings belong to the described syndrome, which is uncommon and has no genetic implication. Personal antecedent: convulsive syndrome and corrective surgery for congenital bent foot.

Espinha bífida e mielodisplasia em ruminantes: Relato de caso

Spina bifida with mielodysplasia are described in calf and lamb in this report. Locomotor abnormalities in the pelvic limbs and vertebral malformation were found in both animals, and arthrogryposis was also present in the calf. The mielodysplasia was very similar in these animals, and both were characterized by non separation of ventral and dorsal horns, areas with medular canal duplication and syringomyelia. No cases of spina bifida was previously described in Brazil.

Rinolitiase: Atualizacao e relato de caso

Rhinoliths are rares and, in general, develop in response to foreign body lodged in the nose. This study briefly comments the clinics features of one case of rhinolithiasis that occurred during two years period. The etiology of rinoliths, differencial diagnosis and a review of the literature are also included. The authors concluded that the presence of calcified stones must be considered in cases of sinusitis or rhinitis not responding to medical therapy.

Doença de Castleman multicêntrica: Relato de um caso

Castleman's disease (CD) is an uncommon lymphoproliferative disorder that is morphologically and clinically heterogeneous. Both a localized benign variant and a multicentric form with systemic manifestations have been described. Although there are many published cases in literature, there are a few reports about this pathology in Brazil. We describe a patient with several manifestations of multicentric CD: lymphadenopathy, weight loss, fever, arthralgia, myalgia, and hepatosplenomegaly. Pathological examination of excised cervical lymph node revealed its rarest form: a CD of the hyaline-vascular type in multicentric presentation.

Injeção subaracnóidea inadvertida de corticoíde em tratamento de dor crônica da coluna lombar. Relato de caso

BACKGROUND AND OBJECTIVES: Before epídural steroids were used in chronic lumbar pain, subarachnoid injection of these agents was the treatment of choice. Although still preconized by some authors, this technique may lead to severe complications with neurological sequelae. This report aimed at describing a case of accidental subarachnoid injection of steroid associated to local anesthetics during epidural puncture to treat lumbar pain. CASE REPORT: Male patient, 46 years old, followed byneuro-surgery for presenting right sciatic pain for 9 month, refractory to clinical treatment due to L 4-L 5 disk protrusion confirmed by CT scan, without neurological deficit. Epidural puncture for pain treatment was performed in L 4-L 5 with 17G needle and 10 mL solution were injected containing 4 mL of 0.25% bupivacaine, 80 mg methylprednisolone and 4 mL of 0.9% saline. Although there has not been CSF reflux, 5 minutes after injection there were sensory block in T 4 and motor block in T 6, associated to blood pressure and heart rate decrease. CONCLUSIONS: Accidental subarachnoid injections with the association of steroids for pain relief may cause adverse effects. There are several risks, varying from mild transient symptoms to nervous injuries, including spinal cord injuries. Our patient had no sequelae from the accidental subarachnoid injection, probably because it has been a single injection.

Paracoccidioidomicose intestinal: Relato de caso

The authors report a case of intestinal involvement of paracoccidioidomycosis and discuss the symptoms, diagnosis and treatment in a patient thought to have colonic cancer. The differential diagnosis should be considered with cancer.

Pneumoencéfalo intraventricular após perfuração acidental de dura-máter. Relato de caso

BACKGROUND AND OBJECTIVES: The loss of resistance to air to identify the epidural space is widely used. However, the accidental perforation of the dura mater is one of the possible complications of this procedure, with an estimated incidence between 1% and 2%. The objective of this report was to describe the case of a patient with intraventricular pneumocephalus after the accidental perforation of the dura mater using the loss of resistance with air technique. CASE REPORT: Female patient, 26 years old, 75 kg, 1.67 m, physical status ASA I, with a 38-week pregnancy, was referred to the obstetric service for a cesarean section. Venipuncture was performed after placement of the monitoring. The patient was placed in a sitting position for administration of the epidural anesthesia. During the identification of the epidural space with the loss of resistance with air technique, an accidental perforation of the dura mater was diagnosed by observing free flow of CSF through the needle. The technique was modified to epidural anesthesia and anesthetics were administered by the needle placed in the subarachnoid space. In the first 24 hours, the patient developed headache and she was treated with caffeine, dypirone, hydration, hydrocortisone, and bed rest; despite those measures, the patient's symptoms worsened and evolved to headache in decubitus. A CT scan of the head showed the presence of pneumocephalus. After evaluation by a specialist, the patient remained under observation, with progressive improvement of the symptoms and was discharged from the hospital in the fifth day, without complications. CONCLUSIONS: Pneumocephalus after accidental perforation of the dura mater presented headache with the characteristics of headache secondary to loss of CSF, but with spontaneous resolution after the air was absorbed. Invasive measures, such as epidural blood patch, were not necessary. © Sociedade Brasileira de Anestesiologia, 2006.

Melanoma de coróide: Relato de caso insuspeito

The choroidal melanoma is the most frequent intraocular tumor in elderly, occurring mainly in the 60th. This paper shows a misdiagnosis tumor affecting a female aging 36 years-old, misdiagnosed and initially treated as a toxoplasmic uveitis. The tumor had orbit and neck metastasis. The authors call attention to the necessity of early diagnosis to improve the outcome.