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| Format: | Artículo científico |
| Language: | en |
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Academia Mexicana de Cirugía, A.C.
2007
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| Online Access: | https://www.redalyc.org/articulo.oa?id=66275510 |
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Table of Contents:
- Adenoma velloso de recto con alteración hidroelectrolítica severa. Informe de dos casos Iván de la Serna-Ortiz Ernesto Sierra-Montenegro José Luis Rocha-Ramírez Eduardo Villanueva-Sáenz José Manuel Fernández-Rivero René Soto-Quirino Medicina Villous adenoma mucus secretory diarrhea hydroelectrolytic depletion Background: Approximately 10 % of all colorectal adenomasare constituted by villous adenomas. Their relationship withhydroelectrolytic depletion is rare. We report two cases withvillous adenoma that presented hydroelectrolytic depletion withclinical and surgical management, exclusively.Clinical cases: Case 1. Patient was a 76-year-old female withhypertension and 3 months evolution of symptoms such asasthenia, adynamia, unexplained weight loss, and abundantmucus with diarrhea. Serum potassium value was 2.2 mEq/l .Upon rectal exam we found a sessile, exophitic soft tumor withirregular surface of approximately 10 cm in diameter. We alsoperformed a transanal resection of tumor reporting villous adenoma.The patient was discharged from the hospital at the 4thpostoperative day with potassium values within normal limits.Case 2. Patient was a 76-year-old female with diabetes andhypertension of long evolution. She reported a 4-month clinicalevolution with non-bloody diarrhea and abundant mucus. Shereported nausea, vomiting and no unexplained weight loss.Serum potassium value was 2.1 mEq/l . During the rectal examwe identified a sessile, polypoid, 5-cm diameter tumor that didnot involve deep planes. In addition, we carried out a transanalresection of the polyp. The patient was discharged from thehospital on the 5th postoperative day. Potassium value was 4.3mEq/l.Conclusions: Size and location of the villous adenoma arerelated to the production of mucus secretory diarrhea. The inhibitingwell-known indomethacin of the prostaglandins has beenused to decrease the mucus secretion. In every patient withpresence of mucus, persistent diarrhea and occasional rectalbleeding of 1 month, it is necessary to carry out lower endoscopyto rule out the presence of villous adenoma. 2007 artículo científico 0009-7411 https://www.redalyc.org/articulo.oa?id=66275510 en http://www.redalyc.org/revista.oa?id=662 Cirugía y Cirujanos application/pdf Academia Mexicana de Cirugía, A.C. Cirugía y Cirujanos (México) Num.5 Vol.75