Objetivo: Reportar el caso de un paciente con antecedente de múltiples cirugías por peritonitis y abdomen abierto, con hallazgo intraoperatorio de osificación heterotópica en el mesenterio.

Introduccion : Las tecnicas quirurgicas para la fistula perianal compleja han tenido altas tasas de recidiva asociado al riesgo de incontinencia fecal. La tecnica de LIFT (Ligadura Interesfinterica del trayecto fistuloso) ha logrado menores tasas de recidiva con casi nulo riesgo de incontinencia segun reportes internacionales. Sin embargo aun no esta consolidada como tecnica estandar para esta patologia. Objetivo : Presentar los resultados (exito clinico e incontinencia segun escala de Wexner) de nuestros pacientes con fistula perianal compleja operados con tecnica de LIFT . Material y Metodos : Estudio descriptivo de cohorte prospectiva no aleatoria, con pacientes operados por fistula perianal compleja en el Hospital del Salvador, entre los anos 2015 al 2017. Resultados : Se incluyen 22 pacientes operados. En un 77% se obtiene exito terapeutico en la primera cirugia y hasta un 90% con una segunda cirugia mas simple. Ninguno de los pacientes modifico su Wexner preoperatorio. Conclusiones : En pacientes con fistula perianal compleja la tecnica de LIFT es una alternativa que ofrece igual o mejores tasas de curacion clinica con bajo riesgo de incontinencia fecal.

Short-and long-term results with Karydaki's technique for sacrococcygeal pilonidal diseaseIntroduction: Sacrococcygeal pilonidal cyst or sinus is a common condition in young people.There is still discussion about which of the many existing techniques is best suited to resolve this condition.Objective: To analyze the short-and long-term use of Karydaki's technique in our Hospital.Material and Methods: We analyzed prospective protocols from patients with pilonidal cyst with Karydaki's technique from June 2005 to August 2010.Clinical and telephonic follow-up was done to all patients and a satisfaction survey done to a random sample of the series.Results: We analyzed 62 patients with mean age of 24.5 years (15-45), being 33 men (53%).Cysts were previously relapsed in 20.9% of cases.The average hospital stay was 2.5 days (1-3).Early complications occurred in 14.3% of patients being the most common seroma in 8% and dehiscence in 6.4%.At a mean follow up of 38 months (12-62), relapse occurred in two patients (3.2%), one at 6 months and the other at 3 years, being resolved one by a new Karydaki's technique and the other with marsupialization.Among the group surveyed for satisfaction, 75% found the technique satisfactory or very satisfactory in terms of aesthetics and 95% would recommend this technique.Conclusions: Karydaki's operation achieves with a simple and aesthetic technic a low recurrence and morbidity and a complete recovery after 15 days in most patients.

Laparoscopic peritoneal lavage as treatment for acute perforated diverticulitis Introduction: Sigmoid diverticular disease is common in the occidental world and it is responsible for a great number of hospitalizations. The prevalence of diverticular disease increases with age and only in few cases it is manifest as diverticulitis. Diverticulitis produces variable clinical manifestations, ranging from simple inflammation that only requires medical management, to a life threatening condition, due to a free perforation that requires urgent surgery. Clinical case: In this article we present a clinical case of complicated diverticulitis with free perforation treated with laparoscopic peritoneal lavage.

Short-and long-term results with Karydaki's technique for sacrococcygeal pilonidal disease Introduction: Sacrococcygeal pilonidal cyst or sinus is a common condition in young people. There is still discussion about which of the many existing techniques is best suited to resolve this condition. Objective: To analyze the short-and long-term use of Karydaki's technique in our Hospital. Material and Methods: We analyzed prospective protocols from patients with pilonidal cyst with Karydaki's technique from June 2005 to August 2010. Clinical and telephonic follow-up was done to all patients and a satisfaction survey done to a random sample of the series. Results: We analyzed 62 patients with mean age of 24.5 years (15-45), being 33 men (53%). Cysts were previously relapsed in 20.9% of cases. The average hospital stay was 2.5 days (1-3). Early complications occurred in 14.3% of patients being the most common seroma in 8% and dehiscence in 6.4%. At a mean follow up of 38 months (12-62), relapse occurred in two patients (3.2%), one at 6 months and the other at 3 years, being resolved one by a new Karydaki's technique and the other with marsupialization. Among the group surveyed for satisfaction, 75% found the technique satisfactory or very satisfactory in terms of aesthetics and 95% would recommend this technique. Conclusions: Karydaki's operation achieves with a simple and aesthetic technic a low recurrence and morbidity and a complete recovery after 15 days in most patients.

Laparoscopic peritoneal lavage as treatment for acute perforated diverticulitis Introduction: Sigmoid diverticular disease is common in the occidental world and it is responsible for a great number of hospitalizations. The prevalence of diverticular disease increases with age and only in few cases it is manifest as diverticulitis. Diverticulitis produces variable clinical manifestations, ranging from simple inflammation that only requires medical management, to a life threatening condition, due to a free perforation that requires urgent surgery. Clinical case: In this article we present a clinical case of complicated diverticulitis with free perforation treated with laparoscopic peritoneal lavage.

Acute complicated diverticulitis. New trends in treatment Diverticular disease refers to the presence of colon diverticula. Its prevalence increases with age and in a few cases present as diverticulitis. Acute complicated diverticulitis is potentially mortal, since it can perforate and require emergency surgery. the treatment of choice is the excision of the perforated segment and the creation of a proximal colostomy. there are other therapeutic alternatives such as excision with pri- mary anastomosis and novel approaches such as laparoscopic peritoneal lavage. We herein review the new treatments of acute diverticulitis.

Acute complicated diverticulitis. New trends in treatment Diverticular disease refers to the presence of colon diverticula. Its prevalence increases with age and in a few cases present as diverticulitis. Acute complicated diverticulitis is potentially mortal, since it can perforate and require emergency surgery. The treatment of choice is the excision of the perforated segment and the creation of a proximal colostomy. There are other therapeutic alternatives such as excision with primary anastomosis and novel approaches such as laparoscopic peritoneal lavage. We herein review the new treatments of acute diverticulitis.