Psoas abscess secondary to Pott’s disease
Tuberculosis is the primary cause of death due to infections. Osteoarticular involvement represents up to 20% of extrapulmonary tuberculosis cases, and tuberculous spondylodiscitis is the most common type. We present the case of a 31-year-old male patient with a history of close contact with a relative with tuberculosis who sought medical care due to low back pain, fever, night sweats and loss of weight that had started 5 months before. A computed tomography scan revealed a right psoas abscess and lytic lesions in L5-S1. The abscess was percutaneously drained under CT guidance, and the culture was positive for Mycobacterium tuberculosis. During antituberculosis treatment, the patient evolved with tuberculous meningitis with a favorable clinical outcome. Spinal tuberculosis should be considered in young patients with chronic low back pain and systemic symptoms, especially those with a history of exposure. Early diagnosis through imaging tests and microbiological confirmation enables the initiation of effective, multidisciplinary treatment.
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Intussusception in adults due to metastasis from renal cell carcinoma
Intussusception, or intestinal invagination, is a rare cause of bowel obstruction in adults. An underlying organic cause is identified in most cases, with malignant tumors being the most prevalent etiology. For this reason, surgery is the treatment of choice in this age group. We present two clinical cases of adult patients diagnosed with intussusception secondary to metastases from renal cell carcinoma. Both patients underwent enterectomy of the affected segment with end-to-end anastomosis. Thepathological examination revealed metastases of renal cell carcinoma. Both cases highlight the importance of a timely and accurate diagnosis of intussusception in adults, as well as the need for surgical treatment.
External mandibular fixation in maxillofacial gunshot injury
Maxillofacial gunshot injuries constitute a clinical challenge due to the complex anatomy and high risk of morbidity and mortality. Comminuted mandibular fractures resulting from ballistic trauma are often associated with bone loss, bacterial infection, and extensive soft tissue damage, limiting the use of open reduction with rigid internal fixation. We present the case of a 19-year-old male patient with a comminuted mandibular fracture caused by a bullet, managed with external fixation with bicortical Kirschner wires, a silicone tube, and self-curing acrylic resin. The technique enabled the stabilization of the bone fragments without the necessity for extensive approaches, thereby preserving the periosteal blood supply and reducing the risk of complications. External fixation constitutes an effective and low-cost alternative for managing complex mandibular fractures, particularly in patients with polytrauma or involvement of other tissues. This method serves as both a definitive treatment and a bridging treatment for future reconstruction.
Liver Transplantation for Unresectable Perihilar Cholangiocarcinoma: A Case Report Following a Strict Oncologic Selection Protocol
Perihepatic cholangiocarcinoma (pCCA) is one of the most challenging hepatobiliary tumors to treat in terms of surgical complexity and poor prognosis in unresectable cases. In selected patients without metastatic disease, liver transplantation (LT) performed according to a protocol that includes neoadjuvant therapy has emerged as an accepted curative option. We present the case of a 52-year-old man with unresectable pCCA due to bilateral vascular involvement, who was treated according to a strict institutional protocol that included neoadjuvant chemoradiotherapy and orthotopic liver transplantation. Despite recurrent episodes of cholangitis during follow-up, tumor markers remained normal, and a staging laparoscopy ruled out distant metastases. Cadaveric liver transplantation was successfully performed without significant intraoperative complications. This case demonstrates the feasibility and favorable outcomes of standardized transplantation for unresectable pCCA, supporting its implementation in specialized centers with carefully selected patients. Liver transplantation following a protocol offers the possibility of prolonged survival in cases where curative options have historically been unavailable.
Accuracy of artificial intelligence for staging and decision-making in esophageal and gastric cancer
Background: Artificial intelligence (AI) has demonstrated increasing potential in oncology, including in imaging analysis and as a tool for supporting clinical decision-making. Objective: The aim of this study was to evaluate an AI conversational model, trained using up-to-date clinical guidelines, to assist with staging and initial treatment planning in patients with gastroesophageal cancer. Materials and methods: We conducted a retrospective study of patients with esophageal, gastric, and gastroesophageal junction cancer treated at a tertiary care hospital between December 2023 and May 2025. A virtual clinical assistant or chatbot was developed using ChatGPT-4.5® (OpenAI), configured to interpret test results in accordance with the NCCN and ESMO guidelines. The chatbot was designed to determine the clinical stage (cTNM), suggest a treatment plan, and identify relevant findings. The answers were compared with the decisions made by the treating physician. Results: Of the 53 patients evaluated, 34 met the inclusion criteria. The accuracy between the cTNM staging determined by the medical team and that of the chatbot was 94%. The concordance in the suggested therapeutic approach was 85%. The discrepancies were due to differences in the interpretation of the stage, clinical considerations not available to the AI, and social or logistical factors that influenced the medical decision. Conclusion: AI, implemented through a chatbot trained using clinical guidelines, proved useful in supporting staging and initial treatment planning for gastroesophageal cancer, with high concordance with clinical decisions.
Accuracy, staging, and decision-making: artificial intelligence in gastroesophageal cancer
The importance of asking the right questions: prompt engineering and language models in clinical practice
Sample size calculation is an essential component of the methodological design in medical research. In scientific studies, reporting the sample size improves the interpretability of the results, strengthening both the internal validity and ethical legitimacy of the study. This aspect is particularly important in surgery, given that many clinical events are relatively rare and surgical techniques can vary considerably from surgeon to surgeon.
Encapsulating peritoneal sclerosis: a case report of cocoon syndrome, an unusual cause of bowel obstruction
Encapsulating peritoneal sclerosis (EPS), also known as cocoon syndrome, is a rare cause of bowel obstruction in which the small intestine is encased by a thin fibrous membrane. We report the case of a 76-year-old male patient with no history of abdominal surgery who presented with colicky abdominal pain, vomiting, and abdominal distension. A computed tomography (CT) scan revealed severe bowel obstruction. During surgery, loops of the ileum were found to be encased in fibrous tissue, confirming a type II EPS. The adhesions were released and intraoperative intestinal perforations were repaired. The patient evolved with favorable outcome. The diagnosis is often complex and is frequently confirmed during surgery. A CT scan helps guide treatment by revealing dilated loops and thickened membranes. There are no standardized international guidelines. In cases of obstruction, surgery is the treatment of choice. This case highlights the importance of considering EPS in patients with no history of surgery.
Partial bowel obstruction caused by intussusception as a late complication following Roux-en-Y gastric bypass surgery
Intussusception is more common in pediatric patients, and its incidence in adults is low, typically associated with diverticula, polyps, tumors, or a history of previous surgeries. Early surgical intervention is considered the treatment of choice. A 44-year-old female patient with a history of Roux-en-Y gastric bypass is admitted with a clinical diagnosis of partial bowel obstruction, suggestive of intussusception based on computed tomography scan findings. An exploratory laparoscopy was performed for diagnostic and therapeutic purposes. An invaginated segment of the alimentary loop was found 10 centimeters from the base of the Roux-en-Y anastomosis, with preserved blood supply and motility, and was reduced. The postoperative period was uneventful, and the patient was discharged 48 hours after the procedure. There were no late complications. Laparoscopy is considered the preferred approach because it offers better postoperative outcomes, reduced postoperative ileus, a faster return to work, reduced pain, and enhanced cosmetic results compared to the conventional approach.
Artificial intelligence-based chatbots: the importance of asking the right questions
Background: Artificial intelligence-based chatbots (CBIA) are a widely used source of medical information. Prompt engineering (PE) focuses on designing and optimizing the questions asked of AI/ CBs to improve responses. Objective: The aim of this study was to compare the quality of prompts and the responses provided by an AiCB for clinical case resolution in general surgery, before and following PE training. Materials and methods: Three fictional clinical cases were developed for residents in general surgery to solve using ChatGPT-4®. After they were trained in PE, the participants solved the cases again. The quality of the prompts was evaluated using a scale (5-15 points) that explored completeness, context, input data, output format, and instructions. The chatbot’s answers were assessed using a scale (3- 15 points) that included accuracy, completeness, and relevance. The results obtained before and following PE training were compared. Results: Sixteen postgraduate year 1 to 4 residents participated in the study. The quality of prompts improved significantly following PE training, as assessed by total score [7.9 (1.8) vs. 10.4 (2.1), p< 0.01] for completeness, context, data input, and output format categories. Chatbot’s responses also improved across the categories and total score [10.2 (2) vs. 11.9 (1.8), p<0.01]. Conclusion: Training in PE significantly improved the quality of prompts and AiCB’s responses for solving general surgery clinical cases.
Short-term outcomes of surgical treatment for retroperitoneal tumors over a 10-year period
Background: Retroperitoneal tumors are uncommon, and their surgical removal poses a challenge for surgeons, as the space where they develop contains major blood vessels that are often compressed or displaced by the tumor. Sarcomas are the most common retroperitoneal tumors. Objective: The aim of this study was to evaluate the short-term outcomes of surgical resection for retroperitoneal tumors. Material and methods: We conducted an observational, retrospective and descriptive study. The medical records of patients who underwent surgery between January 2005 and December 2024 were reviewed. The demographic, clinical and operative variables were analyzed. Results: A total of 12 patients underwent surgery; 8 had malignant lesions, 7 of which were sarcomas. There were no deaths in the series and 4 patients developed in 4 cases (33%). Mean length of hospital stay was 6.5 days. An R0 resection confirmed by pathological examination was achieved in 9 patients. Three patients who could be followed up developed tumor recurrences. Conclusion: Sarcomas were the most common retroperitoneal tumors. An R0 resection was achieved in most cases, with complication rates comparable to those reported in other series.
Soft tissue sarcomas of the extremities and trunk. Surgical and oncological outcomes in patients with local disease
Background: Local soft tissue sarcomas (STS) of the extremities and superficial trunk require multimodal treatment to achieve local control rates > 80%. Objective: The aim of this study was to describe the long-term surgical and oncological outcomes of patients with STS of the extremities and trunk with local disease. Materials and methods: We conducted a retrospective, descriptive and observational study of patients with STS of the extremities and trunk who underwent surgery between 2008 and 2024. Patients were divided into 3 groups: primary tumors (G!), local recurrences (G2) and margin widening following inadequate resections (G3). The clinical and pathological characteristics, type of resection and reconstruction, complications, and adjunctive treatment therapy were recorded. Local recurrence-free survival (LRFS) and overall survival (OS) were evaluated in each group. Results: A total of 124 patients were included: 61 (49%) in group 1, 37 (30% in group 2, and 26 (21%) in group 3. Median tumor size was 8.5 cm (IQR 3.25-12). All the tumors were completely resected with limb preservation in 98.8%. Reconstructive procedures were performed in 36 cases (29%), with a higher incidence in groups G2 and G3. Radiation therapy was administered to 22 patients in G1, 6 as neoadjuvant therapy and 16 as adjuvant therapy. In G1, 5-year LRFS, distant metastases and OS were 82.8%, 63.5%, and 79.3%, respectively. In G2 and G3, the rates were 61.6%, 75%, and 85.3%.
Usefulness of microbiological bile analysis in grade II cholecystitis according to the Tokyo classification
Background: The Tokyo Guidelines 2018 for the Management of Cholecystitis (TG18) recommend intraoperative microbiological bile analysis (MBA) in moderate cases (grades II) to identify microorganisms and adjust antibiotic therapy. Objective: he aim of this study was to describe the results of samples obtained by intraoperative gallbladder aspiration for MBA and its association with comorbidities, PPI use, prior antibiotic therapy, and postoperative complications in patients with grade II cholecystitis. Material and methods: This observational, prospective and descriptive study included adult patients (> 18 years) diagnosed with grade II acute cholecystitis according to the TG18 managed with laparoscopic cholecystectomy (LC). Patients were assigned to two groups based on a positive or negative MBA. The data analyzed included demographic variables, medical history, and surgical and microbiological characteristics. The chi-square test (χ²) was used to compare categorical variables. A p-value < 0.05 was considered statistically significant. Results: Of the 272 patients who underwent LC, 51 had grade II acute cholecystitis; 29 (57%) were women, and mean age was 57 years (SD 18). The MBA was positive in 14 (27%) cases. Ten patients had a body mass index (BMI) of 25 or higher, 5 had comorbidities, and 7 used PPIs. None of the patients had received antibiotic therapy prior to hospitalization. E. coli was the most common germ involved (28%). All the germs were susceptible to ceftriaxone. There were no intraoperative adverse events resulting from gallbladder aspiration or postoperative complications.
Technical resources for tension-free closure of the hiatus for recurrent hiatal hernia repair
Copyright (c) 2026 Revista Argentina de Cirugía http://dx.doi.org/10.25132/raac.v118.n1.1878
Rapunzel syndrome with distal intestinal obstruction secondary to trichobezoar
A trichobezoar is an indigestible hair mass in the gastrointestinal tract. It is most common in young women with psychiatric disorders such as trichotillomania and trichophagia. We present the case of a 16-year-old otherwise healthy female patient without a prior history of psychiatric disorders who consulted for abdominal pain lasting one week, associated with vomiting and intolerance to oral feeding. On physical examination, there was evidence of alopecia, and a palpable mass was noted in the epigastric region. The computed tomography scan revealed an image suggestive of a gastric trichobezoar occupying the entire stomach and extending into the duodenum, consistent with Rapunzel syndrome. The mass was extracted via laparotomy with gastrotomy, and an enterotomy was performed due to the presence of trichobezoars in the distal ileum. The postoperative period was uneventful, and the patient was discharged on postoperative day 5.This case highlights the importance of considering this diagnosis in patients with gastrointestinal symptoms and alopecia, without a prior history of psychiatric disorders.
Copyright (c) 2026 Revista Argentina de Cirugía http://dx.doi.org/10.25132/raac.v118.n1.1909
Pancreatic insulinomas are rare tumors that primarily affect women and should be considered in cases of hypoglycemia during the first trimester of pregnancy. Laparoscopic surgery is the preferred treatment option during the second trimester of fetal development. We report the case of a 24-year-old woman who underwent laparoscopic enucleation of a pancreatic insulinoma and presented with recurrence 15 months later during the second trimester of pregnancy. It was also managed with laparoscopic enucleation in the second trimester, with resolution of the clinical picture
Copyright (c) 2026 Revista Argentina de Cirugía http://dx.doi.org/10.25132/raac.v118.n1.1896
In Ipso Vivimus et Movemur: spatial intelligence, world models, and elite ultra-complex surgery as the upper limit benchmark for embodied AGI (Artificial General Intelligence)
Although large language models have achieved remarkable fluency in symbolic reasoning and dialogue, they remain fundamentally limited in their sensorimotor competence, which surgeons develop through decades of deliberate practice. Based on the theory of embodied cognition and contemporary proposals for predictive models of the world, I argue that the most significant obstacle standing in the way of artificial general intelligence (AGI) is not linguistic, but physical: the ability to anchor perception, planning, and action within the relentless constraints of real-world dynamics. As an illustrative benchmark for the upper limit, I propose the “AGI benchmark in surgery”—the hypothetical point at which an autonomous robotic system could safely and reliably perform ultra-complex surgical procedures, such as multi-visceral transplantation, complex hepatopancreatobiliary resections, and robot-assisted microsurgical reconstructions, while matching or surpassing the abilities of elite human surgeons. This perspective breaks down the benchmark into a practical ladder of milestones and describes the technical requirements—tactile sensing, compliant control, hierarchical planning, and predictive models of the world—needed to bridge the gap between simulation and clinical reality.
Copyright (c) 2026 Revista Argentina de Cirugía http://dx.doi.org/10.25132/raac.v118.n1.1964
Surgical management of parathyroid diseases: a single-center experience with different technological resources
Background: Hyperparathyroidism (HPT) is an endocrine disorder that can lead to significant complications, including impaired calcium and phosphorus metabolism, with consequences on cardiovascular, bone, and renal health. Objective: The aim of this study was to describe the short- and mid-term results of surgical treatment in patients undergoing surgery due to PHPT, SHPT and THPT. Material and methods: We conducted a retrospective and observational cohort study. Material and methods: The clinical records of patients undergoing surgery between January 2018 and April 2025 were reviewed. The variables analyzed included the number of patients, demographic characteristics, types of diseases, surgical techniques, complications, and short- and mid-term follow-up. The standard reference values for the biochemical tests of the institutional laboratory were considered. Results: A total of 37 cases were included; 29 patients with PHPT (78.4%), 7 with SHPT (18.9%), and 1 with THPT (2.7%). Fifteen patients underwent bilateral neck exploration, 11 patients underwent minimally invasive neck exploration, and 11 patients underwent transoral endoscopic parathyroidectomy via a vestibular approach (TOEPVA). Five patients (13.5%) presented hypocalcemia and 3 (8.1%) developed temporary dysphonia. There were no surgical site infections. Serum calcium levels normalized in 86.5% of patients within 30 days of surgery. Conclusion: The utilization of the aforementioned techniques in the series presented did not result in significant complications with surgical treatment and facilitated the normalization of calcemia in the majority of cases.
Copyright (c) 2026 Revista Argentina de Cirugía http://dx.doi.org/10.25132/raac.v118.n1.1921
The substantial volume of publications being currently produced makes it difficult for researchers to read each work, as their time is limited. The selection process is based on the preliminary information provided in the articles: the title and abstract. The title and abstract function as an introduction, encouraging readers to consider reading and citing the research paper in future articles. Consequently, these two components of every scientific article must be written with great care, as all authors want their work to be known and cited.
Copyright (c) 2026 Revista Argentina de Cirugía http://dx.doi.org/10.25132/raac.v118.n1.cymmrm
Editorial on: "Comparison between patients younger or older than 50 years of age undergoing surgery for colorectal cancer"
Copyright (c) 2026 Revista Argentina de Cirugía http://dx.doi.org/10.25132/raac.v118.n1.edjlm
Comparison between patients younger or older than 50 years of age undergoing surgery for colorectal cancer
Background: The incidence of colorectal cancer (CRC) is increasing in people < 50 years, a group that has traditionally been excluded from screening programs and is characterized by the presence of more aggressive tumors. This trend poses diagnostic, therapeutic, and social challenges. Objectives: The aim of this study was to compare the characteristics of patients aged 50 or younger versus those over 50 who underwent surgery for CRC. Material and methods: We conducted a cross-sectional, analytical and retrospective study. The following variables were recorded: demographic data, American Society of Anesthesiologists (ASA) physical status classification, and histopathological and therapeutic characteristics of patients undergoing CCR surgery between January 2019 and December 2024. The variables were compared using Pearson’s chi-square test or Fisher’s exact test. Results: A total of 155 patients were included and assigned to two groups: those ≤ 50 years (n = 36) and those > 50 years (n = 119). Younger patients exhibited a higher proportion of men (p = 0.016), cases classified as ASA grade 1 (p = 0.004) and rectal cancer (p = 0.026). There were no significant differences in the histological characteristics, recurrence rate (p = 0.407), or overall mortality (p = 1.0). There was a non-significant trend among young patients to present poorly differentiated tumors (11.1% vs. 6.7%; p = 0.202) and to receive chemotherapy at stage II (30% vs. 15%; p = 0.358). Conclusion: Patients aged 50 years or younger showed differences in demographics, ASA physical status classification, and tumor location
Copyright (c) 2026 Revista Argentina de Cirugía http://dx.doi.org/10.25132/raac.v118.n1.1910
De Garengeot hernia: a rare location of the appendix therapeutic approach
De Garengeot hernia is defined as a femoral hernia containing the appendix. This report describes a 55-year-old female patient who presented with acute lower abdominal pain radiating to the right lower limb, persisting for 4 days. Physical examination revealed a flat, soft abdomen with tenderness in the lower right quadrant and an irreducible mass below the inguinal ligament. Abdominal ultrasonography demonstrated an irreducible right inguino-femoral hernia. The hernia sac contained free fluid and inflamed adipose tissue, as well as a blind-ending bowel loop. The patient underwent hernia repair via an inguinal incision. A De Garengeot hernia was identified, with the femoral sac containing free fluid and the appendix, which had no signs of acute inflammation. This is a rare condition, and the surgical approach for repairing the abdominal wall largely depends on the preoperative diagnosis, based on the progression of symptoms.
Copyright (c) 2026 Revista Argentina de Cirugía http://dx.doi.org/10.25132/raac.v118.n1.1845
Management of tooth avulsion: a systematic review
Tooth avulsion is one of the most serious traumatic dental injuries (TDIs), and it occurs mainly in pediatric and adolescent patients. Early, evidence-based management is essential to optimize prognosis and preserve dental and periodontal health. This systematic review integrates existing literature that deals with clinical protocols and outcomes related to the treatment of avulsed permanent teeth. It focus specifically on the timing of replantation, use of various storage media, splinting methods, timing and technique of endodontic treatment, and use of regenerative materials. Interventional trials, case reports, and retrospective cohort studies are included, all aimed at elucidating the variables determining prognosis. The review demonstrates superior outcomes through early replantation and illustrates how technological advancements in materials such as platelet-rich fibrin (PRF) and mineral trioxide aggregate (MTA) have expanded the window for delayed replantation therapy. The methodological quality of the included studies was evaluated using standardized critical appraisal instruments. The evidence supports a protocol-based, multidisciplinary approach that incorporates current bioactive materials and early emergency treatment to achieve optimal long-term results. The aim of this review is to help clinicians and stakeholders in the management of dental trauma and guide future research identifying optimized treatment for avulsed permanent teeth.
Copyright (c) 2026 Revista Argentina de Cirugía http://dx.doi.org/10.25132/raac.v118.n1.1923
Adrenalectomies in a department of general surgery
Background: Adrenal tumors account for 0.6 to 1.5% of all abdominal neoplasms. The evaluation of adrenal tumors requires specific imaging tests, clinical evaluation, and endocrine workup. Laparoscopic adrenalectomy is the preferred technique. Objective: The aim of this study was to describe the results of laparoscopic adrenalectomies performed in a general surgery department for the treatment of adrenal gland disease. Material and methods: We conducted an observational, descriptive and retrospective study of patients undergoing surgery between January 2014 and April 2025. Results: A total of 15 patients were included; mean age was 58.5 years (SD 15.6), and 9 (60%) were women. The preoperative diagnosis was made by clinical evaluation in 7 cases (46.7%), during cancer workups in 4 cases (26.7%), and incidentally in 4 cases (26.7%). The surgical approach was performed using transperitoneal laparoscopic technique. Conversion to open surgery was necessary in 1 patient (6.7%). Mean operative time was 183.6 minutes (SD 51.3). There were 2 complications (13.3%), both grade 4a of the Clavien-Dindo classification. Mean hospital length of stay was 5 days (range: 2-30). The pathology reports documented 5 cases (33.5%) of pheochromocytoma, 3 cases (20%) of adrenal cortical adenoma, 2 cases (13.3%) of metastasis, and 5 cases (33.5%) of other diagnoses. Conclusion: Most diagnoses were made during clinical evaluation or cancer workups, and the transperitoneal laparoscopic approach was a safe option with an acceptable conversion rate (6.7%) and favorable postoperative outcomes.
Copyright (c) 2026 Revista Argentina de Cirugía http://dx.doi.org/10.25132/raac.v118.n1.e-1915
Retroperitoneal paraganglioma presenting as acute pancreatitis
Paragangliomas are rare neuroendocrine tumors that arise from the chromaffin cells of the autonomic nervous system paraganglia. The estimated incidence is 0.8 per 100,000 people. The initial manifestation of functioning paragangliomas is hypertension in 90% of cases. We present a rare case of a 55-year-old male patient who was previously asymptomatic and presented with clinical criteria consistent with acute pancreatitis, with no evidence of any other etiology. The imaging tests detected a para-aortic retroperitoneal mass displacing the distal pancreas. During open surgery, a tumor compromising the left adrenal gland was removed. During the tumor manipulation, the patient exhibited a significant increase in blood pressure, which subsided after the tumor was resected. Histopathological examination confirmed a paraganglioma with a mutation in the SDHB gene. After a two-year period of clinical observation, there was no evidence of local or metastatic tumor recurrence.
Copyright (c) 2026 Revista Argentina de Cirugía http://dx.doi.org/10.25132/raac.v118.n1.1847
Comparison between paragastric blockade and intraperitoneal local anesthetic instillation for the treatment of visceral pain and associated autonomic symptoms following sleeve gastrectomy
Background: Visceral pain (VP) and its associated autonomic symptoms (AAS) are common in the immediate postoperative period following sleeve gastrectomy (SG). Intraperitoneal local anesthetic instillation (IPLA) is often used to treat VP. Promising results with paragastric autonomic neural blockade (PG-ANB) were reported in 2022. Objective: The aim of this study was to compare the efficacy PG-ANB with IPLA and a control group in managing visceral pain and associated autonomic symptoms following SG. Material and methods: We conducted a prospective, double-blind, randomized clinical trial in a highvolume center over a 9-month period. A total of 192 patients undergoing SG were included (101 women and 91 men) and assigned to three groups: PG-ANB (n = 85), IPLA (n = 96), and NIAT (n = 11). Pain scores, nausea, and vomiting at 8 and 24 hours after surgery were investigated. Results: At 8 hours, the PG-ANB group experienced less pain than the control group (85.9% vs. 54.5%, Fisher’s exact test 0.023; p < 0.05), with no significant differences compared to the IPLA group (85.9% vs. 80.2%, Fisher’s exact test 0.3308; p > 0.05). The occurrence of associated autonomic symptoms was significantly lower in the PG-ANB group compared to the IPLA group (2.4% vs. 21.9%, Fisher’s exact test = 0.0001; p < 0.05). No differences were observed at 24 hours. There were no complications associated with PG-ANB or IPLA. The control group was terminated for ethical reasons. Conclusion: PG-ANB was a safe and effective technique for preventing VP and AAS after SG.
Copyright (c) 2026 Revista Argentina de Cirugía http://dx.doi.org/10.25132/raac.v118.n1.1826
Relato Oficial de las Jornadas de Otoño 2024 - Inteligencia Artificial en Cirugía
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Percutaneous management of a bile duct stricture secondary to a laparoscopic clip
Bile duct injuries are serious complications of laparoscopic cholecystectomies with a prevalence between 0.4% and 1.5%. We report the case of a 51-year-old male patient with a bile duct stricture secondary to a laparoscopic clip following a laparoscopic cholecystectomy for acute cholecystitis. The patient was treated with a percutaneous approach, which relieved symptoms and dilated the obstruction, resolving the condition during the 24-month follow-up. The percutaneous approach provided initial relief from the acute event, followed by definitive treatment. This approach avoided the complications of major surgery. We did not find similar cases after conducting a comprehensive literature search, which underscores the value of the present case.
Copyright (c) 2025 Revista Argentina de Cirugía http://dx.doi.org/10.25132/raac.v117.n4.1894
Littoral cell hemangioma in the spleen: a rare benign vascular tumor in a pediatric patient
The spleen is a richly vascularized organ and is rarely the site of tumors. Among the most frequent are hemangioma and lymphangioma. Littoral cell angioma (LCA) is a rare primary vascular tumor of the spleen that arises from the cells lining the venous sinuses of the red pulp. There are two forms of LCA: diffuse multinodular and solitary (less frecuentely). Since LCA mainly affects individuals between the ages of 40 and 60, reports of this condition in children are extremely rare. We present the case of an asymptomatic pediatric patient who, through an incidental finding on ultrasound, was diagnosed with a splenic nodule with progressive growth and thrombocytopenia, and underwent further investigation and surgical treatment with laparoscopic splenectomy. The histopathological result confirmed the presence of a solitary littoral cell tumor, which is a rarer presentation.
Copyright (c) 2025 Revista Argentina de Cirugía http://dx.doi.org/10.25132/raac.v117.n4.1907