RENATO SILVEIRA LEAL
Índice h a partir de 2011
1
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
8 resultados
Resultados de Busca
Agora exibindo 1 - 8 de 8
bookPart Trauma esplênico(2019) MENEGOZZO, Carlos Augusto Metidieri; LEAL, Renato SilveirabookPart Dor abdominal no cardiopata(2018) SILVA, Eduardo Rissi; LEAL, Renato Silveira; AKAMINE, Masahiko; UTIYAMA, Edivaldo M.- Case report of peritoneal carcinomatosis in the clinical course of pancreatic solid pseudopapillary neoplasm (Frantz's tumor) in a patient with a history of blunt abdominal trauma(2023) DAMOUS, Sergio Henrique Bastos; YAMAZUMI, Marcia Harumi; CAVASSIN, Guilherme Pasquini; RASSLAN, Roberto; LEAL, Renato Silveira; UTIYAMA, Edivaldo MassazoIntroduction: Pancreatic solid pseudopapillary neoplasm (SPN), or Frantz's tumor, is a rare tumor with low malignant potential and a high cure rate when treated by complete surgical resection. There have been few reports of metastatic disease as a result of blunt abdominal trauma. Presentation of case: A 13-year-old female patient was a victim of blunt abdominal trauma in 2019. A computed tomography (CT) scan showed a voluminous hemoperitoneum associated with a tumor in the pancreatic tail whose characteristics suggested a pseudopapillary tumor. The patient remained hemodynamically stable and nonoperative treatment was chosen. Two months later, a CT scan showed resolution of the hemoperitoneum and delimitation of the neoplasm in the tail of the pancreas. Elective body and tail pancreatectomy with laparoscopic splenectomy was performed. The patient remained asymptomatic for 15 months until she developed abdominal pain and constipation. A CT scan suggested peritoneal carcinomatosis, which was confirmed by biopsy of the lesions. Clinical discussion: A pancreatic SPN, in the context of an abdominal injury, can undergo metastatic progression despite surgical resection with curative intent and adherence to the precepts of minimally invasive oncological surgery. It is important to plan for the long-term follow-up of patients, as well as to understand the risk factors for recurrence. Conclusion: Although pancreatic SPN has a good prognosis, rupture of its capsule due to external trauma, as reported in the present case, may be a mechanism for peritoneal dissemination of the tumor with a consequent reduction in the length of disease-free survival.
bookPart Dor abdominal no cardiopata(2015) SILVA, Eduardo Rissi; LEAL, Renato Silveira; AKAMINE, Masahiko; UTIYAMA, Edivaldo M.bookPart Esplenectomia(2012) DAMOUS, Sérgio; LEAL, Renato; BERNINI, Celso de Oliveira; UTIYAMA, Edivaldo MassazobookPart Dor abdominal no cardiopata(2015) SILVA, Eduardo Rissi; LEAL, Renato Silveira; AKAMINE, Masahiko; UTIYAMA, Edivaldo M.bookPart Dor abdominal no cardiopata(2018) SILVA, Eduardo Rissi; LEAL, Renato Silveira; AKAMINE, Masahiko; UTIYAMA, Edivaldo M.- Three-stage management of complex pancreatic trauma with gastroduodenopancreatectomy: A case report(2018) DAMOUS, Sergio Henrique Bastos; DARCE, George Felipe Bezerra; LEAL, Renato Silveira; COSTA JR., Adilson Rodrigues; FERREIRA, Pedro Henrique Alves; BERNINI, Celso de Oliveira; UTIYAMA, Edivaldo MassazoINTRODUCTION: Severe injuries of the pancreatic head and duodenum in haemodynamically unstable patients are complex management. The purpose of this study is to report a case of complex pancreatic trauma induced by gunshot and managed with surgical approaches at three different times. PRESENTATION OF CASE: Exploratory laparotomy was indicated after initial emergency room care, with findings of cloudy blood-tinged fluid and blood clots on the mesentery near the hepatic angle, on the region of the 2nd portion of the duodenum and at the pancreatic head. Gastroduodenopancreatectomy was performed with right hemicolectomy and the peritoneal cavity was temporarily closed by a vacuum peritoneostomy. Surgical reopening occurred on the fifth postoperative day, and the patient was subjected to single-loop reconstruction of the intestinal transit with telescoping pancreaticojejunal anastomosis, biliodigestive anastomosis with termino-lateral hepaticojejunal anastomosis with a Kehr drain and gastroenteroanastomosis in 2 planes. The terminal ileostomy was maintained. After 2 days, the patient was subjected to abdominal wall closure without complications, which required relaxing Gibson incisions and wound closure with polypropylene mesh placement in a pre-aponeurotic position closed with multiple stitches. RESULTS: The patient was discharged on the 40th post-trauma day without drains, with a functioning ileostomy and with a scheduled reconstruction of intestinal transit. CONCLUSION: In the presence of multiple associated injuries, hemodynamic instability and the need for an extensive surgical procedure such as duodenopancreatectomy, damage control surgery performed in stages as reported here enables the clinical stabilization of the patient for definitive treatment, achieving better survival results. (C) 2018 The Authors.