was read the article
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"tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "202" "paginaFinal" => "203" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Is pneumomediastinum and cervical emphysema a sign of poor prognosis in colorectal anastomosis leakage?" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1110 "Ancho" => 1672 "Tamanyo" => 225401 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">1A) Corte axial de la TC que muestra enfisema cervical supraclavicular anterior y posterior. B) Corte axial de la TC que muestra neumomediastino (flechas). C) Corte axial de la TC que muestra neumoperitoneo moderado (flecha). D) Corte axial de la TC que muestra mínima burbuja extraluminal en vecindad de anastomosis colorrectal (flecha).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Emilio Peña Ros, Pedro A. Parra Baños, Maria Fe Candel Arenas, Antonio Albarracín Marín-Blázquez" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Emilio" "apellidos" => "Peña Ros" ] 1 => array:2 [ "nombre" => "Pedro A." 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Consequences of Delay in Diagnosis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "204" "paginaFinal" => "205" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Trauma duodenal. Consecuencias del retraso en su diagnóstico" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 722 "Ancho" => 925 "Tamanyo" => 113071 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Fistula in the second-third portion of the duodenum.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Sergio Builes Ramírez, María Alejandra García Novoa, Nicolasa Fernández Soria, Manuel Gómez Gutiérrez" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Sergio" "apellidos" => "Builes Ramírez" ] 1 => array:2 [ "nombre" => "María Alejandra" "apellidos" => "García Novoa" ] 2 => array:2 [ "nombre" => "Nicolasa" "apellidos" => "Fernández Soria" ] 3 => array:2 [ "nombre" => "Manuel" "apellidos" => "Gómez Gutiérrez" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0009739X15002663" "doi" => "10.1016/j.ciresp.2015.10.004" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0009739X15002663?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173507716000508?idApp=UINPBA00004N" "url" => "/21735077/0000009400000003/v2_201603270038/S2173507716000508/v2_201603270038/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2173507716000466" "issn" => "21735077" "doi" => "10.1016/j.cireng.2014.12.022" "estado" => "S300" "fechaPublicacion" => "2016-03-01" "aid" => "1559" "copyright" => "AEC" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Cir Esp. 2016;94:201-2" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 752 "formatos" => array:3 [ "EPUB" => 11 "HTML" => 559 "PDF" => 182 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Fresh Cadaver, an Old Surgical Model in Current General Surgery" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "201" "paginaFinal" => "202" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Los cadáveres en fresco, un antiguo modelo quirúrgico en la cirugía general actual" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Óscar Vidal, César Ginestà, Juan José Espert, Mauro Valentini, Juan Carlos García-Valdecasas" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Óscar" "apellidos" => "Vidal" ] 1 => array:2 [ "nombre" => "César" "apellidos" => "Ginestà" ] 2 => array:2 [ "nombre" => "Juan José" "apellidos" => "Espert" ] 3 => array:2 [ "nombre" => "Mauro" "apellidos" => "Valentini" ] 4 => array:2 [ "nombre" => "Juan Carlos" "apellidos" => "García-Valdecasas" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0009739X14003984" "doi" => "10.1016/j.ciresp.2014.12.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0009739X14003984?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173507716000466?idApp=UINPBA00004N" "url" => "/21735077/0000009400000003/v2_201603270038/S2173507716000466/v2_201603270038/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Is Pneumomediastinum and Cervical Emphysema a Sign of Poor Prognosis in Colorectal Anastomosis Leakage?" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "202" "paginaFinal" => "203" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Emilio Peña Ros, Pedro A. Parra Baños, Maria Fe Candel Arenas, Antonio Albarracín Marín-Blázquez" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Emilio" "apellidos" => "Peña Ros" "email" => array:1 [ 0 => "emilio.doctor@gmail.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Pedro A." "apellidos" => "Parra Baños" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Maria Fe" "apellidos" => "Candel Arenas" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Antonio" "apellidos" => "Albarracín Marín-Blázquez" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Reina Sofía, Murcia, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Universidad Católica San Antonio, Murcia, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "¿Es el neumomediastino y enfisema cervical un signo de mal pronóstico en la dehiscencia de anastomosis colorrectal?" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 997 "Ancho" => 1502 "Tamanyo" => 201507 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Axial CT image showing anterior and posterior supraclavicular cervical emphysema; (B) axial CT image showing pneumomediastinum (arrows); (C) axial CT scan showing moderate pneumoperitoneum (arrow); (D) axial CT image showing a minimal extraluminal bubble in the vicinity of the colorectal anastomosis (arrow).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We have read with interest the article by Dr. de la Plaza Llamas et al.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a> about pneumomediastinum and cervical emphysema as initial signs in colorectal anastomotic dehiscence. Recently, we had the opportunity to treat a similar case, and its exceptional nature has made us inclined to share our experience and to comment on some details of the case in question.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The patient is an 85-year-old male who was being studied for iron-deficiency anaemia and was diagnosed with sigmoid adenocarcinoma. Thoracoabdominal CT scan showed no evidence of metastatic disease, with a reported radiological stage of T<span class="elsevierStyleInf">2</span>N<span class="elsevierStyleInf">0</span>M<span class="elsevierStyleInf">0</span>. He was treated by a laparoscopic approach, involving sigmoidectomy with mechanical end-to-end colorectal anastomosis. The patient progressed favourably but presented marked supraclavicular cervical emphysema on the 4th day post-op, which extended to the upper extremities, thorax and abdomen, with no associated symptoms of abdominal pain. Thoracoabdominal CT scan demonstrated important pneumomediastinum and cervical emphysema (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A and B), moderate abdominal pneumoperitoneum in the supramesocolic compartment (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C), 2 minimal bubbles in the vicinity of the colorectal anastomosis (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>D) and no presence of liquid or other alterations. A new laparoscopic procedure detected a punctiform dehiscence at the anterior side of the colorectal anastomosis, evidence of which was seen with an air test, although there was no presence of associated peritonitis. The anastomosis was resected and a new mechanical end-to-end colorectal anastomosis was created. During the postoperative period, the patient evolved favourably, with spontaneous resolution of the emphysema after having received no specific treatment. The patient was discharged 7 days after the reoperation.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Pneumomediastinum and cervical emphysema are uncommon signs at the onset of colorectal anastomosis dehiscence,<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">1,2</span></a> although they have also been observed in cases of perforated diverticulitis<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">3</span></a> and perforation after endoscopic polypectomy.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">4</span></a> As indicated in the literature, a delayed diagnosis determines the prognosis.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">2</span></a> In our case, the diagnosis occurred in the first few days post-op, which provided for early treatment and avoided the development of peritonitis and associated morbidity, at which time we were able to construct a new anastomosis. In the cited case,<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a> the fact that dehiscence was not diagnosed until 11 days after surgery (because the patient presented no symptoms during hospitalisation), lengthened the hospital stay to 60 days, with what we can only assume was important postoperative morbidity, and made it impossible to perform an anastomosis during the operation.</p><p id="par0020" class="elsevierStylePara elsevierViewall">We would like to emphasise that, although pneumomediastinum and cervical emphysema can be the first signs of presentation of colorectal anastomosis dehiscence, any delay in diagnosis and intraabdominal conditions that are encountered will determine the therapeutic approach and prognosis. This should not necessarily mean a severe condition associated with high morbidity and prolonged hospital stay.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Peña Ros E, Parra Baños PA, Candel Arenas MF, Albarracín Marín-Blázquez A. ¿Es el neumomediastino y enfisema cervical un signo de mal pronóstico en la dehiscencia de anastomosis colorrectal? Cir Esp. 2016;94:202–203.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 997 "Ancho" => 1502 "Tamanyo" => 201507 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Axial CT image showing anterior and posterior supraclavicular cervical emphysema; (B) axial CT image showing pneumomediastinum (arrows); (C) axial CT scan showing moderate pneumoperitoneum (arrow); (D) axial CT image showing a minimal extraluminal bubble in the vicinity of the colorectal anastomosis (arrow).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib0025" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Neumomediastino y enfisema cervical como comienzo de dehiscencia de anastomosis colorrectal" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R. 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2020 May | 28 | 9 | 37 |
2020 April | 28 | 6 | 34 |
2020 March | 23 | 1 | 24 |
2020 February | 29 | 7 | 36 |
2020 January | 17 | 11 | 28 |
2019 December | 21 | 10 | 31 |
2019 November | 6 | 9 | 15 |
2019 October | 16 | 7 | 23 |
2019 September | 17 | 6 | 23 |
2019 August | 17 | 9 | 26 |
2019 July | 23 | 25 | 48 |
2019 June | 12 | 20 | 32 |
2019 May | 87 | 17 | 104 |
2019 April | 17 | 4 | 21 |
2019 March | 6 | 0 | 6 |
2019 February | 10 | 4 | 14 |
2019 January | 3 | 0 | 3 |
2018 December | 1 | 5 | 6 |
2018 November | 3 | 1 | 4 |
2018 October | 5 | 3 | 8 |
2018 September | 3 | 2 | 5 |
2018 August | 1 | 1 | 2 |
2018 July | 4 | 1 | 5 |
2018 June | 5 | 1 | 6 |
2018 May | 7 | 0 | 7 |
2018 April | 2 | 2 | 4 |
2018 March | 6 | 0 | 6 |
2018 February | 8 | 3 | 11 |
2018 January | 9 | 1 | 10 |
2017 December | 7 | 0 | 7 |
2017 November | 8 | 4 | 12 |
2017 October | 6 | 0 | 6 |
2017 September | 5 | 1 | 6 |
2017 August | 18 | 3 | 21 |
2017 July | 11 | 3 | 14 |
2017 June | 13 | 1 | 14 |
2017 May | 14 | 3 | 17 |
2017 April | 4 | 3 | 7 |
2017 March | 9 | 2 | 11 |
2017 February | 8 | 0 | 8 |
2017 January | 9 | 3 | 12 |
2016 December | 22 | 4 | 26 |
2016 November | 16 | 0 | 16 |
2016 October | 22 | 1 | 23 |
2016 September | 22 | 1 | 23 |
2016 August | 18 | 0 | 18 |
2016 July | 25 | 1 | 26 |
2016 June | 13 | 3 | 16 |
2016 May | 1 | 0 | 1 |