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Background: Diabetic hand syndrome is a complication of diabetes mellitus that is rarely described in Mexico. It covers a wide spectrum of nervous, tendinous and infectious disorders. The tropical variant of the disease is described as a necrotizing infection in the upper extremity, generally secondary to superficial trauma. Treatment includes metabolic control, antibiotics and different surgical techniques. Currently, complementary therapies include surgical debridement, flap reconstruction, negative pressure therapy, larval debridement, and stem cell grafting. The objective was to describe negative pressure therapy (NPT) as an adjunctive treatment for a case of tropical diabetic hand syndrome (TDHS) complicated by abscess and compartment syndrome, and we also made a literature review., Clinical Case: 50-year-old male patient with diabetic hand syndrome complicated by abscess and compartment syndrome. Fasciotomy and surgical drainage were performed, complementing the treatment with negative pressure therapy. After 10 days of complementary therapy and 20 more days of follow-up, the patient presented adequate remission., Conclusion: The use of NPT in the treatment of TDHS helped to limit the infection damage, and allowed the patient to be monitored on an outpatient basis, reducing his hospital stay., (Licencia CC 4.0 (BY-NC-ND) © 2024 Revista Médica del Instituto Mexicano del Seguro Social.)

Background: Splenic infarction is a rare cause of acute abdomen. The two main causes are thromboembolic diseases and infiltrative hematological disorders. The splenic abscess is the result of a hematogenous seeding, whose causes are trauma, splenic artery embolization, endocarditis, and immunocompromised states., Clinical Case: 48-year-old male patient with a history of chronic myelomonocytic leukemia on mercaptopurine-based treatment, who presented intermittent asthenia, adynamia, and abdominal distension for 2 months; a computed tomography of the abdomen with intravenous contrast was performed, reporting areas of infarction and an image suggestive of a splenic abscess in the upper pole, for which an open splenectomy was performed with adequate clinical evolution. A documentary review of the disease and of the therapeutic options was carried out, with an emphasis on surgical management., Conclusion: The main cause of morbidity and mortality in the case presented was splenic infarction, which is aggravated by the presence of hematological diseases; therefore, the identification of those patients at risk of complications will allow in a timely manner a diagnostic and therapeutic approach, and the detection of those who require urgent surgical management., (Licencia CC 4.0 (BY-NC-ND) © 2024 Revista Médica del Instituto Mexicano del Seguro Social.)

Background: Hemophagocytic syndrome or hemophagocytic lymphohistiocytosis (HL) is an immune hyperactivation of multifactorial etiology, characterized by excessive activation of lymphocytes and macrophages, as well as numerous pro-inflammatory cytokines. It has a non-specific and highly variable clinical presentation, with splenomegaly being one of the clinical manifestations. Due to its nature, it can manifest during childhood or adult life, which is why it is a disease of diagnostic and therapeutic complexity., Clinical Case: 38-year-old male patient without comorbidities, who presented with abdominal pain, choluria, fever > 38 °C and diaphoresis of more than 10 days of evolution. A bone marrow aspirate was performed as part of the diagnostic approach with data compatible with hemophagocytosis and cytopenias. The immunosuppressive management did not show the expected response, which is why an open splenectomy was performed as the last therapeutic option with adequate hematological control. A documentary review of the disease was carried out, and of the therapeutic options, emphasizing surgical management in case of refractoriness to medical treatment., Conclusions: Splenectomy increases the overall survival rate and the time free of HL progression, even though there are still no studies to determine with certainty the ideal time to perform a splenectomy in patients with pancytopenia without splenomegaly who suffer from hemophagocytic syndrome., (Licencia CC 4.0 (BY-NC-ND) © 2024 Revista Médica del Instituto Mexicano del Seguro Social.)

The thyroid descends through the foramen cecum leaving the thyroglossal duct, which disappears between the fifth and the tenth week of pregnancy. The lack of involution of any part of this duct results in thyroglossal cyst formation. Its diagnostic approach is made by cervical ultrasound, computed tomography and magnetic resonance imaging. Approximately 1 % of the thyroglossal cyst formation contains malignant elements, and the most reported primary tumor has been papillary carcinoma. The recommended treatment for these carcinomas is controversial and it has evolved as time goes by. From Sistrunk procedure to neck dissection with total thyroidectomy and complementary therapies, such as iodine ablation and thyroid supplements, yet there is still no consensus as to the type of surgery and postoperative management it should be used to treat this carcinoma. Therapy should be applied according to each specific case, and it should be based on histological diagnosis, the invasive character of the tumor, and the lymph node affectation. In this paper we review the literature published so far with regards to the treatment of this carcinoma.

Background: adenocarcinoid tumor is a rare malignancy that combines clinical and histological features of epithelial origin (adenocarcinoma) and neuroendocrine (carcinoid), occupies less than 1 % of all colorectal cancer histology, occurring mainly in the appendix and its presence in the colon is rare., Clinical Case: we present a case of a 41-year-old female with sigmoid colon tumor, who underwent an extended left hemicolectomy and anastomosis; having a good postoperative evolution, with hospital stay of seventh days. The final histopathological study reported was adenocarcinoid colon tumor with free margins of injuries and four positive nodes of adenocarcinoma., Conclusions: adenocarcinoid tumors are present in the appendix in 85 to 95 % of all cases and only 6 % are located in the colon (13 % in sigmoid). Early diagnosis is certainly the most important determinant of good prognosis, in these cases the five-year survival is 80 to 84 %, and 15 years of 60 %.