Medicina

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    Manga Gástrica en Tratamiento para Obesidad Mórbida y sus complicaciones
    (Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-10-01) Vizcaíno Bautista, Mauricio Vladimir; Pancho Zela, Marlon Mauricio Dr.
    The sleeve gastrectomy is a surgical procedure for the treatment of morbid obesity indicated in people with higher BMI (body mass index) of 40 kg / m2 or BMI of 35 to 39.9 kg / m2 more severe comorbidities. Obesity is a disease whose prevalence is increasing both in Ecuador and in the rest of the world. Poor diet and insufficient physical activity were the main risk factors for this alarming increase. Obesity is associated with an increased risk of diabetes mellitus, dyslipidemia, cardiovascular disease, cancer, bone and joint disease and other diseases that significantly impair the quality of life of people. Clinical Case Analysis: male patient aged 43 underwent bariatric surgery for morbid obesity grade II, body mass index (BMI) 38.5 more comorbidities, hypertension, diabetes mellitus II, herniated disc L4 and L3, and eating disorder. Checks before bariatric surgery do not yield to pharmacological and non-pharmacological conventional medical treatment. Latacunga IESS Hospital, Surgery department with corresponding conducting pre-surgical examination performed surgical procedure without complications. On the third day post-surgical patient presented left upper quadrant pain of great intensity and apparent cause ingestion of solid foods. Dren with liquid odor, suspicious clinical picture compatible to more peritonitis secondary dehiscence suture. Patient underwent surgery again where fetid liquid contained approximately 20cc is evidenced, subsequently suture level reaching the diagnosis of gastric fistula is performed.
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    Pileflebitis Asociado A Absceso de Psoas Iliaco en Adulto Mayor
    (Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-06-01) Rodríguez Toapanta, Lissette Estefanía; Chuchuca Serrano, Jorge Ricardo Dr.
    Pylephlebitis of intraabdominal infectious origin (psoas abscess) in the elderly is rare. It is defined as septic thrombophlebitis of the portal vein and superior mesenteric, considered a complication for any infectious focus is intra-abdominal or pelvic drained by the branches of the portal venous system is triggered. The case of a male patient of 68 years with a clinical picture of 15-day history of fever, abdominal pain and bloating, jaundice, edema of the left thigh and lumbar region ipsilateral mass is presented. Abdominal radiography at admission showed an obstructive pattern of small intestine; ultrasound revealed purulent soft tissue and muscles of the left lower back. Surgical drainage of the collection was made and subsequently CT abdomen and pelvis in which iliopsoas muscle abscess, which then opens spontaneously into abdominal cavity was shown. Septic condition of the patient from admission required ICU management, its evolution was not satisfactory; pylephlebitis a dialog with intrahepatic abscesses refractory to treatment was started. He remained hospitalized in unstable condition, family requested discharge; patient died at home after a few days. In 1990, mortality was 70%, today it is 25% thanks to technological advances in imaging and antibiotic therapy. However in rural and limited economic capacity areas access to these resources remains a challenge