Medicina
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Item 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 challengeItem Fistula Biliar con Síndrome de Mirizzi(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-05-01) Salguero Lozada, Johana Monserrath; Blacio Villa, Carlos Omar Dr.SUMMARY This study analyzes the clinical case of a patient Fistula Bladder Syndrome Mirizzi, disease, biliary tract is one of the most common diseases in the surgery department, and Mirizzi syndrome is one of the infrequent complications of these pathologies but with timely and appropriate treatment can be prevented. This is a female patient of 22 years who presented to the Emergency “Hospital Provincial Docente Ambato” on several occasions for a month to present epigastric pain radiating to the right upper quadrant where it is treated as a disease peptic acid, the day of admission exacerbated box, characterized by abdominal pain of great intensity that is accompanied by nausea, vomiting arriving food content once. Patient oriented physical painful on palpation examination consents right upper quadrant, abdominal soft depressible. Where it is treated with acid peptic disease diagnosis by not improve the picture communicates surgery which valued decide, request additional examinations and imaging; eco reports cholecystitis - cholelithiasis so their income is decided and surgical treatment is performed to the three patient days jaundice and decided to perform ERCP reporting dilated bile duct 8mm, 5mm choledocholithiasis with calculation. Papillotomy calculation is performed and is removed, after which bile output is displayed in height forming a small cystic bilioma.Item Colestasis Neonatal(2016-05-01) Muñoz Arévalo, Johanna Gabriela; Vaca Pazmiño, Carlos Fernando Dr. PhD.The following case was taken as an object of study due to hyperbilirubinemia is one of the biggest causes of admission to the neonatology service, however colestaisi by biliary atresia is a case with low incidence. It is a 27 days of life female patient who is born with Apgar 8/9 atermino without any history of importance,the patient comes with 2 days of suffer of widespread Jaundice besides coluria and physical examination .At acolia jaundiced tint, palpable liver. The patient is admitted with diagnosis of pathological jaundice, Bilirubin Total 31.2 mg / dl, Direct Bilirubin 21.94 mg / dl, reticulocytes 0.4%, while hospitalized multiple routine exams are performed to rule out pathologies that relate to this type of symptomatology such as sepsis and metabolic problems. The obtained results were within normal values; nevertheless,due to the persisting symptoms, a new abdominal eco is made, which reported mild hepatic growth with choledochal dilatation. Taking this as indirect signs of biliary atresia. Consequently she is transferred to Hospital Vaca Ortiz where colangioresonancia is done, confirming diagnosis. Currently,the patient is on palliative treatment on hold of surgical resolution .