Medicina
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Item “Esplenomegalia gigante secundaria a linfoma”(Universidad Técnica de Ambato - Facultad de Ciencias de la Salud - Carrera de Medicina, 2018-10-01) Oñate Silva, Ibeth Cristina; Yépez Yerovi, Fabián Eduardo Dr.Splenomegaly is defined as the increase in spleen size greater than its normal dimensions, (in adults it is 12 × 7 × 3.5 cm) with an approximate weight of 150 g and a volume of 300 milliliters. By frequency, the main causes of splenomegaly are portal hypertension due to chronic liver disease, lymphomas, leukemias and neoplasms. Regarding the clinical case, it is related to a female patient of 62 years, with no relevant clinical history, surgical antecedents; uncomplicated appendicetomy 4 years ago. She went to the outpatient clinic for presenting abdominal pain of 10 years of evolution, said pain is continuous low intensity deafness that has been increasing continuously in recent months, reports occasional ecchymosis in the abdomen and back. To the patient physical examination in good general conditions with overweight, no adenopathies are palpated, attention is drawn to the abdomen, globose, soft, depressible, painful to palpation in left hypochondrium and flank, palpable, hard, painful mass, incursion with breathing. The laboratory report is in normal parameters. Imaging Abdominal ultrasound: Splenomegaly. In abdominal tomography: Lobed hypodense solid images of 9 x 7 cm located in the splenic area with slight contrast enhancement. Splenectomy is planned in approximately 1 month, the same one that went without complications. The postoperative findings are: spleen of 18 x 8 x 8 centimeters that I present 2 irregular masses, with whitish tissue inside, weight 740 grams, patient is discharged without complications. Awaiting histopathological report which reveals diffuse splenic lymphoma of b cells of the red pulp. Patient receives chemotherapy in a specialized oncology unit, for 6 cycles without complications. Currently the disease is in remissionItem Linfoma no Hodgkin Intestinal como causa de Obstrucción Intestinal(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-10-01) Escobar López, Gabriela Silvana; Yépez Yerovi Dr., Fabián EduardoFor female patient, 31 years old, with personal pathological history of hypertension 4 months without treatment, family medical history is presented; deceased sister 3 months ago with gastric cancer and systemic lupus erythematosus; and hypertensive mother. Patient comes to the emergency room with abdominal pain of a month of evolution, which intensifies 24 hours, located in epigastric cramping of great intensity that radiates flank and right iliac fossa, accompanied vomited food content three times and abdominal distention, constipation also relates a week ago. In the review of instruments and systems are asthenia and fine lees for about a month, weight loss of 10 kg 8 months ago. The patient consents physical examination oriented, algid, afebrile, hydrated. Abdomen globose, soft painful epigastric tenderness and right iliac fossa, Mac Burney and positive Bloomberg depressible. In laboratory tests striking a hemoglobin of 6.9 g / dL and a hematocrit of 24.4%, 54.4 MCV, MCH MCHC 15.4 and 28.3. The entry into service of surgery is decided with a diagnosis of acute abdomen and exploratory laparotomy was performed, in which tumor mass is at the level of terminal ileum 45 cm of ileocecal valve occluding the intestinal lumen 10 by 12 cm. And diverticulum ileal 50 cm of ileocecal valve. Diverticulum and tumor resection is performed with oncologic criteria with terminal end anastomosis, and sample is sent for histopathological examination; which reports intestinal non-Hodgkin lymphom