Medicina
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Item MANEJO DE LA PILEFLEBITIS COMO COMPLICACIÓN POST APENDICECTOMÍA(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2024-06-10) Jordán Oña, Rodrigo Andrés; Loaiza Merino, Iván PatricioPylephlebitis is a rare but serious complication, associated with risks such as liver abscesses, sepsis, and acute liver failure that results in post-appendectomy portal vein thrombosis. Therefore, the objective of the study was to evaluate the effectiveness of care and management protocols for post-appendectomy pylephlebitis, in order to identify the best clinical practices and improve patient care. A systematic review of scientific literature was carried out, applying non-probabilistic convenience sampling 40 scientific works published between 2018 and 2023 were selected, using databases such as PubMed/Medline, Elsevier Scopus, Science Direct, and Taylor & Francis. The results revealed that post-appendectomy pylephlebitis has a low incidence, predominantly affecting men, with symptoms such as fever and abdominal pain. The most common causes are diverticulitis and acute appendicitis. The preferred treatment includes broad-spectrum antibiotics and, in some cases, anticoagulants. Research suggests the need for standardized care protocols to optimize the management of this complication.Item Pileflebitis, complicación extraña de apendicitis aguda en paciente gestante, reporte de un caso(Universidad Técnica de Ambato/Facultad de Ciencias de la Salud/Carrera de Medicina, 2020-10-01) Moya Romero, Katherine Solange; Guanuchi Quito, Franklin Hernán Dr. Esp.Objective: To characterize a pregnant patient who presents with pileflebitis as a strange complication of acute appendicitis. Discussion: A case of a pregnant 18-year-old female patient is reported, who reports diffuse abdominal pain of moderate to great intensity, accompanied by vomiting and diarrheal stools, as well as jaundice in the chest and legs. Hepatitis was diagnosed clinically without specifying the results of examinations and treatment that was not referred started, as she did not show improvement, she was transferred to the Ambato General Teaching Hospital. The previous clinical picture is ruled out with an in-depth physical examination and complementary examinations, confirming the presence of sepsis of abdominal origin due to acute perforated appendicitis, generalized peritonitis complicated by pilephlebitis; surgical intervention and resolution of the clinical picture is performed. Materials and methods: A retrospective descriptive study based on clinical case analysis is carried out. Conclusions: After reviewing the clinical case and the bibliography, it is concluded that pilephlebitis is septic thrombosis of the portal system due to acute abdominal inflammatory conditions; It presents with variable clinical manifestations depending on the cause of origin and by affected portal branch. The diagnosis includes normal or slightly altered liver function with leukocytosis, positive blood cultures, Doppler ultrasound or computed tomography corroborating the pathology. For therapeutic measures, control of the septic focus, liver abscesses and pylephlebitis is considered.Item Apendicitis Aguda Grado IV complicada con Absceso Hepático(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-10-01) Herrera Guanopatín, Jenny Gabriela; Chicaiza Tayupanta, Jesús Onorato Dr.This case is of a male patient of 27 years old, individual worker, without personal history of importance, who has abdominal pain continuous type located in the right iliac fossa moderate intensity of approximately 48 hours of evolution the same that is accompanied by nausea, vomiting that arrive for 3 times for which they self-medicate without yielding symptoms reason for which go to Provincial General Hospital Latacunga by the emergency service. To be valued, it presents TA 120/80 mmHg, pulse: 100 lpm, respiration rate 18 rpm, saturation O2: 97% by diagnosing acute inflammatory abdomen therefore administered intravenous hydration 1000 ml + intravenous analgesic, also it is sent to perform blood count and ask for evaluation by surgery service. At 6 hours after service is valued by surgery and which by means physical examination and laboratory tests support is diagnosed of acute appendicitis leaving the following indications: none by orally, intravenous hydration 1000 milliliters every 8 hours every 6 hours intravenous antibiotic treatment, analgesia intravenous every 6 hours, intravenous gastric protection every day and admission surgery. At the 11 hours after admission was surgically operated appendicitis find ourselves with a grade IV retroilial perforated in the middle third; I summing abovementioned treatment Metronidazole 500 mg intravenous every eight hours. At two days post-surgery patient with heart rate of 80 beats per minute, oxygen saturation 88%, it presented fever peaksin addition to scleral jaundice which tests Bilirubin, SGOT, SGPT, Doppler ultrasound of liver and portal to rule Pylephlebitis requested and / or liver abscess. It is performed control ecosonographic external consultation study with liver and biliary tract whose results indicate morphologically normal.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 challenge