Medicina
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Item Hematocolpos Secundario a Tabique(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-10-01) Alajo Hinojosa, José Ricardo; Salazar Faz, Fernando Abel Dr.The vaginal tranverse septum is an extremely rare malformation. It is due to an embryonic defect that can stay hidden if the septum is incomplete and requires surgical intervention if it is complete.It exposed the clinical case of a child with this anomaly that presented acute abdominal pain due to hematocolpos that septum had produced, as a result of the obstruction of menstrual flow. It is about a girl of 13 years old without menarche, with a suspected background of Urinary tract infection, who came to the emergency service with a severe abdominal pain it has 72 hours of evolution, colicky, located in the lower abdomen. No fever, vomiting or urinary symptoms. The dietary habit was normal as the depositions. On the examination it was detected a good general and nutritional state. It showed breast development and pubic hair in stage II of Tanner. The abdomen was soft and depressible, without visceromegalies. She had a slight pain on deep palpation at the umbilicus and the suprapubic region, without palpable masses. Appendiceal points were negative and there were no signs of peritoneal irritation. The external genitals were normal. Analytical tests performed in the emergency room, that include hemo, biochemistry, coagulation and simple urine were normal. This patient was hospitalized with a suspected diagnostic of acute abdomen. It was requested an abdominal CT scan, where it was detected an homogeneous and well-defined image, so it as done an abdominal ultrasound, where was found an hematic content image of 11 cm x 9.7 cm x 7.8 cm in diamete localized inside the vagina, possibility of hematocolpos due to another malformation, the patient is hospitalized for study and treatment. Chest radiography and cardiology study were normal and sterile urine cultures. Under aseptic and antiseptic rules draining 400 mL of hematic content it was performed and a complete transverse vaginal septum in the bottom-half of the vagina of about 1.5 cm thick third visualized. Septum resection was performed and subsequently appeared menstrual cycles. The presentation of this case has an objective to consider the presence of this embryonic defect faced with an acute hypogastric abdominal pain in a girl with hematocolpos and also in a girl with pubertal development, primary amenorrhea, and suspected background in mild urinary symptoms.Item Preeclampsia Asociada a Vasa Previa(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-10-01) Pineda Vaca, Vanessa Tatiana; Mena Villarroel, Luis Byron Dr.The Preeclampsia is defined as the appearance of hypertension and proteinuria after the week 20 of the pregnancy. It is in the habit of accompanying of edema in low members but the presence is not necessary of these to be diagnosed. It is an own disease of the pregnancy of which they can treat the symptoms, but only he recovers with the ending of the same one, can cause serious complications both for the woman and for the fetus. The previous vasa is a rare reason of hemorrhage of the third quarter of the pregnancy, in which blood glasses from the placenta intervene between the presentation and the cervical internal orifice. It is a question of a pathology that in most cases is not diagnosed during the pregnancy but she is looked specifically, being responsible for a high mortality perinatal that ranges between 60 % to 90 %, according to different bibliographical sources. There presents a case of one 38-year-old feminine patient, with pregnancy of 31 weeks diagnosed by ultrasound scan, there comes for migraine holocraneana of moderate intensity sharp type that it increases with the activity, accompanied of bled vaginal, does +/-24 hours in few quantity red sparkling color, 20 hours ago it recounts decrease of foetal movements, 12 hours ago abdominal pain adds constant type of moderated to great intensity located in upper abdomen, there is realized ultrasound scan in which there is demonstrated previous occlusive partial placenta and to rejecting vasa previous, there is demonstrated in the foetal electronic monitoring commitment of the foetal well-being, by what emergency Caesarean is realized being the only alive fetus premature baby deposited to neonatalogy, in this clinical case the association was looking between preeclampsia and vasa previous that on not having been it also was discarding it, at the same time one was determining the factors of risk as well as the diagnosis and treatment of the pathologies treated in the topic.