Ciencias de la Salud
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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 Abdomen Agudo por Absceso Tubárico Secundario A Enfermedad Inflamatoria Pélvica más Apendicitis Aguda(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-11-01) Guamancuri Silva, Jorge Gabriel; Pozo Mayorga, Fernando Patricio Dr. Esp.At the Hospital Provincial Docente Ambato (HPDA), the acute abdominal pain is the most frequent cause of query. In the Hospital Provincial Docente Ambato (HPDA), acute abdominal pain is the most frequent cause of consultation. By the other hand, the Gíneco-obstetric pain constitutes the second cause of hospitalization, being in this way the Emergency Service the first contact with the patient. For this reason, is really vital to know about the different pathologies which causes the acute abdomen, and so confront them in the better way. Likewise, it is crucial to determine the first instance if it’s about of a quirurgic acute abdomen and if it needs immediate hospitalization. The most important factor in this situation, because of our environment, is discard a pregnancy at the beggining of the evaluation in a female patient. Considering the possibility of a broken ectopic pregnancy that could turn it in a death or life event, becomes essential. The opportune pelvic acute ache diagnosis is vital, at the first instance, because the delay in the diagnosis increases in a devastating proportion the mortality, and consequently, the recovery time for the patient, the inherent economic spending, and even, in these time too hostile with the medicine career, because of the legal demands.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 Dificultades en atención de Apendicitis Aguda en atención Primaria de Salud(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-10-01) Campaña Zurita, Andrea Gioconda; . Bedoya Vaca, Patricio Aníbal DrIntroduction: Acute appendicitis, described since 1886, is the most common abdominal emergency in the world with an incidence of 11 cases per 10,000 per year. It is the acute inflammation of the vermiform appendix obstruction of light by fecaliths or hypertrophy of the mucosa-associated lymphoid tissue; also it includes twisting or section of the appendicular artery obstruction tumors and parasites. Its diagnosis is based on a complete medical history focused on the evolution of pain and associated symptoms; and the findings during the physical examination, the pain is described acute onset and initially located epigastric or periumbilical level, anorexia, followed by nausea, vomiting and migration of pain to the right iliac fossa, besides presenting febrícula tachycardia, peristalsis and decreased pain McBurney point. Consideration should be given the location of the appendix and the time elapsed since the onset of pain and the proper interpretation of the complementary exams. Development: This case corresponds to a male patient, 21 years old, single, mixed race, born and resident Cevallos Cevallos, Tungurahua, without personal or surgical history; which goes to Quero Health Center, where he received primary health care in the emergency service where according record 008, presented abdominal pain of about 24 hours of evolution associated with vomiting and malaise. At physical examination TA 100 / 60mmHg Fc: 80 lpm, FR: 18 rpm sat02: 96% soft abdomen, painful depressible epigastric, increased RHA gastritis (K29) administering presumed: Ranitidine IV (intravenous) STAT (that time) , butylscopolamine IV STAT and discharged home, partly giving pain for 24 hours. (Hauling difficulties in the timely and early diagnosis of acute appendicitis). This table is exacerbated by which attends private physician who performs a detailed anamnesis referring crampy abdominal pain located in epigastrium radiating to the right iliac fossa of 48 hours of evolution, in addition to referring 8 vomiting nutritional content, it is done abdominal ultrasound report: Gallbladder: exploration painful measures 72 x 34 mm with a 3.6 mm wall thickened and presence of various calculations that measure on average 6 mm thick inside. not painful right iliac fossa exploration with the presence of complex image and thickened appendix 13 mm thick, accompanied by a volume collection has about 67cc. Conclusions: Appendix and appendicular plastron more colecistitis- cholelithiasis so attend Provincial Teaching Hospital surgical Ambato for immediate resolution.Item “Incidencia de complicaciones postquirúrgicas mas frecuentes en los pacientes apendicectomizados en el área de cirugía del hospital provincial docente ambato del periodo enero 2012 –junio 2012”(Universidad Técnica de Ambato - Facultad de Ciencias de la Salud - Carrera de Medicina, 2013-01-01) Chalán Analuisa, Sabrina del Pilar; Cárdenas Naranjo, Vicente Hernán Dr.The research aimed to determine the incidence of postoperative complications in patients appendectomy, was a study of documentary, retrospective, as it analyzed the medical records, operative reports and patient records of patients in the area of General Surgery January to June 2012 Provincial Teaching Hospital Ambato, extracted the necessary information from all patients whose records met the inclusion and exclusion criteria. This research consists of 174 patients, which were obtained as statistical data: incidence of postoperative complications in 10.2% (18 patients), complications that occurred among these were early order of frequency were wound infection 55 , 5%, 11.1% abdominal abscess, and finally other complications such as pneumonia and ileus was found in 33.3%, there was a predominance in females, with a ratio of 1.12 women for every man, the age of the patients ranged from 16 to 97 years, with a mean of 34.34 years among older adults (AM) shows higher complication rate 2.3% (4 of 13 patients complications) By relating the histopathological grade with complications showed that grades 1 and 2 showed no increased complications, accounting for 5.6% of the equivalent of one of 18 cases, whereas the grade 3, were 6 of 18 which 100% were infectious after appendectomy and in grade 4 was shown in 11 patients (61.1%), and complications of all types, with the highest percentage, was presented with wound infections 36.4% (4 cases), followed by intra-abdominal abscess and two cases of pneumonia.Item Cuadriplejia a causa de una Sepsis Orgánica Posterior a una Apendicetomía(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Terapia Física, 2016-05-01) Pila Cando, Blanca Maribel; Jerez Camino, Carlos Milton Dr."The quadriplegia is a state of paralysis affecting all four limbs, affects the spinal cord and the transmission of nerve impulses can not be performed at the level of nerve roots below. Paralysis, represented by the lack of any movement, accompanied by a lack of sensitivity in the same areas with loss of pain sensation and touch. " (1) a case of public health of a 13-year-old has no natal prenatal history and importance as an important reference for further organic quadriplegia have sepsis appendectomy at 10 years old. Patient goes to hospital Pujilí presenting thermal rise, tests are done and diagnose viral bout of flu, 24 hours after the initial symptoms persist accompanied by abdominal pain decay and malaise so it is taken back to the hospital Pujilí 10 December 2012 is evaluated clinically, requested transfer to General Provincial Hospital of Latacunga, he returns to the Hospital of Pujilí, where at the persistence of abdominal pain was decided to perform abdominal ultrasound to diagnosing abdomen acute inflammatory, so it is referred to the Hospital provincial General of Latacunga in which enters the operating room with a preoperative diagnosis of peritonitis. This research seeks to identify stepping patient outcomes from their first contact with the health service to its definitive diagnosis also risk factors and the importance of differential diagnosis were identified. how to act in health care and identify critical points across levels of care will also be analyzed; through review of the clinical history. Thus enhancement options proposed in the management and treatment of patients suffering from spastic quadriplegia.