Ciencias de la Salud
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Item Obstrucción intestinal total secundaria a intususcepción por adenocarcinoma de ciego en paciente adulto, a propósito de un caso(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2022-11) Jaramillo Núñez, Steven Alejandro; Cadena, Juan Carlos Dr. Esp.Introduction: Colon adenocarcinoma is one of the most prevalent malignant tumors around the world. Intussusception occurs when a segment of the intestine moves towards an adjacent segment, which can cause intestinal obstruction and even ischemia. Although it is easy to treat, its diagnosis represents a challenge, especially when it occurs in adulthood, since most of the cases are diagnosed in pediatric age. The final treatment will be surgical intervention, whether open or laparoscopic, both being according to the surgeon's choice, but certain benefits can be determined from the latter, such as accelerated healing, shorter hospital stay, and reduced risk of incisional hernia. Objective: To describe a clinical case and carry out its respective analysis based on the bibliography found about colon adenocarcinoma that produces intussusception. Materials and methods: Descriptive study and clinical case presentation. Results: Clinical case of a 64-year-old female patient with no relevant history who presented abdominal pain for approximately 2 years, which was exacerbated in the days before going to the health home. Due to his clinical history and physical examination and imaging tests, a surgical intervention was performed for intestinal obstruction, with the finding of an intestinal invagination secondary to an adenocarcinoma of the cecum. Conclusions: The rapid and adequate management of an intestinal obstruction is necessary to reduce morbidity and mortality, in this case, the incidental finding of intestinal intussusception was correctly resolved by the surgeon, which favored the satisfactory evolution of the patient.Item 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 lymphomItem Fístula Enterocutánea Secundaria a Apendicectomía(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-10-01) Beltrán Guachón, Grace Estefanía; Pancho Zela, Marlon Mauricio Dr.It is defined as enterocutaneous fistula (FEC) to the existing pathological communication of a portion of the gastrointestinal tract into the skin. As an important complication of gastroenterological surgery, 75-90% of fistulas is presented as a postoperative complication in most cases, with an incidence of 0.8-2% in abdominal surgery.1-4-11 The development of an enterocutaneous fistula is a serious problem that can face any surgeon during the exercise of their profession, bringing physical and emotional repercussions for both the patient and family and physician and health institution where it is. 3-4-10 They are associated with high morbidity and mortality forcing a prolonged hospital stay, complications and electrolyte mainly as sepsis, malnutrition and metabolic imbalance.1-2-9 Therefore it requires a multidisciplinary intervention adapted by each particular case.3-4 Increased life expectancy and the advancement of surgery in the treatment of increasingly complex conditions, should contribute in the near future, to a considerable increase in their frequency. It is attributed to enterocutaneous fistulas mortality 15-37%, which rises further and can exceed 60% when associated to complications and mencionadas.4-12 Reviewing the case of a 29-year-old it was held intervened on January 26, 2016 in the Yerovi Mackuart Hospital of Salcedo, which comes because of abdominal pain, cramping, high intensity, about 5 hours evolution, located in mesogastrio and lower abdomen, accompanied by nausea that comes vomiting for 5 times, in which complementary studies is done reaching a diagnosis of acute appendicitis, surgery is decided by performing an exploratory laparotomy and found multiple perforations in cecum and colon with mesenteric thrombosis signs so appendectomy is performed more right hemicolectomy more lateral anastomosis term transverse loop ileostomy ileus more drainage and placement; it remains hospitalized for eight days, start to have purulent liquid drainage site, so it was decided to transfer to Provincial General Hospital in Latacunga on February 4, 2016 with a diagnosis of enterocutaneous fistula. Provincial General Hospital in Latacunga is received to the patient at the Department of General Surgery, it is decided to maintain hydration, antibiotic therapy, laboratory tests and imaging studies, which remains hospitalized for 21 days. Given patient is discharged with good performance and has surgery scheduled reentry, return of intestinal transit. The patient is progressing well from his second surgery without presenting complication, it is decided discharged on April 21, 2016. On April 24, 2016 was readmitted for an intestinal partial obstruction the same that resolves spontaneously and is discharged the May 2, 2016.