Apendicitis Aguda Grado IV complicada con Absceso Hepático

Abstract

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.