“Fibrilación auricular más isquemia mesentérica”

Abstract

A 65-year-old male patient living in the community of Conambo, a Shuar ethnic group, married, without school instruction, a farmer, with no pathological antecedents, ten hours before admission, presented severe abdominal pain localized in the epigastrium and mesogastrium accompanied by Nausea that reach the vomit for several occasions of bilious content in addition to a syncope prior to admission, is evaluated by the Internal Medicine Service who evaluate the patient and determine that he presents a Paroxysmal Atrial Fibrillation for which they administer an Antiarrhythmic, Of abdominal pain is performed a CT scan of the abdomen finding free fluid in all its spaces, distended small bowel loops and thickened walls, are consulted to the Surgery Service who by evaluating the case and decide to perform an Exploratory Laparotomy finding, liquid of more or Minus 1000 cen Cubic meters in the abdominal cavity at one meter of the ileocecal valve, ischemia and signs of intestinal suffering of one meter of extension with segments of ischemia are present, so that peritoneoostomy is left, the patient is admitted to the Intensive Care Present hemodynamic compromise, presents criteria for anti-coagulation, is performed re-intervention finding necrotic areas so that the resection of 50 cm of small intestine is performed and performing a terminated anastomosis terminal with continuous points.