Medicina
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Item Calidad de Diagnóstico de un Seudoquiste Pancreático(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-10-01) Sánchez Centeno, Edgar Israel; Atiaja Arias, Jeanet Verónica Dra. Esp.The Pancreatic pseudocyst is a collection of fluid encapsulated with an inflammatory wall defined usually outside the pancreas with minimal or no necrosis. Rich in amylase and other pancreatic enzymes without communication with the main conduit. They occur after 4 weeks after the onset of acute pancreatitis, and develops as a postsurgical complication. The case of a female patient of 22 years with a clinical picture of 15 days of evolution is presented. Physical examination unquantified characterized by abdominal pain and asthenia, nausea, vomiting, mild headache holocraneana, thermal rise. The Eco and Computed Tomography (CT) Abdominal concluded with the diagnosis of pancreatic pseudocysts so he was made a cistoyeyunoanastomosis splenectomy and distal pancreatectomy more. After two weeks the patient comes predominance presenting abdominal pain at the site of surgical intervention, so he entered. He underwent an ECO and an abdominal CT scan which concludes with ileus Intestinal hospitalized for 6 days, receiving good response after treatment and discharge decide on favorable terms. At three weeks after discharge the patient comes presenting moderate abdominal pain accompanied by nausea, vomiting, malaise and signs of dehydration. It is assessed by the Internal Medicine concluded as a diagnostic electrolyte imbalance and dehydration. Receive analgesia and hydration treatment, no complications so it is given a medical discharge. Next control is indicated but no go.Item Embarazo Ectópico Abdominal y Shock Hipovolémico(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-11-01) Aucapiña Rodríguez, Luz Cecilia; Gavilanes Sáenz, Víctor Patricio Dr.The abdominal ectopic pregnancy is an exceptional anomaly that represents 1% of ectopic pregnancies; it is associated with high morbidity and mortality, maternal and fetal. The risk of maternal mortality is 7 to 8 times greater than a tubal pregnancy and it is 90 ectopic times greater than an intrauterine pregnancy. This is a pathology of difficult diagnosis that, in many cases, belatedly established and it is considered an obstetric emergency. Female patient of 23 years old who presents an abdominal pain of 2 months evolution and amenorrhea of approximately 17 weeks, she is admitted to Hospital General Puyo by abdominal pain in study and hypovolemic shock, βHCG is performed with positive result and eco FAST showing free liquid in abdominal cavity and an appearance of embryo outside the uterine cavity with movement, so it is considered a probable accident ectopic pregnancy. On physical examination is hypotensive, tachycardic with generalized pallor, Algic facies, oral mucosal semihumid. An Emergency exploratory laparotomy with identification of abdominal ectopic pregnancy, salpingectomy, right oophorectomy, partial omentectomy is performed. Also, compensation with blood products for trans-surgical cardiovascular instability is indicated. The patient is transferred to intensive therapy to control and manage cardiovascular. Presenting a satisfactory evolution and at 17 hours of admission she is discharged to continue handling by gynecology and obstetrics where she remains hospitalized 2 days and sent homeItem Inercia Colónica en Paciente Femenina de 19 años, con Diagnóstico Inicial de Abdomen Agudo(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-10-01) Sailema Sailema, Gabriela Ximena; Arguello Guanotasig, Santiago Alexis Dr. Esp.Colonic inertia occurs primarily in young women and is characterized by severe defecation infrequency, which can reach even one to two monthly depositions. This case is a female patient 19 years old; Pathologic Personal Background: Pneumonia Bilateral more Febrile Seizures, chronic constipation more parasitosis by Ameba Histolytica, Abdomen Obstructive; Surgical Background: Appendectomy. Attends the H.P.G.L to present about 2 days as apparent date, abdominal pain, cramping, intense, EVA scale (9/10), does the same that is located in epigastric, lower abdomen and radiates right upper quadrant and is accompanied by bloating and nausea refers this pain then appeared intake of chicken soup more aromatic water Physical examination patient conscious, oriented, afebrile, álgica;Abdominal surgical scar about 3 centimeters in length located in the right iliac fossa, distended abdomen, bowel sounds decreased in the entire large bowel, presence of tympanic to percussion, nonpitting abdomen, painful on palpation and generalized depth is observed, without signs of peritoneal irritation. It is worth emergency surgery guard who request additional examinations and decide their income in general surgery with partial presumptive diagnosis of acute obstructive abdomen. After conducting further investigations, more repetitive representations of constipation and clinical evaluation of the patient, Inertia Colonic diagnosed, so we decided to perform surgical treatment: left hemicolectomy + anastomosis colorectal term omentectomy + terminal + partial placement of drainage; during laparotomy is: left colon increased in size and length. Favorable postoperative course so the 29 days of hospitalization is decided hospital in good general conditions and outpatient control.Item Ruptura Vesical en Trauma Abdominal Secundario a un Accidente de Tránsito(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-10-01) Pazmiño Andrade, Roxana Cristina; Yépez Yerovi, Fabián Eduardo Dr. Esp.Abdominal trauma is a common worldwide entity with the main cause traffic accidents. In our country accidents are among the five leading causes of death in the general population, so the trauma is the leading cause of deaths unrelated to an underlying disease. In blunt abdominal trauma, bladder injury is a rare entity and must meet precise physiological characteristics as this is distended that the present conditions it to break up with a soft thump. Bladder rupture may go unnoticed when associated with severe trauma and substances that alter an adequate response as the intake of alcohol. For the above conditions the importance of appropriate initial assessment of the patient with a detailed medical history, a thorough analysis of all risk factors, mechanisms of injury, physical examination and additional tests to reach a true diagnosis is emphasized. The management of intraperitoneal bladder rupture through the years and until now has been considered a surgical emergency; based on a quick scan with repair and bladder drainage this being the mainstay of treatment. So obtaining an excellent prognosis. This clinical case is a 30 year old patient presenting bladder rupture blunt abdominal trauma. The analysis of this case aims to generate scientific basis about the subject.