Medicina

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Absceso Esofágico Secundario a Ingesta de Cuerpo Extraño en Paciente Adulto Mayor
(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-10-01) Silva Rodríguez, Luis Ramón; Vilaña Icaza, Juan Carlos Dr. Esp.
The ingestion of foreign bodies is very common in everyday medical practice, constituting the second indication of emergency upper gastrointestinal endoscopy after gastrointestinal bleeding. In children is more frequent intake of inorganic foreign bodies and these round and blunt (coins, buttons, batteries, parts of toys), rather than sharp; however, in adults organic foreign bodies are the most common (poorly chewed food bowls, bones, fish bones). One of the complications of foreign body ingestion (Fishtail) can be INTRAMURAL esophageal abscess is a rare disorder characterized by a large laceration between mucosal and submucosal layer of the esophageal wall without drilling. They are also responsible for 7 to 14% of all esophageal perforations, which can lead to serious injuries such as neck deep abscesses, mediastinitis among others. This case is a female patient 75 years old with a history of diabetes mellitus type two. Refers back to the accidental ingestion of Fishbone, 48 hours, presents dysphagia and neck pain of moderate intensity, go to sub-health center where it is valued, and they decide to transfer to conducting imaging study. It is valued in emergency, irritable patient, algica, physical examination presence of clots level oropharynx is evident, further examination which report a high glycemia, leukocytes with deviation to the left, elementary and microscopic examination of urine, infection is performed. In cervical spine x-ray foreign body in esophagus projected level 6. cervical vertebra seen its entry into service of Internal Medicine is decided, by apparent box esophageal abscess, esophageal perforation and decompensation of their underlying disease and to complement other tests. reporting chest tomography us morphology of the esophagus is distended in almost all their passage predominantly performed above level - carinal, study suggests supplementing with upper endoscopy, the same as reported ESOPHAGEAL Abscess.
Absceso Esofágico Secundario a Ingesta de Cuerpo Extraño en Paciente Adulto Mayor
(2016-10-01) Silva Rodríguez, Luis Ramón; Vilaña Icaza, Juan Carlos Dr. Esp.
The ingestion of foreign bodies is very common in everyday medical practice, constituting the second indication of emergency upper gastrointestinal endoscopy after gastrointestinal bleeding. In children is more frequent intake of inorganic foreign bodies and these round and blunt (coins, buttons, batteries, parts of toys), rather than sharp; however, in adults organic foreign bodies are the most common (poorly chewed food bowls, bones, fish bones). One of the complications of foreign body ingestion (Fishtail) can be INTRAMURAL esophageal abscess is a rare disorder characterized by a large laceration between mucosal and submucosal layer of the esophageal wall without drilling. They are also responsible for 7 to 14% of all esophageal perforations, which can lead to serious injuries such as neck deep abscesses, mediastinitis among others. This case is a female patient 75 years old with a history of diabetes mellitus type two. Refers back to the accidental ingestion of Fishbone, 48 hours, presents dysphagia and neck pain of moderate intensity, go to sub-health center where it is valued, and they decide to transfer to conducting imaging study. It is valued in emergency, irritable patient, algica, physical examination presence of clots level oropharynx is evident, further examination which report a high glycemia, leukocytes with deviation to the left, elementary and microscopic examination of urine, infection is performed. In cervical spine x-ray foreign body in esophagus projected level 6. cervical vertebra seen its entry into service of Internal Medicine is decided, by apparent box esophageal abscess, esophageal perforation and decompensation of their underlying disease and to complement other tests. reporting chest tomography us morphology of the esophagus is distended in almost all their passage predominantly performed above level - carinal, study suggests supplementing with upper endoscopy, the same as reported ESOPHAGEAL Abscess.
“Absceso pancreático secundario a pancreatitis aguda”
(Universidad Técnica de Ambato - Facultad de Ciencias de la Salud - Carrera de Medicina, 2018-10-01) Chamorro Barona, David Enrique; Guanuchi Quito, Franklin Dr. Esp.
Pancreatic abscess is a circumscribed collection of pus, with little or no necrotic content. It is usually a complication of severe pancreatitis, four weeks after the onset of symptomatology, product of necrosis with subsequent liquefaction of tissue and secondary infection, constituting the abscess, and located in the vicinity of the affected organ. The symptomatology is non-specific, so the finding of gas is the only specific radiological sign, and percutaneous bacteriology is the only method to confirm the diagnosis in the preoperative period. Translated with www.DeepL.com/TranslatorWe present the case of a male patient of 27 years old, who was treated in the emergency service of the Ambato General Teaching Hospital for abdominal pain, which was catalogued as surgical problem, an exploratory laparotomy was performed, finding steate necrosis on the epiplon, and purulent collections on the pancreas’s tail and body, as well as purulent fluid on retroperitoneum. The abscess was drained and 3 drainages were put, 2 of the, on epigastrium and the last one on the left parietal-colic slide, the patient was also treated with broad spectrum antibiotics. The present work pretends to identify the critical points of the attention, proposing a therapeutic and diagnostic strategy for the management of severe pancreatitis and complications.
Absceso Pulmonar por Klebsiella Pneumoniae
(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-10-01) Valverde Tixilema, Jairo Marcelo; Sunta Ruiz, Mario Leopoldo Dr.
Lung abscess caused by Klebsiella pneumoniae usually due to aspiration of infected material from the upper respiratory tract, in immunosuppressed patients often complicated with abscess formation. They are usually caused by anaerobic bacteria and is often associated with periodontal diseases, sometimes multiple germs acting synergistically involved. This case concerns a 48-year-old born and lives in Simiatug Province of Bolivar, female, married, indigenous, farmer, illiterate, Catholic, unknown blood type. With a history of pulmonary tuberculosis diagnosed BK + 9 years apparently completed treatment. Patient comes for a cough and hemoptysis. Family of patient complains that makes it about a month has dry cough of great intensity and frequency which evolves into coughing that mobilizes secretions yellowish, fetid with traces of blood very difficult elimination which produces dyspnea on moderate effort to clinical accompanied, chills, hyporexia, hike ends unquantified and asthenia. Presenting clinical picture is exacerbated dyspnea with minimal effort the same as the passage of time evolves orthopnoea whereby the patient in a bad condition decides to go to a nursing home. In reviewing devices and systems it has a weight loss of approximately 15 kg in a month because of reduced food intake. Physical examination shows: Blood Pressure: 90/60 mmHg, heart rate: 80 beats per minute, respiratory rate 24 per minute, axillary temperature: 370C, Sat O2: 70%. conscious, oriented, hemihydrate, afebrile patients cachectic dependent oxygen by nasal cannula, dry skin, normal color hypoelastic, Glasgow 15/15, average overall. Head: normocephalic, hair normal implantation, Eyes: isochoric pupils normorreactivas light Nose: nasal septum no deviations, normal implantation Ears: normal implantation, External Auditory Canal: permeable, Mouth: no injuries, wet and pink oral mucosa, teeth in poor condition, remains sputum yellowing of fetid odor, oropharynx observed: no failure, Neck: symmetrical, thyroid OA, Thorax: domed in left hemithorax, mobility and expandability decreased, not nodal chains are palpated, decreased adipose tissue, Heart: rhythmic heart sounds no murmurs Lungs: abolished based vesicular murmur and middle third pulmonary right field, increased vocal vibration in right lung field, Abdomen: no lesions are seen, soft painless pitting on palpation, noises hydroaerial: present, Tips: symmetrical, preserved tone and strength, presence of edema ++ / +++ which leaves fovea.
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.
Pileflebitis Asociado A Absceso de Psoas Iliaco en Adulto Mayor
(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-06-01) Rodríguez Toapanta, Lissette Estefanía; Chuchuca Serrano, Jorge Ricardo Dr.
Pylephlebitis of intraabdominal infectious origin (psoas abscess) in the elderly is rare. It is defined as septic thrombophlebitis of the portal vein and superior mesenteric, considered a complication for any infectious focus is intra-abdominal or pelvic drained by the branches of the portal venous system is triggered. The case of a male patient of 68 years with a clinical picture of 15-day history of fever, abdominal pain and bloating, jaundice, edema of the left thigh and lumbar region ipsilateral mass is presented. Abdominal radiography at admission showed an obstructive pattern of small intestine; ultrasound revealed purulent soft tissue and muscles of the left lower back. Surgical drainage of the collection was made and subsequently CT abdomen and pelvis in which iliopsoas muscle abscess, which then opens spontaneously into abdominal cavity was shown. Septic condition of the patient from admission required ICU management, its evolution was not satisfactory; pylephlebitis a dialog with intrahepatic abscesses refractory to treatment was started. He remained hospitalized in unstable condition, family requested discharge; patient died at home after a few days. In 1990, mortality was 70%, today it is 25% thanks to technological advances in imaging and antibiotic therapy. However in rural and limited economic capacity areas access to these resources remains a challenge