Medicina
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Item FLUIDOTERAPIA INICIAL EN EL TRATAMIENTO DE LA PANCREATITIS AGUDA(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2024-09-24) Iza Molina, Diego Xavier; Tite Andi, Silvia TatianaObjective: To determine the initial fluid therapy of choice in patients diagnosed with acute pancreatitis. Method: A descriptive design type of literature review was used with inclusion criteria in articles of scientific journals in databases such as: Redalyc, Scielo, PubMed/Medline, Web of Science and Scopus. The Prisma method was used to classify, identify eligibility criteria. Results: The use of Ringer's lactate in the management of acute pancreatitis is considered beneficial in the studies analyzed with statistically significant results that highlight shorter hospital stay, risk of admission to intensive care and progression to complications or severity. Conclusion: The best fluid to treat this pathology is ringer lactate and the infusion volume should be around 2,500 - 4,000 milliliters in 24 hours. Because aggressive hydration predisposes to the development of renal failure and acute respiratory failure with mechanical ventilatory support.Item Pseudoquiste pancreático como complicación tardía de la pancreatitis aguda(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2022-11) Lluglla Guerra, Valeria Azucena; Guanuchi Quito, Franklin Med. Esp.Pancreatic Pseudocyst is a local pancreatic complication, characterized by the accumulation of fluid, with little or no necrotic tissue inside, this entity is frequent in pathologies such as acute or chronic pancreatitis, leading to produce several affectations that can become serious and harmful to life. Pancreatic pseudocysts (PP) represent a difficult problem for physicians treating pancreatic disorders. Their treatment requires a multidisciplinary team of surgeons, radiologists and gastroenterologists. Historically, they have been treated conservatively or surgically, with acceptable rates of complications and recurrences. However, recent advances in imaging studies such as radiology and endoscopy have led physicians to implement percutaneous and endoscopic drainage in their treatment algorithms. In addition, laparoscopic surgery is an attractive alternative when surgical drainage is required. The aim of this review is to summarize the relationship of acute pancreatitis with pancreatic pseudocyst. In addition, diagnostic and therapeutic tools in the management of pancreatic pseudocysts.Item Síndrome de mirizzi y pancreatitis aguda de origen biliar(Universidad Técnica de Ambato/Facultad de Ciencias de la Salud/Carrera de Medicina, 2021-11-01) Santamaria Salazar, Karen Mishell; Chicaiza Tayupanta, Jesús Onorato Dr. Esp.Objetivo: Analizar el caso clínico de una paciente con pancreatitis aguda de origen litiásico, asociada a síndrome de Mirizzi, para destacar el algoritmo diagnóstico, revisar el procedimiento quirúrgico realizado y fundamentar el tratamiento clínico que nos aporte con un mejor conocimiento de esta patología que es muy relevante y frecuente en nuestro medio. Materiales y métodos: Estudio descriptivo observacional de análisis de caso clínico. Discusión: Se reporta el caso de una paciente femenina de 55 años de edad, quien presenta dolor abdominal de moderada intensidad de 48 horas de evolución, localizado en epigastrio e hipocondrio derecho acompañado de ictericia conjuntival, distensión abdominal con signo de Murphy positivo. Se diagnostica como Pancreatitis aguda secundaria a Colecistitis aguda litiásica más Síndrome de Mirizzi al cual se le proporciona un manejo clínico y quirúrgico, el mismo que evoluciona favorablemente. Conclusiones: Se analizó el caso de una paciente con pancreatitis aguda y Síndrome de Mirizzi, que evidencio que los profesionales involucrados tienen experticia tanto en el manejo clínico como quirúrgico de estas patologías.Item ancreatitis aguda como complicación de una colangio pancreatografia retrogada endoscópica cpre, en paciente con coledocolitiasis: a propósito de un caso(Universidad Técnica de Ambato/Facultad de Ciencias de la Salud/Carrera de Medicina, 2021-06-01) Agualongo Maliza, Christian Eduardo; Chicaiza Tuyapanta, Jesús OnoratoObjective: To analyze the pathophysiology, clinical manifestations, risk factors, diagnostic and therapeutic complexities of Acute Pancreatitis as a complication of an Endoscopic Retrograde Pancreatography Cholangiography (C.P.R.E). Materials and methods: Retrospective descriptive study of clinical case analysis. Discussion: A case of a 58-year-old male patient is reported with moderate intensity abdominal pain of a few days of evolution, which is located in the right upper quadrant after eating copious food. The patient was diagnosed with choledocholithiasis for this reason, a C.P.R.E endoscopic retrograde pancreatography cholangiography was performed and after that he presented acute pancreatitis, with pertinent complementary studies the diagnosis of acute pancreatitis was reached. Conclusions: The problems related to this clinical case were analyzed, as well as the bibliographic review of different articles related to this pathology, in this way patients with the presence of signs and symptoms of post-C.PRE pancreatitis were characterized, as well as their management. and possible complications.Item “Necrosis pancreática secundaria a pancreatitis aguda grave”(Universidad Técnica de Ambato - Facultad de Ciencias de la Salud - Carrera de Medicina, 2018-05-01) Freire Tobanda, Ana Cecilia; Loaiza Merino, Iván PatricioDr. Esp.Pancreatic necrosis is considered one of the main local complications associated with severe or severe acute pancreatitis and its presence only indicates greater severity, which can cause a high mortality rate if it is not diagnosed and treated in time given that the complications overlapping can further worsen the results. The present case is about a male patient A 67-year-old male patient, with no personal or significant family medical history, who goes to the Ambato social insurance hospital on May 4, referred to the city of Puyo, for presenting abdominal pain for 19 days of great intensity, sudden onset, located in mesograstrium that is not irradiated so it goes to Basic Hospital of Puyo where it remains for 16 days for a picture compatible with severe pancreatitis in treatment with surgery floor care presenting deterioration general with poor evolution so open cholecystectomy is performed after which requires intensive care for 6 days plus subsequent recovery in the surgery floor until today that is assessed and referred to the Ambato social insurance hospital for ERCP and treatment of clinical picture. With echo reporting the intra and extrahepatic bile ducts without 0.7 mm ductile dilation. Gallbladder of thickened walls 4mm, with several calculations inside. And TAC simple and contrasted 30% necrosis of the pancreas liquid collection in head + liquid peripancreatic and perihepatic. Patient admitted to the surgery service with diagnosis of severe pancreatitis plus peripancreatic necrosis and choledocholithiasis, to perform ERCP. Presenting an unfavorable evolution, nephrology is interconsultated by laboratory analytical values reporting chronic renal failure, which does not prevent scheduled surgery (ERCP) but the patient adds generalized jaundice, with oxygen desaturation, ERCP is not performed due to obstruction When the endoscopic approach was caused by weight compression at the time of the procedure, an exploratory laparotomy was performed, finding plasma at the level of the gallbladder and fistulous tract difficult to identify, plus head and tail necrosis of the pancreas. Present for what is treated in the intensive care unit.