Ciencias de la Salud
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Item Abdomen Agudo Quirúrgico Secundario a Rotura Uterina por Legrado Inducido(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-10-01) Chango Silva, Margarita Fernanda; Pancho Zela Dr., Marlon MauricioIntroduction. Abdominal pain is a complex, sometimes difficult to diagnose and one of the most frequent causes of consultation in emergency services entity, and it is for all medical meet its features to quickly determine the conduct to be followed, since its timely decision may depend on the outcome of the patient. The clinical signs and symptoms are varied and depend on the etiology. In our case report the cause of acute abdomen was the same uterine perforation that may be iatrogenic or spontaneous. Iatrogenic causes include procedures such as dilation and curettage. Spontaneous causes are less commonly responsible for uterine perforation. Given the severity of the disease it is very important to study the female population to prevent irremediable complications in the patient. Objective. Evaluate the clinical management of patients with acute abdomen secondary to surgical uterine perforation. Development. This case is a female patient 26 years of age diagnosed incomplete abortion from 10 weeks pregnancy about concerns that perform curettage twice a week after you have perforativo peritoneal syndrome so go to hospital IESS Riobamba, there perform additional biochemical and imaging test, so is diagnosed with acute abdomen possible uterine rupture, and perform emergency surgery. He later transferred to Hospital IESS Ambato where he is transferred to Ambato IESS Hospital where he is admitted to the intensive therapy during hospitalization is relaparotomy, develop favorably. Conclusions. The acute abdomen secondary to uterine perforation, is a box that requires a proper diagnosis and an immediate resolution because it is at risk the life of the patient. In our case report the clinical management was not entirely appropriate.Item Shock Hipovolémico Secundario a Hemorragia Obstétrica por Inversión Uterina en Sala de Partos(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-10-01) Toalombo Eugenio, Graciela Estefanía; González Guevara, Laura Catalina Dra. ESP.Postpartum hemorrhage, mostly caused by uterine atony is the most common preventable cause of maternal mortality worldwide, and the second leading cause of maternal death in Ecuador. 4-6 Among the causes of postpartum hemorrhage is uterine inversion, a rare and serious complication that occurs in the third stage of labor, has an incidence of 1: 20,000 -1: 25,000 partos.13 This case is a female patient of 22 years old, born in Santo Domingo and living in Puyo, without personal pathological or family history of importance, is in her second pregnancy of 40.1 weeks last menstrual period (LMP), during his pregnancy was hospitalized for threatened preterm delivery more urinary tract infection. Go to gynecological emergencies present labor decided to send him to proceed to cefalovaginal birth, left in spontaneous evolution, resulting in childbirth at three hours and forty-five minutes, I received newborn anthropometric parameters of a newborn macrosomia with good general condition, in the period lasts more than 30 minutes delivery by retained placenta, is extracted manually incompletely, the vaginal touch incomplete uterine inversion palpating under short general anesthesia review is done and reduced manually uterus with maneuver Johnson, curettage and Bakri balloon placement is done. Patient signs of moderate hypovolemic shock with a loss of approximately 2000 milliliters blood crystalloid solutions so more globular packages are administered and plasma cool to recover blood volume; warrants admission to ICU, hypovolemic shock is persistent, a new uterine inversion, which is determined with the help of relaxation and bleeding, the conditions of the user warrant mechanical ventilatory support invasive, remains under observation without ruling hysterectomy evidence . Remains in ICU for 3 days thereafter to monitor their discharge is decided by the department of gynecology where it is kept under observation without improving clinical symptoms or signs of possible complications and decides high. In its evolution goes for outpatient control being in good general condition.Item Hipoplasia Uterina como Causa de Amenorrea Primaria(2016-10-01) López Valencia, Jessica Anabel; León Baquero, Érica Fernanda Dra.Uterine hypoplasia is generally regarded as a congenital problem caused by the interruption of the development of the Müllerian duct in the different stages of the embryonic development, being a rare gynecological problem in adolescents and women of childbearing age that manifest themselves as primary amenorrhea, infertility or obstetric complications. This case report is a last female patient 18 years old, born and resident in the city of Puyo, unmarried, secondary education, student, blood type unknown, with a history Gynecology-Obstetrics important bearing no menarche, date menstruation and menstrual cycles. Patient is referred to the Subcentro Urban Health Puyo and transferred to the General Hospital of Puyo to present absence of menstruation, where physical examination performed without evidence of pathology, laboratory tests within normal parameters, imaging tests such as ultrasound and computed tomography of the pelvis report hypoplastic uterus plus a karyotype reporting normal phenotype. The case is analyzed, but there is a lack of interest by the patient in their pathology to not continue with their medical checks, so you get to a diagnosis of uterine hypoplasia through anamnesis and complementary examinations.