Facultad de Ciencias Médicas

Permanent URI for this communityhttps://dspace-test.ucuenca.edu.ec/handle/123456789/19

Browse

Browsing Facultad de Ciencias Médicas by Subject "Abdomen agudo"

Filter results by typing the first few letters
Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    Caso clínico 1: hernia diafragmática postraumática, Caso clínico 2: hernioplastia insicional lumbar
    (Universidad de Cuenca, 2023-06-15) Castro Palaguachi, Verónica Graciela; Quichimbo Sangurima, Fausto Marcelo
    Introduction: Diaphragmatic hernias are defined as the passage of abdominal organs into the thoracic cavity through a defect in the diaphragm, sometimes resulting from severe trauma, constituting a surgical challenge. Thoracoabdominal incisions are commonly used for various thoracic and vascular cases, although they are rarely used for diaphragmatic hernias, which are usually repaired by laparotomy, thoracotomy or minimally invasive approaches. Case report: We present the clinical case of a 25-year-old patient with a history of penetrating stab wound trauma 4 years ago, who came to the emergency room with diffuse abdominal pain diagnosed on admission as acute partial subocclusive abdomen treated surgically by exploratory laparotomy with surgical findings of non-diseased appendix and ileus, with torpid evolution 5 days later he presented respiratory difficulty, chest x-ray was performed showing left pleural effusion, treated with pleural drainage obtaining fecaloid liquid of approximately 1500ml volume, so it was decided to perform an urgent thoracotomy finding perforated diaphragmatic hernia + pleural empyema + necrosis of the splenic angle of the colon, diaphragmatic herniorraphy + pleural cavity lavage + decortication + pleural drainage + laparotomy + resection of the splenic angle of the colon + end-to-end anastomosis + peritoneal peritoneal cavity lavage + peritoneal cavity lavage + pleural drainage + peritoneal anastomosis + peritoneal anastomosis terminal anastomosis + peritoneal cavity lavage + Jackson Pratt drain placement Results: Patient remained hospitalized for 43 days, presented as a complication pachyepleuritis left empyema reintervened by left lateral thoracotomy, evolving favorably after receiving treatment with intravenous is discharged home in good condition. Introduction: Lumbar hernia is the rarest of all abdominal wall hernias and represents only 0.2% of all hernias. About 20% are congenital, mainly secondary to embryonic development defects, while 80% are acquired.1,2 The most recent literature recommends the laparotomy approach with the use of prosthetic materials as the most appropriate, so the procedure is fast, easy, and safe.2,3 Clinical case: A 46-year-old patient with a history of left radical nephrectomy by lumbotomy approach in 2021, who presents moderate intensity pain and sensation of mass protrusion in the left lumbar region. The physical examination showed a wall defect of approximately 10 cm diameter throughout abdominal content protruded at repose and before Valsalva maneuvers, but it was also reducible by external compression. Simple and contrast-enhanced computerized axial tomography (CAT) of the abdomen and pelvis reported a hernial defect at the left lumbar level with omental content of approximately 8x7cm without compromise of vascularization. A lumbar insicional hernioplasty was performed with a double mesh technique, “sandwich” type, one of them placed intraperitoneal and the second retromuscular. Conclusion: Surgical repair by open approach of hernial defects at the lateral level, using double mesh (intraperitoneal and inframuscular) “sandwich” type, is a safe technique and with satisfactory results in those patients with a defect greater than 5 cm with a bad quality aponeurosis.
  • Thumbnail Image
    Item
    Frecuencia de comorbilidades asociados con abdomen agudo quirúrgico en adultos mayores. Hospital Vicente Corral Moscoso. Cuenca 2020
    (Universidad de Cuenca, 2022-02-09) Rosero Arévalo, David Gabriel; Gutiérrez Piedra, Ítalo
    Antecedent: worldwide, the acute surgical abdomen constitutes approximately 20% of the care registered for older adults in emergencies and is related to comorbidities that they acquire and that are probably related to the recovery or prognosis of said acute abdomen. Objective: to determine the frequency of comorbidities with Acute Surgical Abdomen in older adults. Vicente Corral Moscoso Hospital. Cuenca 2020. Materials and methods: the universe made up of all patients over 65 years of age who are admitted for surgical resolution. Descriptive study. The characterization of the population will be carried out through descriptive statistics, through frequencies and percentages, for statistical significance through the 95% confidence interval and p-value 0.05. SPSS version 21 and Excel programs will be used. Results: there are 105 men and 113 women with ages between 65 and 96 years (M = 75.3; SD = 7.6). The inflammatory type was the predominant in 71.2%, the vascular the least common 0.9%. Of the total of operated, 25.6% had cardiological comorbidities, 18.6% metabolic, 38.9% previous surgeries, but there was no statistical association. Acute obstructive abdomen is related to previous surgeries, and cardiological or metabolic comorbidities with more days of hospitalization with a p 0.004 Conclusions: international studies identify similarities in comorbidities that were cardiological determining arterial hypertension, and diabetes in terms of metabolic, the main type of acute abdomen is inflammatory, as in our research.
  • Thumbnail Image
    Item
    Reporte de caso clínico 1: falacia ad populum tras reparo de hernia inguinalderecha Reporte de caso clínico 2: hernia de amyand resuelta con técnica de Shouldice modificada
    (Universidad de Cuenca, 2023-04-21) Cevallos Guamancela, Álvaro Javier; Vásquez Palacios, Cristian Felipe
    Introduction: The ad populum fallacy or abdominal vortex sign is described as twistingof the mesentery and loops of the small intestine, giving rise to an acute obstructive abdomen that may be associated with necrosis or intestinal perforation, which is why it is considered a surgical emergency. This entity was initially described as intestinal malrotation, however several cases have currently been reported considering this non- pathognomic sign of a specific entity. (1). Clinical case: A case of a patient with crampy abdominal pain of 7 months of evolution associated with weight loss, abdominal distension, cramping located in the mesogastrium and hypogastrium constantly with periods of increased intensity, has presented weight loss is presented. of approximately 20 kg in 7 months as a surgical history hernioplasty with the Lichtenstein technique 7 months ago Conclusion: The presentation of ad popolum fallacy or whirpool sing is infrequent and is associated with intestinal malrotation. However, it has also been described in cecal and sigmoid volvulus with intestinal obstruction, in our case it was associated as a post-surgical complication after inguinal hernioplasty with the Lichtenstein technique.