Volúmen 35 No . 1 (2017)

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Browsing Volúmen 35 No . 1 (2017) by Subject "Conductos Biliares"

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    Ileo biliar, reporte de caso clínico
    (Universidad de Cuenca. Facultad de Ciencias Médicas, 2017-04) Salamea A, Juan Josué; Salamea A, Pablo Andrés
    Biliary ileus is the secondary mechanical intestinal obstruction to the intraluminal impact of a litho; it is considered as a complication of cholelithiasis that provokes a fistula in the digestive tract, allowing the migration of the stones. Sometimes occurs by natural passage through the biliary tract due to alterations of the sphincter of Oddi, especially after the surgical extension of the same. It is a rare pathology that is more common in the elderly, the most international series report an average age between 60 and 84 years. It mainly affects the female sex, with a male relation: female ratio ranging from 1: 3 to 1: 6, attributed to the higher frequency in that sex biliary disease. This condition is preceded by acute or chronic cholecystitis (75% of cases). CASE REPORT It is a case of a man, he is 83-year-old and he goes to emergency service presenting pain and bloating, nausea and vomit, in the physical examination it was observed a distended abdomen with abolished bowel sounds, tympanic to percussion, painful to profuse palpation. Laboratory tests are performed and indicate an increased leukocyte count, CRP increased minimally over the upper limit, imaging examinations CT specifically indicates the existence of gas in bile duct and a hyper dense image at the level of the small intestine. The patient still presents pain, for this reason it is projected an exploratory laparotomy.