Published 2020-12-07
Keywords
- Tránsito gastrointestinal/Obstrucción intestinal/Cirugía,
- Hernia/com- plicaciones
- Gastrointestinal transit / Intestinal obstruction / Surgery,
- Hernia / compli- cations
How to Cite
Copyright (c) 2020 Nicolás Ayala Servín, Marcia Duré Martínez, César A. Urizar, Victor Samaniego, Rocio Ayala, Romina Morales, Gabriela Nuñez, Larissa Insfrán, Edgar García, Rosa Sánchez, Roberto Corbeta
This work is licensed under a Creative Commons Attribution 4.0 International License.
Abstract
Background: Intestinal occlusion is the persistent arrest of intestinal transit, hinders movement towards distal sections. Adherence secondary to surgeries, the most frequent cause, collaborates in internal hernia formation in 4%. Need for surgical intervention is 6.4-10%. Case Report: Woman, 76 years old, 24 hours of evolution of generalized abdominal pain, due to crisis. Stopping 4-day and gas leak, 24 hours. Sigmoidostomy by CA of Sigmoid Colon. Physical examination: soft abdomen, depressant, diffuse pain, defense and pain in sudden decompression; RHA present. Increased soundness It presents neutrophilia, lymphopenia, thrombocytopenia. Urea, creatinine, BD, AST, TP, INR, high fibrinogen. Rx. of abdomen: hydroaryan levels. Ultrasound: Meteor. Simple TAC: obstruction of thin wings with multiple joints; in the transition zone. Diagnosis: Complete Intestinal Oclusion. Exploratory laparotomy consists of thin, violet coloration, multiple flanges and adhesions to the wall, epiplonic and interasas. They provide internal hernias with a 150-230 cm fitting of the fixed handle. Freezes and dissect adhesions and flanges with release of layered. Slim thin wings respond with better coloration and peristaltism. Discussion: 20% of cases of bowel occlusion caused by hernia, 1% of the total for internal hernia. Abdominal adhesions caused by 93% in postoperative cases, such as the picture. 95% of cases of flanges and adhesions are located in the small intestine, such as the presentation. Crisis type pain coincides as a symptomatology of the case. With compatible clinic, simple x-ray of abdomen and simple TAC (Gold Standard). Early surgery prevents intestinal strangulation, resulting in the restoration of the circulation and peristaltism of the wings.
Downloads
Metrics
References
- Espinoza d. Universidad nacional de san agustín facultad de medicina. : 50
- Ojeda Oviedo L, Maidana Zorrilla G, Medina Bello E, Ruiz Diaz K, Urbieta A, Méreles R, et al. Oclusión intestinal: Frecuencia y causas en un servicio de cirugía. Rev Cir Parag [Internet]. 2011; 35(2):17–20. Available from: http://sopaci.org.py/wp/wp-content/uploads/2016/03/OjedaOviedo.pdf
- Enríquez Sánchez DS. Análisis de la obstrucción intestinal en pacientes mayores de 50 años [Internet]. Universidad de Granada; 2007. Available from: https://hera.ugr.es/tesisugr/17243750.pdf
- Correa-Rovelo JM, Villanueva-López GC, Medina-Santillan R, Carrillo-Esper R, Díaz-Girón-Gidi A. Obstrucción intestinal secundaria a formación de adherencias postoperatorias en cirugía abdominal. Revisión de literatura. Cir Cir [Internet]. 2015; 83(4):345–51. Available from: http://www.redalyc.org/pdf/662/66242706015.pdf
- Puig CA, Lillegard JB, Fisher JE, Schiller HJ. Hernia of cecum and ascending colon through the foramen of Winslow. Int J Surg Case Rep [Internet]. 2013;4(10):879–81. Available from: http://dx.doi.org/10.1016/j.ijscr.2013.07.014
- Di Saverio S, Coccolini F, Galati M, Smerieri N, Biffl WL, Ansaloni L, et al. Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2013 update of the evidence-based guidelines from the world society of emergency surgery ASBO working group. World J Emerg Surg. 2013;8(1):1–14.
- Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (asbo): 2013 update of the evidence-based guidelines from the world society of emergency surgery asbo working group | world journal of emergency surgery | full text [internet]. [Citado 15 de abril de 2018]. Disponible en: https://wjes.biomedcentral.com/articles/10.1186/1749-7922-8-42
- Mcdonagh T, Jelinek GA. Two cases of paraduodenal hernia, a rare internal hernia. J Accid Emerg Med [Internet]. 1996; 13:64–8. Available from: http://emj.bmj.com/content/emermed/13/1/64.full.pdf
- García-Oria M, Muñoz de la Fuente A, Peraza Casjús JM, Bodega Quiroga I, Martínez Pozuelo A, Serrano Muñoz A. Hernia interna de Quain como causa de abdomen agudo. Sanid Mil [Internet]. 2012; 68(4). Available from: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1887-85712012000400006
- Perry JF, Smith GD, Yoheniro EG. Intestinal obstruction due to adhesions: a review of 388 cases. Ann Surg. 1955; 142(810):814.
- Brolin RE. The role of gastrointestinal tube decompression in the treatment of mechanical intestinal obstruction. Am Surg. 1983 Mar; 49(3):131–7.
- Räf LE. Causes of abdominal adhesions in cases of intestinal obstruction. Acta Chir Scand. 1969; 135:73–6.
- DeCherney AH, diZerega GS. Clinical problem of intraperitoneal postsurgical adhesion formation following general surgery and the use of adhesion prevention barriers. Surg Clin North Am. 1997 Jun;77(3):671–88.
- León-Ramírez D, Cárdenas-Lailson E, González-Monroy LE, Antonio J, Ruiz P, Ramírez-solís ME, et al. Factores pronósticos en oclusión intestinal por adherencias postoperatorias. Rev Hosp Gral Dr M Gea González [Internet]. 2002;4(4):106–9. Available from: http://www.medigraphic.com/pdfs/h-gea/gg-2001/gg014c.pdf
- Mujica K, Morillo D. Obstrucción intestinal por bridas y adherencias. Análisis de 135 casos en el Hospital Central Universitario Antonio María Pineda, durante el período 1994-2003. Boletín Médico de Postgrado [Internet]. 2005; 21(1):1–5. Available from: http://bibvirtual.ucla.edu.ve/db/psm_ucla/edocs/bm/BM2101/BM210107.pdf
- Ortega Quintanilla J, Martínez Moya M, Rodríguez Rodríguez AJ, Ocete Pérez RF, Cabello Bautista JM, Aguilar García JJ. OBSTRUCCIÓN INTESTINAL: Lo que el radiólogo debe ver, y el cirujano quiere escuchar [Internet]. SERAM. 2012. p. S-1402. Available from: https://posterng.netkey.at/esr/viewing/index.php?module=viewing_poster&task=viewsection&pi=112251&ti=366006&si=1146&searchkey=#poster
- Maroto N, Garriguez V. Oclusión y seudooclusión intestinal. In: Montoro MA, García Pagán JC, editors. Intestino delgado y colon. 2o. Madrid: Jarpyo Editores; 2012. p. 373–82.