Uso de sellante tisular en trauma pancre??tico en ni??os.

By 20 julio, 2017Resumen, Resumen vol3

Eduardo Villamil Giraldo1, Miguel Andr??s Bedoya L??pez2

1 Cirujano Pediatra. Hospital Infantil Los ??ngeles, Pasto, Colombia.
2 M??dico y Cirujano. Hospital Infantil Los ??ngeles, Pasto, Colombia.

RESUMEN

El trauma pancre??tico es una patolog??a poco frecuente que representa un reto diagn??stico y terap??utico, desde el inicio de la atenci??n del paciente hasta el control de las posibles complicaciones. Se exponen los m??todos diagn??sticos actuales incluyendo la amilasemia, la tomograf??a de abdomen, y la colangiograf??a retr??grada endosc??pica como m??todo confirmatorio y de manejo no invasivo. As?? mismo, en caso de mayor compromiso cl??nico, la identificaci??n de lesiones por medio de laparotom??a. Seg??n los hallazgos, clasificaci??n de la lesi??n pancre??tica y el estado cl??nico del paciente, se plantean los diversos tratamientos y complicaciones.
Presentamos el caso de una paciente donde se presenta ruptura postraum??tica del p??ncreas, que requiere laparotom??a por presentar signos de irritaci??n peritoneal y se maneja la lesi??n con el uso de un sellante tisular a base de fibrin??geno, manejo elegido por inestabilidad cl??nica y riesgos quir??rgicos, logrando evoluci??n favorable y adecuada recuperaci??n. Ponemos a consideraci??n dada la poca literatura respecto a este tema, este m??todo de tratamiento para lesiones traum??ticas de p??ncreas en este tipo de pacientes.

ABSTRACT

Pancreatic trauma is an infrequent condition that presents a diagnostic and therapeutic challenge from the initial approach to the patient until possible complications are properly treated. We discuss current diagnostic methods including seric amylase; contrast enhanced computed tomography scan, and endoscopic retrograde cholangiopancreatography as a confirmatory diagnostic method but also as non-invasive treatment. As well as in severe cases the use of laparotomy to identify the injuries properly. According to the findings, the classification of the pancreatic lesion and the condition of the patient, several treatments are proposed and complications.
We present a case with post-traumatic pancreatic rupture that requires laparotomy because signs of peritoneal irritation were found during the examination of the patient. The injury was managed with the use of a fibrinogen tissue sealant, it because the patient presented hemodynamic instability and high surgical risk, accomplishing a favorable outcome and recovery. We consider given the limited literature on this subject, this method of treatment for pancreatic trauma injuries in such patients.

Palabras clave: P??ncreas, Trauma, Sellante tisular, Peritonitis

CIRUPED

Author CIRUPED

More posts by CIRUPED

Leave a Reply