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[original-brands]

BIBA SALE ON MINOR SKD & KURTIS

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[womens-clothing-online]

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[biba-shorts]

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[biba-online-sale]

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[natb00]

Ronda Cx general.

Jorge, 47 años.

Dx:

Ileus vs obstrucción intestinal postquirúrgica temprana.

Obstrucción intestinal por bridas intervenida quirúrgicamente.

Rasgos disfuncionales de personalidad con sintomas ansiosos y depresivo.

Procedimientos:

11/08/2023: Laparotomia exploratoria, liberacion de adherencias, enterorrafias multiples.

**Hallazgos: se libera sindrome adherencial desde el angulo de traitz hasta la ileotransverso anastomosis.

Antecedentes personales:

Patologicos: Ca de colon en remisión, Asma.

Quiurgicos: *Ca colón: 08/08/2022: laparotomía exploratoria, hemicolectomía derecha, anastomosis ileotransversa latero-lateral mecánia, eventerorrafia vialfex sobre vaiflex y sistema de presión negativa.

16/08/2022: lavado peritoneal, eventrorrafia primaria. *CA basocelular en frente.

*Bypass gástrico + resección de lesión colónica. *Esfinteroplastia anal + Hemorroidectomía. *Septoturbinoplastia.

Toxicológicos: Exfumador desde hace 17 años.

Alérgico a ASA, yodo (rash). Intolerante al litio.

Subjetivo: paciente refiere pasar una buena noche, logra conciliar el sueño, dolor controlado, tolerando VO y deambulación, diuresis espontanea.

EF: PA 116/78, FC 90, SaO2 92%. Paciente en buenas condiciones generales, alerta, orientado en las 3 esferas mentales, colaborador al momento del interrogatorio. Mucosas palidas, anictericas. Abdomen blando, depresible, levemente distendido, dolor difuso a la palpación, sin signos de irritación peritoneal. Herida qx sana. Extremidades sin edema.

Drenando 3700 cc por sonda nasogastrica.

Imágenes:

15/08/2023:ECO hepatobiliar: no hay signos ecográficos de colelitiasis ni colecistitis aguda. Prominencia de la via biliar intra y extrahepatica, sin evidencia de lesiones obstructivas por este método.

15/08/2023: Dilatación del estómago, duodeno y asas yeyunales por íleo. No se observan zonas de transición ni signos de obstrucción intestinal de alto grado. Neumoperitoneo postquirúrgico. Liquido laminar en pelvis. No se observan colecciones. Diltación de la via biliar intra y extrahepática, el colédoco alcanza 11 mm, hallazgo estable respecto a estudio previo en 2022. Atelectasis bibasales y liquido pleural laminar bilateral.

10/08/2023: Obstrucción intestinal con zona de transición en ada de ileon, localizada en flanco-hipocondrio derecho, varios centimetros antes de la anastomosis ileo transversa. Anastomosis ileo transversa sin signos de estenosis. Quistes simples renales bilaterales de pequeño tamaño.

Paraclinicos:

14/08/2023: Ca 8.5, Cl 104, Na 148, K 3.55, Cr 1.1, PCR 47, BUN 18.2 , Hb 12.3 Leucos 3700, plaquetas 274000.

11/08/2023: pH 7. 37, PCO2 37, PO2 171, HCO3 21. 4, BE -3. 4, Hb 14. 8, Hto 42, Sodio 133, Potasio 4. 6, Lactato 1, Glucosa 131.

10/08/2023: ALT 14, AST 16, Amilasa 48, Btotal 0. 50, Bdirecta 0. 18, Calcio 9. 4, Cloro 107. 4, Sodio 139, Potasio 4. 5, Cr 0. 97, Fosfatasa alcalina 107, GGT 28, PCR 0. 65, BUN 12. 3, Hb 15. 5, Hto 45, Plaq 260000. Leucos 10700, Neu 8057.

Análisis: Paciente de 47 años, con antecedente de CA de colón que fue resecado, consulta por cuadro clinico de obstrucción intestinal por bridas, no respondio a manejo conservador, por lo que fue llevado el 11/08/2023 a laparotomia exploratoria, liberacion de adherencias, enterorrafias multiples. Hace dos días paciente presente aumento de distención abdominal y dolor abdominal, sin franca mejoría de sintomatología inicial, por lo que ordenan paraclinicos de control donde encuentran elevación marcada de PCR y ordenan TAC de control, en el que se encuentra dilatación del estómago, duodeno y asas yeyunales por íleo, no se observan zonas de transición ni signos de obstrucción intestinal de alto grado, además encuentran diltación de la via biliar intra y extrahepática por lo que el día de ayer ordenan ecografía hepatobiliar en la cual no se encuentran signos de colelitiasis ni colecistis. El día de hoy encontramos al paciente levemente distendido, dolor abdominal controlado, tolerando VO, ya presentó deposiciones, drenando 3700 cc por sonda nasogastrica. Continuamos vigilancia.

[original-brands]

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𝐅𝐚𝐜𝐞𝐛𝐨𝐨𝐤 :- https://facebook.com/udesigns.women 

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𝐖𝐞𝐛𝐬𝐢𝐭𝐞: https://udesigns.co.in

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[original-brands]

BIBA SKD & BIBA KURTIS Get BIBA SHAWLS & BIBA SHRUGS ➤ 

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[womens-clothing-online]

[𝐁𝐈𝐁𝐀] » Buy Online Flared Fusion Wear BIBA Long Kurtis

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[original-brands]

Biba Online Sale - Up to 70% Off! Shop Now and Save Big

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Don't miss out on the amazing Biba Online Sale! Get up to 70% off on pretty dresses, kurta sets, and suits for women. Hurry and grab the best deals on Indian ethnic wear and designer ladies' suit sets before they're gone!

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[original-brands]

(via Complete Your Look with BIBA Accessories)

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https://youtube.com/BrandedSurplusGoods/ https://original-surplus-brands.blogspot.com https://originalsurplus.wordpress.com

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[womens-clothing-online]

[𝐁𝐈𝐁𝐀 𝐒𝐊𝐃] »  BIBA KURTIS - Trendy Premium Sarees, Lehenga & Unstitched Suits

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[womens-clothing-online]

[𝐁𝐈𝐁𝐀] » BIBA KURTIS || Buy Online Straight Kurti, Kurtis, Suits, Dresses » [𝐁𝐈𝐁𝐀 𝐒𝐀𝐋𝐄]

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[womens-clothing-online]

[BIBA SKD] » [BIBA SALE] » [100% ORIGINAL ETHNIC DRESSES] » [BIBA SURPLUS]

Don't miss out on the BIBA SKD online sale! Shop now and save big on a wide range of ethnic wear, including suits, kurtas, and dresses. Upgrade your wardrobe with BIBA's stylish and comfortable outfits at discounted prices.

Summary: Upgrade your ethnic wardrobe with BIBA's SKD online sale. Shop now and save big on a wide range of ethnic wear, including suits, kurtas, and dresses. Find stylish and comfortable outfits at discounted prices.

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[udesigns]

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Branded Surplus Goods

10K views 8 months ago

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