Lipoma gástrico y obstrucción pilórica en una mujer de 51 años Esta paciente se sometió a una gastrectomía atípica, que ocasionó estenosis del píloro. . Rubio T, Repiso M, Sarasibar H. Invaginación intestinal en el adulto secundaria a. Recientemente se ha propuesto que la estenosis pilórica debe ser incluida en la El carcinoma de vejiga, frecuente en adultos de la población general, se ha.
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We present the case of a year-old woman, allergic to iodine contrast, with a history of type 2 diabetes mellitus, hypercholesterolaemia, goitre and hypothyroidism due to Hashimoto thyroiditis. She had been admitted on multiple occasions since for acute gastric dilatation secondary to pyloric stenosis, which was of unknown aetiology due to the patient’s refusal to undergo diagnostic tests.
She had severe ischaemic colitis, with secondary sigmoid perforation inrequiring surgical resection and permanent colostomy in the left iliac fossa. She was admitted to our department for sudden onset abdominal pain, accompanied by vomiting and absence of flatulence. On physical examination, she presented severe abdominal distension, tympanism and findings of peritoneal irritation. Blood tests found compensated metabolic acidosis, with normal full blood count, coagulation, C-reactive protein and basic biochemistry.
Abdominal X-ray revealed severe gastric dilatation Fig. Severe gastric dilatation on conventional abdominal X-ray. Abdominal computed tomography images.
A Coronal slice; B Sagittal estenoxis Pneumoperitoneum in upper abdomen and small amount of perigastric free fluid. The patient underwent surgical treatment with total gastrectomy and bowel adu,to reconstruction by Roux-en-Y oesophagojejunostomy. We were unable to use the laparoscopic approach given the patient’s severe gastric distension. A stomach measuring 30 cm at the longest axis was observed in the surgical specimen, with a thickened pylorus Fig.
No perforation site was found in the specimen, attributing the pneumoperitoneum to diffusion of air secondary to the severe gastric dilatation. Hypertrophy at pyloric level in transverse slice of surgical specimen.
Hypertrophic pyloric stenosis in adults is a rare entity, with a wide range of symptoms although it can be asymptomaticproducing dyspepsia, vomiting or even occlusive symptoms with pneumoperitoneum. The aetiology remains uncertain, but several hypotheses have been proposed, namely 1,2,4: No apparent lesion identified:. Neuromuscular incoordination due to changes in the Auerbach plexus or vagal hyperactivity.
Persistence of childhood stenosis.
Most authors favour this theory, in which the disease remains latent and is reactivated by secondary factors setenosis as inflammation, oedema, and spasm. Pyloric stenosis in adults and children presents similar anatomical and histopathological abnormalities, which supports this hypothesis. Associated with gastric, pyloric or duodenal lesion, such as gastritis, peptic lesions or tumours. Clinical symptoms are variable and rarely diagnostic, with predominantly abdominal pain, persistent vomiting, esetnosis satiety, anorexia, dyspepsia and weight loss.
Asymptomatic patients or those with few symptoms do not require treatment, while patients with clinical evidence require surgery. Among the various surgical techniques used, pylorectomy with minimal gastrectomy seems to obtain better outcomes. Endoscopic treatment by means of pyloric dilation has also been described, but has a high rate of recurrence and should be used only in selected cases patients with high surgical risk or who refuse surgery.
Please cite this article as: Estejosis article Next article. November Pages Letter to the Editor. This item has received. Show more Show less. She had severe ischaemic colitis, with secondary sigmoid perforation inrequiring surgical resection and permanent colostomy in the left iliac fossa.
Lipoma gástrico y obstrucción pilórica en una mujer de 51 años
Severe gastric dilatation on conventional abdominal X-ray. Pneumoperitoneum in upper abdomen and small amount of perigastric free fluid. Hypertrophy at pyloric level piloricq transverse slice of surgical specimen.
Simple and complicated hypertrophic pyloric stenosis in the adult.
Gut, 6pp. Rev Med Hondur, 47pp. Ann Surg,pp.
Diagnosis and therapy of primary hypertrophic pyloric stenosis in adults: J Gastrointest Surg, 10pp. Subscribe to our Newsletter. Three clinical cases with Acute pancreatitis due to venous artery Si continua navegando, consideramos que acepta su uso.
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