12.PREZENTARI LA CONGRESE
CAZ RAR DE EVENTRAŢIE POSTOPERATORIE GIGANTĂ ABDOMINALĂ CU PIERDEREA DREPTULUI DE DOMICILIU – CURA CHIRURGICALĂ ALLOPLASTICĂ CU PROTEZA HI-TEX PARP MP
Autorii: Dragoş ŞERBAN2; Cristian BRĂNESCU1; Costel ŞAVLOVSCHI2; Alin KRAFT2; Claudia PANŢU3; Camelia GĂVAN2; Florin TIUCĂ2; Horia PANŢU2; Ana-Maria DASCĂLU2; Meda COMANDAŞU2; Sorin OPRESCU2;
1. Clinica de Chirurgie Digestivă Superioară, Spitalul Universitar de Urgenţă Bucureşti
2. Universitatea de Medicină şi Farmacie “Carol Davila” Bucureşti
3. SC Medical Express SRL
Abstract:
Prezentam un caz clinic al unei bolnave cu eventratie postoperatorie giganta cu pierderea dreptului de domiciliu, din al carui trecut chirurgical important mentionam: (1) ocluzie intestinala operata in urgenta cauzata de neoplasm colon unghi splenic cu colo-colo anastomoza in anul 2006 si (2) colectomie segmentara colon unghi splenic.
La 2 ani de la operatie a prezentat eventratie giganta, ce a necesitat interventie chirurgicala.
Datorita pierderii dreptului de domiciliu si suprafetei intinse a eventratiei, s-a folosit o plasa Medical Express HI-TEX PARP MP cu dimensiuni 30 / 30 cm. Evolutia postoperatorie a fost in consecinta favorabila, bolnava fiind externata vindecat.
GIANT MALIGNANT GASTRIC PERFORATION – AN ATYPICAL SURGICAL SOLUTION
Autorii: Dragoş ŞERBAN2; Cristian BRĂNESCU1; Costel ŞAVLOVSCHI2; Răzvan BORCAN2; Ana-Maria DASCĂLU2; Corneliu TUDOR1; Camelia GĂVAN2; Florin TIUCĂ2; Alin KRAFT2; Meda COMANDAŞU2; Sorin OPRESCU2.
1. Emergency University Hospital, Upper Digestive Surgery Clinic of Bucharest, Romania
2. “Carol Davila” University of Medicine and Pharmacy of Bucharest, Romania
Abstract:
Perforatie gastrica gigantica maligna – solutie chirurgicala atipica.
Prezentam cazul unui bolnav in varsta de 52 de ani venit in SUUB, in urgenta cu diagnosticul de abdomen acut, pneumoperitoneu, la care s-a impus interventie chirurgicala de urgenta.
Intraoperator, s-a constatat carcinomatoza peritoneala, ascita, perforatie gastrica de 3,5-4 cm aspect de linita gastrica fara posibilitate de valorificare a materialului gastric exitent s-a recurs la o solutie atipica de plombaj gastric cu metrial epiplooic prin tractiune transgastrica.
Solutia a fost salvatoare pentru evolutia imediata a perforatiei gastrice.
Boala de fond nu a fost elementul in discutie, bolnavul fiind preluat de serviciul de oncologie; imaginile intra operatorii sunt sugestive.
Giant malignant gastric perforation – an atypical surgical solution.
We present the case of a 52-year old male patient, hospitalized on an emergency basis at the Emergency University Hospital of Bucharest, after being diagnosed with pneumoperitoneum acute abdomen, for which emergency surgery was mandatory.
Upon this, peritoneal carcinomatosis, ascitis, a 3.5 – 4 cm gastric perforation appearing like gastric linitis were found. Due to the lack of available gastric material, an atypical solution of gastric packing with epiploic material by means of transgastric traction had to be used; the intra-surgery images are relevant in this respect.
The solution proved successful for the immediate development of the gastric perforation.
The underlying condition was not focused on, the patient being directed to the Oncology department.
