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>Revistas >Cirugía y Cirujanos >Año 2008, No. 6


Tavares-de la Paz LA, Sánchez-Fernández P, Salazar-Lozano C, Salazar-Murillo H
Drenaje percutáneo de ascitis secundaria a pancreatitis aguda grave asociada a síndrome compartimental abdominal. Informe de dos casos
Cir Cir 2008; 76 (6)

Idioma: Español
Referencias bibliográficas: 33
Paginas: 515-518
Archivo PDF: 44.48 Kb.


Texto completo




RESUMEN

Introducción: Son diversos los informes acerca de la presencia de síndrome compartimental abdominal (SCA) en pacientes con pancreatitis aguda grave. El tratamiento agresivo del SCA mediante la realización de una laparotomía descompresiva formal, evacuación del líquido de ascitis y cierre temporal de la pared abdominal, se ha asociado con mejoría instantánea de todos los parámetros fisiológicos del paciente en estado crítico. Sin embargo, la morbilidad y mortalidad asociadas son inaceptablemente altas.
Casos clínicos: Dos pacientes con pancreatitis aguda grave y SCA en quienes se logró descompresión abdominal exitosa mediante la evacuación de líquido de ascitis con la colocación de un catéter peritoneal, apreciando una significante disminución de la presión intraabdominal y disminución de los parámetros del ventilador. Lo anterior permitió evitar por completo la cirugía en un paciente y retrasarla de manera significativa en otro.
Conclusiones: La descompresión abdominal mediante la evacuación del líquido de ascitis a través de un catéter peritoneal en pacientes con pancreatitis aguda grave y SCA (secundario a una obligada resucitación hídrica masiva), es una opción terapéutica útil y segura para disminuir la presión intraabdominal y retrasar o evitar por completo una laparotomía con cierre temporal de la pared abdominal.


Palabras clave: Síndrome compartimental abdominal, pancreatitis aguda severa, falla orgánica múltiple, catéter peritoneal.


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>Revistas >Cirugía y Cirujanos >Año2008, No. 6
 

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