Guerra MD, Inda TA, Saavedra SJR

Language: Spanish
References: 5
Page: 32-35
PDF size: 116.25 Kb.

ABSTRACT

Patient of 18 year-old female, status Single, domestic worker; who went to the Hospital “Rafael Pascacio Gamboa” of Tuxtla Gutiérrez Chis. because of “Mass” tumorous. FAH not significant for the current suffering. AC it has begun 3 months ago with asthenia, weakness, paleness of teguments and pain in right Hemiabdomen, accompanying of irregularities in the habit intestinal, lost of weight (5 kg). Anorexy. She went for medical consultation on her neighbourhood, were she had treatment with the help of vitamins and iron. To the exploration it was felt “mass” tumorous in abdomen located in flank and right hypochondrium, of painful firm consistency to the mobilization for external maneuvers, active bowel sounds; extremities thoracic and pelvic lost weight, vaginal tact was omitted; rest of normal exploration. Diagnose and results: Clinical analysis (BH, EGO, TP, TTP, QS, Group and Factor Rh). The Hb 7.4 and Type “O” Rh (+), Subtract of the results inside normal parameters, Rx, Colon for enema, showed defect of having filled in upward colon; Colonoscopy: it confirmed very irregular exuberant neoplasy; that occupies 90% of the light of the colon with erosion area and wide ulceration. The tissue it is appreciated stony measuring 8 cm approx. It doesn’t allow the step to cecum, multiple biopsies were taken. Treatment: 24 h before the treatment she present; sharp pain intense nausea, vomit, light dehydration to moderate. And it is managed with solutions parenterals, NGP. Fast lastly she presents frank data of sharp abdomen for those that she spends to operating room of urgency for laparotomy explorating being made; right hemicolectomy with ileo-transverse anastomosis in one layer. Findings: Extensive handles of small bowel, Intussusceptions to 30 cm of the ileocecal valve, necrosis ileo-ileal, cecum and upward colon with process neoplastics. Postoperative evolution: Fistula abdominal wound-uretero, is managed with probe of Foley that negativist to the 7 days, rest of the evolution inside the normal thing, gains weight, Hb of 12.5 g and she incorporates to their daily activities. Diagnose definitive: Report of histopathology, Lymphoma of cells B of type Burkitt, primary of colon.

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