Basilio OA, Méndez TA, Gamma HJ, Hernán Villar S, Escobedo J

Language: Spanish
References: 10
Page: 19-23
PDF size: 96.80 Kb.

ABSTRACT

A 24 years male patient introduced by EMT’S, at 2:30 am with the history of fire gun shoot 45 minutes before his arrive, the vital signs were BP 80-50 mmHg, CF. 120x’ RF. 26x’, the patient was operated, the findings were hemoperitoneum 2,500 cc, pancreatic body injury, injury of both surfaces in stomach, hepatic injury, section of splenic artery, and lesion of kidney. The chirurgic treatment was hemoperitoneum drainage, hepatorraphia, gastrorraphia in two planes, in both surfaces, splenic artery ligadure, the transchirurgic bleeding was 1,500 cc, with a total hemoperitoneum of 4,000 cc. We decided to close all the layers of the abdominal wall. We put a Saratoga drainage to pancreatic bed and to Morrison space, the patient was taken to ICU requiring mechanical ventilation. In the next 5 days the patient present fever and a subphrenic collection was finded with US, corresponding to an undrainaged hematoma, the fever disappeared on day 9. A pancreatic fistula was found on the left drainage, with an output of 300 mL the first day and 200 mL the second day. At the 18th day of stay, an abdominal TAC was done, with out evidence of collections, we decided to send the patient to home, with minimal pancreatic drainage, and tolerating enteral diet.

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