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Órgano Oficial del Hospital Angeles Health System

2012, Number 2

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Acta Med 2012; 10 (2)

Autoimmune disease as total colectomy complication due to colonic inertia

Ibarrola-Calleja JL, Rodríguez-González M, Núñez-Bentz F, Ordóñez-Céspedes J, García-Garma A, Terrazas-Rodríguez R

Language: Spanish
References: 28
Page: 91-95
PDF size: 286.02 Kb.


ABSTRACT

Feminine patient of 37 years old, with pyrosis, epigastric pain, and several years of constipation, she does not evacuate more than 2 times a month; non laxative work. The diagnosis was severe gastro-esophageal reflux and colonic inertia; it was taken to the O.R where we do a fundoplication, and a total colectomy with ileo-rectum anastomosis, without any complication. The patient evacuate in the second day; at the third day it began with several diarrheal evacuations, which led her to intensive care unit for more effective rehydration, however in a few hours she initiated with a severe inflammatory response, with polyserositis, with an expense drains of more than 5 liters; we begin to believe in an autoimmune problem lupus like, we started a high doses of steroids. The patient was better; however she developed pancreatitis; which causes venous circulatory phenomena in the small intestine, that is why we decided to reoperate, finding a segmental mesenteric thrombosis with secondary ischemic hemorrhagic enteritis, we performed a 80 cm ileon resection with a new entero-rectum anastomosis; she progress well achieving extubated; but because the insurance ran out, she was transfer to another hospital where she stayed 5 more days and went home.


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