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2007, Número 3

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Cir Gen 2007; 29 (3)


Resección extensa de intestino delgado en el accidente vascular mesentérico

Terrazas EF, Galindo NA, Sanjurjo GJL, Cerón DU

Idioma: Español
Referencias bibliográficas: 55
Paginas: 217-224
Archivo PDF: 159.18 Kb.


RESUMEN

Objetivo: Presentar la experiencia en resección extensa de intestino delgado en el accidente vascular mesentérico y revisar la literatura.
Sede: Centro de atención de tercer nivel.
Diseño: Presentación de casos clínicos.
Casos presentados: Se presentan tres casos con accidente vascular mesentérico, dos de ellos de origen arterial embólico y uno de origen venoso trombótico, manejados con éxito. La resección extensa y masiva necesaria para una necrosis de intestino delgado secundaria a accidente vascular mesentérico, requiere juicio de decisión que considere la posibilidad de sobrevida; pero también está influenciada por recursos médico-tecnológicos de nutrición parenteral ambulatoria y de trasplante intestinal.
Conclusión: La resección extensa y masiva de intestino delgado, que deja un segmento de intestino corto, se maneja mejor mediante el cierre del asa aferente de yeyuno, drenando adecuadamente el estómago y el duodeno, haciendo una fístula mucosa del íleon residual y dejando un drenaje para el líquido quiloso de ascitis que habitualmente se forma. Las complicaciones postoperatorias son múltiples, por lo que se deberá mantener un control estricto multidisciplinario del enfermo. La decisión para la restitución del tránsito intestinal requiere de preparación temprana y debe realizarse oportunamente.


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