Terrazas EF, Mancera SC, Galindo NA

Idioma: Español
Referencias bibliográficas: 38
Paginas: 186-191
Archivo PDF: 122.24 Kb.

RESUMEN

Objetivo: Presentar un caso poco frecuente de ruptura de colon sigmoides secundario a trauma cerrado de abdomen y su manejo mediante cirugía laparoscópica asistida con la mano. Sede: Hospital de tercer nivel de atención. Diseño: Presentación de caso clínico y revisión de la literatura. Descripción del caso: Paciente masculino de 52 años, quien sufre traumatismo abdominal cerrado diez días previos a su ingreso a urgencias, refiere dolor abdominal difuso y hematoma de pared en flanco y fosa ilíaca izquierdos, ingresa sin leucocitosis, con neutrofilia de 87%, se realiza tomografía axial computada la cual mostró aire libre en cavidad abdominal y colección alrededor de colon sigmoides. Es intervenido quirúrgicamente mediante cirugía laparoscópica asistida con la mano, encontrando perforación de sigmoides y absceso pericolónico. Se realiza resección de sigmoides perforado y procedimiento de Hartmann con colostomía. Evoluciona satisfactoriamente, siendo egresado al 5° día. Se realiza restitución de tránsito intestinal término-terminal mediante laparoscopia asistida con la mano 11 semanas después, evolucionando satisfactoriamente y siendo egresado al 5° día. Conclusiones: El método de cirugía laparoscópica asistida con la mano puede ser útil y satisfactorio para el manejo de lesiones perforadas de colon secundarias a trauma cerrado de abdomen. Este recurso deberá ser evaluado en estudios prospectivos comparativos.

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