Santamaría AJR, Rodríguez WU, Sámano GM, Caballero AG

Language: Spanish
References: 0
Page: 40-43
PDF size: 202.33 Kb.

ABSTRACT

lntroduction. The gallbladder perforation is arare complication of the acute cholecystitis that is associated with a mortality of 70%; to establish the late diagnosis of acute cholecystit is determines serious consequences as the gallbladder perforation, serious sepsis or septic shock of biliary origin with bad forecast. The treatment undoubtedly is surgical and consists in cholecystectomy, surgical wash and drainage, and even in the repair of the complications that presents. The surgical boarding can be opened or laparoscopic. Clinical case. Male of 47 years w ith LAPE's precedent 15 years ago for secondary abdominal traumatism for car accident. He enters to the Service of Urgencies with classic picture of biliary colic; diagnosis joins of hydrocholecystis; it proposes surgical resolution, without accepting the above mentioned treatment; he voluntarily discharge and 24 hrs later here enters with information of SIRS and gallbladder perforation, for what he surrenders to surgical treatment. Conclusions. The managing of the gallbladder perforation is the surgical treatment: the cholecystectomy, surgical wash and drainage; the treatment of the severe sepsis is based on the hydrotherapy and antibiotic therapy, since the infection owes even in 95% to gram negative bacteria and normally exists more than one etiologic agent. Considering in addition the complications that should appear in the above mentioned treatments, such as biliomas, biliary fistulas, intrabdominal abscesses, pancreatic abscess, as for the surgical ones; pulmonary acute injury, pneumonia associated with ventilator, SIRPA, septic refractory shock and FOM as for the proper ones of the managing in UCI for sepsis severe.