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Coágulos intraluminales en postoperatorio de una hepaticoyeyunostomía: rara complicación para un rápido actuar

dc.contributor.authorMarín Marmolejo, Juan Carlosspa
dc.contributor.authorSarmiento, Luis Antoniospa
dc.contributor.authorMartínez, Juan Davidspa
dc.date.accessioned2020-10-27T14:19:11Z
dc.date.available2020-10-27T14:19:11Z
dc.date.issued2020-07-22
dc.identifier.issn2382-4603
dc.identifier.issn0123-7047
dc.identifier.urihttp://hdl.handle.net/20.500.12749/9893
dc.description.abstractIntroducción: La obstrucción intestinal por coágulo intraluminal es una complicación posquirúrgica poco frecuente reportada en la literatura. Reportamos el caso de un paciente con obstrucción intestinal por coágulos intraluminales posquirúrgicos de una hepaticoyeyunostomía con Y de Roux. Caso clínico: Paciente masculino de 53 años de edad, se presenta con cuadro de colangitis recurrente, secundaria a estenosis benigna de la vía biliar post colecistectomía laparoscópica, realizada hace 2 años. En su manejo con endoprótesis por colangiopancreatografía retrógrada endoscópica (CPRE) no mejoró de sus episodios de colangitis, por lo que se consideró el paso a una reconstrucción tipo hepaticoyeyunostomía. En el postoperatorio temprano, presentó signos de obstrucción intestinal. La tomografía computarizada (TC) abdominal contrastada demostró líquido libre y signos de obstrucción. Es llevado a cirugía de urgencia, encontrándose la anastomosis en Y de Roux obstruida por gran coágulo intraluminal, requiriendo enterotomía para su extracción. Discusión: La obstrucción intestinal postoperatoria secundaria a un coágulo intraluminal es inusual, se debe sospechar en paciente con síntomas de obstrucción intestinal. El método ideal para el diagnóstico es la tomografía y el tratamiento es con relaparotomía para extraer los coágulos. Es importante el conocimiento de esta entidad para cualquier médico, ya que es una rara complicación en la que se necesita una buena sospecha diagnóstica y un tratamiento oportuno.spa
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dc.language.isospaspa
dc.publisherUniversidad Autónoma de Bucaramanga UNAB
dc.relationhttps://revistas.unab.edu.co/index.php/medunab/article/view/3823/3289
dc.relationHttps://revistas.unab.edu.co/index.php/medunab/article/view/3823/3302
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dc.relation.urihttps://revistas.unab.edu.co/index.php/medunab/article/view/3823
dc.rightsDerechos de autor 2020 MedUNAB
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/
dc.sourceMedUNAB; Vol. 23 Núm. 2 (2020): agosto - noviembre 2020: Cirugía general, Coronavirus, Hemorroides; 294-300
dc.titleCoágulos intraluminales en postoperatorio de una hepaticoyeyunostomía: rara complicación para un rápido actuarspa
dc.title.translatedPostoperative intraluminal blood clots after a hepaticojejunostomy: rare, fast-action complicationeng
dc.publisher.facultyFacultad Ciencias de la Saludspa
dc.publisher.programPregrado Medicinaspa
dc.type.driverinfo:eu-repo/semantics/article
dc.type.localArtículospa
dc.type.coarhttp://purl.org/coar/resource_type/c_6501
dc.subject.keywordsThrombosiseng
dc.subject.keywordsSmall intestineeng
dc.subject.keywordsIntestinal obstructioneng
dc.subject.keywordsGastrectomyeng
dc.subject.keywordsPostoperative periodeng
dc.identifier.instnameinstname:Universidad Autónoma de Bucaramanga UNABspa
dc.type.hasversionInfo:eu-repo/semantics/publishedVersion
dc.type.hasversioninfo:eu-repo/semantics/acceptedVersion
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.relation.referencesShah MM, Rather AA, Khan FA. Acute Bowel Obstruction After Hepaticojejunostomy Caused by Blood Clots. Journal of the society of laparoendoscopic surgeon. 2014;30(2):1-4. https://doi.org/10.4293/CRSLS.2014.00188spa
dc.relation.referencesOhi R, Yaoita S, Kamiyama T, Ibrahim M, Hayashi Y, Chiba T. Surgical treatment of congenital dilatation of the bile duct with special reference to late complications after total excisional op- eration. J Pediatr Surg. 1990;25(1):613-617. https://doi.org/10.1016/0022-3468(90)90346-Bspa
dc.relation.referencesYamataka A, Ohshiro K, Okada Y, et al. Complications after cyst excision with hepaticoenterostomy for choledochal cysts and their surgical management in children versus adults. J Pedi- atr Surg. 1997; 32(2):1097-1102. https://doi.org/10.1016/S0022-3468(97)90407-3spa
dc.relation.referencesLewis CE, Jensen C, Tejirian T, Dutson E, Mehran A. Early jejunojejunostomy obstruction after laparoscopic gastric bypass: case series and treatment algorithm. Surg Obes Relat Dis. 2009;5(2):203-207. https://doi.org/10.1016/j.soard.2008.10.003spa
dc.relation.referencesKoppman JS, Li C, Gandsas A. Small bowel obstruction after laparoscopic Roux-En-Y gastric bypass: a review of 9,527 patients. J Am Coll Surg. 2008;206:571-84. https://doi.org/10.1016/j.jamcollsurg.2007.10.00spa
dc.relation.referencesPazouki A, Pakaneh M, Khalaj A, Tamannaie Z, Jangjoo A, Shapoori P, et al. Blood bezoar causing obstruction after laparoscopic Roux-en-Y gastric bypass. Int J Surg Case Rep [Internet]. Surgical Associates Ltd. 2014;5(4):183-5. https://doi.org/10.1016/j.ijscr.2013.12.022spa
dc.relation.referencesAbbas MA, Collins JM, Olden KW, et al. Spontaneous intra-mural small-bowel hematoma: clinical presentation and long-term outcome. Arch Surg. 2002;137:306-310. https://doi.org/10.1001/archsurg.137.3.306spa
dc.relation.referencesSoricelli E, Facchiano E, Quartararo G, Beltrame B, Leuratti L, Lucchese M. Large Hemobezoar Causing Acute Small Bowel Obstruction After Roux-en-Y Gastric Bypass: Laparoscopic Management. Obes Surg. Obesity Surgery; 2017;27(7):1906-7. https://doi.org/10.1007/s11695-017-2708-4spa
dc.relation.referencesFelsher J, Brodsky J, Brody F. Small bowel obstruction after laparoscopic Roux-en-Y gastric bypass. Surgery. 2003;134(3):501-505. https://doi.org/10.1067/S0039-6060(03)00251-4spa
dc.relation.referencesMcLaughlan J. Fatal false aneurysmal tumour occupying nearly the whole of the duodenum. Lancet 2. 1838:30(766). https://doi.org/10.1016/S0140-6736(02)95675-8spa
dc.subject.lembCiencias de la saludspa
dc.subject.lembMedicinaspa
dc.subject.lembCiencias medicasspa
dc.identifier.repourlrepourl:https://repository.unab.edu.co
dc.description.abstractenglishIntroduction: An intestinal obstruction due to intraluminal blood clots is a postoperative complication that is infrequently reported in literature. We reported the case of a patient with an intestinal obstruction due to postoperative intraluminal blood clots from a Roux-en-Y hepaticojejunostomy. Clinical Case: A 53-year-old male patient appeared with recurring cholangitis secondary to a benign stenosis of the bile duct after a laparoscopic cholecystectomy performed 2 years prior. Treatment with an endoprosthesis by endoscopic retrograde cholangiopancreatography (ERCP) did not improve cholangitis episodes, for which reason transition to reconstruction by hepaticojejunostomy was considered. He showed signs of intestinal obstruction during early postoperative care. The computed tomography (CT) scan of the abdomen with contrast showed free fluid and signs of obstruction. The patient was taken to an emergency surgery, where the Roux-en-Y anastomosis was found to be obstructed by a large intraluminal blood clot. It required an enterotomy to be extracted. Discussion: A postoperative intestinal obstruction secondary to intraluminal blood clots is unusual, but must be suspected in patients with symptoms of intestinal obstruction. The ideal method for diagnosis is by tomography and treatment involves a relaparotomy to extract the blood clots. It is important for doctors to have knowledge of this condition, since it is a rare complication that requires good diagnostic insight and timely treatment.eng
dc.subject.proposalTrombosisspa
dc.subject.proposalIntestino delgadospa
dc.subject.proposalObstrucción intestinalspa
dc.subject.proposalGastrectomíaspa
dc.subject.proposalPeriodo posoperatoriospa
dc.identifier.doi10.29375/01237047.3823
dc.type.redcolhttp://purl.org/redcol/resource_type/ART
dc.rights.creativecommonsAtribución-NoComercial-SinDerivadas 2.5 Colombia*


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