ABSTRACT
BACKGROUND: Blunt pancreatic injuries occur when a high-energy crushing force is applied to the upper abdomen. In adults, the majority of blunt pancreatic injuries result from motor vehicle accidents. CASE REPORT: Male with 32 years old had a high-energy crushing history in witch he was pressured by the chest on the front car area. His life signs demonstrated to be regular. Ct scan demonstrated body pancreatic edema. All routine laboratorial exams were normal, EUS revealed pancreatic lesion grade II without involvement of the pancreatic duct and an impressive superior mesenteric vein thrombosis. He was sustained by means of anti- coagulation for about two months and after that time the multislice CT scan showed a mesenteric vein recanalization and a normal pancreatic parenchyma. The patient had an uneventfull follow-up. CONCLUSION: Patients presenting possible pancreatic trauma associated to superior mesenteric vein thrombosis, EUS must be used firstly.
INTRODUÇÃO: Traumas pancreáticos fechados ocorrem em acidentes que promovem força intensa no abdome superior, principalmente em acidentes automobilísticos. RELATO DO CASO: Homem de 32 anos foi jogado contra a área frontal de seu automóvel. Seus sinais vitais eram normais. CT mostrou edema pancreático. EUS mostrou lesão pancreática grau II sem envolvimento do ducto pancreático, mas com impressionante trombose da veia mesentérica superior. Ele foi mantido com anticoagulants por dois meses e após este period novo scan mostrou recanalização e pâncreas normal. Teve seguimento favorável. CONCLUSÃO: Paciente apresentando edema pancreático associado a possível trombose de veia mesentérica superior deve ser submetido à EUS para monitorização e acompanhamento.
ABSTRACT
El tromboembolismo venoso es una patología que ocurre aproximadamente en 1 de cada 1 000 personas en el mundo, de las cuales más de la mitad corresponde a casos de trombosis venosa profunda. La principal complicación aguda de la trombosis venosa profunda es el embolismo pulmonar, que resulta fatal en 20%-30% de los casos. La anticoagulación es la estrategia más eficaz para la prevención de esta complicación, sin embargo, está contraindicada en situaciones frecuentes. Los filtros de vena cava inferior constituyen una alternativa no farmacológica para la prevención del embolismo pulmonar en aquellos pacientes que presentan trombosis venosa profunda. Este artículo hace revisión de los aspectos históricos de estos dispositivos, con especial interés en los denominados filtros recuperables, en cuanto a sus indicaciones, técnica de colocación-retiro, eficacia y seguridad
Venous thromboembolism is a disease which occurs in 1 out of 1000 people around the world, accounting for about a half of cases of deep venous thrombosis. Deep venous thrombosis major complication is pulmonary embolism, fatal in 20%-30% of cases. Anticoagulation is the most effective strategy to prevent pulmonary embolism, however, this is contraindicated in frequent clinical situations. Inferior vena cava filters are a non-pharmacological alternative in these cases. This article reviews historical aspects of these devices, with particular interest in those denominated retrievable filters, describing indications, implantation-retrieval technique, efficacy and safety
Subject(s)
Pulmonary Embolism/surgery , Pulmonary Embolism/pathology , Pulmonary Embolism/therapy , Vena Cava Filters/trends , Disease Prevention , Device Removal/methodsABSTRACT
El tromboembolismo pulmonar (TEP) es un problema muy frecuente, además de muy grave, siendo una causa importante de mortalidad. Un 30% son mortales en ausencia de diagnóstico y tratamiento. Probablemente se trata del problema médico grave que más frecuentemente se queda sin diagnosticar.Se narra un caso de tromboembolismo pulmonar en presencia de varios factores de riesgo: intervención quirúrgica, inmovilización prolongada por reposo en cama, además de una miocardiopatía dilatada de fondo, sin que se haya realizado una profilaxis adecuada. Se realiza una revisión bibliográfica resaltándose la importancia de la profilaxis ante la presencia de uno o más factores de riesgo, para disminuir su incidencia.
Lung thromboembolism (TEP) is a very frequent problem, besides being dangerous, it is potentially lethal. 30% are mortal in absence of a diagnosis and treatment. It is probably the more serious medical condition frequently underdiagnosed. We present a case of lung thromboembolism involving several risk factors: surgical intervention, prolonged inmovilization, besides an extensive underlying dilated miocardiopathy, without having received an appropriate prevention. A bibliographical review was carried out, pointing out the importance of prevention in regards to the presence of one or more risk factors, in order to diminish their incidence.