RESUMO
Se presenta la aplicación y uso del ultrasonido intravascular, efectuado en los primeros cuatro pacientes en nuestra institución; dos de ellos con lesión arterial coronaria, uno en arteria periférica y un paciente a quien se efectuó revisión de una derivación portosistemica intrahepática por vía yugular (TIPS). Se plantea la alternativa diagnóstica del ultrasonido intravascular, para valorar las características de la pared vascular, los sitios estenóticos, así como componentes de la estenosis, presentando algunas imagenes características
Assuntos
Humanos , Ultrassom , Ultrassonografia , Ultrassonografia/instrumentação , Doença das Coronárias/diagnóstico , Doença das CoronáriasRESUMO
Transjugular intrahepatic portosystemic shunt-stent (TIPS) was performed in 5 patients with cirrhosis and portal hypertension. Bleeding varices occurred in 4 patients and refractory ascites in one. We used 2 Wallstents and 3 Strecker stents. Shunt patency, recurrent variceal hemorrhage and ascites were evaluated. The shunts were created from a transjugular approach between the hepatic and portal vein, with diameters of 10 mm. Portal pressure was adequately decreased in all cases. The hospital stay, following TIPS was 3 days. Complete variceal decompression was identified endoscopically in 3 patients, and partial in one. Four shunts were patent by ultrasound and color Doppler at 1 to 6 months of follow up. One patient presented encephalopathy and one died at third day after TIPS. Initial results suggest that TIPS is an effective method of portal decompression for treatment of variceal hemorrhage and refractory ascites. The main complication was encephalopathy and only one patient died.
Assuntos
Hipertensão Portal/cirurgia , Derivação Portossistêmica Cirúrgica/métodos , Adulto , Idoso , Ascite/etiologia , Ascite/cirurgia , Procedimentos Cirúrgicos Eletivos , Varizes Esofágicas e Gástricas/etiologia , Varizes Esofágicas e Gástricas/cirurgia , Feminino , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/cirurgia , Humanos , Hipertensão Portal/complicações , Cirrose Hepática/complicações , Cirrose Hepática/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , StentsRESUMO
Subphrenic abscess is a rare complication of amebic liver abscess, its diagnosis and treatment are problematic. We present one patient with a right subphrenic abscess secondary to amebiasis. Treatment with chloramphenicol and percutaneous drainage had good response. Radiological intervention is an option in treatment of this kind of complication.
