RESUMO
Splenic vessel aneurysm is often a casual pathology during strumental imaging or laparotomy. The first cause for the formation of the aneurysm is a vessel primitive degenerative pathology of the medium wall, or idiopathic cystic medionecrosis, that to develop in aneurysmatic dissection. In the early diagnosis, in the selective patients, resulted indicate an endovascular therapy, while in emergency the laparotomy is a gold strandard for reduction morbility and mortality. In this paper, the Authors described a rare case of rupture of the lienal vessel aneurysm in Erdheim disease, and reported clinical features, indications and procedures for better treatment.
Assuntos
Aneurisma Roto/etiologia , Aneurisma/etiologia , Aneurisma/cirurgia , Doença de Erdheim-Chester/complicações , Esplenectomia , Artéria Esplênica , Esplenopatias/etiologia , Adulto , Aneurisma/diagnóstico , Aneurisma Roto/diagnóstico , Aneurisma Roto/cirurgia , Humanos , Masculino , Pancreatectomia/métodos , Ruptura Espontânea , Esplenopatias/diagnóstico , Esplenopatias/cirurgia , Resultado do Tratamento , Procedimentos Cirúrgicos VascularesRESUMO
The AA report on 12 cases of intestinal infarction for acute mesenteric ischemia (IMA) in critical patients observed in the last 2 years. In this work some clinical data, blood tests and strumental considerations are described. IMA is a vascular emergency with severe prognosis and high rate morbidity and mortality, often correlated to a diagnostic delay. The discrepancy between symptoms and clinical objectivity must suggest the suspect, especially in patients with cardiac pathology, short lasting diarrhoea, bowel hemorrhage or only abdominal pain rebel to the analgesics; with the laboratory indexes and strumental data it can be carried out an early diagnosis and then begin the more opportune therapeutical treatment. The increase of blood sugar together to the triad leucocytosis--haemoconcentration and metabolic acidosis, in previously non diabetic patients, confirm the suspect of IMA in the very initial phases of this pathology.
Assuntos
Colo/irrigação sanguínea , Íleo/irrigação sanguínea , Infarto/diagnóstico , Acidose/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Diagnóstico Precoce , Feminino , Hematócrito , Humanos , Infarto/sangue , Infarto/etiologia , Infarto/mortalidade , Infarto/cirurgia , Isquemia/sangue , Isquemia/complicações , Isquemia/diagnóstico , Isquemia/mortalidade , Isquemia/cirurgia , Leucocitose/sangue , Masculino , Isquemia Mesentérica , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Doenças Vasculares/sangue , Doenças Vasculares/complicações , Doenças Vasculares/diagnóstico , Doenças Vasculares/mortalidade , Doenças Vasculares/cirurgiaRESUMO
The AA report some considerations on the treatment and surgical approach during acute mesenteric ischemia (IMA) focusing some indications for a timely and suitable therapeutic approach. In the last 2 years, they treated 12 cases of IMA in critical patients. Early identification allows avoiding advanced phases of the intestinal infarct/bowel necrosis; in this phase the multidisciplinary approach for the hemodynamic stabilization is a priority, together with rianimatory support and surgery operation. The preservation of the intestinal vitality is essential to avoid the need of bowel resections or at least a major one. A suitable treatment permits a better survival and improvement of the quality of life. Surgical timing requires the intervention within 12 hours since the beginning of the symptoms to be more efficacious.