RESUMEN
In recent years we have observed in our country an increase in complications associated with bacterial pneumonia, such as pleural effusion and empyema. The initial treatment is an association of antibiotics, covering the potential germ involved, and the placement of a pleural drainage tube, in order to accelerate the resolution process. Formation of septa within the pleural cavity requires additional therapy (antifibrinolytic treatment, videothorascopy), but no one of these two alternatives is been demonstrated better than the other. We present a review that covers last 15 years (1990-2006), related to management of empyema. The management strategy with initial instillation of antifibrinolytic intrapleural makes our series the longest in our country using such treatment (30 of 50 patients reviewed (60) were treated with this technique). Initial success was 96% with this modality, without rescuing surgery. There is also a descriptive analysis of several clinical, laboratory and radiological parameters. In comparative analysis, length of stay in intensive care unit decreases in those patients treated with antifibrinolytics. This result is a prove of the efficacy of this treatment, and quite encourageing.
Asunto(s)
Empiema Pleural/tratamiento farmacológico , Fibrinolíticos/uso terapéutico , Activador de Plasminógeno de Tipo Uroquinasa/uso terapéutico , Adolescente , Antifibrinolíticos/uso terapéutico , Niño , Preescolar , Empiema Pleural/etiología , Femenino , Humanos , Lactante , Masculino , Derrame Pleural/complicaciones , Estudios RetrospectivosRESUMEN
Bile leaks are a rare complication secondary to closed liver trauma. The diagnosis is usually late, which increases the morbidity and hospital stay. We report a case of biloma secondary to severe liver injury, including a description of the diagnosis and management. We also describe the different types of bile leaks, the techniques of early diagnosis and various treatment modalities existing for this type of injury.