RESUMEN
We report a case of bowel perforation after the accomplishment of a radical prostatectomy, the secondary complications to the peritonitis and the resolution of the same ones.
Asunto(s)
Adenocarcinoma/cirugía , Colon Sigmoide/lesiones , Perforación Intestinal/etiología , Prostatectomía/efectos adversos , Neoplasias de la Próstata/cirugía , Anciano , Humanos , MasculinoRESUMEN
Presentamos un caso clínico en el que un paciente presentó una perforación intestinal intraperitoneal tras la realización de un prostatectomía radical, las complicaciones secundarias a la peritonitis fecaloidea y la resolución de las mismas (AU)
We report a case of bowel perforation after the accomplishment of a radical prostatectomy, the secondary complications to the peritonitis and the resolution of the same ones (AU)
Asunto(s)
Humanos , Masculino , Anciano , Neoplasias de la Próstata/patología , Prostatectomía/métodos , Fístula Urinaria/complicaciones , Fístula Urinaria/cirugía , Perforación Intestinal/complicaciones , Peritonitis/complicaciones , Colostomía/métodosRESUMEN
INTRODUCTION: The Mirizzi Syndrome (MS) is a rare variation of cholelitiasis, in which a calculus impacted in the Hartmann Pouch compresses the biliary pathway triggering an obstructive jaundice, frequently followed by inflammatory phenomenon and a number of complications. OBJECTIVE: To establish the frequency of the Mirizzi Syndrome in complicated cholelitiasis in the elderly patient and analyze the most suitable diagnosis and treatment options. PATIENTS AND METHOD: Cases of Mirizzi Syndromes in symptomatic inflammatory biliary lithiasis were selected in a five-year period among patients older than 70, who had undergone urgent operation. Epidemiology, private hospital, diagnosis, operating variables, morbility and hospitalization were analyzed. RESULTS: Twelve (12) patients with Mirizzi Syndrome were detected, with an average age of 77.2 in 197 cases of complicated cholelitiasis. A laparoscopic examination was made in 67% of the cases, with a conversion rate of 50%. The most frequent finding was the biliary extrinsic compression without Csendes-I fistula (58%). The postsurgical morbility was of 58%, including two deaths (17%) and the medium-term postoperative hospital stay was of 9.5 days. CONCLUSIONS: This research emphasizes the importance of the Mirizzi Syndrome (MS) in the symptomatic cholelitiasis in geriatric patients. This syndrome usually acts like a biliar surgical emergency and the early diagnosis of an elderly patient with jaundice is the key that enables immediate biliary decompression through a cholecystectomy. Management choices are in debate; however, due to its advantages in cases of elderly patients, a laparoscopic treatment is proposed, unless strictly contraindicated.