Date ticket, Name: ZAHRA Sex: M Prename: FAWAZ Age: 61 Date of admittance : 09/09/2011 30/09/2011 Diagnosis date: Post

neo colon fistula anastomotica stang operated (spleen hydatic angle) – 17.08.2011. Cataracts both eyes. EPICRIZA Patient in the age of 61 years, operated in Syria, Damascus, on 17.08 for neo angle spleen hydatic colonic stenozat, Occlusive, for which he has been colectomie type Hartman, over 10 days later, restored on 27.08 digestive continuity by colo-coloanstomosis T-T, with the unfavourable evolution of postoperative, followed by the appearance of postoperative bleeding in day 4 of a under fistula, treated conservatively (antibiotic – Tienam + Targocid, nutirite total parental), it is internee for investigations and specialty treatment. At the time of ICU clinical examination reveals thin abdomen, mobile, painless, no peritoneal signs of irritation, vomit or nauseous, hemodynamic and cardiopulmonary balanced, this presents an under fistula, expressing a routed drainage of approximately 400-500 ml fecaloid. Internment of analyses: eosinophils = 10600/mm3, Na=129,3 mmol/l, corn syrup=143 mg/dl, the remaining tests in the normal range. CT exam: ticken abnormal cloggy at the level of anastomosis and a fine infiltration of the fat tissue its adjacent; without fluid collections or abdominothoracic expansive processes. Wound ulcer secretion: Spp. Proteus (sensitive at Tazocin, Cefuroxime, Imipenem, Meropenem, Sulperazona) and Escherichia Coli ( sensitive at Tazonin, Imipenem, Meropenem, Sulperazona). Opens the conservative treatment of the under fistula (electrolit rebalancing, antibiotics – Tazonin + Targocid, parental nutritional support, prokinetics, analgesics) whit slow favorable evolution, with the improvement of general condition, resume digestive tolerance and intestinal transit, normalization of biological constants with a progressive decrease of the fecaloid drainage, suppression of bottled dren but with a persistence minimal fecaloid drainage (are opting for conservative treatment, with a local daily toilet of the ulcer and with a fecaloid drainage lead into a colon badge. CT exam (25.09): „zona de ingrosare a mucoasei anstomozei post operatorii, fara colectii constituite locale sau intraperitoneale”. Recommendations: -avoid physical efforts big 1 year -igieno-dietary regim according to the indications -treatment in accordance with Rp

Returns to the restroom and changing the ulcer dressing according to the indications -Returns to check him over a month .Specialized consult Oncology in order to establish the therapeutic conduct ..

ct examination with contrast substance not being pathological pulmonary masses. hilarious or Mediastinal widening .

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