{"id":553,"date":"2015-08-11T19:02:31","date_gmt":"2015-08-11T19:02:31","guid":{"rendered":"https:\/\/sred.ro\/?p=553"},"modified":"2022-01-18T13:06:05","modified_gmt":"2022-01-18T13:06:05","slug":"aspect-colonoscopic-neobisnuit-intr-un-caz-de-ocluzie-de-vena-mezenterica-inferioara-asociata-cu-ciroza","status":"publish","type":"post","link":"https:\/\/sred.ro\/en\/aspect-colonoscopic-neobisnuit-intr-un-caz-de-ocluzie-de-vena-mezenterica-inferioara-asociata-cu-ciroza\/","title":{"rendered":"Unusual colonoscopy features in a patient with inferior mezenteric vein oclusion and liver cirrhosis"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row][vc_column][vc_column_text]\u00cen serviciul nostru s-a prezentat un b\u0103rbat \u00een v\u00e2rst\u0103 de 54 de ani, cu ciroz\u0103 etanolic\u0103 clasa Child A, acuz\u00e2nd dureri abdominale debutate brusc, insotite de febr\u0103 38oC \u0219i absen\u021ba tranzitului intestinal, simptome instalate de aproximativ 3 zile. La prezentare, se palpa o mas\u0103 tumoral\u0103 de consisten\u021b\u0103 crescut\u0103 \u00een zona de proiec\u021bie a colonul sigmoid, cre\u0219terea transaminazelor la nivel dublu fa\u021b\u0103 de valorile normale, absen\u021ba anemiei si leucocitozei, PCR de valori normale, coagulograma f\u0103r\u0103 modific\u0103ri. Radiografia abdominal\u0103 pe gol a decelat multiple nivele hidroaerice cu distensia suprajacent\u0103 a colonului ascendent \u0219i transvers. AngioCT-ul abdominal a vizualizat vase mezenterice patente, \u00eengro\u0219area peretelui sigmoidian \u0219i infiltrarea mezenterului. Rectosigmoidoscopia a decelat mucoas\u0103 sigmoidian\u0103 \u00eengro\u0219at\u0103 de culoare alb\u0103struie, f\u0103r\u0103 ulcera\u021bii sau eroziuni \u0219i pierderea elasticit\u0103\u021bii la insufla\u021bie sau biopsie, similar aspectului infiltrativ. Pe biopsie nu au fost eviden\u021biate modific\u0103ri ischemice ale mucoasei sau infiltrate inflamatorii. Lu\u00e2nd \u00een considerare posibilitatea unei etiologii ischemice, s-a ini\u021biat terapia anticoagulant\u0103 \u0219i antibiotic\u0103, dar simptomele au persistat. Din acest motiv s-a efectuat laparotomie cu hemicolectomie st\u00e2ng\u0103, care a ar\u0103tat tromboz\u0103 venoas\u0103 mezenteric\u0103 la nivelul vaselor mici, asociate cu infarct colonic, elemente confirmate la examenul anatomopatologic . Bilan\u021bul de trombofilie a fost negativ. Evolu\u021bia pacientului a fost favorabil\u0103, acesta prezent\u00e2ndu-se la control dup\u0103 3 luni.[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text]<\/p>\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" title=\"YouTube video player\" src=\"https:\/\/www.youtube.com\/embed\/RdnEkDMPdd4\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>[vc_row][vc_column][vc_column_text]\u00cen serviciul nostru s-a prezentat un b\u0103rbat \u00een v\u00e2rst\u0103 de 54 de ani, cu ciroz\u0103 etanolic\u0103 clasa Child A, acuz\u00e2nd dureri abdominale debutate brusc, insotite de febr\u0103 38oC \u0219i absen\u021ba tranzitului intestinal, simptome instalate de aproximativ 3 zile. La prezentare, se palpa o mas\u0103 tumoral\u0103 de consisten\u021b\u0103 crescut\u0103 \u00een zona de proiec\u021bie a colonul sigmoid, [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":554,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[26],"tags":[],"class_list":["post-553","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-cazul-lunii"],"featured_image_src":{"landsacpe":["https:\/\/sred.ro\/wp-content\/uploads\/2021\/11\/screen-848x445.jpg",848,445,true],"list":["https:\/\/sred.ro\/wp-content\/uploads\/2021\/11\/screen-463x348.jpg",463,348,true],"medium":["https:\/\/sred.ro\/wp-content\/uploads\/2021\/11\/screen-300x169.jpg",300,169,true],"full":["https:\/\/sred.ro\/wp-content\/uploads\/2021\/11\/screen.jpg",848,478,false]},"_links":{"self":[{"href":"https:\/\/sred.ro\/en\/wp-json\/wp\/v2\/posts\/553","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/sred.ro\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/sred.ro\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/sred.ro\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/sred.ro\/en\/wp-json\/wp\/v2\/comments?post=553"}],"version-history":[{"count":2,"href":"https:\/\/sred.ro\/en\/wp-json\/wp\/v2\/posts\/553\/revisions"}],"predecessor-version":[{"id":688,"href":"https:\/\/sred.ro\/en\/wp-json\/wp\/v2\/posts\/553\/revisions\/688"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/sred.ro\/en\/wp-json\/wp\/v2\/media\/554"}],"wp:attachment":[{"href":"https:\/\/sred.ro\/en\/wp-json\/wp\/v2\/media?parent=553"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/sred.ro\/en\/wp-json\/wp\/v2\/categories?post=553"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/sred.ro\/en\/wp-json\/wp\/v2\/tags?post=553"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}