REPÚBLICA BOLIVARIANA DE VENEZUELA MINISTERIO DEL PODER POPULAR PARA LA DEFENSA HOSPITAL MILITAR “DR. CARLOS ARVELO” UNIVERSIDAD NACIONAL EXPERIMENTAL EXPERIMENTAL DE LOS LLANOS CENTRALES “RÓMULO GALLEGOS” CLÍNICA QUIRÚRGICA III
PATOLOGÍA PANCREÁTICA
Autora: Euk!"# Z$!% C.I& '(.()'.*+( +,- A- /$ M$/"0"1
Facilitador: B2# C3041 C!0#5 67- 8*'9
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Te$t E$'ec"fico de La(oratorio: Hiperamilasemia:
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Te$t Radiol!ico:
Radiografía Abdominal: E1 u1 R /$ =/-6$15 $"#,$ 2- @u$ #$
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La Ultrasonografía: D$,$!6"1& P;10!$# !1/$ $/$6,-#- 7 !$>$2
u1 ;!$ #-1-2u0$1,$ !$2,"> 2 2u! /-1/$ $#,; $2 $/$6 - %#$u/-@u"#,$. E# 6;# #$1#"=2$ @u$ 2 TAC $1 "/$1,":"0! 2 $1:$!6$// 2",";#"0 7 $# u#/ $1 2 $>2u0"<1 "1"0"2 /$ %0"$1,$# 0-1 %10!$,","# u/ Tomografía Axial Computarizada (TAC: L TAC $# $2 6$-! ,$#, 1-
"1>#">- @u$ /$,$!6"1 2-# 06="-# 6-!:-2<"0-# $1 2 %10!$,","# u/. E#,-# 06="-# "102u7$1 $1#1036"$1,- 7 u1 "6$1 1- 3-6-$1$ /$2 %;10!$#. C6="-# $1 2 !$"<1 %$!"%10!$;,"0 #u$#,"> /$ "1:260"<1 7 0u6u20"<1 /$ 24@u"/-#. L "17$00"<1 !;%"/ /$ =-2-# /$ 0-1,!#,$ /u!1,$ 2 T-6-!:4 C-6%u,!"?/ %u$/$ $#,=2$0$! 2 "1,$!"// /$ 2 6"0!-0"!0u20"<1 $1 $2 %;10!$#. H-7 #$ 0$%, @u$ $# $2 6,-/- $#,;1/! /$ /"1<#,"0- 7 /$ $>2u0"<1 %! 0-1-0$! $2 !/- /$ N$0!-#"#5 $# 2 TAC 0-1 0-1,!#,$ 0-1 u1 $#%$0":"0"// /$ 6;# /$2 * #$1 2 02#":"00"<1 /$ B2,3?! J!/ AEK5 @u$ !$>$2 2 !>$// /$ 2 2$#"<1 %10!$;,"0. Clasifi!a!i"n de la #an!reatitis (Atlanta $%%&:
'. P10!$,","# Au/ G!>$5 0u1/- $#,; #-0"/ :22# 6u2,"-!;1"0# - 0-6%2"00"-1$# 2-02$# !$%!$#$1,1 $2 '* 2 8* /$ ,-/# 2# %10!$,","# u/#. 8. P10!$,","# 2$>$5 %-! 2$#"-1$# %!$1@u"12$# /$ 0-!, $>-2u0"<1. Clasifi!a!i"n Clíni!o #atol"gi!a (Atlanta $%%&:
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A=#0$#-# %10!$;,"0-# JAPK.
Colangio #an!reatografía Retr"grada Endos!"pi!a (C#RE: E# u1
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Dia!n$tico Diferencial: S$ /$=$ !$2"?! $1 ,-/- /-2-! =/-6"12 #$>$!- @u$ 0u# 6!0/"10!$6$1,- /$ 2 6"2# #!"0. L-# %!"10"%2$# /"1<#,"0-# /":$!$10"2$# #-1& '. Ú20$! /u-/$12 %$!:-!/5 - %$!:-!0"<1 /$ -,!# >4#0$!#. 8. C-2$#0"#,","# u/5 "u2 @u$ 2 20$! /u-/$125 %u$/$ #$! 0-6%/ /$ %10!$,","# u/. . I#@u$6" 6$#$1,!"0 7 -=#,!u00"<1 "1,$#,"12. ). I1:!,- /$ 6"-0!/"-5 %u$/$ /$,$!6"1! u1 #$>$!- /-2-! =/-6"125 %$!- 2 6"2#$6" 1- $#,; u6$1,/. 9. P0"$1,$ 0-1 1$u6-145 %u$/$ %!$#$1,! #$>$!- /-2-! =/-6"12 7 :"$=!$. 6.
L 60!-6"2#$6" $# u1 0-1/"0"<1 $1 2 0u2 $2 1">$2 /$ 6"2# #!"0 ,"$1$ u1 !1- '* >$0$# 67-! /$ 2- 1-!62 7 %u$/$ #$! /$#0u="$!, /u!1,$ u1 $>-2u0"<1 /$ /-2-! =/-6"12 "1,$!6",$1,$. L 60!-6"2#$6" $#,; :-!6/ %-! 2 u1"<1 /$ u1 6"2# 1-!62 /$ 2,- %$#- 6-2$0u2!. E#, 0-6%2$ 6-20u2 1- $# :"2,!/ %-! $2 2<6$!u2- $2 %-!0$1,$ /$ 02$!$10$ /$ 6"2# 7 0!$,"1"1 $# 6!0/6$1,$ !$/u0"/ J'K.
Paracente$i$ Peritoneal: E2 0-2-!5 2 02"// 7 -,!-# 0!0,$!$# -=,$1"/-# /$2 24@u"/- %$!",-1$2 %-! %u10"<1 %$!",-1$25 31 #"/- %!0,"0/-# %-! u1 !u%- /$ I12,$!!. E2 322?- /$ u1 :2u"/- =!u1-5 "1/"0 2 %!$#$10" /$ u1 #$>$! %10!$,","# 3$6-!!;"0.
Te$t S)rico: V!"# %!-,$41# 0-6- 2 6$,2=6"15 2 2: 8 60!-2-=u2"15 2 :-#:-2"%# A85 2 $2#,#5 2 2: '1,",!"%#"1 0-6%2$6$1,- 7 2 P!-,$41 C R$0,">5 31 #"/- $#,u/"/# $,$1#6$1,$ 7 /$,$!6"11 #$! u1 =u$1 "1/"0/-! %!-1<#,"0-. L P!-,$41 C !$0,"> 1- %!$0$ 1,$# /$2 8/-. /4 /$ 3-#%",2"?0"<1.
Co*'licacione$: Locale$ + $i$t)*ica$, Compli!a!iones 'istmi!as: •
S&oc-: E2 /$#!!-22- /$ u1 #3-0k %!$0-? $1 %10!$,","# u/ $# $2 67-! :0,-! /$ !"$#- /$ 6u$!,$. E2 #$0u$#,!- /$ u1 $1-!6$ >-2u6$1 /$ 24@u"/-# $1 $2 $#%0"- %$!"%10!$;,"0-5 2 3$6-!!" 7 2 /"#6"1u0"<1 #$>$! /$ 2 !$#"#,$10" >#0u2! %$!":!"05 0-1,!"=u7$1 2 #$>$!"// /$2 #3-0k 3"%$!>-26"0-.
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.i'o/ia: P!$#$1,$ $1 $2 9 /$ %0"$1,$# 0-1 %10!$,","# 7 /$ $#,-# $2 * ,"$1$ :22 !$#%"!,-!". H7 /$!!6$ %2$u!25 @u$ ,"$1$ 2,- 1">$2 /$ 6"2#. L 6;# #$!" 0-6%2"00"<1 $# $2 D"#,!$# R$#%"!,-!"- JARDSK 7 #$ $10u$1,! $1 $2 8* /$ %0"$1,$# 0-1 #$>$! %10!$,","#.
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Falla Renal: O0u!!$ $1 $2 89 /$ %0"$1,$# 0-1 #$>$! %10!$,","#. L /";2"#"# 1- $# 0-616$1,$ !$@u$!"/5 %$!- 2 6-!,2"// $# /$ 9*.
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.e*orra!ia Ga$trointe$tinal: E#,; %!$#$1,$ $1 ) 2 /$ %0"$1,$# 0-1 #$>$! %10!$,","#. L 0-u20"<1 "1,!>#0u2! /"#$6"1/ JDICK %u$/$ !>! $2 %!-=2$6 3$6-!!;"0-.
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Ca*(io$ 0eta(lico$: H"%-020$6"5 3"%$!2"0$6" $ 3"%$! ,!"2"0$!"/$6" #-1 0-6u1$#. L 3"%$!2"%"/$6" 1- $# 62 %!-1<#,"0-.
Compli!a!iones Lo!ales:
E2 >10$ 7 $2 "10!$6$1,- /$2 u#- /$ 2 T.C. 3 #"/- /$ 7u/ $1 /$:"1"! 2# 0-6%2"00"-1$# %10!$;,"0# $1 $2 0u!#- /$ u1 %10!$,","# u/& •
F-!60"<1 /$ P#$u/-@u"#,$ -0u!!$ /$2 '* '9 /$ %0"$1,$# 0-1 %10!$,","# 2-# @u"#,$# %u$/$1 $#,! $1 $2 0u$!%- /$2 %;10!$#5 $1 $2 -6$1,- 6$1-! J0>"// !$,!-%$!",-1$2K 7 $#%0"- %$!"!!$12.
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Trata*iento: P0"$1,$ 0-1 %10!$,","#5 #$ %u$/$ !$0u%$!! !;%"/6$1,$. E2 #-%-!,$ 7 $2 6-1",-!$- /$2 /$#!!-22- /$ 6u03# 0-6%2"00"-1$# #-1 $2 %!"10"%2 :-0/$ u1 %21 "1"0"2 /$ ,!,6"$1,-&
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