Ecografia interventionala in drenajul colectiilor abdominale
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Transcript of Ecografia interventionala in drenajul colectiilor abdominale
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ECOGRAFIA ECOGRAFIA INTERVENTIONALAINTERVENTIONALA
IN COLECTIILE ABDOMINALEIN COLECTIILE ABDOMINALE
Andritoiu A, Mercut D, Silosi C, Resceanu Aurelia, Spitalul Clinic de Urgenta MilitarSpitalul Clinic de Urgenta Militar ,,Dr. Stefan Odobleja,, Craiova
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DefinitieDefinitie
Manevre invazive efectuate sub ghidaj US, in scop de DIAGNOSTIC si/sau TERAPEUTIC
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US interventionalaUS interventionala
• Punctie/biopsie • Drenaje percutane
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Drenajul percutan Drenajul percutan in colectiile in colectiile abdominaleabdominale
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TehnicaTehnica
• Truse de drenaj
• Abord pecutan ghidat US, CT
• Scop diagnostic
• Evacuator
• Terapeutic
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IndicatiiIndicatii
• Abces subfrenic
• Pseudochist pancreas
• Abces hepatic
• Chist hepatic simptomatic
• Chist hidatic
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Caz clinicCaz clinic
• CR, B, 41 ani
• Stenoza pilorica operata-complicata cu fistula de bont - sepsis
• US – colectie neomogena interhepato-diafragmatic
• Drenajul percutana al colectiei (ghidaj US)
• Culturi : E Coli
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Colectie Colectie abdominala abdominala
post-pancreatitapost-pancreatita
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Caz clinicCaz clinic
• CM, B, 38 ani
• Dureri abdominale difuze
• Febra
• Stare generala alterata (sepsis)
• Abuz recent de alcool
• US/CT abdomen: colectie transonica in bisac pe ambele flancuri
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Plan terapeuticPlan terapeutic
ABORD CHIRURGICAL• Lombotomie dr• Drenaj• Ineficient
ABORD ECHO-INTERVENTIONAL
• Eco-2D• Punctie aspirativa ac fin• 21 G• Eficient !!!
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Pseudochist pancreas - drenajPseudochist pancreas - drenaj
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Peritonita biliara Peritonita biliara prin perforatie prin perforatie
colecisticacolecistica
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• C I, M, 48 ani
• Clinic: durere intensa, socogena in hipocondrul drept cu iradiere in umarul drept
• APP: limfom gastric operat (gastrectomie totala) in ultimile 6 luni
Caz clinicCaz clinic
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Colectie interhepato-diafragmatica Colecist perforat, mulat pe calculi
US
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Insertia trocarului sub ghidaj ecografic
Bila drenata in exces din cavitatea peritoneala
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CONCLUZIE
Manevrele interventionale efectuate sub ghidaj imagistic confera un plus de siguranta si eficienta in diagnosticul si drenajul colectiilor abdominale