Colograma distal en pacientes pediátricos con ano imperforado para valoración de posibles fístulas post-operatorias trabajo a realizar en pacientes pediátricos con ano imperforado en el Hospital de Niños Dr. Roberto Gilbert Elizalde
Fecha
2014
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Tecnología Médica
Resumen
Hoy en día es cada vez más frecuente en hospitales pediátricos la presencia de pacientes quirúrgicos digestivos. El espectro de las malformaciones anorrectales es muy amplio y variado. Puede haber defectos casi imperceptibles, que sólo una detenida y minuciosa inspección del área genital y perineal, permitirá identificarlos; por otro lado hay defectos evidentes a simple vista. Para valorar el tracto digestivo inferior es necesario realizar técnicas de imágenes que nos permita valorar u observar el grado de la malformación. Un estudio de mucha ayuda al momento de tomar una decisión de tipo quirúrgico es el invertograma. El invertograma es el estudio que se realiza en pacientes recién nacidos en el cual no se evidencias fistulas rectal de ningún tipo o locación Si el invertograma reporta una distancia mayor a 1cm entre los dos cabos se realiza la colostomía; si la distancia entre ambos cabos es menor de 1cm, se puede realizar anoplastia o un descenso sagital posterior limitado En caso de que existan presencia de fistulas se realiza un colograma distal que consiste en inyectar medio de contraste hidrosoluble a presión, a través del cabo distal de la colostomía para demostrar la parte más distal del recto y su relación con el tracto urinario o descartar presencia de fístula recto-uretral con pasaje de contraste a vejiga y uretra en el caso de que existiera una fistula. Con este trabajo se quiere aportar conocimientos acerca de cómo se realiza esta técnica colograma distal su utilidad beneficios e importancia antes y después de un procedimiento quirúrgico. Este documento será un grano de arena, que será transmitido a los futuros licenciados. Este método o técnica es de importancia, su utilización adecuada puede ayudar a mejorar el estado del paciente. Cuando un paciente no se le puede administrar medio de contraste yodados es útil la administración de medio de contraste hidrosoluble utilizados en esta técnica.
Nowadays, the presence of digestive surgical patients is becoming more frequent in pediatric hospitals. The spectrum of anorectal malformations is very wide and varied. There may be almost imperceptible defects, which only a careful and thorough inspection of the genital and perineal area will allow to identify them; On the other hand there are obvious defects at a glance. To assess the lower digestive tract, it is necessary to perform imaging techniques that allow us to assess or observe the degree of the malformation. A very helpful study when making a surgical decision is the invertogram. The invertogram is the study performed in newborn patients in which there is no evidence of rectal fistulas of any type or location. If the invertogram reports a distance greater than 1cm between the two ends, the colostomy is performed; If the distance between the two ends is less than 1cm, anoplasty or a limited posterior sagittal descent can be performed. If a fistula is present, a distal cologram is performed, which involves injecting water-soluble contrast medium under pressure through the distal end. of the colostomy to demonstrate the most distal part of the rectum and its relation to the urinary tract or to rule out the presence of a recto-urethral fistula with a contrast passage to the bladder and urethra in the event of a fistula. With this work we want to contribute knowledge about how this distal colograma technique is performed, its usefulness and importance before and after a surgical procedure. This document will be a grain of sand, which will be transmitted to future graduates. This method or technique is important, its proper use can help improve the condition of the patient. When a patient can not be given iodinated contrast medium, the administration of water-soluble contrast medium used in this technique is useful.
Nowadays, the presence of digestive surgical patients is becoming more frequent in pediatric hospitals. The spectrum of anorectal malformations is very wide and varied. There may be almost imperceptible defects, which only a careful and thorough inspection of the genital and perineal area will allow to identify them; On the other hand there are obvious defects at a glance. To assess the lower digestive tract, it is necessary to perform imaging techniques that allow us to assess or observe the degree of the malformation. A very helpful study when making a surgical decision is the invertogram. The invertogram is the study performed in newborn patients in which there is no evidence of rectal fistulas of any type or location. If the invertogram reports a distance greater than 1cm between the two ends, the colostomy is performed; If the distance between the two ends is less than 1cm, anoplasty or a limited posterior sagittal descent can be performed. If a fistula is present, a distal cologram is performed, which involves injecting water-soluble contrast medium under pressure through the distal end. of the colostomy to demonstrate the most distal part of the rectum and its relation to the urinary tract or to rule out the presence of a recto-urethral fistula with a contrast passage to the bladder and urethra in the event of a fistula. With this work we want to contribute knowledge about how this distal colograma technique is performed, its usefulness and importance before and after a surgical procedure. This document will be a grain of sand, which will be transmitted to future graduates. This method or technique is important, its proper use can help improve the condition of the patient. When a patient can not be given iodinated contrast medium, the administration of water-soluble contrast medium used in this technique is useful.
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Ano imperforado, Colograma distal, Pedatría, Hospital de Niños Dr. Roberto Gilbert Elizalde, Cantón Guayaquil, Ecuador