We report the case of a 39-year-old patient with a history of chronic gastritis, functional colopathy and appendectomy, referred by another public institution for severe abdominal pain. He had been admitted 6 days pre...We report the case of a 39-year-old patient with a history of chronic gastritis, functional colopathy and appendectomy, referred by another public institution for severe abdominal pain. He had been admitted 6 days previously for nausea, vomiting, diarrhea, fever, asthenia since the onset of dyspnea with 89% desaturation in ambient air and a dry cough. A diagnosis of gastroenteritis was made and treated without success. The appearance of abdominal distension and bloating motivated his transfer to the CTPI where the rRT-PCR was carried out positive and an X-ray of the abdomen without preparation which had demonstrated a significant aerocoly with agglutination of handle. Surgical management under general anesthesia found a clean cavity after coeliotomy, multiple intestino-intestinal, intestino-parietal and omentum-parietal adhesions. The gesture consisted of an adhesiolysis, omentectomy. The postoperative follow-up was favorable with resumption of transit on D5 postoperative. Put under the COVID-19 treatment protocol, the rRT-PCR was negative on D13, output on D14 and removal of the D19 files without postoperative complications.展开更多
We report the case of a 28-month-old male child with no particular history who was admitted to the emergency room for severe abdominal pain associated with vomiting, asthenia and fever at 39.1<span style="whit...We report the case of a 28-month-old male child with no particular history who was admitted to the emergency room for severe abdominal pain associated with vomiting, asthenia and fever at 39.1<span style="white-space:nowrap;">˚</span>C that had progressed for 4 days. He was conscious, polypneic at 32 cycles/min on admission. On palpation the abdomen was distended, painful as a whole, more pronounced in the epigastrium. There was abdominal contracture, generalized defense, a cry with sudden decompression of the umbilicus. On abdominal auscultation, there was a disappearance of prehepatic dullness, a decrease in the dullness of the flanks and absence of hydro-aeric noises. On the digital rectal examination, Douglas’s cul de sac was bulging and sensitive. An unprepared X-ray of the abdomen revealed diffuse grayness, lateral gas crescent pneumoperitoneum under diaphragm. The preoperative resuscitation consisted of the placement of a nasogastric tube, a urinary catheter, a peripheral venous route and the fluid electrolyte rebalancing adapted according to the blood ionogram, early antibiotic therapy with broad aero and anaerobic spectrum. Surgical management under general anesthesia found at laparotomy a perforation of the anterior surface of the duodenal bulb which we estimate to be 1 cm in diameter with fibrin deposits. The gesture was the toilet of the peritoneal cavity;suture of the bank and the operative consequences were simple.展开更多
文摘We report the case of a 39-year-old patient with a history of chronic gastritis, functional colopathy and appendectomy, referred by another public institution for severe abdominal pain. He had been admitted 6 days previously for nausea, vomiting, diarrhea, fever, asthenia since the onset of dyspnea with 89% desaturation in ambient air and a dry cough. A diagnosis of gastroenteritis was made and treated without success. The appearance of abdominal distension and bloating motivated his transfer to the CTPI where the rRT-PCR was carried out positive and an X-ray of the abdomen without preparation which had demonstrated a significant aerocoly with agglutination of handle. Surgical management under general anesthesia found a clean cavity after coeliotomy, multiple intestino-intestinal, intestino-parietal and omentum-parietal adhesions. The gesture consisted of an adhesiolysis, omentectomy. The postoperative follow-up was favorable with resumption of transit on D5 postoperative. Put under the COVID-19 treatment protocol, the rRT-PCR was negative on D13, output on D14 and removal of the D19 files without postoperative complications.
文摘We report the case of a 28-month-old male child with no particular history who was admitted to the emergency room for severe abdominal pain associated with vomiting, asthenia and fever at 39.1<span style="white-space:nowrap;">˚</span>C that had progressed for 4 days. He was conscious, polypneic at 32 cycles/min on admission. On palpation the abdomen was distended, painful as a whole, more pronounced in the epigastrium. There was abdominal contracture, generalized defense, a cry with sudden decompression of the umbilicus. On abdominal auscultation, there was a disappearance of prehepatic dullness, a decrease in the dullness of the flanks and absence of hydro-aeric noises. On the digital rectal examination, Douglas’s cul de sac was bulging and sensitive. An unprepared X-ray of the abdomen revealed diffuse grayness, lateral gas crescent pneumoperitoneum under diaphragm. The preoperative resuscitation consisted of the placement of a nasogastric tube, a urinary catheter, a peripheral venous route and the fluid electrolyte rebalancing adapted according to the blood ionogram, early antibiotic therapy with broad aero and anaerobic spectrum. Surgical management under general anesthesia found at laparotomy a perforation of the anterior surface of the duodenal bulb which we estimate to be 1 cm in diameter with fibrin deposits. The gesture was the toilet of the peritoneal cavity;suture of the bank and the operative consequences were simple.
