Surgery with minimally invasive technologies for acute infected pancreatic necrosis in an elderly patient. Case report
Journal Title: Хірургія України - Year 2019, Vol 0, Issue 3
Abstract
One of the main problems in the treatment of pancreatic necrosis continues to be the choice of the most rational surgical tactics. The wide use of minimally invasive technologies in the complex treatment of acute pancreatitis reduced mortality significantly, even with its infected forms. The effect on the severity of the patient’s condition and the course of acute pancreatitis of premorbid background does not cause discussion. Here, a special group of people of advanced and senile age, the severity of concomitant diseases of which is not inferior to the severity of the underlying pathology. A case of surgical treatment of acute infected pancreatic necrosis in an elderly patient is described. Just minimally invasive technologies were applied in the treatment regimen. The patient was hospitalized in the surgical department with complaints of severe pain in the upper parts of abdomen with radiation to the back, nausea, vomiting, general weakness and malaise for two days. After an appropriate clinical and instrumental examination, the diagnosis of acute pancreatic necrosis was established. The concomitant pathology was established too: hypertension III stage 2nd degree, ischemic heart disease: stable angina pectoris II class, diffuse cardiosclerosis, aortic atherosclerosis, heart failure IIB stage, atherosclerotic encephalopathy II stage with cerebrospinal venous distension, chronic bilateral pyelonephritis, fatty hepatosis, chronic gastroduodenitis, deforming gonarthrosis of the II degree. Considering age and comorbidity, conservative therapy was carried out for 4 hours. A decision was made to perform surgical intervention due to the lack of positive dynamics and the progression of acute pancreatic necrosis with enzymatic peritonitis clinical picture. The chosen intervention was minimally invasive, which influenced the success of the treatment. the use of minimally invasive technologies in the treatment of pancreatic necrosis in this age group is a promising direction.
Authors and Affiliations
K. Y. Parkhomenko, A. G. Drozdova, M. V. Suplichenko
Keywords
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- EP ID EP670249
- DOI 10.30978/SU2019-3-60
- Views 136
- Downloads 0
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