Experiencia clínica en la utilización de imágenes diagnósticas en pacientes con fístulas intestinales en posoperatorios de cirugía abdominal con estancia prolongada. Hospital Mederi-Hospital Universitario Mayor, 2016 – 2017
Thesis
Introduction: Intestinal fistulas are a catastrophic complication of abdominal surgery, associated with serious complications. One of the clinical challenges in the diagnosis and management of this pathology, where a great diversity of criteria is expressed and possibly duplicity and waste of resources, is the imaging characterization of these fistulas. Methods: A descriptive observational study was conducted in patients who underwent abdominal surgery in Méderi-HUM between 2016 - 2017 and developed postoperative intestinal fistulas with prolonged stays (≥ 9 days), to describe the use of diagnostic imaging studies. Results: We identified 27 patients with post-operative intestinal fistulas. Intestinal obstruction, acute appendicitis and cholecystitis were the most frequent pathologies that indicated the initial surgery. Within the initial group of 27 patients diagnosed with intestinal fistulas in 20 patients a second diagnostic image was requested, 12 of them underwent a third image and 4 patients a fourth image. Analysis: Follow-up during the time of the study revealed that, after suspecting the intestinal fistula, 36 additional diagnostic images were requested during the period of attention observed. It was found that only after carrying out 16 of these images were changes in medical treatment identified. Medical treatment changes consisted of pharmacological adjustments or surgical interventions to patients. It is necessary to continue with investigations (prospective and with a greater number of samples) to carry out a better diagnostic and therapeutic approach.
