Ecografia interventionala in drenajul colectiilor abdominale

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rolul ecografiei in ghidarea imagistica a drenajului colectiilor abdominale-exemplificari cu cazuistica personala

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  • 1. E COGRAF INT RVE IONAL IA E NT A IN COL CT E AB E IIL DOM INAL EAndritoiu A, Mercut D, Silosi C, Resceanu Aurelia, Spitalul Clinic de Urgenta Militar ,,Dr. Stefan Odobleja,, Craiova

2. DefinitieManevre invazive efectuate sub ghidaj US, in scop de DIAGNOSTIC si/sau TERAPEUTIC 3. US interventionala Punctie/biopsie Drenaje percutane 4. Drena percutan in jul colectiile abdom inale 5. T ehnica Truse de drenaj Abord pecutan ghidat US, CT Scop diagnostic Evacuator Terapeutic 6. Indicatii Abces subfrenic Pseudochist pancreas Abces hepatic Chist hepatic simptomatic Chist hidatic 7. Caz clinic CR, B, 41 ani Stenoza pilorica operata-complicata cu fistula de bont - sepsis US colectie neomogena interhepatodiafragmatic Drenajul percutana al colectiei (ghidaj US) Culturi : E Coli 8. Colectie abdom inala post-pancreatita 9. Caz 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 10. P terapeutic lan ABORD CHIRURGICAL Lombotomie dr Drenaj Ineficient ABORD ECHOINTERVENTIONAL Eco-2D Punctie aspirativa ac fin 21 G Eficient !!! 11. P seudochist pancreas - drenaj 12. P eritonita biliara prin perforatie colecistica 13. Caz clinic 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 14. USColectie interhepato-diafragmaticaColecist perforat, mulat pe calculi 15. Insertia trocarului sub ghidaj ecografic Bila drenata in exces din cavitatea peritoneala 16. CONCLUZIE Manevrele interventionale efectuate sub ghidaj imagistic confera un plus de siguranta si eficienta in diagnosticul si drenajul colectiilor abdominale