Caz clinic

Hernie diafragmal gastric posttraumatic stnga cu necroza total a stomacului, empiem pleural total stg. Sepsis sever, oc septic reversibil.

Balica I., M., Oprea A.C., Criucichevivi I.M., Cazacu N.

Analize la internare (28-11-04) Analiza lichidului pleural: Rou-tulbure, miros fetid, proteine - 33,0 g/L, reacia Rivalt pozitiv.Eritrocite neschimbate acoper cmpul de vedere. Analiza sedumentului centrifugat: leucocite 80-100 n c/v; neutrofile - 96%, limfocite - 4%ECG Ritm sinusal, fcc- 120/min, AE-normalFR-40/min., ps 110/min, TA 80/40 mm Hg, t-38,6 C0 , Scorul SIRS= 4An.gen.snge: Er.- 3,6; Hb- 116,0; Ic- 0,96; L- 28,2; ns- 29 s- 58 limf- 4 mono- 9; VSH 37Ionograma: K- 4,2; Na- 140; Ca- 2,1; Mg- 1,0; Cl- 100,0Biochimia: Protrombina- 94; fibrinogen- 5,8; proteine tot.- 48g/lBilirubina 17,6(2,2)15,4; AST- 0,34; ALT- 0,86; ureea- 10.0Coag. nc- 5 min. sfrit - 6 minpH- 7,42 pCO2-34 BE(-2) pO2 -135 sat.O2 99%

29-11-2004Er.- 3,6; Hb- 115,0; L- 9,0;ns- 58; s- 33; limf- 3; mono- 5urea - 11,0; creatinina- 118,0;bilirubina 30,8 (11,0) 19,8amilaza snge 32 apoi 29Histologia 98010 - inflamaie flegmonoas a ntregului perete gastric cu focare masive de necroz

29/111/127/12AST1,411,898,241,550,17ALT3,104,483,42,920,43

7-12-2004Er.- 3,8; Hb- 109,0; L- 14,6;miel- 2; ns- 23; s- 68; limf- 3; mono- 4urea- 10,0; AST- 0,34; ALT- 0,82 bilirubuna 17,6 ( 2,2) 15,4fibrinogen- 3,8; protrombina- 80