diff --git "a/data/test.conll" "b/data/test.conll" --- "a/data/test.conll" +++ "b/data/test.conll" @@ -1,22482 +1,57069 @@ -Paciente B-PRESENT_ILLNESS +Escolar B-PRESENT_ILLNESS de I-PRESENT_ILLNESS sexo I-PRESENT_ILLNESS femenino, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY +con I-PRESENT_ILLNESS +siete I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +procedente B-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -asma I-PAST_MEDICAL_HISTORY -bronquial, I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial, I-PAST_MEDICAL_HISTORY -hipertrofia I-PAST_MEDICAL_HISTORY -miocárdica I-PAST_MEDICAL_HISTORY -septal, I-PAST_MEDICAL_HISTORY -obesidad I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hipotiroidismo I-PAST_MEDICAL_HISTORY +Río I-PAST_MEDICAL_HISTORY +Negro. I-PAST_MEDICAL_HISTORY +Vivía I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +zona I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -larga I-PAST_MEDICAL_HISTORY -data. I-PAST_MEDICAL_HISTORY -A B-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -74 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -control I-PRESENT_ILLNESS -médico I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -pesquisa I-PRESENT_ILLNESS -facies I-PRESENT_ILLNESS -acromegaloide, I-PRESENT_ILLNESS -manos I-PRESENT_ILLNESS -anchas I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -dedos I-PRESENT_ILLNESS -gruesos I-PRESENT_ILLNESS +crianza I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +ganado I-PAST_MEDICAL_HISTORY +bovino, I-PAST_MEDICAL_HISTORY +ovino I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +vacuno I-PAST_MEDICAL_HISTORY +cercano I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +domicilio. I-PAST_MEDICAL_HISTORY +Consultó B-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +convulsiones I-PRESENT_ILLNESS +tónico-clónicas I-PRESENT_ILLNESS +generalizadas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +aproximadamente I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +año I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -pies I-PRESENT_ILLNESS -grandes. I-PRESENT_ILLNESS -Se B-EXPLORATION -solicitó I-EXPLORATION -GH I-EXPLORATION -basal I-EXPLORATION -que I-EXPLORATION -estaba I-EXPLORATION -elevada: I-EXPLORATION -2, I-EXPLORATION -8 I-EXPLORATION -y I-EXPLORATION -1, I-EXPLORATION -6 I-EXPLORATION -ng/ml. I-EXPLORATION -Posteriormente I-EXPLORATION +una I-PRESENT_ILLNESS +hemiparesia I-PRESENT_ILLNESS +braquio-crural I-PRESENT_ILLNESS +derecha I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +mes I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +aparición. I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +RM I-EXPLORATION +de I-EXPLORATION +cerebro I-EXPLORATION se I-EXPLORATION -realizó I-EXPLORATION -medición I-EXPLORATION -postcarga I-EXPLORATION +informó I-EXPLORATION +como I-EXPLORATION +un I-EXPLORATION +tumor I-EXPLORATION +supratentorial I-EXPLORATION +expansivo I-EXPLORATION de I-EXPLORATION -75 I-EXPLORATION -g I-EXPLORATION +6 I-EXPLORATION +cm I-EXPLORATION de I-EXPLORATION -glucosa, I-EXPLORATION -observándose I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -60 I-EXPLORATION -min I-EXPLORATION -un I-EXPLORATION -valor I-EXPLORATION +diámetro, I-EXPLORATION de I-EXPLORATION -GH I-EXPLORATION +localización I-EXPLORATION +subcortical I-EXPLORATION +temporo-parietal I-EXPLORATION +izquierdo I-EXPLORATION que I-EXPLORATION -no I-EXPLORATION -suprimió: I-EXPLORATION -2, I-EXPLORATION -3 I-EXPLORATION -ng/ml I-EXPLORATION -con I-EXPLORATION -glicemia I-EXPLORATION +colapsaba I-EXPLORATION +ventrículos I-EXPLORATION +y I-EXPLORATION +desplazaba I-EXPLORATION +la I-EXPLORATION +línea I-EXPLORATION +media. I-EXPLORATION +Imágenes I-EXPLORATION +complementarias I-EXPLORATION +descartaron I-EXPLORATION +compromiso I-EXPLORATION de I-EXPLORATION -166 I-EXPLORATION -mg/dl. I-EXPLORATION -Hormonas I-EXPLORATION -tiroideas I-EXPLORATION -bajo I-EXPLORATION -terapia I-EXPLORATION +otros I-EXPLORATION +órganos. I-EXPLORATION +La I-EXPLORATION +serología I-EXPLORATION +para I-EXPLORATION +hidatidosis I-EXPLORATION +por I-EXPLORATION +técnica I-EXPLORATION de I-EXPLORATION -sustitución I-EXPLORATION -con I-EXPLORATION -levotiroxina I-EXPLORATION +HAI I-EXPLORATION +fue I-EXPLORATION +negativa. I-EXPLORATION +No I-EXPLORATION +tuvo I-EXPLORATION +eosinofilia I-EXPLORATION +ni I-EXPLORATION +alteraciones I-EXPLORATION en I-EXPLORATION -rango I-EXPLORATION -normal I-EXPLORATION -(T4L: I-EXPLORATION -1, I-EXPLORATION -49 I-EXPLORATION -ng/dl, I-EXPLORATION -TSH: I-EXPLORATION -1, I-EXPLORATION -45 I-EXPLORATION -mUI/L) I-EXPLORATION -y I-EXPLORATION -prolactina I-EXPLORATION -(PRL): I-EXPLORATION -22, I-EXPLORATION -9 I-EXPLORATION -ng/ml. I-EXPLORATION -Se I-EXPLORATION -solicitó I-EXPLORATION +el I-EXPLORATION +laboratorio I-EXPLORATION +general. I-EXPLORATION +Inició B-TREATMENT +tratamiento I-TREATMENT +previo I-TREATMENT +a I-TREATMENT +la I-TREATMENT +cirugía I-TREATMENT +con I-TREATMENT +albendazol I-TREATMENT +por I-TREATMENT +sospecha I-TREATMENT +clínica I-TREATMENT +e I-TREATMENT +imagenológica I-TREATMENT +de I-TREATMENT +hidatidosis. I-TREATMENT +Se I-TREATMENT +realizó I-TREATMENT +exéresis I-TREATMENT +total I-TREATMENT +del I-TREATMENT +quiste. I-TREATMENT +La B-EXPLORATION +anatomía I-EXPLORATION +patológica I-EXPLORATION +mostró I-EXPLORATION una I-EXPLORATION -tomografía I-EXPLORATION -computada I-EXPLORATION -(TAC) I-EXPLORATION +lesión I-EXPLORATION +quística I-EXPLORATION +con I-EXPLORATION +pared I-EXPLORATION +membranosa I-EXPLORATION +acelular, I-EXPLORATION +tinción I-EXPLORATION de I-EXPLORATION -silla I-EXPLORATION -turca I-EXPLORATION -que I-EXPLORATION -evidenció I-EXPLORATION -un I-EXPLORATION -adenoma I-EXPLORATION +ácido I-EXPLORATION +peryódico I-EXPLORATION de I-EXPLORATION -10 I-EXPLORATION -mm I-EXPLORATION -lateralizado I-EXPLORATION -a I-EXPLORATION -izquierda I-EXPLORATION +Schiff I-EXPLORATION +(PAS) I-EXPLORATION +positiva, I-EXPLORATION +en I-EXPLORATION +una I-EXPLORATION +de I-EXPLORATION +sus I-EXPLORATION +caras, I-EXPLORATION +con I-EXPLORATION +calcoforitos I-EXPLORATION y I-EXPLORATION -desviación I-EXPLORATION -del I-EXPLORATION -tallo I-EXPLORATION -a I-EXPLORATION -derecha. I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -rechazó I-TREATMENT -tratamiento I-TREATMENT -quirúrgico. I-TREATMENT -Tres B-EXPLORATION -años I-EXPLORATION -después I-EXPLORATION +restos I-EXPLORATION +celulares. I-EXPLORATION +Además, I-EXPLORATION se I-EXPLORATION -realizó I-EXPLORATION -nueva I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -silla I-EXPLORATION -turca I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -adenoma I-EXPLORATION +observaron I-EXPLORATION +escólices I-EXPLORATION +con I-EXPLORATION +variables I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -7 I-EXPLORATION -mm I-EXPLORATION -que I-EXPLORATION -deformaba I-EXPLORATION -el I-EXPLORATION -diafragma I-EXPLORATION -selar I-EXPLORATION +necrosis I-EXPLORATION y I-EXPLORATION -provocaba I-EXPLORATION -un I-EXPLORATION -leve I-EXPLORATION -hundimiento I-EXPLORATION +degeneración. I-EXPLORATION +La B-EVOLUTION +paciente I-EVOLUTION +presentó I-EVOLUTION +como I-EVOLUTION +secuela I-EVOLUTION +una I-EVOLUTION +hemiparesia I-EVOLUTION +facio-braquio-crural I-EVOLUTION +derecha I-EVOLUTION +que I-EVOLUTION +le I-EVOLUTION +dificultaba I-EVOLUTION +la I-EVOLUTION +deambulación. I-EVOLUTION + I-EVOLUTION + +Niña B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +13 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +consultó I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +AV I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +ambos I-PRESENT_ILLNESS +ojos I-PRESENT_ILLNESS +(0, I-PRESENT_ILLNESS +1 I-PRESENT_ILLNESS +OD I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +0, I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS +OI I-PRESENT_ILLNESS +). I-PRESENT_ILLNESS +En B-EXPLORATION +el I-EXPLORATION +examen I-EXPLORATION +de I-EXPLORATION +fondo I-EXPLORATION de I-EXPLORATION +ojo I-EXPLORATION +se I-EXPLORATION +objetivó I-EXPLORATION la I-EXPLORATION -silla I-EXPLORATION -turca, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -hemorragia I-EXPLORATION -intratumoral. I-EXPLORATION +EMQ I-EXPLORATION +bilateral. I-EXPLORATION En I-EXPLORATION -ese I-EXPLORATION -momento, I-EXPLORATION -el I-EXPLORATION -IGF I-EXPLORATION -1 I-EXPLORATION -(factor I-EXPLORATION -de I-EXPLORATION -crecimiento I-EXPLORATION -insulino-simil I-EXPLORATION -1) I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -en I-EXPLORATION -rango I-EXPLORATION -normal I-EXPLORATION -bajo I-EXPLORATION -para I-EXPLORATION la I-EXPLORATION -edad: I-EXPLORATION -64, I-EXPLORATION -1 I-EXPLORATION -ng/ml I-EXPLORATION -(64-188 I-EXPLORATION -ng/ml). I-EXPLORATION +angiografía I-EXPLORATION +fluoresceínica I-EXPLORATION +presentaba I-EXPLORATION +una I-EXPLORATION +epiteliopatía I-EXPLORATION +pigmentaria I-EXPLORATION +difusa I-EXPLORATION +con I-EXPLORATION +edema I-EXPLORATION +exudativo I-EXPLORATION +y I-EXPLORATION +desprendimientos I-EXPLORATION +retinianos I-EXPLORATION +serosos I-EXPLORATION +secundarios. I-EXPLORATION A I-EXPLORATION los I-EXPLORATION -siete I-EXPLORATION -años I-EXPLORATION +5 I-EXPLORATION +meses I-EXPLORATION de I-EXPLORATION -seguimiento, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -nueva I-EXPLORATION -medición I-EXPLORATION +edad, I-EXPLORATION +había I-EXPLORATION +sido I-EXPLORATION +tratada I-EXPLORATION +con I-EXPLORATION +éxito I-EXPLORATION de I-EXPLORATION -GH I-EXPLORATION -postcarga I-EXPLORATION +una I-EXPLORATION +histiocitosis I-EXPLORATION de I-EXPLORATION -glucosa, I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -60 I-EXPLORATION -min I-EXPLORATION +células I-EXPLORATION +de I-EXPLORATION +Langerhans, I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION se I-EXPLORATION -observó I-EXPLORATION +realizó I-EXPLORATION un I-EXPLORATION -valor I-EXPLORATION +estudio I-EXPLORATION +sistémico I-EXPLORATION +completo, I-EXPLORATION +incluidas I-EXPLORATION +pruebas I-EXPLORATION de I-EXPLORATION -1 I-EXPLORATION -ng/ml I-EXPLORATION -con I-EXPLORATION -glicemia I-EXPLORATION +imagen I-EXPLORATION +craneal I-EXPLORATION +y I-EXPLORATION +orbitarias. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +encontró I-EXPLORATION +ningún I-EXPLORATION +hallazgo I-EXPLORATION +significativo. I-EXPLORATION +Se B-TREATMENT +inició I-TREATMENT +terapia I-TREATMENT +con I-TREATMENT +corticosteroides I-TREATMENT +tópicos, I-TREATMENT +peribulbares I-TREATMENT +y I-TREATMENT +orales. I-TREATMENT + I-TREATMENT +Las I-TREATMENT +inyecciones I-TREATMENT +de I-TREATMENT +triamcinolona I-TREATMENT +peribulbar I-TREATMENT +se I-TREATMENT +repitieron I-TREATMENT +en I-TREATMENT +cuatro I-TREATMENT +ocasiones I-TREATMENT +a I-TREATMENT +lo I-TREATMENT +largo I-TREATMENT +del I-TREATMENT +siguiente I-TREATMENT +año, I-TREATMENT +logrando I-TREATMENT +sólo I-TREATMENT +mejorías I-TREATMENT +transitorias I-TREATMENT +del I-TREATMENT +edema I-TREATMENT +macular I-TREATMENT +y I-TREATMENT +los I-TREATMENT +desprendimientos I-TREATMENT +serosos. I-TREATMENT +En I-TREATMENT +septiembre I-TREATMENT +de I-TREATMENT +2002, I-TREATMENT +comenzó I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +ciclosporina I-TREATMENT +oral I-TREATMENT +y I-TREATMENT +en I-TREATMENT +marzo I-TREATMENT +de I-TREATMENT +2003 I-TREATMENT +se I-TREATMENT +añadió I-TREATMENT +azatioprina, I-TREATMENT +debido I-TREATMENT +a I-TREATMENT +la I-TREATMENT +persistencia I-TREATMENT +del I-TREATMENT +EMQ. I-TREATMENT +Finalmente, I-TREATMENT +se I-TREATMENT +inyectaron I-TREATMENT +4 I-TREATMENT +mg I-TREATMENT +de I-TREATMENT +triamcinolona I-TREATMENT +intravítrea I-TREATMENT +en I-TREATMENT +ambos I-TREATMENT +ojos I-TREATMENT +en I-TREATMENT +julio I-TREATMENT +de I-TREATMENT +2003 I-TREATMENT +con I-TREATMENT +mejoría I-TREATMENT +inicial I-TREATMENT +del I-TREATMENT +EMQ I-TREATMENT +y I-TREATMENT +de I-TREATMENT +la I-TREATMENT +AV. I-TREATMENT +Se I-TREATMENT +repitieron I-TREATMENT +las I-TREATMENT +inyecciones I-TREATMENT +dos I-TREATMENT +veces I-TREATMENT +en I-TREATMENT +el I-TREATMENT +OD I-TREATMENT +y I-TREATMENT +una I-TREATMENT +vez I-TREATMENT +más I-TREATMENT +en I-TREATMENT +el I-TREATMENT +OI. I-TREATMENT +En B-EXPLORATION +diciembre I-EXPLORATION de I-EXPLORATION -174 I-EXPLORATION -mg/dl. I-EXPLORATION -A I-EXPLORATION -los I-EXPLORATION -nueve I-EXPLORATION -años I-EXPLORATION +2004, I-EXPLORATION se I-EXPLORATION -reevaluó I-EXPLORATION -con I-EXPLORATION -resonancia I-EXPLORATION -nuclear I-EXPLORATION -magnética I-EXPLORATION -(RM), I-EXPLORATION +registraron I-EXPLORATION +PIO I-EXPLORATION +de I-EXPLORATION +27 I-EXPLORATION +mmHg I-EXPLORATION +OD I-EXPLORATION +y I-EXPLORATION +26 I-EXPLORATION +mmHg I-EXPLORATION +OI, I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION que I-EXPLORATION -mostró I-EXPLORATION -presencia I-EXPLORATION -del I-EXPLORATION -adenoma I-EXPLORATION +se I-EXPLORATION +indica I-EXPLORATION +terapia I-EXPLORATION +tópica I-EXPLORATION +con I-EXPLORATION +timolol I-EXPLORATION +0, I-EXPLORATION +5% I-EXPLORATION +y I-EXPLORATION +dorzolamida I-EXPLORATION +0, I-EXPLORATION +02% I-EXPLORATION +(Cosopt®). I-EXPLORATION +En I-EXPLORATION +marzo I-EXPLORATION de I-EXPLORATION -7 I-EXPLORATION -mm, I-EXPLORATION -lateralizado I-EXPLORATION -a I-EXPLORATION -izquierda, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION +2005, I-EXPLORATION +la I-EXPLORATION +paciente I-EXPLORATION +presenta I-EXPLORATION +pérdida I-EXPLORATION de I-EXPLORATION -hemorragia I-EXPLORATION -y I-EXPLORATION -medición I-EXPLORATION +AV I-EXPLORATION +severa I-EXPLORATION +bilateral I-EXPLORATION +(<0,05) I-EXPLORATION +por I-EXPLORATION +desarrollo I-EXPLORATION de I-EXPLORATION -IGF1 I-EXPLORATION -bajo I-EXPLORATION -el I-EXPLORATION -rango I-EXPLORATION -normal: I-EXPLORATION -48, I-EXPLORATION -1 I-EXPLORATION -ng/ml I-EXPLORATION -(55-166 I-EXPLORATION -ng/ml). I-EXPLORATION - I-EXPLORATION +cataratas I-EXPLORATION +intumescentes. I-EXPLORATION +Tras B-EVOLUTION +cirugía I-EVOLUTION +de I-EVOLUTION +facoextracción I-EVOLUTION +con I-EVOLUTION +implantación I-EVOLUTION +de I-EVOLUTION +lente I-EVOLUTION +intraocular I-EVOLUTION +sin I-EVOLUTION +complicaciones, I-EVOLUTION +la I-EVOLUTION +AV I-EVOLUTION +es I-EVOLUTION +de I-EVOLUTION +0, I-EVOLUTION +3 I-EVOLUTION +en I-EVOLUTION +ambos I-EVOLUTION +ojos. I-EVOLUTION + I-EVOLUTION -Paciente B-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -31 I-PRESENT_ILLNESS +71 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY +diagnosticado B-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -depresión, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -hemorragia I-PRESENT_ILLNESS -digestiva I-PRESENT_ILLNESS -alta I-PRESENT_ILLNESS -72 I-PRESENT_ILLNESS -h I-PRESENT_ILLNESS -posterior I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -ingesta I-PRESENT_ILLNESS +carcinoma I-PAST_MEDICAL_HISTORY +epidermoide I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +pulmón I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +microcítico I-PAST_MEDICAL_HISTORY +estadio I-PAST_MEDICAL_HISTORY +IIIb. I-PAST_MEDICAL_HISTORY +Inició I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +quimioterápico I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +cisplatino I-PAST_MEDICAL_HISTORY +75 I-PAST_MEDICAL_HISTORY +mg/m2 I-PAST_MEDICAL_HISTORY +día I-PAST_MEDICAL_HISTORY +1, I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +vinorelbina I-PAST_MEDICAL_HISTORY +oral I-PAST_MEDICAL_HISTORY +60 I-PAST_MEDICAL_HISTORY +mg/m2 I-PAST_MEDICAL_HISTORY +días I-PAST_MEDICAL_HISTORY +1 I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +8, I-PAST_MEDICAL_HISTORY +cada I-PAST_MEDICAL_HISTORY +tres I-PAST_MEDICAL_HISTORY +semanas, I-PAST_MEDICAL_HISTORY +combinado I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +radioterapia. I-PAST_MEDICAL_HISTORY +Coincidiendo B-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +infusión I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +segundo I-PRESENT_ILLNESS +ciclo I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -30 I-PRESENT_ILLNESS -mL I-PRESENT_ILLNESS +cisplatino, I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +episodio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -paraquat I-PRESENT_ILLNESS -(138 I-PRESENT_ILLNESS -mg/kg) I-PRESENT_ILLNESS +disnea I-PRESENT_ILLNESS +brusca I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -intención I-PRESENT_ILLNESS -suicida. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Ingresó B-EXPLORATION -consciente, I-EXPLORATION -Glasgow I-EXPLORATION -15, I-EXPLORATION -con I-EXPLORATION -hemodinamia I-EXPLORATION -estable I-EXPLORATION -y I-EXPLORATION -afebril. I-EXPLORATION -Al I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -destacaban I-EXPLORATION -úlceras I-EXPLORATION -orales I-EXPLORATION -y I-EXPLORATION -faríngeas. I-EXPLORATION -En I-EXPLORATION -su I-EXPLORATION -laboratorio I-EXPLORATION -de I-EXPLORATION -ingreso I-EXPLORATION -se I-EXPLORATION -evidenció I-EXPLORATION -injuria I-EXPLORATION -renal I-EXPLORATION -aguda I-EXPLORATION -(creatinina: I-EXPLORATION -9, I-EXPLORATION -58 I-EXPLORATION -mg/dL, I-EXPLORATION -BUN: I-EXPLORATION -95 I-EXPLORATION -mg/dL) I-EXPLORATION -y I-EXPLORATION -hepática I-EXPLORATION -(bilirrubina I-EXPLORATION -total: I-EXPLORATION -6, I-EXPLORATION -3 I-EXPLORATION -mg/dL, I-EXPLORATION -GOT: I-EXPLORATION -140 I-EXPLORATION -U/L, I-EXPLORATION -GPT I-EXPLORATION -331 I-EXPLORATION -U/L). I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -(TC) I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -la I-EXPLORATION -cual I-EXPLORATION -mostró I-EXPLORATION -foco I-EXPLORATION -de I-EXPLORATION -condensación I-EXPLORATION -pulmonar I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -neumonía I-EXPLORATION -basal I-EXPLORATION -izquierda, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -perforación I-EXPLORATION -esofágica. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -hidratación I-TREATMENT -parenteral, I-TREATMENT -hemodiálisis, I-TREATMENT -antibióticos I-TREATMENT -empíricos I-TREATMENT -(ceftriaxona) I-TREATMENT -y I-TREATMENT -se I-TREATMENT -ingresó I-TREATMENT -a I-TREATMENT -unidad I-TREATMENT -de I-TREATMENT -cuidados I-TREATMENT -intensivos. I-TREATMENT -Se B-EXPLORATION -realizó I-EXPLORATION -endoscopía I-EXPLORATION -digestiva I-EXPLORATION -alta I-EXPLORATION -diferida I-EXPLORATION -(día I-EXPLORATION -4 I-EXPLORATION -de I-EXPLORATION -hospitalización) I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -panesofagitis I-EXPLORATION -cáustica I-EXPLORATION -grado I-EXPLORATION -2. I-EXPLORATION - I-EXPLORATION -Evolucionó B-EVOLUTION -estable I-EVOLUTION -hasta I-EVOLUTION -el I-EVOLUTION -sexto I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -hospitalización, I-EVOLUTION -presentando I-EVOLUTION -insuficiencia I-EVOLUTION -respiratoria I-EVOLUTION -grave I-EVOLUTION -rápidamente I-EVOLUTION -progresiva I-EVOLUTION -con I-EVOLUTION -imágenes I-EVOLUTION -compatibles I-EVOLUTION -con I-EVOLUTION -fibrosis I-EVOLUTION -pulmonar I-EVOLUTION -aguda. I-EVOLUTION -Se B-TREATMENT -inició I-TREATMENT -terapia I-TREATMENT -inmunosupresora I-TREATMENT -con I-TREATMENT -protocolo I-TREATMENT -de I-TREATMENT -metilprednisolona I-TREATMENT -1 I-TREATMENT -g/día I-TREATMENT -por I-TREATMENT -3 I-TREATMENT -días, I-TREATMENT -ciclofosfamida I-TREATMENT -1 I-TREATMENT -g/día I-TREATMENT -IV I-TREATMENT -por I-TREATMENT -2 I-TREATMENT -días I-TREATMENT -y I-TREATMENT -N-acetilcisteína I-TREATMENT -para I-TREATMENT -modular I-TREATMENT -daño I-TREATMENT -por I-TREATMENT -estrés I-TREATMENT -oxidativo, I-TREATMENT -el B-EVOLUTION -cual I-EVOLUTION -no I-EVOLUTION -tuvo I-EVOLUTION -respuesta, I-EVOLUTION -presentando I-EVOLUTION -caída I-EVOLUTION -de I-EVOLUTION -PaFi I-EVOLUTION -a I-EVOLUTION -40, I-EVOLUTION -falleciendo I-EVOLUTION -al I-EVOLUTION -octavo I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -hospitalización. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -89 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -anamnésticamente I-PRESENT_ILLNESS -comunicó I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -presencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -decaimiento I-PRESENT_ILLNESS -físico, I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -cefalea I-PRESENT_ILLNESS -fronto-temporal I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -momento I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -ingreso, I-PRESENT_ILLNESS -condición I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -sido I-PRESENT_ILLNESS -interpretada I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -alteraciones I-PRESENT_ILLNESS +caída I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -carácter I-PRESENT_ILLNESS -depresivo. I-PRESENT_ILLNESS -Sin I-PRESENT_ILLNESS -embargo, I-PRESENT_ILLNESS la I-PRESENT_ILLNESS -instalación I-PRESENT_ILLNESS +saturación I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -visión I-PRESENT_ILLNESS -borrosa, I-PRESENT_ILLNESS -asociada I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -ojo I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -(OI), I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -agravó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS +oxígeno I-PRESENT_ILLNESS +hasta I-PRESENT_ILLNESS el I-PRESENT_ILLNESS -último I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -ocular I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -visión I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -ojo I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -(OD) I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -obligaron I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -consultar I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -oftalmología. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Evaluada B-EXPLORATION -en I-EXPLORATION -neuro-oftalmología I-EXPLORATION -se I-EXPLORATION -definió I-EXPLORATION -un I-EXPLORATION -fondo I-EXPLORATION +70%, I-PRESENT_ILLNESS +que B-TREATMENT +recuperó I-TREATMENT +parcialmente I-TREATMENT +con I-TREATMENT +corticoterapia I-TREATMENT +y I-TREATMENT +oxígeno I-TREATMENT +a I-TREATMENT +alto I-TREATMENT +flujo. I-TREATMENT +La B-EXPLORATION +gravedad I-EXPLORATION de I-EXPLORATION -ojo I-EXPLORATION -con I-EXPLORATION -papilas I-EXPLORATION -rosadas, I-EXPLORATION -planas I-EXPLORATION -y I-EXPLORATION -netas. I-EXPLORATION -Se I-EXPLORATION -observaron I-EXPLORATION +dicha I-EXPLORATION +reacción I-EXPLORATION +fue I-EXPLORATION +clasificada I-EXPLORATION +según I-EXPLORATION +la I-EXPLORATION +Common I-EXPLORATION +Toxicity I-EXPLORATION +Criteria I-EXPLORATION +(versión I-EXPLORATION +4.0) I-EXPLORATION +9 I-EXPLORATION +en I-EXPLORATION +RHS I-EXPLORATION +grado I-EXPLORATION +3, I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -OI I-EXPLORATION -exudados I-EXPLORATION -blanquecinos I-EXPLORATION -(temporales I-EXPLORATION -superiores) I-EXPLORATION -hacia I-EXPLORATION la I-EXPLORATION -macula, I-EXPLORATION que I-EXPLORATION se I-EXPLORATION -interpretaron I-EXPLORATION -como I-EXPLORATION -posible I-EXPLORATION -área I-EXPLORATION -isquémica I-EXPLORATION +recomienda I-EXPLORATION +cambiar I-EXPLORATION +el I-EXPLORATION +tratamiento, I-EXPLORATION +opción I-EXPLORATION +a I-EXPLORATION +veces I-EXPLORATION +limitada I-EXPLORATION +por I-EXPLORATION +la I-EXPLORATION +quimiosensibilidad I-EXPLORATION +del I-EXPLORATION +tumor, I-EXPLORATION +o I-EXPLORATION +bien I-EXPLORATION +aplicar I-EXPLORATION +protocolos I-EXPLORATION de I-EXPLORATION -origen I-EXPLORATION -arterial, I-EXPLORATION -también I-EXPLORATION +desensibilización I-EXPLORATION +en I-EXPLORATION +aquellos I-EXPLORATION +pacientes I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION se I-EXPLORATION -constató I-EXPLORATION +desee I-EXPLORATION +discontinuar I-EXPLORATION la I-EXPLORATION -parálisis I-EXPLORATION -del I-EXPLORATION -III I-EXPLORATION -par I-EXPLORATION -derecho, I-EXPLORATION -sin I-EXPLORATION -compromiso I-EXPLORATION +terapia. I-EXPLORATION +Se I-EXPLORATION +decidió I-EXPLORATION +la I-EXPLORATION +realización I-EXPLORATION de I-EXPLORATION +pruebas I-EXPLORATION +cutáneas I-EXPLORATION +con I-EXPLORATION +cisplatino, I-EXPLORATION +para I-EXPLORATION +confirmar I-EXPLORATION la I-EXPLORATION -pupila. I-EXPLORATION -Debido B-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -estos I-DERIVED_FROM/TO -hallazgos I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -examen I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -destacaba I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -PCR I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -57, I-DERIVED_FROM/TO -7 I-DERIVED_FROM/TO -(VR: I-DERIVED_FROM/TO -< I-DERIVED_FROM/TO -5, I-DERIVED_FROM/TO -0), I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -derivada I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -hospitalización I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -Servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Neurología I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -Hospital I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -Salvador I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -sospecha I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -arteritis I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -temporal. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -de I-EXPLORATION -hospitalización, I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -encontraron I-EXPLORATION -síntomas I-EXPLORATION -de I-EXPLORATION -claudicación I-EXPLORATION -mandibular, I-EXPLORATION -o I-EXPLORATION -de I-EXPLORATION -polimialgia I-EXPLORATION -reumática, I-EXPLORATION -tampoco I-EXPLORATION -se I-EXPLORATION -vieron I-EXPLORATION -o I-EXPLORATION -palparon I-EXPLORATION -cambios I-EXPLORATION -o I-EXPLORATION -induraciones I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -trayecto I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -arterias I-EXPLORATION -temporales. I-EXPLORATION -Llamó I-EXPLORATION -la I-EXPLORATION -atención, I-EXPLORATION -que I-EXPLORATION -en I-EXPLORATION +posible I-EXPLORATION +asociación I-EXPLORATION +entre I-EXPLORATION la I-EXPLORATION -mirada I-EXPLORATION -binocular I-EXPLORATION -se I-EXPLORATION -produjera I-EXPLORATION -una I-EXPLORATION -desviación I-EXPLORATION -espontánea I-EXPLORATION -del I-EXPLORATION -ojo I-EXPLORATION -izquierdo I-EXPLORATION -hacia I-EXPLORATION -afuera I-EXPLORATION +reacción I-EXPLORATION +anafiláctica I-EXPLORATION y I-EXPLORATION -abajo, I-EXPLORATION -que I-EXPLORATION -con I-EXPLORATION la I-EXPLORATION -oclusión I-EXPLORATION -del I-EXPLORATION -ojo I-EXPLORATION -derecho, I-EXPLORATION -el I-EXPLORATION -ojo I-EXPLORATION -izquierdo I-EXPLORATION -volvía I-EXPLORATION -a I-EXPLORATION -su I-EXPLORATION -posición I-EXPLORATION -central I-EXPLORATION -(sugerente I-EXPLORATION -de I-EXPLORATION -exclusión I-EXPLORATION -del I-EXPLORATION -ojo I-EXPLORATION -izquierdo I-EXPLORATION -por I-EXPLORATION -falta I-EXPLORATION -de I-EXPLORATION -visión). I-EXPLORATION -Se I-EXPLORATION -constató I-EXPLORATION -una I-EXPLORATION -pérdida I-EXPLORATION +administración I-EXPLORATION de I-EXPLORATION -visión I-EXPLORATION -que I-EXPLORATION -sólo I-EXPLORATION -llegaba I-EXPLORATION +dicho I-EXPLORATION +citostático. I-EXPLORATION +Además, I-EXPLORATION +debido I-EXPLORATION a I-EXPLORATION -cuenta I-EXPLORATION -dedos. I-EXPLORATION -El I-EXPLORATION -ojo I-EXPLORATION -derecho I-EXPLORATION -presentaba I-EXPLORATION -una I-EXPLORATION -limitación I-EXPLORATION -completa I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -aducción I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -limitación I-EXPLORATION -menor I-EXPLORATION -en I-EXPLORATION la I-EXPLORATION -elevación I-EXPLORATION -y I-EXPLORATION -depresión. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -compromiso I-EXPLORATION +existencia I-EXPLORATION de I-EXPLORATION +una I-EXPLORATION +importante I-EXPLORATION +reactividad I-EXPLORATION +cruzada I-EXPLORATION +entre I-EXPLORATION las I-EXPLORATION -vías I-EXPLORATION -motoras I-EXPLORATION -o I-EXPLORATION -sensitivas I-EXPLORATION -centrales, I-EXPLORATION -ni I-EXPLORATION -periféricas. I-EXPLORATION -Se I-EXPLORATION -completó I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -destacando I-EXPLORATION -VHS: I-EXPLORATION -80, I-EXPLORATION -0 I-EXPLORATION -mm/h I-EXPLORATION -(VR: I-EXPLORATION -1, I-EXPLORATION -0-24, I-EXPLORATION -0) I-EXPLORATION -y I-EXPLORATION -Recuento I-EXPLORATION -de I-EXPLORATION -blancos: I-EXPLORATION -7.870, I-EXPLORATION -en I-EXPLORATION -rango I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -Resonancia I-EXPLORATION -Magnética I-EXPLORATION -de I-EXPLORATION -cerebro I-EXPLORATION -en I-EXPLORATION -secuencias I-EXPLORATION -ponderadas I-EXPLORATION +sales I-EXPLORATION de I-EXPLORATION -T2 I-EXPLORATION +platino I-EXPLORATION +cuya I-EXPLORATION +incidencia I-EXPLORATION +aún I-EXPLORATION +no I-EXPLORATION +ha I-EXPLORATION +sido I-EXPLORATION +establecida8, I-EXPLORATION +se I-EXPLORATION +decidió I-EXPLORATION +realizar I-EXPLORATION +dichas I-EXPLORATION +pruebas I-EXPLORATION con I-EXPLORATION -saturación I-EXPLORATION -grasa, I-EXPLORATION -permitió I-EXPLORATION -destacar I-EXPLORATION -un I-EXPLORATION -incremento I-EXPLORATION +los I-EXPLORATION +tres I-EXPLORATION +análogos I-EXPLORATION de I-EXPLORATION -señal I-EXPLORATION -en I-EXPLORATION -ambas I-EXPLORATION -arterias I-EXPLORATION -temporales I-EXPLORATION -superficiales I-EXPLORATION +platino. I-EXPLORATION +Las I-EXPLORATION +soluciones I-EXPLORATION +madre I-EXPLORATION +utilizadas I-EXPLORATION +fueron: I-EXPLORATION +cisplatino I-EXPLORATION +1 I-EXPLORATION +mg/ml, I-EXPLORATION +carboplatino I-EXPLORATION +10 I-EXPLORATION +mg/ml I-EXPLORATION y I-EXPLORATION +oxaliplatino I-EXPLORATION +5 I-EXPLORATION +mg/ml. I-EXPLORATION +A I-EXPLORATION +partir I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -partes I-EXPLORATION -blandas I-EXPLORATION -periarteriales. I-EXPLORATION -Con I-EXPLORATION -medio I-EXPLORATION -de I-EXPLORATION -contraste I-EXPLORATION +éstas, I-EXPLORATION se I-EXPLORATION -acentuó I-EXPLORATION -el I-EXPLORATION -realce I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -arterial I-EXPLORATION +realizaron I-EXPLORATION +diluciones I-EXPLORATION +1/10000, I-EXPLORATION +1/1000, I-EXPLORATION +1/100 I-EXPLORATION y I-EXPLORATION +1/10 I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -partes I-EXPLORATION -blandas. I-EXPLORATION -Además, I-EXPLORATION -en I-EXPLORATION -T1WI I-EXPLORATION +los I-EXPLORATION +tres I-EXPLORATION +platinos I-EXPLORATION +para I-EXPLORATION +administración I-EXPLORATION +intradérmica. I-EXPLORATION + I-EXPLORATION +Las I-EXPLORATION +pruebas I-EXPLORATION +cutáneas I-EXPLORATION +realizadas I-EXPLORATION con I-EXPLORATION -gadolinio I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -impregnación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vaina I-EXPLORATION -de I-EXPLORATION -ambos I-EXPLORATION -nervios I-EXPLORATION -ópticos, I-EXPLORATION -realce I-EXPLORATION -irregular I-EXPLORATION -de I-EXPLORATION +cisplatino I-EXPLORATION +fueron I-EXPLORATION +positivas I-EXPLORATION +para I-EXPLORATION la I-EXPLORATION -grasa I-EXPLORATION -intraconal I-EXPLORATION -y I-EXPLORATION -periférica I-EXPLORATION -de I-EXPLORATION -ambas I-EXPLORATION -arterias I-EXPLORATION -oftálmicas. I-EXPLORATION -Realce I-EXPLORATION -parietal I-EXPLORATION -supraclinoídeo I-EXPLORATION -de I-EXPLORATION -ambos I-EXPLORATION -sifones I-EXPLORATION -carotideos. I-EXPLORATION -Corte I-EXPLORATION -axial I-EXPLORATION -en I-EXPLORATION -FLAIR I-EXPLORATION +solución I-EXPLORATION +madre I-EXPLORATION y I-EXPLORATION -difusión I-EXPLORATION -del I-EXPLORATION -mismo I-EXPLORATION -corte, I-EXPLORATION -muestra I-EXPLORATION -lesiones I-EXPLORATION -isquémicas I-EXPLORATION -agudas I-EXPLORATION -cerebelosas I-EXPLORATION -en I-EXPLORATION +negativas I-EXPLORATION +para I-EXPLORATION el I-EXPLORATION -lado I-EXPLORATION -derecho. I-EXPLORATION -En I-EXPLORATION -TOF I-EXPLORATION -importantes I-EXPLORATION -irregularidades I-EXPLORATION -del I-EXPLORATION -segmento I-EXPLORATION -V4 I-EXPLORATION -de I-EXPLORATION -ambas I-EXPLORATION -arterias I-EXPLORATION -vertebrales. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -se I-EXPLORATION -complementó I-EXPLORATION -con I-EXPLORATION -Ecotomografía I-EXPLORATION -Doppler I-EXPLORATION -color I-EXPLORATION -con I-EXPLORATION -transductor I-EXPLORATION -lineal I-EXPLORATION +resto I-EXPLORATION de I-EXPLORATION -alta I-EXPLORATION -frecuencia, I-EXPLORATION -que I-EXPLORATION -demostró I-EXPLORATION -disminución I-EXPLORATION -del I-EXPLORATION -lumen I-EXPLORATION +diluciones. I-EXPLORATION +En I-EXPLORATION +los I-EXPLORATION +demás I-EXPLORATION +análogos I-EXPLORATION de I-EXPLORATION -ambas I-EXPLORATION -arterias I-EXPLORATION -temporales I-EXPLORATION -superficiales, I-EXPLORATION -más I-EXPLORATION -importante I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -lado I-EXPLORATION -izquierdo, I-EXPLORATION -con I-EXPLORATION -engrosamiento I-EXPLORATION -parietal I-EXPLORATION -hipoecogénico I-EXPLORATION -(signo I-EXPLORATION -del I-EXPLORATION -halo). I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -dexametasona I-TREATMENT -endovenosa, I-TREATMENT -que I-TREATMENT -debió I-TREATMENT -suspenderse I-TREATMENT -al I-TREATMENT -tercer I-TREATMENT -día I-TREATMENT -por I-TREATMENT +platino, I-EXPLORATION +las I-EXPLORATION +pruebas I-EXPLORATION +resultaron I-EXPLORATION +todas I-EXPLORATION +negativas, I-EXPLORATION +por B-TREATMENT +lo I-TREATMENT +que, I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +protocolizar I-TREATMENT +una I-TREATMENT +pauta I-TREATMENT +de I-TREATMENT +desensibilización I-TREATMENT +para I-TREATMENT +la I-TREATMENT +administración I-TREATMENT +del I-TREATMENT +siguiente I-TREATMENT +ciclo I-TREATMENT +de I-TREATMENT +cisplatino. I-TREATMENT + I-TREATMENT +El I-TREATMENT +PD I-TREATMENT +consistió I-TREATMENT +en I-TREATMENT +12 I-TREATMENT +etapas I-TREATMENT +para I-TREATMENT +la I-TREATMENT +administración I-TREATMENT +de I-TREATMENT +la I-TREATMENT +dosis I-TREATMENT +total I-TREATMENT +del I-TREATMENT +fármaco I-TREATMENT +(140 I-TREATMENT +mg). I-TREATMENT +El I-TREATMENT +protocolo I-TREATMENT +consistió I-TREATMENT +en I-TREATMENT +ir I-TREATMENT +aumentando I-TREATMENT +de I-TREATMENT +forma I-TREATMENT +progresiva I-TREATMENT +la I-TREATMENT +velocidad I-TREATMENT +de I-TREATMENT +infusión I-TREATMENT +y I-TREATMENT +la I-TREATMENT +concentración I-TREATMENT +del I-TREATMENT +fármaco. I-TREATMENT +Se I-TREATMENT +prepararon I-TREATMENT +tres I-TREATMENT +soluciones I-TREATMENT +de I-TREATMENT +las I-TREATMENT +siguientes I-TREATMENT +diluciones: I-TREATMENT +1/100; I-TREATMENT +1/10 I-TREATMENT +y I-TREATMENT +1/1, I-TREATMENT +con I-TREATMENT un I-TREATMENT -episodio I-TREATMENT -confusional I-TREATMENT -agudo, I-TREATMENT -atribuido I-TREATMENT -al I-TREATMENT -tratamiento, I-TREATMENT +volumen I-TREATMENT +total I-TREATMENT +de I-TREATMENT +250 I-TREATMENT +ml. I-TREATMENT +La I-TREATMENT +primera I-TREATMENT +solución I-TREATMENT se I-TREATMENT -cambió I-TREATMENT -por I-TREATMENT -bolos I-TREATMENT +utilizó I-TREATMENT +en I-TREATMENT +los I-TREATMENT +cuatro I-TREATMENT +primeros I-TREATMENT +pasos, I-TREATMENT +la I-TREATMENT +segunda I-TREATMENT +en I-TREATMENT +los I-TREATMENT +cuatro I-TREATMENT +siguientes, I-TREATMENT +y I-TREATMENT +la I-TREATMENT +tercera I-TREATMENT +solución I-TREATMENT +en I-TREATMENT +los I-TREATMENT +últimos I-TREATMENT +cuatro I-TREATMENT +pasos. I-TREATMENT +La I-TREATMENT +velocidad I-TREATMENT de I-TREATMENT -metilprednisolona I-TREATMENT -durante I-TREATMENT -3 I-TREATMENT -días I-TREATMENT +infusión I-TREATMENT +se I-TREATMENT +incrementó I-TREATMENT +cada I-TREATMENT +quince I-TREATMENT +minutos, I-TREATMENT +de I-TREATMENT +forma I-TREATMENT +que I-TREATMENT +con I-TREATMENT +cada I-TREATMENT +paso I-TREATMENT +se I-TREATMENT +administraba I-TREATMENT +el I-TREATMENT +doble I-TREATMENT +que I-TREATMENT +en I-TREATMENT +el I-TREATMENT +paso I-TREATMENT +anterior. I-TREATMENT +En I-TREATMENT +el I-TREATMENT +último I-TREATMENT +paso I-TREATMENT +se I-TREATMENT +mantuvo I-TREATMENT +la I-TREATMENT +velocidad I-TREATMENT +constante I-TREATMENT +hasta I-TREATMENT +acabar I-TREATMENT +de I-TREATMENT +administrar I-TREATMENT +la I-TREATMENT +dosis I-TREATMENT +total. I-TREATMENT +En I-TREATMENT +la I-TREATMENT +tabla I-TREATMENT +1 I-TREATMENT +se I-TREATMENT +resumen I-TREATMENT +las I-TREATMENT +soluciones I-TREATMENT y I-TREATMENT -luego I-TREATMENT -prednisona I-TREATMENT -oral. I-TREATMENT -La B-EVOLUTION +el I-TREATMENT +esquema I-TREATMENT +de I-TREATMENT +administración I-TREATMENT +del I-TREATMENT +protocolo I-TREATMENT +de I-TREATMENT +desensibilización. I-TREATMENT + I-TREATMENT +La I-TREATMENT +administración I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +en I-TREATMENT +hospital I-TREATMENT +de I-TREATMENT +día I-TREATMENT +bajo I-TREATMENT +estrecha I-TREATMENT +monitorización I-TREATMENT +y I-TREATMENT +supervisión I-TREATMENT +médica, I-TREATMENT +con I-TREATMENT +una I-TREATMENT +duración I-TREATMENT +total I-TREATMENT +de I-TREATMENT +5 I-TREATMENT +horas I-TREATMENT +y I-TREATMENT +37 I-TREATMENT +minutos. I-TREATMENT +El B-EVOLUTION paciente I-EVOLUTION -evolucionó I-EVOLUTION -sin I-EVOLUTION -dolor, I-EVOLUTION -manteniendo I-EVOLUTION -escaso I-EVOLUTION -lenguaje I-EVOLUTION -y I-EVOLUTION -cierto I-EVOLUTION -compromiso I-EVOLUTION -cuantitativo I-EVOLUTION -de I-EVOLUTION -conciencia. I-EVOLUTION -En I-EVOLUTION -los I-EVOLUTION -días I-EVOLUTION -subsiguientes I-EVOLUTION -apareció I-EVOLUTION -hipotonía I-EVOLUTION -del I-EVOLUTION -hemicuerpo I-EVOLUTION -izquierdo, I-EVOLUTION -asociada I-EVOLUTION -a I-EVOLUTION -signo I-EVOLUTION -de I-EVOLUTION -Babinski I-EVOLUTION -ipsilateral, I-EVOLUTION -que I-EVOLUTION +no I-EVOLUTION +presentó I-EVOLUTION +ninguna I-EVOLUTION +RHS I-EVOLUTION +durante I-EVOLUTION la I-EVOLUTION -TC I-EVOLUTION -de I-EVOLUTION -control I-EVOLUTION -pudo I-EVOLUTION -asociar I-EVOLUTION -a I-EVOLUTION -importante I-EVOLUTION -hipodensidad I-EVOLUTION -cerebelosa I-EVOLUTION -bilateral I-EVOLUTION -e I-EVOLUTION -hipodensidad I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -lóbulos I-EVOLUTION -occipitales I-EVOLUTION -y I-EVOLUTION -tálamo I-EVOLUTION -derecho, I-EVOLUTION -sugerentes I-EVOLUTION -de I-EVOLUTION -nuevas I-EVOLUTION -lesiones I-EVOLUTION +infusión I-EVOLUTION del I-EVOLUTION -territorio I-EVOLUTION -posterior, I-EVOLUTION -acaecidas I-EVOLUTION -en I-EVOLUTION -pleno I-EVOLUTION -tratamiento I-EVOLUTION -corticoidal. I-EVOLUTION +citostático I-EVOLUTION +mediante I-EVOLUTION +el I-EVOLUTION +PD I-EVOLUTION +ni I-EVOLUTION +posteriormente. I-EVOLUTION I-EVOLUTION -Hombre B-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -26 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -procedente B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -zona I-PAST_MEDICAL_HISTORY -rural I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -municipio I-PAST_MEDICAL_HISTORY +61 I-PRESENT_ILLNESS +años. I-PRESENT_ILLNESS +Asmática, B-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +hipotiroidismo I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +sustitutivo I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +portadora I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -Tibú, I-PAST_MEDICAL_HISTORY -Norte I-PAST_MEDICAL_HISTORY +marcapasos I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +bloqueo I-PAST_MEDICAL_HISTORY +aurículo-ventricular I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -Santander. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS +2o I-PAST_MEDICAL_HISTORY +grado. I-PAST_MEDICAL_HISTORY +Apendicectomizada I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +infancia. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Acude B-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +agudo I-PRESENT_ILLNESS +tipo I-PRESENT_ILLNESS +distensión, I-PRESENT_ILLNESS +asociado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +saciedad I-PRESENT_ILLNESS +precoz, I-PRESENT_ILLNESS +náuseas I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +vómitos I-PRESENT_ILLNESS +postprandiales I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -cinco I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS +2-3 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -fiebre, I-PRESENT_ILLNESS -escalofríos, I-PRESENT_ILLNESS -dolores I-PRESENT_ILLNESS -musculares, I-PRESENT_ILLNESS -cefalea, I-PRESENT_ILLNESS -artralgias, I-PRESENT_ILLNESS -astenia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -adinamia. I-PRESENT_ILLNESS -Se B-EXPLORATION -realizó I-EXPLORATION -estudio I-EXPLORATION -para I-EXPLORATION -hemoparásitos, I-EXPLORATION -encontrándose I-EXPLORATION -ocasionales I-EXPLORATION -tripomastigotes, I-EXPLORATION -según I-EXPLORATION -el I-EXPLORATION -reporte I-EXPLORATION -del I-EXPLORATION -Laboratorio I-EXPLORATION -Clínico I-EXPLORATION -del I-EXPLORATION -Hospital I-EXPLORATION -Erasmo I-EXPLORATION -Meoz. I-EXPLORATION -El I-EXPLORATION -ecocardiograma I-EXPLORATION -mostró I-EXPLORATION -leve I-EXPLORATION -derrame I-EXPLORATION -pericárdico I-EXPLORATION -y I-EXPLORATION -leve I-EXPLORATION -dilatación I-EXPLORATION -ventricular I-EXPLORATION -izquierda. I-EXPLORATION -Además, I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -franca I-EXPLORATION -leucopenia I-EXPLORATION -(3.200 I-EXPLORATION -leucocitos/µl) I-EXPLORATION -y I-EXPLORATION -plaquetopenia I-EXPLORATION -(69.000 I-EXPLORATION -plaquetas/µl). I-EXPLORATION -Se B-TREATMENT -administró I-TREATMENT -tratamiento I-TREATMENT -etiológico I-TREATMENT -con I-TREATMENT -benzonidazol I-TREATMENT -en I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -350 I-TREATMENT -mg/día I-TREATMENT -por I-TREATMENT -60 I-TREATMENT -días. I-TREATMENT -El I-TREATMENT -diagnóstico I-TREATMENT -se I-TREATMENT -confirmó I-TREATMENT -por I-TREATMENT -lectura I-TREATMENT -de I-TREATMENT -lámina I-TREATMENT -de I-TREATMENT -extendido I-TREATMENT -de I-TREATMENT -sangre I-TREATMENT -periférica I-TREATMENT +evolución. I-PRESENT_ILLNESS +Durante I-PRESENT_ILLNESS +este I-PRESENT_ILLNESS +tiempo I-PRESENT_ILLNESS +ha I-PRESENT_ILLNESS +perdido I-PRESENT_ILLNESS +10 I-PRESENT_ILLNESS +kg I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +peso. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +destaca I-EXPLORATION +abdomen I-EXPLORATION +distendido, I-EXPLORATION +timpanizado, I-EXPLORATION +doloroso I-EXPLORATION +de I-EXPLORATION +forma I-EXPLORATION +difusa I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación I-EXPLORATION +sin I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +irritación. I-EXPLORATION +Ruidos I-EXPLORATION +metálicos. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +urgencias I-EXPLORATION +se I-EXPLORATION +realiza I-EXPLORATION +Rx I-EXPLORATION +de I-EXPLORATION +abdomen I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +aprecia I-EXPLORATION +marcada I-EXPLORATION +dilatación I-EXPLORATION +gástrica I-EXPLORATION +y I-EXPLORATION +duodenal I-EXPLORATION +(signo I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +doble I-EXPLORATION +burbuja). I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +realiza I-EXPLORATION +gastroscopia I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +estómago I-EXPLORATION +con I-EXPLORATION +motilidad I-EXPLORATION +prácticamente I-EXPLORATION +ausente I-EXPLORATION +y I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +restos I-EXPLORATION +alimentarios. I-EXPLORATION +El I-EXPLORATION +duodeno I-EXPLORATION +se I-EXPLORATION +encuentra I-EXPLORATION +edematoso I-EXPLORATION +con I-EXPLORATION +imposibilidad I-EXPLORATION +de I-EXPLORATION +pasar I-EXPLORATION +a I-EXPLORATION +segunda I-EXPLORATION +porción, I-EXPLORATION +se I-EXPLORATION +toman I-EXPLORATION +biopsias I-EXPLORATION +que I-EXPLORATION +fueron I-EXPLORATION +informadas I-EXPLORATION +posteriormente I-EXPLORATION +como I-EXPLORATION +duodenitis I-EXPLORATION +inespecífica I-EXPLORATION +con I-EXPLORATION +ausencia I-EXPLORATION +de I-EXPLORATION +células I-EXPLORATION +malignas. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +TC I-EXPLORATION +de I-EXPLORATION +abdomen I-EXPLORATION +se I-EXPLORATION +visualiza I-EXPLORATION +dilatación I-EXPLORATION +gástrica I-EXPLORATION +y I-EXPLORATION +duodenal I-EXPLORATION +con I-EXPLORATION +estenosis I-EXPLORATION +en I-EXPLORATION +3a I-EXPLORATION +porción I-EXPLORATION +duodenal. I-EXPLORATION + I-EXPLORATION +Ante I-EXPLORATION +estos I-EXPLORATION +resultados I-EXPLORATION +se I-EXPLORATION +realiza I-EXPLORATION +EGD I-EXPLORATION +baritado I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +aprecia I-EXPLORATION +3 I-EXPLORATION +estenosis I-EXPLORATION +lisas I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +bordes I-EXPLORATION +regulares, I-EXPLORATION +en I-EXPLORATION +segunda-tercera I-EXPLORATION +porción I-EXPLORATION +duodenal, I-EXPLORATION +con I-EXPLORATION +paso I-EXPLORATION +dificultoso I-EXPLORATION +de I-EXPLORATION +contraste, I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +diafragmas. I-EXPLORATION + I-EXPLORATION +Dado B-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +hallazgos, I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +rehistorió I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +comentó I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +siempre I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +tenido I-PAST_MEDICAL_HISTORY +saciedad I-PAST_MEDICAL_HISTORY +precoz I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +digestiones I-PAST_MEDICAL_HISTORY +lentas, I-PAST_MEDICAL_HISTORY +siendo I-PAST_MEDICAL_HISTORY +siempre I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +persona I-PAST_MEDICAL_HISTORY +muy I-PAST_MEDICAL_HISTORY +delgada I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +talla I-PAST_MEDICAL_HISTORY +corta. I-PAST_MEDICAL_HISTORY +Se B-TREATMENT +realizó I-TREATMENT +gastroenteroanastomosis I-TREATMENT en I-TREATMENT -el I-TREATMENT -INS. I-TREATMENT +Y I-TREATMENT +Roux. I-TREATMENT I-TREATMENT -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS +Hombre B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS -y B-PAST_MEDICAL_HISTORY -padres I-PAST_MEDICAL_HISTORY -consanguíneos, I-PAST_MEDICAL_HISTORY -oriundos I-PAST_MEDICAL_HISTORY +58 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +chofer B-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -Medellín, I-PAST_MEDICAL_HISTORY -con B-FAMILY_HISTORY -el I-FAMILY_HISTORY -antecedente I-FAMILY_HISTORY -de I-FAMILY_HISTORY -un I-FAMILY_HISTORY -hermano I-FAMILY_HISTORY -medio I-FAMILY_HISTORY -fallecido I-FAMILY_HISTORY -con I-FAMILY_HISTORY -esta I-FAMILY_HISTORY -misma I-FAMILY_HISTORY -entidad I-FAMILY_HISTORY -en I-FAMILY_HISTORY -el I-FAMILY_HISTORY -periodo I-FAMILY_HISTORY -perinatal. I-FAMILY_HISTORY -La B-PAST_MEDICAL_HISTORY -ecografía I-PAST_MEDICAL_HISTORY -prenatal I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -reportada I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -normal. I-PAST_MEDICAL_HISTORY -Nació I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -cesárea I-PAST_MEDICAL_HISTORY +ambulancia, I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -peso I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -peso I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -2.030 I-PAST_MEDICAL_HISTORY -g I-PAST_MEDICAL_HISTORY +tabaquismo I-PAST_MEDICAL_HISTORY +activo I-PAST_MEDICAL_HISTORY +(5 I-PAST_MEDICAL_HISTORY +cigarrillos/día) I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -talla I-PAST_MEDICAL_HISTORY +obesidad I-PAST_MEDICAL_HISTORY +(IMC I-PAST_MEDICAL_HISTORY +31 I-PAST_MEDICAL_HISTORY +kg/m2) I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +historia I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -38 I-PAST_MEDICAL_HISTORY -cm. I-PAST_MEDICAL_HISTORY -Se B-PRESENT_ILLNESS -observó I-PRESENT_ILLNESS -cuello I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -tórax I-PRESENT_ILLNESS -cortos, I-PRESENT_ILLNESS +5 I-PAST_MEDICAL_HISTORY +días I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +mialgias, I-PAST_MEDICAL_HISTORY +tos, I-PAST_MEDICAL_HISTORY +odinofagia I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +rinorrea. I-PAST_MEDICAL_HISTORY +Un B-PRESENT_ILLNESS +día I-PRESENT_ILLNESS +antes I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +ingreso I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +agregó I-PRESENT_ILLNESS +disnea I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -abdomen I-PRESENT_ILLNESS -ligeramente I-PRESENT_ILLNESS -distendido. I-PRESENT_ILLNESS -Presentó I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS +compromiso I-PRESENT_ILLNESS +cuantitativo I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -dificultad I-PRESENT_ILLNESS -respiratoria I-PRESENT_ILLNESS -progresiva I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -primeros I-PRESENT_ILLNESS -15 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -vida. I-PRESENT_ILLNESS -En B-TREATMENT -la I-TREATMENT -actualidad, I-TREATMENT -necesita I-TREATMENT -oxígeno I-TREATMENT -permanente. I-TREATMENT -La B-EXPLORATION -ecocardiografía I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION +conciencia. I-PRESENT_ILLNESS +Ingresó B-EXPLORATION +al I-EXPLORATION +Servicio I-EXPLORATION de I-EXPLORATION -tórax I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -apiñamiento I-EXPLORATION +Urgencia I-EXPLORATION +comprometido I-EXPLORATION +de I-EXPLORATION +conciencia, I-EXPLORATION +mal I-EXPLORATION +perfundido, I-EXPLORATION +hipotenso I-EXPLORATION +(106/46 I-EXPLORATION +mmHg), I-EXPLORATION +taquicárdico I-EXPLORATION +(106/min), I-EXPLORATION +con I-EXPLORATION +uso I-EXPLORATION +de I-EXPLORATION +musculatura I-EXPLORATION +accesoria, I-EXPLORATION +saturando I-EXPLORATION +60-67% I-EXPLORATION +por I-EXPLORATION +oximetría I-EXPLORATION de I-EXPLORATION -vertebras I-EXPLORATION -cérvico-torácicas I-EXPLORATION +pulso I-EXPLORATION +a I-EXPLORATION +Fi02 I-EXPLORATION +ambiental I-EXPLORATION y I-EXPLORATION -fusión I-EXPLORATION -costal I-EXPLORATION -posterior, I-EXPLORATION -además I-EXPLORATION +con I-EXPLORATION +roncus I-EXPLORATION +en I-EXPLORATION +ambos I-EXPLORATION +campos I-EXPLORATION +pulmonares. I-EXPLORATION +Se I-EXPLORATION +administró I-EXPLORATION +oxigenoterapia I-EXPLORATION +con I-EXPLORATION +mascarilla I-EXPLORATION de I-EXPLORATION -hemivértebras I-EXPLORATION -lumbares. I-EXPLORATION - I-EXPLORATION - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -8 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -llevada I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -urticaria I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -angioedema I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -contacto I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -agua I-PRESENT_ILLNESS -fría. I-PRESENT_ILLNESS -En B-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -ocasión, I-PAST_MEDICAL_HISTORY -mientras I-PAST_MEDICAL_HISTORY -estaba I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -piscina, I-PAST_MEDICAL_HISTORY -presentó I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -episodio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipotonía I-PAST_MEDICAL_HISTORY -generalizada, I-PAST_MEDICAL_HISTORY -palidez I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -pérdida I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -conciencia, I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -requirió I-PAST_MEDICAL_HISTORY -hospitalización. I-PAST_MEDICAL_HISTORY -Con I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -consumo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -bebidas I-PAST_MEDICAL_HISTORY -frías I-PAST_MEDICAL_HISTORY -presentaba I-PAST_MEDICAL_HISTORY -eritema I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -edema I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -cuello. I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -practicó I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -prueba I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -cubo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hielo, I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -positiva I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -seis I-PAST_MEDICAL_HISTORY -minutos. I-PAST_MEDICAL_HISTORY -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -ciproheptadina, I-TREATMENT -consiguiéndose I-TREATMENT -mejoría I-TREATMENT -de I-TREATMENT -la I-TREATMENT -sintomatología. I-TREATMENT -Un B-EVOLUTION -mes I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -inicio I-EVOLUTION -del I-EVOLUTION -tratamiento, I-EVOLUTION -se I-EVOLUTION -hizo I-EVOLUTION -una I-EVOLUTION -nueva I-EVOLUTION -prueba I-EVOLUTION -con I-EVOLUTION -cubo I-EVOLUTION -de I-EVOLUTION -hielo, I-EVOLUTION -la I-EVOLUTION -cual I-EVOLUTION -fue I-EVOLUTION -negativa I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -10 I-EVOLUTION -minutos. I-EVOLUTION -La B-TREATMENT -paciente I-TREATMENT -recibió I-TREATMENT -ciproheptadina I-TREATMENT -por I-TREATMENT -seis I-TREATMENT -meses I-TREATMENT -llegando I-TREATMENT -hasta I-TREATMENT -la I-TREATMENT -dosis I-TREATMENT -tope I-TREATMENT -para I-TREATMENT -su I-TREATMENT -peso, I-TREATMENT -pero I-TREATMENT -por I-TREATMENT -persistencia I-TREATMENT -de I-TREATMENT -síntomas I-TREATMENT -asociados I-TREATMENT -al I-TREATMENT -contacto I-TREATMENT -con I-TREATMENT -el I-TREATMENT -frío, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -cambiar I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -por I-TREATMENT -cetirizina I-TREATMENT -más I-TREATMENT -montelukast. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -ha I-EVOLUTION -sido I-EVOLUTION -seguida I-EVOLUTION -durante I-EVOLUTION -cuatro I-EVOLUTION -años I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -actualidad I-EVOLUTION -todavía I-EVOLUTION -presenta I-EVOLUTION -urticaria I-EVOLUTION -asociada I-EVOLUTION -al I-EVOLUTION -baño I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -piscinas, I-EVOLUTION -pero I-EVOLUTION -sin I-EVOLUTION -afectación I-EVOLUTION -respiratoria I-EVOLUTION -y I-EVOLUTION -de I-EVOLUTION -resolución I-EVOLUTION -espontánea. I-EVOLUTION - I-EVOLUTION - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -58 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -proveniente B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Orito, I-PAST_MEDICAL_HISTORY -Putumayo I-PAST_MEDICAL_HISTORY -(Amazonia I-PAST_MEDICAL_HISTORY -colombiana), I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -diarrea I-PRESENT_ILLNESS -recurrente, I-PRESENT_ILLNESS -tratada I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -forma I-PRESENT_ILLNESS -repetida I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -agentes I-PRESENT_ILLNESS -antiparasitarios I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -hallazgos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -estrongiloidiasis I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -materia I-PRESENT_ILLNESS -fecal. I-PRESENT_ILLNESS -La B-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -referida I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -Hospital I-DERIVED_FROM/TO -Universitario I-DERIVED_FROM/TO -Clínica I-DERIVED_FROM/TO -Universitaria I-DERIVED_FROM/TO -Colombia, I-DERIVED_FROM/TO -ubicado I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -Bogotá. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -Presentaba B-EXPLORATION -dilatación I-EXPLORATION -del I-EXPLORATION -conducto I-EXPLORATION -biliar I-EXPLORATION -extrahepático I-EXPLORATION -demostrada I-EXPLORATION +alto I-EXPLORATION +flujo I-EXPLORATION +sin I-EXPLORATION +respuesta, I-EXPLORATION por I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -(colangiorresonancia). I-EXPLORATION -Presentaba I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -deshidrogenasa I-EXPLORATION -láctica I-EXPLORATION -de I-EXPLORATION -337 I-EXPLORATION -mg/dl I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +intubó I-EXPLORATION y I-EXPLORATION -no I-EXPLORATION -tenía I-EXPLORATION -reporte I-EXPLORATION +se I-EXPLORATION +trasladó I-EXPLORATION +a I-EXPLORATION +UCI. I-EXPLORATION +Los I-EXPLORATION +exámenes I-EXPLORATION de I-EXPLORATION -calcio I-EXPLORATION -sérico. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -revisión I-EXPLORATION -por I-EXPLORATION -sistemas, I-EXPLORATION -refería I-EXPLORATION -malestar I-EXPLORATION -e I-EXPLORATION -importante I-EXPLORATION -pérdida I-EXPLORATION +laboratorio I-EXPLORATION +mostraron I-EXPLORATION +alteración I-EXPLORATION de I-EXPLORATION -peso; I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -manifestaciones I-EXPLORATION -cutáneas. I-EXPLORATION -Tenía B-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -previa I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -proctitis I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -específica, I-PAST_MEDICAL_HISTORY -colecistectomía, I-PAST_MEDICAL_HISTORY -histerectomía, I-PAST_MEDICAL_HISTORY -obstrucción I-PAST_MEDICAL_HISTORY -intestinal I-PAST_MEDICAL_HISTORY -secundaria I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -adherencias I-PAST_MEDICAL_HISTORY -pélvicas I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -infecciones I-PAST_MEDICAL_HISTORY -frecuentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -vías I-PAST_MEDICAL_HISTORY -urinarias. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Después B-TREATMENT -de I-TREATMENT -una I-TREATMENT -biopsia I-TREATMENT -no I-TREATMENT -diagnóstica I-TREATMENT -de I-TREATMENT -la I-TREATMENT -ampolla I-TREATMENT -de I-TREATMENT -Vater, I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -requirió I-TREATMENT -una I-TREATMENT -pancreatoduodenectomía. I-TREATMENT -En B-EXPLORATION la I-EXPLORATION -mucosa I-EXPLORATION -duodenal I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -una I-EXPLORATION -neoplasia I-EXPLORATION -linfoide I-EXPLORATION -pleomorfa I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -grandes, I-EXPLORATION +función I-EXPLORATION +renal I-EXPLORATION con I-EXPLORATION -expresión I-EXPLORATION -difusa I-EXPLORATION +creatinina I-EXPLORATION +plasmática I-EXPLORATION de I-EXPLORATION -CD3, I-EXPLORATION -CD4 I-EXPLORATION +2, I-EXPLORATION +45 I-EXPLORATION +mg/dL I-EXPLORATION +desde I-EXPLORATION +el I-EXPLORATION +ingreso I-EXPLORATION y I-EXPLORATION -CD56; I-EXPLORATION -CD20 I-EXPLORATION -y I-EXPLORATION -CD30 I-EXPLORATION -focal, I-EXPLORATION -un I-EXPLORATION -índice I-EXPLORATION +NU I-EXPLORATION de I-EXPLORATION -proliferación I-EXPLORATION -(MIB1) I-EXPLORATION +47 I-EXPLORATION +mg/dL. I-EXPLORATION +Tenía I-EXPLORATION +una I-EXPLORATION +PCR I-EXPLORATION +elevada I-EXPLORATION +(200 I-EXPLORATION +mg/L), I-EXPLORATION +con I-EXPLORATION +recuento I-EXPLORATION de I-EXPLORATION -60 I-EXPLORATION -% I-EXPLORATION +leucocitos, I-EXPLORATION +eritrocitos I-EXPLORATION y I-EXPLORATION -eosinofilia I-EXPLORATION -tisular I-EXPLORATION -asociada, I-EXPLORATION +plaquetas I-EXPLORATION +normales. I-EXPLORATION +Además, I-EXPLORATION +presentó I-EXPLORATION +una I-EXPLORATION +elevación I-EXPLORATION +de I-EXPLORATION +LDH I-EXPLORATION +plasmática I-EXPLORATION +(1.500 I-EXPLORATION +U/L) I-EXPLORATION +y I-EXPLORATION +lactato I-EXPLORATION +arterial I-EXPLORATION +45 I-EXPLORATION +mg/dL I-EXPLORATION +(4,5-14,4). I-EXPLORATION +La I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +tórax I-EXPLORATION +confirmó I-EXPLORATION +una I-EXPLORATION +neumonía I-EXPLORATION +multilobar I-EXPLORATION +por I-EXPLORATION lo I-EXPLORATION que I-EXPLORATION -llevó I-EXPLORATION -a I-EXPLORATION +se I-EXPLORATION +inició I-EXPLORATION +tratamiento I-EXPLORATION +empírico I-EXPLORATION +con I-EXPLORATION +ceftriaxona, I-EXPLORATION +moxifloxacino I-EXPLORATION +y I-EXPLORATION +oseltamivir. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +paciente I-EXPLORATION +evolucionó I-EXPLORATION +con I-EXPLORATION un I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -linfoma I-EXPLORATION -T I-EXPLORATION -periférico, I-EXPLORATION -NOS I-EXPLORATION -( I-EXPLORATION -Peripheral I-EXPLORATION -T-Cell I-EXPLORATION -Lymphoma, I-EXPLORATION -Not I-EXPLORATION -Otherwise I-EXPLORATION -Specified I-EXPLORATION -). I-EXPLORATION -Se I-EXPLORATION -determinó I-EXPLORATION -la I-EXPLORATION -ausencia I-EXPLORATION +shock I-EXPLORATION +(con I-EXPLORATION +requerimientos I-EXPLORATION de I-EXPLORATION -compromiso I-EXPLORATION +noradrenalina I-EXPLORATION +hasta I-EXPLORATION +0, I-EXPLORATION +15 I-EXPLORATION +μg/kg/min) I-EXPLORATION +e I-EXPLORATION +insuficiencia I-EXPLORATION +respiratoria I-EXPLORATION +catastrófica I-EXPLORATION +en I-EXPLORATION +VM, I-EXPLORATION +decidiéndose I-EXPLORATION +ventilar I-EXPLORATION +en I-EXPLORATION +posición I-EXPLORATION +prono. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +microbiológico I-EXPLORATION +no I-EXPLORATION +demostró I-EXPLORATION +agentes I-EXPLORATION +por I-EXPLORATION +hemocultivos, I-EXPLORATION +urocultivo, I-EXPLORATION +cultivo I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -medula I-EXPLORATION -ósea I-EXPLORATION +aspirado I-EXPLORATION +endotraqueal I-EXPLORATION +o I-EXPLORATION +panel I-EXPLORATION +viral I-EXPLORATION por I-EXPLORATION -histología I-EXPLORATION +inmunofluorescencia. I-EXPLORATION +La I-EXPLORATION +serología I-EXPLORATION +para I-EXPLORATION +VIH I-EXPLORATION +fue I-EXPLORATION +negativa I-EXPLORATION y I-EXPLORATION -citometría I-EXPLORATION +se I-EXPLORATION +confirmó I-EXPLORATION +una I-EXPLORATION +influenza I-EXPLORATION +A I-EXPLORATION +H1N1 I-EXPLORATION +pdm09 I-EXPLORATION +por I-EXPLORATION +RPC. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +complementario I-EXPLORATION +por I-EXPLORATION +RPC I-EXPLORATION +reveló I-EXPLORATION +además I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -flujo. I-EXPLORATION +ADV I-EXPLORATION +y I-EXPLORATION +VRS I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +vía I-EXPLORATION +aérea. I-EXPLORATION I-EXPLORATION -Considerando I-EXPLORATION -como I-EXPLORATION -diagnóstico I-EXPLORATION -diferencial I-EXPLORATION +Desde I-EXPLORATION +las I-EXPLORATION +48 I-EXPLORATION +h I-EXPLORATION +del I-EXPLORATION +ingreso I-EXPLORATION +disminuyeron I-EXPLORATION +los I-EXPLORATION +requerimientos I-EXPLORATION +de I-EXPLORATION +noradrenalina I-EXPLORATION +(0, I-EXPLORATION +03 I-EXPLORATION +μg/kg/min), I-EXPLORATION +estabilizándose I-EXPLORATION +su I-EXPLORATION +insuficiencia I-EXPLORATION +respiratoria I-EXPLORATION +(PaFi I-EXPLORATION +> I-EXPLORATION +250), I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +volvió I-EXPLORATION +a I-EXPLORATION +posición I-EXPLORATION +supina. I-EXPLORATION +No I-EXPLORATION +obstante, I-EXPLORATION +presentó I-EXPLORATION +una I-EXPLORATION +progresión I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +IRA, I-EXPLORATION +desde I-EXPLORATION +oliguria I-EXPLORATION +hasta I-EXPLORATION la I-EXPLORATION -leucemia I-EXPLORATION +anuria, I-EXPLORATION +con I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION -células I-EXPLORATION -T I-EXPLORATION -del I-EXPLORATION -adulto, I-EXPLORATION +la I-EXPLORATION +creatinina I-EXPLORATION +hasta I-EXPLORATION +5, I-EXPLORATION +7 I-EXPLORATION +mg/dL, I-EXPLORATION +NU I-EXPLORATION +hasta I-EXPLORATION +98 I-EXPLORATION +mg/dL I-EXPLORATION +e I-EXPLORATION +hiperkalemia I-EXPLORATION +grave. I-EXPLORATION +Se I-EXPLORATION +inició I-EXPLORATION +soporte I-EXPLORATION +dialítico I-EXPLORATION +con I-EXPLORATION +HD I-EXPLORATION +intermitente I-EXPLORATION +diaria. I-EXPLORATION +La I-EXPLORATION +evolución I-EXPLORATION +de I-EXPLORATION +oliguria I-EXPLORATION +a I-EXPLORATION +anuria I-EXPLORATION +no I-EXPLORATION +permitió I-EXPLORATION +realizar I-EXPLORATION +FENa; I-EXPLORATION +sin I-EXPLORATION +embargo, I-EXPLORATION +el I-EXPLORATION +paciente I-EXPLORATION +había I-EXPLORATION +sido I-EXPLORATION +reanimado I-EXPLORATION +y I-EXPLORATION +estabilizado I-EXPLORATION +hemodinámicamente I-EXPLORATION +(con I-EXPLORATION +mínimo I-EXPLORATION +requerimiento I-EXPLORATION +de I-EXPLORATION +vasoactivos), I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +era I-EXPLORATION +planteable I-EXPLORATION +un I-EXPLORATION +componente I-EXPLORATION +pre-renal I-EXPLORATION +en I-EXPLORATION +ese I-EXPLORATION +contexto. I-EXPLORATION +No I-EXPLORATION se I-EXPLORATION -ordenó I-EXPLORATION -una I-EXPLORATION -prueba I-EXPLORATION -ELISA I-EXPLORATION +pudieron I-EXPLORATION +efectuar I-EXPLORATION +imágenes I-EXPLORATION +abdominales I-EXPLORATION para I-EXPLORATION -HTLV1/2, I-EXPLORATION +evaluar I-EXPLORATION la I-EXPLORATION -cual I-EXPLORATION -resultó I-EXPLORATION -positiva I-EXPLORATION +anatomía I-EXPLORATION +renal, I-EXPLORATION +ya I-EXPLORATION +que I-EXPLORATION +su I-EXPLORATION +condición I-EXPLORATION +inestable I-EXPLORATION +impidió I-EXPLORATION +su I-EXPLORATION +realización. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +paciente I-EXPLORATION +presentó I-EXPLORATION +un I-EXPLORATION +nuevo I-EXPLORATION +deterioro I-EXPLORATION +gasométrico I-EXPLORATION +con I-EXPLORATION +PaFi I-EXPLORATION +menor I-EXPLORATION +a I-EXPLORATION +150, I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +hizo I-EXPLORATION +necesario I-EXPLORATION +volver I-EXPLORATION +a I-EXPLORATION +VM I-EXPLORATION +en I-EXPLORATION +posición I-EXPLORATION +prono. I-EXPLORATION +Se I-EXPLORATION +descartó I-EXPLORATION +una I-EXPLORATION +falla I-EXPLORATION +ventricular I-EXPLORATION +por I-EXPLORATION +ecocardiografía I-EXPLORATION y I-EXPLORATION se I-EXPLORATION -confirmó I-EXPLORATION -mediante I-EXPLORATION +administraron I-EXPLORATION +bolos I-EXPLORATION +de I-EXPLORATION +metilprednisolona I-EXPLORATION +62, I-EXPLORATION +5 I-EXPLORATION +mg I-EXPLORATION +por I-EXPLORATION +5 I-EXPLORATION +días I-EXPLORATION +en I-EXPLORATION +contexto I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +SDRA I-EXPLORATION +grave. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +examen I-EXPLORATION +de I-EXPLORATION +orina, I-EXPLORATION +al I-EXPLORATION +recuperar I-EXPLORATION +la I-EXPLORATION +diuresis, I-EXPLORATION +mostró I-EXPLORATION +un I-EXPLORATION +perfil I-EXPLORATION +inflamatorio I-EXPLORATION +con I-EXPLORATION una I-EXPLORATION -prueba I-EXPLORATION +proteinuria I-EXPLORATION de I-EXPLORATION -Western I-EXPLORATION -Blot, I-EXPLORATION -también I-EXPLORATION -positiva I-EXPLORATION -para I-EXPLORATION -HTLV-1 I-EXPLORATION -(presencia I-EXPLORATION +300 I-EXPLORATION +mg/dL, I-EXPLORATION +hematuria I-EXPLORATION +con I-EXPLORATION +eritrocitos I-EXPLORATION +incontables I-EXPLORATION +e I-EXPLORATION +índice I-EXPLORATION +proteinuria/creatininuria I-EXPLORATION de I-EXPLORATION -bandas I-EXPLORATION +7.384 I-EXPLORATION +mg/g. I-EXPLORATION +Por I-EXPLORATION +su I-EXPLORATION +parte, I-EXPLORATION +los I-EXPLORATION +valores I-EXPLORATION de I-EXPLORATION -discriminación I-EXPLORATION -p19-I, I-EXPLORATION -gp46-I I-EXPLORATION +CK, I-EXPLORATION +C3 I-EXPLORATION y I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -GP46-II). I-EXPLORATION -El B-EVOLUTION -tipo I-EVOLUTION -de I-EVOLUTION -leucemia/linfoma I-EVOLUTION -de I-EVOLUTION -células I-EVOLUTION -T I-EVOLUTION -del I-EVOLUTION -adulto I-EVOLUTION -identificado I-EVOLUTION -correspondió I-EVOLUTION -a I-EVOLUTION -un I-EVOLUTION -linfoma I-EVOLUTION -agresivo. I-EVOLUTION -La B-TREATMENT -paciente I-TREATMENT -recibió I-TREATMENT -cinco I-TREATMENT -ciclos I-TREATMENT +C4 I-EXPLORATION +resultaron I-EXPLORATION +normales I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +autoinmune I-EXPLORATION +con I-EXPLORATION +ANCA-c, I-EXPLORATION +ANCA-p I-EXPLORATION +y I-EXPLORATION +ANA I-EXPLORATION +fue I-EXPLORATION +negativo. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +marcadores I-EXPLORATION +virales I-EXPLORATION +de I-EXPLORATION +hepatitis I-EXPLORATION +B I-EXPLORATION +y I-EXPLORATION +C I-EXPLORATION +fue I-EXPLORATION +negativo. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +paciente I-EXPLORATION +mejoró I-EXPLORATION +progresivamente I-EXPLORATION +de I-EXPLORATION +su I-EXPLORATION +cuadro I-EXPLORATION +respiratorio I-EXPLORATION +extubándose I-EXPLORATION +a I-EXPLORATION +los I-EXPLORATION +21 I-EXPLORATION +días. I-EXPLORATION +En B-TREATMENT +total, I-TREATMENT +se I-TREATMENT +completaron I-TREATMENT +15 I-TREATMENT +sesiones I-TREATMENT de I-TREATMENT -quimioterapia I-TREATMENT -combinada I-TREATMENT -(CHOP) I-TREATMENT -antes B-EVOLUTION +HD I-TREATMENT +recuperando I-TREATMENT +la I-TREATMENT +función I-TREATMENT +renal, I-TREATMENT +con I-TREATMENT +mejoría I-TREATMENT +de I-TREATMENT +sedimento I-TREATMENT +urinario I-TREATMENT +inflamatorio I-TREATMENT +(proteinuria I-TREATMENT +de I-TREATMENT +30 I-TREATMENT +mg/dL I-TREATMENT +y I-TREATMENT +eritrocitos I-TREATMENT +2-4 I-TREATMENT +por I-TREATMENT +campo) I-TREATMENT +y I-TREATMENT +normalización I-TREATMENT +de I-TREATMENT +la I-TREATMENT +diuresis. I-TREATMENT +Se B-EVOLUTION +dio I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +al I-EVOLUTION +mes I-EVOLUTION +y I-EVOLUTION +medio I-EVOLUTION +de I-EVOLUTION +internación. I-EVOLUTION +El I-EVOLUTION +paciente I-EVOLUTION +tenía I-EVOLUTION +indicación I-EVOLUTION de I-EVOLUTION +vacuna I-EVOLUTION +influenza I-EVOLUTION +por I-EVOLUTION su I-EVOLUTION -fallecimiento. I-EVOLUTION -No I-EVOLUTION +obesidad I-EVOLUTION +y I-EVOLUTION +ser I-EVOLUTION +personal I-EVOLUTION +de I-EVOLUTION +salud, I-EVOLUTION +pero I-EVOLUTION +no I-EVOLUTION +la I-EVOLUTION +había I-EVOLUTION +recibido. I-EVOLUTION +Se I-EVOLUTION +efectuó I-EVOLUTION +un I-EVOLUTION +control I-EVOLUTION +un I-EVOLUTION +año I-EVOLUTION +después, I-EVOLUTION +que I-EVOLUTION +mostró I-EVOLUTION +normalización I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +función I-EVOLUTION +renal I-EVOLUTION +y I-EVOLUTION +un I-EVOLUTION +sedimento I-EVOLUTION +de I-EVOLUTION +orina I-EVOLUTION +normal. I-EVOLUTION + I-EVOLUTION +Estudios I-EVOLUTION +moleculares I-EVOLUTION + I-EVOLUTION +En I-EVOLUTION +el I-EVOLUTION +Instituto I-EVOLUTION +de I-EVOLUTION +Salud I-EVOLUTION +Pública I-EVOLUTION +de I-EVOLUTION +Chile I-EVOLUTION +las I-EVOLUTION +muestras I-EVOLUTION +respiratorias I-EVOLUTION +se I-EVOLUTION +sometieron I-EVOLUTION +a I-EVOLUTION +extracción I-EVOLUTION +de I-EVOLUTION +ácidos I-EVOLUTION +nucleicos I-EVOLUTION +totales I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +equipo I-EVOLUTION +automatizado I-EVOLUTION +EASYMAG I-EVOLUTION +de I-EVOLUTION +Nuclisens. I-EVOLUTION +Se I-EVOLUTION +realizó I-EVOLUTION +RT-RPC I-EVOLUTION +usando I-EVOLUTION +el I-EVOLUTION +protocolo I-EVOLUTION +estándar I-EVOLUTION +del I-EVOLUTION +CDC I-EVOLUTION +para I-EVOLUTION +la I-EVOLUTION +detección I-EVOLUTION +y I-EVOLUTION +subtipificación I-EVOLUTION +de I-EVOLUTION +virus I-EVOLUTION +influenza I-EVOLUTION +(CDC I-EVOLUTION +real I-EVOLUTION +time I-EVOLUTION +RT-PCR I-EVOLUTION +protocol I-EVOLUTION +for I-EVOLUTION +detection I-EVOLUTION +and I-EVOLUTION +characterization I-EVOLUTION +of I-EVOLUTION +influenza, I-EVOLUTION +2012), I-EVOLUTION +y I-EVOLUTION +para I-EVOLUTION +otros I-EVOLUTION +virus I-EVOLUTION +respiratorios I-EVOLUTION +(Real-time I-EVOLUTION +RT-PCR I-EVOLUTION +assay I-EVOLUTION +for I-EVOLUTION +non-influenza I-EVOLUTION +respiratory I-EVOLUTION +viruses) I-EVOLUTION +en I-EVOLUTION +termociclador I-EVOLUTION +7500 I-EVOLUTION +Fast I-EVOLUTION +de I-EVOLUTION +Applied I-EVOLUTION +Biosystems. I-EVOLUTION +Se I-EVOLUTION +amplificó I-EVOLUTION +un I-EVOLUTION +panel I-EVOLUTION +de I-EVOLUTION +virus I-EVOLUTION +respiratorios I-EVOLUTION +que I-EVOLUTION +incluyen I-EVOLUTION +influenza, I-EVOLUTION +virus I-EVOLUTION +respiratorio I-EVOLUTION +sincicial, I-EVOLUTION +metapneumovirus, I-EVOLUTION +parainfluenza I-EVOLUTION +1, I-EVOLUTION +2 I-EVOLUTION +y I-EVOLUTION +3, I-EVOLUTION +adenovirus I-EVOLUTION +y I-EVOLUTION +rinovirus, I-EVOLUTION +que I-EVOLUTION +fue I-EVOLUTION +el I-EVOLUTION +que I-EVOLUTION +permitió I-EVOLUTION +detectar I-EVOLUTION +las I-EVOLUTION +co-infecciones I-EVOLUTION +ya I-EVOLUTION +descritas. I-EVOLUTION + I-EVOLUTION +Además, I-EVOLUTION +para I-EVOLUTION +explorar I-EVOLUTION +la I-EVOLUTION +existencia I-EVOLUTION +de I-EVOLUTION +mutaciones I-EVOLUTION +que I-EVOLUTION +pudieran I-EVOLUTION +estar I-EVOLUTION +potencialmente I-EVOLUTION +asociadas I-EVOLUTION +a I-EVOLUTION +una I-EVOLUTION +mayor I-EVOLUTION +gravedad I-EVOLUTION +clínica, I-EVOLUTION se I-EVOLUTION hizo I-EVOLUTION +un I-EVOLUTION estudio I-EVOLUTION -post I-EVOLUTION -mórtem. I-EVOLUTION +de I-EVOLUTION +secuenciación I-EVOLUTION +del I-EVOLUTION +segmento I-EVOLUTION +HA1 I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +hemaglutinina I-EVOLUTION +viral, I-EVOLUTION +mediante I-EVOLUTION +secuenciación I-EVOLUTION +por I-EVOLUTION +el I-EVOLUTION +método I-EVOLUTION +de I-EVOLUTION +Sanger I-EVOLUTION +en I-EVOLUTION +un I-EVOLUTION +equipo I-EVOLUTION +Applied I-EVOLUTION +Biosystems/Genetic I-EVOLUTION +analyzer I-EVOLUTION +3500. I-EVOLUTION +Ambas I-EVOLUTION +muestras I-EVOLUTION +fueron I-EVOLUTION +comparadas I-EVOLUTION +con I-EVOLUTION +un I-EVOLUTION +grupo I-EVOLUTION +de I-EVOLUTION +76 I-EVOLUTION +muestras I-EVOLUTION +de I-EVOLUTION +distintas I-EVOLUTION +regiones I-EVOLUTION +del I-EVOLUTION +país, I-EVOLUTION +tanto I-EVOLUTION +de I-EVOLUTION +pacientes I-EVOLUTION +ambulatorios I-EVOLUTION +como I-EVOLUTION +hospitalizados, I-EVOLUTION +incluyendo I-EVOLUTION +11 I-EVOLUTION +muestras I-EVOLUTION +de I-EVOLUTION +pacientes I-EVOLUTION +fallecidos. I-EVOLUTION +El I-EVOLUTION +análisis I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +secuenciación I-EVOLUTION +del I-EVOLUTION +segmento I-EVOLUTION +HA1 I-EVOLUTION +de I-EVOLUTION +virus I-EVOLUTION +influenza I-EVOLUTION +H1N1pdm09, I-EVOLUTION +comparado I-EVOLUTION +con I-EVOLUTION +la I-EVOLUTION +cepa I-EVOLUTION +estándar I-EVOLUTION +A/California/07/2009 I-EVOLUTION +demostró I-EVOLUTION +que I-EVOLUTION +ambos I-EVOLUTION +casos I-EVOLUTION +presentaron I-EVOLUTION +las I-EVOLUTION +mismas I-EVOLUTION +ocho I-EVOLUTION +mutaciones I-EVOLUTION +comunes I-EVOLUTION +a I-EVOLUTION +las I-EVOLUTION +otras I-EVOLUTION +76 I-EVOLUTION +muestras I-EVOLUTION +analizadas I-EVOLUTION +del I-EVOLUTION +año I-EVOLUTION +2015, I-EVOLUTION +indicando I-EVOLUTION +que I-EVOLUTION +fueron I-EVOLUTION +las I-EVOLUTION +mismas I-EVOLUTION +cepas I-EVOLUTION +circulantes I-EVOLUTION +(datos I-EVOLUTION +no I-EVOLUTION +mostrados). I-EVOLUTION +Sin I-EVOLUTION +embargo, I-EVOLUTION +la I-EVOLUTION +muestra I-EVOLUTION +del I-EVOLUTION +caso I-EVOLUTION +1 I-EVOLUTION +evidenció I-EVOLUTION +en I-EVOLUTION +forma I-EVOLUTION +única I-EVOLUTION +la I-EVOLUTION +mutación I-EVOLUTION +D222N I-EVOLUTION +que I-EVOLUTION +no I-EVOLUTION +se I-EVOLUTION +detectó I-EVOLUTION +en I-EVOLUTION +ninguna I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +otras I-EVOLUTION +muestras I-EVOLUTION +analizadas. I-EVOLUTION +En I-EVOLUTION +las I-EVOLUTION +dos I-EVOLUTION +muestras I-EVOLUTION +analizadas I-EVOLUTION +y I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +resto I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +muestras I-EVOLUTION +de I-EVOLUTION +esa I-EVOLUTION +temporada, I-EVOLUTION +no I-EVOLUTION +se I-EVOLUTION +detectaron I-EVOLUTION +otras I-EVOLUTION +mutaciones I-EVOLUTION +previamente I-EVOLUTION +reportadas I-EVOLUTION +como I-EVOLUTION +A90S I-EVOLUTION +ni I-EVOLUTION +K180Q. I-EVOLUTION I-EVOLUTION -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -hombre I-PRESENT_ILLNESS -mestizo I-PRESENT_ILLNESS +Preescolar B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -63 I-PRESENT_ILLNESS +4 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -natural B-PAST_MEDICAL_HISTORY +6 I-PRESENT_ILLNESS +meses, I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +femenino, I-PRESENT_ILLNESS +previamente B-PAST_MEDICAL_HISTORY +sana, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +calendario I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -Medellín I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -residente I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -Bogotá, I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -viajado I-PAST_MEDICAL_HISTORY +vacunación I-PAST_MEDICAL_HISTORY +PNI I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +día, I-PAST_MEDICAL_HISTORY +incluyendo I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +dosis I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +vacuna I-PAST_MEDICAL_HISTORY +conjugada I-PAST_MEDICAL_HISTORY +ACWY-CRM197 I-PAST_MEDICAL_HISTORY a I-PAST_MEDICAL_HISTORY los I-PAST_MEDICAL_HISTORY -Estados I-PAST_MEDICAL_HISTORY -Unidos I-PAST_MEDICAL_HISTORY -recientemente. I-PAST_MEDICAL_HISTORY -Presentaba I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -epilepsia I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -crisis I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ausencia I-PAST_MEDICAL_HISTORY -tratadas I-PAST_MEDICAL_HISTORY -adecuadamente; I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -fumaba I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -consumo I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +durante I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +Plan I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -alcohol I-PAST_MEDICAL_HISTORY -era I-PAST_MEDICAL_HISTORY -ocasional. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -debido I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS +Acción I-PAST_MEDICAL_HISTORY +W135. I-PAST_MEDICAL_HISTORY +El B-PRESENT_ILLNESS cuadro I-PRESENT_ILLNESS clínico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -15 I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +caracterizó I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +tres I-PRESENT_ILLNESS días I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -intenso I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -"difícil I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -describir" I-PRESENT_ILLNESS -(más I-PRESENT_ILLNESS -agudo I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -regiones I-PRESENT_ILLNESS -mesogástrica I-PRESENT_ILLNESS +coriza I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -epigástrica), I-PRESENT_ILLNESS -interrupciones I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -sueño, I-PRESENT_ILLNESS -hiporexia I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +hasta I-PRESENT_ILLNESS +38, I-PRESENT_ILLNESS +5 I-PRESENT_ILLNESS +°C, I-PRESENT_ILLNESS +asociado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal, I-PRESENT_ILLNESS +mialgias I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -disminución I-PRESENT_ILLNESS +epistaxis. I-PRESENT_ILLNESS +Consultó I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -frecuencia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -cantidad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -deposiciones I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -siete I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -previos. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -asociaba I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -inicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -síntomas I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +oportunidades I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +SAPU, I-PRESENT_ILLNESS +donde I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +le I-PRESENT_ILLNESS +indicó I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +sintomático I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -ingestión I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -agua I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +antiinflamatorio I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +esteroidal. I-PRESENT_ILLNESS +Al I-PRESENT_ILLNESS +día I-PRESENT_ILLNESS +siguiente I-PRESENT_ILLNESS +aparecieron I-PRESENT_ILLNESS +lesiones I-PRESENT_ILLNESS +violáceas I-PRESENT_ILLNESS +puntiformes I-PRESENT_ILLNESS +generalizadas, I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +es I-PRESENT_ILLNESS +llevado I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +Servicio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -grifo I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -casa. I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS -anterior I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -consultado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS +Urgencia. I-PRESENT_ILLNESS +Ingresó I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -cuatro I-PRESENT_ILLNESS -ocasiones I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -igual I-PRESENT_ILLNESS -motivo. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En B-EXPLORATION -el I-EXPLORATION -momento I-EXPLORATION -del I-EXPLORATION -ingreso, I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -estaba I-EXPLORATION -en I-EXPLORATION -buen I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION -hidratado, I-EXPLORATION -con I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION -de I-EXPLORATION -123/74 I-EXPLORATION -mm I-EXPLORATION -Hg, I-EXPLORATION -frecuencia I-EXPLORATION -cardiaca I-EXPLORATION +paro I-PRESENT_ILLNESS +cardio-respiratorio, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +exantema I-PRESENT_ILLNESS +purpúrico I-PRESENT_ILLNESS +generalizado. I-PRESENT_ILLNESS +Se B-TREATMENT +inició I-TREATMENT +reanimación I-TREATMENT +con I-TREATMENT +masaje I-TREATMENT +cardíaco, I-TREATMENT +adrenalina I-TREATMENT +e I-TREATMENT +intubación I-TREATMENT +orotraqueal, I-TREATMENT +además I-TREATMENT +de I-TREATMENT +ceftriaxona I-TREATMENT +100 I-TREATMENT +mg/kg I-TREATMENT +y I-TREATMENT +vancomicina I-TREATMENT +15 I-TREATMENT +mg/kg/dosis I-TREATMENT +a I-TREATMENT +través I-TREATMENT +de I-TREATMENT +vía I-TREATMENT +intraósea. I-TREATMENT +Falleció B-EVOLUTION +a I-EVOLUTION +consecuencia I-EVOLUTION +de I-EVOLUTION +una I-EVOLUTION +fibrilación I-EVOLUTION +ventricular, I-EVOLUTION +sin I-EVOLUTION +respuesta I-EVOLUTION +a I-EVOLUTION +cardioversión I-EVOLUTION +eléctrica I-EVOLUTION +y I-EVOLUTION +dosis I-EVOLUTION +sucesivas I-EVOLUTION +de I-EVOLUTION +adrenalina. I-EVOLUTION +La B-EXPLORATION +sospecha I-EXPLORATION +diagnóstica I-EXPLORATION +fue I-EXPLORATION +una I-EXPLORATION +meningococcemia I-EXPLORATION +fulminante. I-EXPLORATION +Debido I-EXPLORATION +a I-EXPLORATION +su I-EXPLORATION +gravedad I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +pudo I-EXPLORATION +realizar I-EXPLORATION +estudio I-EXPLORATION de I-EXPLORATION -75 I-EXPLORATION -latidos I-EXPLORATION -por I-EXPLORATION -minuto, I-EXPLORATION -frecuencia I-EXPLORATION -respiratoria I-EXPLORATION +LCR. I-EXPLORATION +Los I-EXPLORATION +hemocultivos I-EXPLORATION +tomados I-EXPLORATION +durante I-EXPLORATION +la I-EXPLORATION +reanimación I-EXPLORATION +fueron I-EXPLORATION +negativos. I-EXPLORATION +Dada I-EXPLORATION +la I-EXPLORATION +alta I-EXPLORATION +sospecha I-EXPLORATION de I-EXPLORATION -16 I-EXPLORATION -por I-EXPLORATION -minuto, I-EXPLORATION -temperatura I-EXPLORATION +etiología I-EXPLORATION +meningocócica, I-EXPLORATION +se I-EXPLORATION +envió I-EXPLORATION +una I-EXPLORATION +muestra I-EXPLORATION de I-EXPLORATION -37 I-EXPLORATION -o I-EXPLORATION -C, I-EXPLORATION -faringe I-EXPLORATION -normal, I-EXPLORATION -cuello I-EXPLORATION -sin I-EXPLORATION -alteraciones, I-EXPLORATION -estado I-EXPLORATION -cardiopulmonar I-EXPLORATION -normal I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -auscultación, I-EXPLORATION -ruidos I-EXPLORATION -peristálticos I-EXPLORATION -reducidos, I-EXPLORATION -dolor I-EXPLORATION -a I-EXPLORATION +sangre I-EXPLORATION +remanente I-EXPLORATION +para I-EXPLORATION +realizar I-EXPLORATION +RPC, I-EXPLORATION la I-EXPLORATION -palpación I-EXPLORATION -en I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -marco I-EXPLORATION -cólico, I-EXPLORATION -ausencia I-EXPLORATION +cual I-EXPLORATION +confirmó I-EXPLORATION +N. I-EXPLORATION +meningitidis I-EXPLORATION +serogrupo I-EXPLORATION +B. I-EXPLORATION + I-EXPLORATION + +Paciente B-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +22 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +caucásico, I-PRESENT_ILLNESS +diagnosticado B-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +meses I-PAST_MEDICAL_HISTORY +antes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +CUC I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +biopsia I-PAST_MEDICAL_HISTORY +compatible. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +mesalazina I-PAST_MEDICAL_HISTORY +1.000 I-PAST_MEDICAL_HISTORY +mg I-PAST_MEDICAL_HISTORY +c/8 I-PAST_MEDICAL_HISTORY +h I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +prednisona I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +dosis I-PAST_MEDICAL_HISTORY +decrecientes I-PAST_MEDICAL_HISTORY +(5 I-PAST_MEDICAL_HISTORY +mg/día), I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +actividad I-PAST_MEDICAL_HISTORY +inflamatoria I-PAST_MEDICAL_HISTORY +actual. I-PAST_MEDICAL_HISTORY +Tres B-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +antes I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +ingreso I-PRESENT_ILLNESS +refiere I-PRESENT_ILLNESS +cefalea I-PRESENT_ILLNESS +intensa I-PRESENT_ILLNESS +persistente, I-PRESENT_ILLNESS +agregándose I-PRESENT_ILLNESS +vómitos I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +trastorno I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +lenguaje. I-PRESENT_ILLNESS +Sin I-PRESENT_ILLNESS +fiebre, I-PRESENT_ILLNESS +fotofobia I-PRESENT_ILLNESS +o I-PRESENT_ILLNESS +alteraciones I-PRESENT_ILLNESS +visuales. I-PRESENT_ILLNESS +No B-EXPLORATION +se I-EXPLORATION +evidenciaba I-EXPLORATION +signología I-EXPLORATION +focal I-EXPLORATION +ni I-EXPLORATION +movimientos I-EXPLORATION +anormales. I-EXPLORATION + I-EXPLORATION +Al I-EXPLORATION +examen, I-EXPLORATION +afebril, I-EXPLORATION +normotenso, I-EXPLORATION +saturación I-EXPLORATION de I-EXPLORATION -signos I-EXPLORATION +98% I-EXPLORATION +ambiental, I-EXPLORATION +con I-EXPLORATION +buena I-EXPLORATION +perfusión. I-EXPLORATION +Ritmo I-EXPLORATION +cardiaco I-EXPLORATION +regular I-EXPLORATION de I-EXPLORATION -irritación I-EXPLORATION -peritoneal, I-EXPLORATION +88 I-EXPLORATION +lpm. I-EXPLORATION +Sin I-EXPLORATION +alteraciones I-EXPLORATION +pleuropulmonares. I-EXPLORATION +Abdomen I-EXPLORATION +indoloro. I-EXPLORATION +Neurológicamente I-EXPLORATION +estaba I-EXPLORATION +vigil I-EXPLORATION +pero I-EXPLORATION +confuso, I-EXPLORATION +con I-EXPLORATION +afasia I-EXPLORATION +fluente I-EXPLORATION +y I-EXPLORATION +déficit I-EXPLORATION +de I-EXPLORATION +comprensión. I-EXPLORATION +Sin I-EXPLORATION +alteración I-EXPLORATION en I-EXPLORATION -tanto I-EXPLORATION -que I-EXPLORATION -los I-EXPLORATION -demás I-EXPLORATION -aspectos I-EXPLORATION -estaban I-EXPLORATION -dentro I-EXPLORATION +la I-EXPLORATION +oculomotricidad. I-EXPLORATION +Sector I-EXPLORATION +espinal I-EXPLORATION +y I-EXPLORATION +meníngeo I-EXPLORATION +sin I-EXPLORATION +alteraciones. I-EXPLORATION +Valoración I-EXPLORATION +general I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -límites I-EXPLORATION -normales. I-EXPLORATION +laboratorio I-EXPLORATION +sin I-EXPLORATION +elementos I-EXPLORATION +a I-EXPLORATION +destacar. I-EXPLORATION I-EXPLORATION -Se I-EXPLORATION -hospitalizó I-EXPLORATION -al I-EXPLORATION -paciente I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -practicaron I-EXPLORATION -evaluaciones I-EXPLORATION -paraclínicas I-EXPLORATION -con I-EXPLORATION -los I-EXPLORATION -siguientes I-EXPLORATION -resultados: I-EXPLORATION -leucocitos: I-EXPLORATION -8.120 I-EXPLORATION -por I-EXPLORATION -mm I-EXPLORATION -3, I-EXPLORATION -neutrófilos: I-EXPLORATION -59, I-EXPLORATION -4 I-EXPLORATION -%, I-EXPLORATION -linfocitos: I-EXPLORATION -16, I-EXPLORATION -0 I-EXPLORATION -%, I-EXPLORATION -eosinófilos: I-EXPLORATION -18, I-EXPLORATION -6 I-EXPLORATION -%, I-EXPLORATION -hemoglobina: I-EXPLORATION -17, I-EXPLORATION -4 I-EXPLORATION -g/dl, I-EXPLORATION -hematocrito: I-EXPLORATION -48, I-EXPLORATION -4 I-EXPLORATION -% I-EXPLORATION -y I-EXPLORATION -plaquetas: I-EXPLORATION -275.000 I-EXPLORATION -por I-EXPLORATION -µl; I-EXPLORATION -el I-EXPLORATION -uroanálisis I-EXPLORATION -fue I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -resultados I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -demás I-EXPLORATION -exámenes I-EXPLORATION -paraclínicos I-EXPLORATION -pertinentes I-EXPLORATION -estuvieron I-EXPLORATION -dentro I-EXPLORATION +Tomografía I-EXPLORATION +axial I-EXPLORATION +computada I-EXPLORATION +(TAC) I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -límites I-EXPLORATION -normales I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -edad. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION -simple, I-EXPLORATION -la I-EXPLORATION -ecografía, I-EXPLORATION -la I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -abdominal I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -colangiopancreatografía I-EXPLORATION -retrógrada I-EXPLORATION -endoscópica I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -alteraciones. I-EXPLORATION -La I-EXPLORATION -endoscopia I-EXPLORATION +encéfalo I-EXPLORATION +mostró I-EXPLORATION +imagen I-EXPLORATION +sugerente I-EXPLORATION de I-EXPLORATION -vías I-EXPLORATION -digestivas I-EXPLORATION -altas I-EXPLORATION -reveló I-EXPLORATION -una I-EXPLORATION -hernia I-EXPLORATION -hiatal I-EXPLORATION +trombosis I-EXPLORATION +venosa I-EXPLORATION +cortical I-EXPLORATION con I-EXPLORATION -anillo I-EXPLORATION +infarto I-EXPLORATION +parenquimatoso I-EXPLORATION +temporo-basal I-EXPLORATION +izquierdo. I-EXPLORATION +Resonancia I-EXPLORATION +magnética I-EXPLORATION +(RM) I-EXPLORATION de I-EXPLORATION -Schatzki, I-EXPLORATION -y I-EXPLORATION -mucosa I-EXPLORATION -antral I-EXPLORATION -congestiva I-EXPLORATION -y I-EXPLORATION -edematosa I-EXPLORATION +cráneo I-EXPLORATION con I-EXPLORATION -algunas I-EXPLORATION -erosiones. I-EXPLORATION -La I-EXPLORATION -biopsia I-EXPLORATION -evidenció I-EXPLORATION -gastritis I-EXPLORATION -crónica I-EXPLORATION -activa, I-EXPLORATION +angiorresonancia I-EXPLORATION en I-EXPLORATION -tanto I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -endoscopia I-EXPLORATION -de I-EXPLORATION -vías I-EXPLORATION -digestivas I-EXPLORATION -bajas I-EXPLORATION -no I-EXPLORATION -reveló I-EXPLORATION -anomalías. I-EXPLORATION - I-EXPLORATION -Durante B-EVOLUTION -la I-EVOLUTION -hospitalización, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -varias I-EVOLUTION -crisis I-EVOLUTION -de I-EVOLUTION -pánico, I-EVOLUTION -agitación I-EVOLUTION -y I-EVOLUTION -ansiedad I-EVOLUTION -además I-EVOLUTION -de I-EVOLUTION -exacerbación I-EVOLUTION -del I-EVOLUTION -dolor I-EVOLUTION -abdominal, I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -requirió I-EVOLUTION -manejo I-EVOLUTION -médico I-EVOLUTION -y I-EVOLUTION -farmacológico I-EVOLUTION -psiquiátrico. I-EVOLUTION -Al I-EVOLUTION -sexto I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -hospitalización, I-EVOLUTION -apareció I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -flanco I-EVOLUTION -abdominal I-EVOLUTION -derecho I-EVOLUTION -un I-EVOLUTION -área I-EVOLUTION -dolorosa I-EVOLUTION -y I-EVOLUTION -eritematosa I-EVOLUTION -de I-EVOLUTION -2 I-EVOLUTION -x I-EVOLUTION -2 I-EVOLUTION -cm, I-EVOLUTION -que I-EVOLUTION -evolucionó I-EVOLUTION -en I-EVOLUTION -un I-EVOLUTION -patrón I-EVOLUTION -migratorio I-EVOLUTION -serpentino I-EVOLUTION -y I-EVOLUTION -avanzó I-EVOLUTION -atravesando I-EVOLUTION -la I-EVOLUTION -línea I-EVOLUTION -media I-EVOLUTION -y I-EVOLUTION -regresando I-EVOLUTION -para I-EVOLUTION -describir I-EVOLUTION -un I-EVOLUTION -trazado I-EVOLUTION -similar I-EVOLUTION -a I-EVOLUTION -una I-EVOLUTION -"X" I-EVOLUTION -alargada. I-EVOLUTION -Se B-EXPLORATION -tomó I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION +tiempo I-EXPLORATION +venoso I-EXPLORATION +informó I-EXPLORATION +infarto I-EXPLORATION +hemorrágico I-EXPLORATION +temporal I-EXPLORATION +izquierdo I-EXPLORATION +con I-EXPLORATION +trombosis I-EXPLORATION de I-EXPLORATION -piel I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -sitio I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -inició I-EXPLORATION -la I-EXPLORATION -lesión, I-EXPLORATION -cuyo I-EXPLORATION -estudio I-EXPLORATION -histopatológico I-EXPLORATION -mostró I-EXPLORATION -atrofia I-EXPLORATION -dermoepidérmica I-EXPLORATION +vena I-EXPLORATION +superficial I-EXPLORATION y I-EXPLORATION -gran I-EXPLORATION -cantidad I-EXPLORATION -de I-EXPLORATION -eosinófilos I-EXPLORATION -perivasculares I-EXPLORATION -e I-EXPLORATION -intersticiales. I-EXPLORATION -Una I-EXPLORATION -semana I-EXPLORATION -después I-EXPLORATION +seno I-EXPLORATION +venoso I-EXPLORATION +sigmoideo I-EXPLORATION +homolateral.. I-EXPLORATION +Exámenes I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -aparición I-EXPLORATION +búsqueda I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -lesión, I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -practicó I-EXPLORATION -un I-EXPLORATION -cuidadoso I-EXPLORATION -examen I-EXPLORATION -manual I-EXPLORATION -y, I-EXPLORATION +trombofilias I-EXPLORATION +fueron I-EXPLORATION +normales I-EXPLORATION +(proteínas I-EXPLORATION +C, I-EXPLORATION +S, I-EXPLORATION +antitrombina I-EXPLORATION +III, I-EXPLORATION +resistencia I-EXPLORATION +a I-EXPLORATION +proteína I-EXPLORATION +C I-EXPLORATION +activada, I-EXPLORATION +homocisteinemia, I-EXPLORATION +factor I-EXPLORATION +20210A, I-EXPLORATION +FV I-EXPLORATION +Leiden, I-EXPLORATION +metil I-EXPLORATION +tetra I-EXPLORATION +hidro I-EXPLORATION +folato I-EXPLORATION +reductasa, I-EXPLORATION +lipoproteína I-EXPLORATION +(a), I-EXPLORATION +factor I-EXPLORATION +VIII, I-EXPLORATION +anticuerpos I-EXPLORATION +anticardiolipinas, I-EXPLORATION +anti I-EXPLORATION +beta2 I-EXPLORATION +glicoproteína, I-EXPLORATION +inhibidor I-EXPLORATION +lúpico, I-EXPLORATION +inhibidor I-EXPLORATION +del I-EXPLORATION +activador I-EXPLORATION +tisular I-EXPLORATION +del I-EXPLORATION +plasminógeno). I-EXPLORATION +Todos I-EXPLORATION +fueron I-EXPLORATION +solicitados I-EXPLORATION +posteriormente I-EXPLORATION al I-EXPLORATION -parpar I-EXPLORATION -la I-EXPLORATION -lesión, I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -un I-EXPLORATION -área I-EXPLORATION -levantada I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -flanco I-EXPLORATION -derecho I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -cual I-EXPLORATION -se I-EXPLORATION -extrajo I-EXPLORATION -una I-EXPLORATION -larva I-EXPLORATION -de I-EXPLORATION -aproximadamente I-EXPLORATION -8 I-EXPLORATION -mm I-EXPLORATION -de I-EXPLORATION -largo I-EXPLORATION -usando I-EXPLORATION -aceite I-EXPLORATION -mineral I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -bajalenguas. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -examen I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -larva I-EXPLORATION -bajo I-EXPLORATION -el I-EXPLORATION -microscopio I-EXPLORATION -de I-EXPLORATION -luz I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -gusano I-EXPLORATION -constituido I-EXPLORATION -por I-EXPLORATION -un I-EXPLORATION -bulbo I-EXPLORATION -cefálico I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -cuerpo; I-EXPLORATION -alrededor I-EXPLORATION +inicio I-EXPLORATION del I-EXPLORATION -bulbo I-EXPLORATION -se I-EXPLORATION -identificaron I-EXPLORATION -las I-EXPLORATION -cuatro I-EXPLORATION -hileras I-EXPLORATION -de I-EXPLORATION -ganchos I-EXPLORATION -características, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -un I-EXPLORATION -largo I-EXPLORATION -esófago I-EXPLORATION -circundado I-EXPLORATION +tratamiento I-EXPLORATION +anticoagulante. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +inició I-TREATMENT +anticoagulación I-TREATMENT +con I-TREATMENT +enoxaparina I-TREATMENT +(1 I-TREATMENT +mg/Kg I-TREATMENT +subcutánea I-TREATMENT +cada I-TREATMENT +12 I-TREATMENT +h) I-TREATMENT +con I-TREATMENT +buena I-TREATMENT +evolución. I-TREATMENT +Se I-TREATMENT +mantuvo I-TREATMENT +tratamiento I-TREATMENT +de I-TREATMENT +CUC I-TREATMENT +con I-TREATMENT +mesalazina I-TREATMENT +y I-TREATMENT +prednisona. I-TREATMENT +Se B-EVOLUTION +otorgó I-EVOLUTION +alta I-EVOLUTION +al I-EVOLUTION +10º I-EVOLUTION +día, I-EVOLUTION +asintomático, I-EVOLUTION +continuando B-TREATMENT +anticoagulación I-TREATMENT +con I-TREATMENT +enoxaparina I-TREATMENT +subcutánea I-TREATMENT +y I-TREATMENT +posteriormente I-TREATMENT +con I-TREATMENT +dicumarínicos I-TREATMENT +por I-TREATMENT +vía I-TREATMENT +oral. I-TREATMENT + I-TREATMENT + +Se B-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +sujeto I-PRESENT_ILLNESS +masculino I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +45 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +soltero, B-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +convive I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +madre, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +mientras I-PRESENT_ILLNESS +cuidaba I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +menor I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +5 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +vecino I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +lugar I-PRESENT_ILLNESS +donde I-PRESENT_ILLNESS +reside, I-PRESENT_ILLNESS +fue I-PRESENT_ILLNESS +sorprendido I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +madre I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +pequeño I-PRESENT_ILLNESS +cuando I-PRESENT_ILLNESS +tocaba I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +genitales I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +niño, I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +colocaba I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +pene I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +erección I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +región I-PRESENT_ILLNESS +glútea I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +pequeño. I-PRESENT_ILLNESS +El I-PRESENT_ILLNESS +acusado I-PRESENT_ILLNESS +acepta I-PRESENT_ILLNESS +haber I-PRESENT_ILLNESS +cometido I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +hecho I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +refiere I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +tener I-PRESENT_ILLNESS +explicación I-PRESENT_ILLNESS +ante I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +ocurrido. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Entre B-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +comprobó I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +estuvo I-PAST_MEDICAL_HISTORY +ingresado I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +2003 I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +Hospital I-PAST_MEDICAL_HISTORY +Psiquiátrico I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +Habana I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +Trastorno I-PAST_MEDICAL_HISTORY +Orgánico I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +Personalidad. I-PAST_MEDICAL_HISTORY +Refiere I-PAST_MEDICAL_HISTORY +ser I-PAST_MEDICAL_HISTORY +producto I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +embarazo I-PAST_MEDICAL_HISTORY +múltiple I-PAST_MEDICAL_HISTORY +(trillizos) I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +cual I-PAST_MEDICAL_HISTORY +solo I-PAST_MEDICAL_HISTORY +él I-PAST_MEDICAL_HISTORY +sobrevivió. I-PAST_MEDICAL_HISTORY +Estudió I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +enseñanza I-PAST_MEDICAL_HISTORY +especial I-PAST_MEDICAL_HISTORY +alcanzando I-PAST_MEDICAL_HISTORY +9o I-PAST_MEDICAL_HISTORY +grado, I-PAST_MEDICAL_HISTORY +luego I-PAST_MEDICAL_HISTORY +abandonó I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +estudios. I-PAST_MEDICAL_HISTORY +Huérfano I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +padre I-PAST_MEDICAL_HISTORY +cuando I-PAST_MEDICAL_HISTORY +tenía I-PAST_MEDICAL_HISTORY +5 I-PAST_MEDICAL_HISTORY +años. I-PAST_MEDICAL_HISTORY +Trauma I-PAST_MEDICAL_HISTORY +craneoencefálico I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +20 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +pérdida I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +conciencia I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +atención I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +neurología. I-PAST_MEDICAL_HISTORY +Lleva I-PAST_MEDICAL_HISTORY +varios I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +desvinculado I-PAST_MEDICAL_HISTORY +laboralmente. I-PAST_MEDICAL_HISTORY +Según I-PAST_MEDICAL_HISTORY +explicó I-PAST_MEDICAL_HISTORY +tuvo I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +única I-PAST_MEDICAL_HISTORY +relación I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +pareja I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +juventud. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Fue B-DERIVED_FROM/TO +remitido I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +nuestra I-DERIVED_FROM/TO +institución I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +objetivo I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +realizar I-DERIVED_FROM/TO +una I-DERIVED_FROM/TO +evaluación I-DERIVED_FROM/TO +psiquiátrica I-DERIVED_FROM/TO +forense. I-DERIVED_FROM/TO +Los B-EXPLORATION +peritos I-EXPLORATION +psiquiatras I-EXPLORATION +actuantes I-EXPLORATION +solicitaron I-EXPLORATION +una I-EXPLORATION +evaluación I-EXPLORATION por I-EXPLORATION -los I-EXPLORATION -sacos I-EXPLORATION -cervicales I-EXPLORATION -que I-EXPLORATION +parte I-EXPLORATION +del I-EXPLORATION +Laboratorio I-EXPLORATION +de I-EXPLORATION +Neurofisiología I-EXPLORATION +Clínica I-EXPLORATION +donde I-EXPLORATION se I-EXPLORATION -unía I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -intestino, I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +entrevista I-EXPLORATION +clínica I-EXPLORATION +al I-EXPLORATION +paciente, I-EXPLORATION +se I-EXPLORATION +registró I-EXPLORATION +un I-EXPLORATION +EEG I-EXPLORATION +en I-EXPLORATION +condiciones I-EXPLORATION +basales I-EXPLORATION +en I-EXPLORATION +estado I-EXPLORATION +de I-EXPLORATION +vigilia I-EXPLORATION +utilizando I-EXPLORATION el I-EXPLORATION -cual I-EXPLORATION -apareció I-EXPLORATION -tapizado I-EXPLORATION -por I-EXPLORATION -epitelio I-EXPLORATION -cilíndrico I-EXPLORATION -simple I-EXPLORATION +equipo I-EXPLORATION +Medicid I-EXPLORATION +V I-EXPLORATION y I-EXPLORATION -de I-EXPLORATION -múltiples I-EXPLORATION -núcleos I-EXPLORATION +el I-EXPLORATION +programa I-EXPLORATION +Track I-EXPLORATION +Walker I-EXPLORATION +(Neuronic, I-EXPLORATION +SA I-EXPLORATION +Cuba). I-EXPLORATION +Se I-EXPLORATION +registraron I-EXPLORATION +3 I-EXPLORATION +minutos I-EXPLORATION +con I-EXPLORATION +los I-EXPLORATION +ojos I-EXPLORATION +cerrados, I-EXPLORATION +2 I-EXPLORATION +minutos I-EXPLORATION con I-EXPLORATION +los I-EXPLORATION +ojos I-EXPLORATION +abiertos, I-EXPLORATION +3 I-EXPLORATION +minutos I-EXPLORATION +durante I-EXPLORATION la I-EXPLORATION -tinción I-EXPLORATION +hiperventilación I-EXPLORATION +y I-EXPLORATION +2 I-EXPLORATION +minutos I-EXPLORATION de I-EXPLORATION -hematoxilina I-EXPLORATION +recuperación. I-EXPLORATION +Se I-EXPLORATION +seleccionaron I-EXPLORATION +de I-EXPLORATION +20 I-EXPLORATION +a I-EXPLORATION +24 I-EXPLORATION +ventanas I-EXPLORATION +del I-EXPLORATION +estado I-EXPLORATION +de I-EXPLORATION +ojos I-EXPLORATION +cerrados, I-EXPLORATION +libres I-EXPLORATION +de I-EXPLORATION +artefactos I-EXPLORATION y I-EXPLORATION -eosina. I-EXPLORATION -Esta I-EXPLORATION -característica I-EXPLORATION -permitió I-EXPLORATION -identificar I-EXPLORATION -al I-EXPLORATION -espécimen I-EXPLORATION -como I-EXPLORATION -perteneciente I-EXPLORATION +se I-EXPLORATION +procedió I-EXPLORATION al I-EXPLORATION -género I-EXPLORATION -Florida I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -Estados I-EXPLORATION -Unidos, I-EXPLORATION -donde I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -consumió I-EXPLORATION -alimentos I-EXPLORATION -preparados I-EXPLORATION +análisis I-EXPLORATION +cuantitativo I-EXPLORATION +del I-EXPLORATION +EEG I-EXPLORATION +comparándose I-EXPLORATION con I-EXPLORATION -pescado I-EXPLORATION +individuos I-EXPLORATION +de I-EXPLORATION +su I-EXPLORATION +misma I-EXPLORATION +edad I-EXPLORATION y I-EXPLORATION -mariscos; I-EXPLORATION -aunque I-EXPLORATION -es I-EXPLORATION -claro I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -área I-EXPLORATION -geográfica I-EXPLORATION -descrita I-EXPLORATION -no I-EXPLORATION -es I-EXPLORATION -endémica I-EXPLORATION -para I-EXPLORATION -esta I-EXPLORATION -condición, I-EXPLORATION -se I-EXPLORATION -sabe I-EXPLORATION -que I-EXPLORATION -más I-EXPLORATION -del I-EXPLORATION -90 I-EXPLORATION -% I-EXPLORATION -del I-EXPLORATION -pescado I-EXPLORATION +sexo I-EXPLORATION y I-EXPLORATION -los I-EXPLORATION -mariscos I-EXPLORATION que I-EXPLORATION -se I-EXPLORATION -expenden I-EXPLORATION -allí I-EXPLORATION -son I-EXPLORATION -importados I-EXPLORATION -desde I-EXPLORATION -países I-EXPLORATION -como I-EXPLORATION -China, I-EXPLORATION -Filipinas, I-EXPLORATION -Tailandia, I-EXPLORATION -Vietnam, I-EXPLORATION -Ecuador, I-EXPLORATION -Perú I-EXPLORATION -y I-EXPLORATION -México, I-EXPLORATION -naciones I-EXPLORATION -reconocidas I-EXPLORATION -por I-EXPLORATION -ser I-EXPLORATION -endémicas I-EXPLORATION -para I-EXPLORATION +forman I-EXPLORATION +parte I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -gnatostomiasis I-EXPLORATION -(15,16). I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -identificación I-EXPLORATION -taxonómica I-EXPLORATION -se I-EXPLORATION -basa I-EXPLORATION +base I-EXPLORATION +de I-EXPLORATION +datos I-EXPLORATION +normativa I-EXPLORATION +cubana. I-EXPLORATION +Se I-EXPLORATION +calculó I-EXPLORATION +el I-EXPLORATION +espectro I-EXPLORATION +de I-EXPLORATION +frecuencia I-EXPLORATION en I-EXPLORATION -ciertas I-EXPLORATION -características I-EXPLORATION -morfológicas I-EXPLORATION +cada I-EXPLORATION +una I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -larva I-EXPLORATION -(17), I-EXPLORATION -entre I-EXPLORATION las I-EXPLORATION +derivaciones I-EXPLORATION +y I-EXPLORATION +luego I-EXPLORATION +las I-EXPLORATION +medidas I-EXPLORATION +espectrales I-EXPLORATION +de I-EXPLORATION +banda I-EXPLORATION +ancha; I-EXPLORATION +el I-EXPLORATION +Poder I-EXPLORATION +Absoluto I-EXPLORATION +(PA), I-EXPLORATION que I-EXPLORATION -se I-EXPLORATION -incluyen I-EXPLORATION +representa I-EXPLORATION la I-EXPLORATION -forma I-EXPLORATION -del I-EXPLORATION -cuerpo, I-EXPLORATION +energía I-EXPLORATION +que I-EXPLORATION +contiene I-EXPLORATION +todo I-EXPLORATION el I-EXPLORATION -número I-EXPLORATION -de I-EXPLORATION -hileras I-EXPLORATION -de I-EXPLORATION -ganchos I-EXPLORATION +EEG I-EXPLORATION +(PA I-EXPLORATION +Total) I-EXPLORATION +o I-EXPLORATION +la I-EXPLORATION +contenida I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -extremo I-EXPLORATION -cefálico I-EXPLORATION +una I-EXPLORATION +banda I-EXPLORATION +de I-EXPLORATION +frecuencia I-EXPLORATION +particular I-EXPLORATION +(delta, I-EXPLORATION +theta, I-EXPLORATION +alfa I-EXPLORATION y I-EXPLORATION +beta); I-EXPLORATION +el I-EXPLORATION +Poder I-EXPLORATION +Relativo I-EXPLORATION +(PR), I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +es I-EXPLORATION +más I-EXPLORATION +que I-EXPLORATION +la I-EXPLORATION +contribución I-EXPLORATION de I-EXPLORATION -ganchos I-EXPLORATION -en I-EXPLORATION cada I-EXPLORATION -hilera, I-EXPLORATION +banda I-EXPLORATION +del I-EXPLORATION +EEG I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -extensión I-EXPLORATION +energía I-EXPLORATION +total I-EXPLORATION del I-EXPLORATION -cuerpo I-EXPLORATION -cubierto I-EXPLORATION -por I-EXPLORATION -espinas I-EXPLORATION +espectro, I-EXPLORATION y I-EXPLORATION +la I-EXPLORATION +Frecuencia I-EXPLORATION +Media I-EXPLORATION +(FM), I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +corresponde I-EXPLORATION +con I-EXPLORATION +los I-EXPLORATION +valores I-EXPLORATION +de I-EXPLORATION +frecuencia I-EXPLORATION +(en I-EXPLORATION +Hz) I-EXPLORATION +que I-EXPLORATION +constituyen I-EXPLORATION el I-EXPLORATION -número I-EXPLORATION +"centro I-EXPLORATION de I-EXPLORATION -núcleos I-EXPLORATION +gravedad", I-EXPLORATION +ya I-EXPLORATION +sea I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -células I-EXPLORATION -intestinales, I-EXPLORATION -rasgos I-EXPLORATION -que I-EXPLORATION -varían I-EXPLORATION -entre I-EXPLORATION -las I-EXPLORATION -especies. I-EXPLORATION -Las I-EXPLORATION -hileras I-EXPLORATION +una I-EXPLORATION +banda I-EXPLORATION +o I-EXPLORATION +bien I-EXPLORATION de I-EXPLORATION -ganchos I-EXPLORATION -le I-EXPLORATION -permiten I-EXPLORATION -a I-EXPLORATION la I-EXPLORATION -larva I-EXPLORATION -abrirse I-EXPLORATION -camino I-EXPLORATION -entre I-EXPLORATION -los I-EXPLORATION -tejidos I-EXPLORATION +totalidad I-EXPLORATION del I-EXPLORATION -huésped I-EXPLORATION -y I-EXPLORATION -producen I-EXPLORATION -el I-EXPLORATION -daño I-EXPLORATION -mecánico I-EXPLORATION -tisular I-EXPLORATION -y I-EXPLORATION +espectro. I-EXPLORATION +Se I-EXPLORATION +estimaron I-EXPLORATION los I-EXPLORATION -síntomas. I-EXPLORATION -La I-EXPLORATION -identificación I-EXPLORATION +generadores I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -especie I-EXPLORATION -es I-EXPLORATION -útil I-EXPLORATION -desde I-EXPLORATION +actividad I-EXPLORATION +lenta I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +frecuencia I-EXPLORATION +7.031 I-EXPLORATION +Hz, I-EXPLORATION +utilizando I-EXPLORATION el I-EXPLORATION -punto I-EXPLORATION +programa I-EXPLORATION +Localizador I-EXPLORATION de I-EXPLORATION -vista I-EXPLORATION -epidemiológico, I-EXPLORATION -pues I-EXPLORATION +Fuentes I-EXPLORATION +(Neuronic, I-EXPLORATION +SA I-EXPLORATION +Cuba) I-EXPLORATION +y I-EXPLORATION el I-EXPLORATION -tratamiento I-EXPLORATION -es I-EXPLORATION +modelo I-EXPLORATION +bayesiano I-EXPLORATION +promediado I-EXPLORATION +(BMA) I-EXPLORATION +12, I-EXPLORATION el I-EXPLORATION -mismo I-EXPLORATION -para I-EXPLORATION -todas I-EXPLORATION -las I-EXPLORATION -especies I-EXPLORATION -(3,5). I-EXPLORATION - I-EXPLORATION -Las I-EXPLORATION -características I-EXPLORATION -clínicas I-EXPLORATION -pueden I-EXPLORATION -dividirse I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -síntomas I-EXPLORATION -inmediatos I-EXPLORATION -posteriores I-EXPLORATION -a I-EXPLORATION +cual I-EXPLORATION +permite I-EXPLORATION +encontrar I-EXPLORATION la I-EXPLORATION -infección I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -síntomas I-EXPLORATION -cutáneos I-EXPLORATION -o I-EXPLORATION -viscerales, I-EXPLORATION -según I-EXPLORATION -sea I-EXPLORATION +densidad I-EXPLORATION +de I-EXPLORATION +corriente I-EXPLORATION +primaria I-EXPLORATION +dentro I-EXPLORATION +del I-EXPLORATION +cerebro, I-EXPLORATION +sin I-EXPLORATION +estar I-EXPLORATION +condicionada I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -caso. I-EXPLORATION -Entre I-EXPLORATION -24 I-EXPLORATION -y I-EXPLORATION -48 I-EXPLORATION -horas I-EXPLORATION -después I-EXPLORATION +modelo I-EXPLORATION +asumido. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +evaluó I-EXPLORATION +la I-EXPLORATION +respuesta I-EXPLORATION +simpática I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -ingestión I-EXPLORATION +piel, I-EXPLORATION +utilizando I-EXPLORATION +dos I-EXPLORATION +diseños I-EXPLORATION +experimentales, I-EXPLORATION +el I-EXPLORATION +primero I-EXPLORATION +conformado I-EXPLORATION +con I-EXPLORATION +16 I-EXPLORATION +imágenes I-EXPLORATION +neutras I-EXPLORATION +obtenidas I-EXPLORATION +a I-EXPLORATION +partir I-EXPLORATION +de I-EXPLORATION +imágenes I-EXPLORATION +estandarizadas I-EXPLORATION del I-EXPLORATION -parásito, I-EXPLORATION +Sistema I-EXPLORATION +Internacional I-EXPLORATION +de I-EXPLORATION +Imágenes I-EXPLORATION +Afectivas I-EXPLORATION +(IAPS; I-EXPLORATION +Center I-EXPLORATION +for I-EXPLORATION +the I-EXPLORATION +Study I-EXPLORATION +of I-EXPLORATION +Emotion I-EXPLORATION +and I-EXPLORATION +Attention-NIMH, I-EXPLORATION +1999) I-EXPLORATION +13 I-EXPLORATION +y I-EXPLORATION +6 I-EXPLORATION +imágenes I-EXPLORATION +de I-EXPLORATION +menores I-EXPLORATION +de I-EXPLORATION +ambos I-EXPLORATION +sexos I-EXPLORATION +desnudos, I-EXPLORATION el I-EXPLORATION -individuo I-EXPLORATION -puede I-EXPLORATION -presentar I-EXPLORATION -malestar I-EXPLORATION -general, I-EXPLORATION -fiebre, I-EXPLORATION -anorexia, I-EXPLORATION -náuseas, I-EXPLORATION -vómito, I-EXPLORATION -diarrea I-EXPLORATION +segundo I-EXPLORATION +utilizó I-EXPLORATION +16 I-EXPLORATION +fotos I-EXPLORATION +neutras I-EXPLORATION y I-EXPLORATION -dolor I-EXPLORATION -abdominal, I-EXPLORATION +6 I-EXPLORATION +que I-EXPLORATION +son I-EXPLORATION +representativas I-EXPLORATION +de I-EXPLORATION +estímulos I-EXPLORATION +sexuales I-EXPLORATION +de I-EXPLORATION +adultos I-EXPLORATION +(parejas I-EXPLORATION +eróticas), I-EXPLORATION +todas I-EXPLORATION +obtenidas I-EXPLORATION +del I-EXPLORATION +sistema I-EXPLORATION +internacional I-EXPLORATION +antes I-EXPLORATION +referido. I-EXPLORATION +Este I-EXPLORATION +tipo I-EXPLORATION +de I-EXPLORATION +evaluación I-EXPLORATION +forma I-EXPLORATION +parte I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +nuevo I-EXPLORATION +método I-EXPLORATION +para I-EXPLORATION el I-EXPLORATION -cual I-EXPLORATION -puede I-EXPLORATION +estudio I-EXPLORATION +experimental I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +emociones, I-EXPLORATION +tiene I-EXPLORATION +además I-EXPLORATION +la I-EXPLORATION +ventaja I-EXPLORATION +de I-EXPLORATION +emplear I-EXPLORATION +estímulos I-EXPLORATION +que I-EXPLORATION +pueden I-EXPLORATION ser I-EXPLORATION -difuso, I-EXPLORATION -epigástrico I-EXPLORATION -o I-EXPLORATION -localizado I-EXPLORATION +fácilmente I-EXPLORATION +presentados I-EXPLORATION +en I-EXPLORATION +contextos I-EXPLORATION +de I-EXPLORATION +laboratorio, I-EXPLORATION +tanto I-EXPLORATION en I-EXPLORATION +formato I-EXPLORATION +analógico I-EXPLORATION +como I-EXPLORATION +digitalizado, I-EXPLORATION +permitiendo I-EXPLORATION el I-EXPLORATION -cuadrante I-EXPLORATION -superior I-EXPLORATION -derecho. I-EXPLORATION - I-EXPLORATION -Gnathostoma I-EXPLORATION +control I-EXPLORATION +preciso I-EXPLORATION +de I-EXPLORATION +su I-EXPLORATION +momento I-EXPLORATION y I-EXPLORATION -como I-EXPLORATION -la I-EXPLORATION -especie I-EXPLORATION -más I-EXPLORATION -probable I-EXPLORATION -a I-EXPLORATION -G. I-EXPLORATION -spinigerum, I-EXPLORATION +tiempo I-EXPLORATION +de I-EXPLORATION +exposición. I-EXPLORATION +El I-EXPLORATION +IAPS I-EXPLORATION +consiste I-EXPLORATION +en I-EXPLORATION +un I-EXPLORATION +conjunto I-EXPLORATION +estandarizado I-EXPLORATION +de I-EXPLORATION +imágenes I-EXPLORATION +en I-EXPLORATION +color I-EXPLORATION con I-EXPLORATION -lo I-EXPLORATION +capacidad I-EXPLORATION +para I-EXPLORATION +evocar I-EXPLORATION +emociones I-EXPLORATION +y I-EXPLORATION +cuyos I-EXPLORATION +contenidos I-EXPLORATION +recorren I-EXPLORATION +un I-EXPLORATION +amplio I-EXPLORATION +abanico I-EXPLORATION +de I-EXPLORATION +categorías: I-EXPLORATION +deporte, I-EXPLORATION +moda, I-EXPLORATION +paisajes, I-EXPLORATION +desastres I-EXPLORATION +naturales, I-EXPLORATION +erotismo, I-EXPLORATION +violencia, I-EXPLORATION +etc., I-EXPLORATION +además, I-EXPLORATION +facilita I-EXPLORATION +enormemente I-EXPLORATION +las I-EXPLORATION +tareas I-EXPLORATION +de I-EXPLORATION +selección I-EXPLORATION +y I-EXPLORATION +control I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +estímulos. I-EXPLORATION +Cada I-EXPLORATION +imagen I-EXPLORATION +del I-EXPLORATION +IAPS I-EXPLORATION +posee I-EXPLORATION +un I-EXPLORATION +valor I-EXPLORATION que I-EXPLORATION -se I-EXPLORATION -confirmó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION +ha I-EXPLORATION +sido I-EXPLORATION +normalizado I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +dimensiones I-EXPLORATION +bipolares I-EXPLORATION de I-EXPLORATION -gnatostomiasis I-EXPLORATION -cutánea. I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -recibió I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -200 I-TREATMENT -mg I-TREATMENT -diarios I-TREATMENT -de I-TREATMENT -albendazol I-TREATMENT -durante I-TREATMENT -18 I-TREATMENT -días I-TREATMENT -y B-EVOLUTION -evolucionó I-EVOLUTION -satisfactoriamente. I-EVOLUTION - I-EVOLUTION +valencia I-EXPLORATION +afectiva I-EXPLORATION +(con I-EXPLORATION +un I-EXPLORATION +rango I-EXPLORATION +que I-EXPLORATION +va I-EXPLORATION +desde I-EXPLORATION +lo I-EXPLORATION +agradable I-EXPLORATION +a I-EXPLORATION +lo I-EXPLORATION +desagradable) I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +arousal I-EXPLORATION +o I-EXPLORATION +activación I-EXPLORATION +(cuyo I-EXPLORATION +rango I-EXPLORATION +oscila I-EXPLORATION +entre I-EXPLORATION +la I-EXPLORATION +excitación I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +calma). I-EXPLORATION + I-EXPLORATION +Los I-EXPLORATION +experimentos I-EXPLORATION +fueron I-EXPLORATION +diseñados I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +programa I-EXPLORATION +Mindtracer I-EXPLORATION +(Neuronic I-EXPLORATION +SA, I-EXPLORATION +Cuba). I-EXPLORATION +Cada I-EXPLORATION +estímulo I-EXPLORATION +tenía I-EXPLORATION +una I-EXPLORATION +duración I-EXPLORATION +de I-EXPLORATION +2000 I-EXPLORATION +milisegundos I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +intervalo I-EXPLORATION +inter-estímulo I-EXPLORATION +fue I-EXPLORATION +de I-EXPLORATION +200.000 I-EXPLORATION +milisegundos. I-EXPLORATION +El I-EXPLORATION +registro I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +equipo I-EXPLORATION +BioDerm I-EXPLORATION +Modelo I-EXPLORATION +2701 I-EXPLORATION +y I-EXPLORATION +dos I-EXPLORATION +electrodos I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +colocaron I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +falange I-EXPLORATION +media I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +dedos I-EXPLORATION +índice I-EXPLORATION +y I-EXPLORATION +medio I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +mano I-EXPLORATION +dominante. I-EXPLORATION + I-EXPLORATION -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -20 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +Niño B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS +12 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +asma I-PAST_MEDICAL_HISTORY +bronquial I-PAST_MEDICAL_HISTORY +intermitente I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +base, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS acude I-PRESENT_ILLNESS a I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -tumoración I-PRESENT_ILLNESS -testicular I-PRESENT_ILLNESS -derecha I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -grandes I-PRESENT_ILLNESS -dimensiones I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS +Pediatría I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -varios I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +centro I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -refiere I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS +salud I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +aparición I-PRESENT_ILLNESS +brusca I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -espalda I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +edema I-PRESENT_ILLNESS +cervical, I-PRESENT_ILLNESS +disfagia I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -ninguna I-PRESENT_ILLNESS -otra I-PRESENT_ILLNESS -sintomatología. I-PRESENT_ILLNESS -La B-EXPLORATION -exploración I-EXPLORATION +dolor I-PRESENT_ILLNESS +torácico I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +esa I-PRESENT_ILLNESS +mañana I-PRESENT_ILLNESS +(aproximadamente I-PRESENT_ILLNESS +seis I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución), I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +contexto I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +crisis I-PRESENT_ILLNESS +asmática I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +niño I-PRESENT_ILLNESS +estaba I-PRESENT_ILLNESS +tratando I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +salbutamol I-PRESENT_ILLNESS +inhalado I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +domicilio. I-PRESENT_ILLNESS +A B-EXPLORATION +su I-EXPLORATION +llegada I-EXPLORATION +presenta I-EXPLORATION +un I-EXPLORATION +regular I-EXPLORATION +estado I-EXPLORATION +general, I-EXPLORATION +palidez I-EXPLORATION +cutánea, I-EXPLORATION +taquipnea I-EXPLORATION y I-EXPLORATION +tiraje I-EXPLORATION +intercostal; I-EXPLORATION +con I-EXPLORATION +hipoventilación I-EXPLORATION +generalizada I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -ecografía I-EXPLORATION -demuestran I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION +auscultación. I-EXPLORATION +Se I-EXPLORATION +observa I-EXPLORATION un I-EXPLORATION -tumor I-EXPLORATION -testicular I-EXPLORATION -de I-EXPLORATION -gran I-EXPLORATION -tamaño I-EXPLORATION +edema I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +cervical I-EXPLORATION +bilateral, I-EXPLORATION con I-EXPLORATION -afectación I-EXPLORATION -retroperitoneal I-EXPLORATION -ganglionar. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION +crepitación I-EXPLORATION +en I-EXPLORATION +dicha I-EXPLORATION +zona. I-EXPLORATION +Ante B-TREATMENT +crisis I-TREATMENT +asmática I-TREATMENT +con I-TREATMENT +score I-TREATMENT +moderado I-TREATMENT +se I-TREATMENT +inicia I-TREATMENT +tratamiento I-TREATMENT +broncodilatador I-TREATMENT +y I-TREATMENT +corticoideo I-TREATMENT +y B-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +deriva I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +Urgencias I-DERIVED_FROM/TO +hospitalarias. I-DERIVED_FROM/TO +Allí B-EXPLORATION +realizan I-EXPLORATION +una I-EXPLORATION radiografía I-EXPLORATION -simple I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -se I-EXPLORATION -evidencia I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION de I-EXPLORATION -múltiples I-EXPLORATION -metástasis I-EXPLORATION -pulmonares I-EXPLORATION -que I-EXPLORATION -son I-EXPLORATION -confirmadas I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -TAC, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -múltiples I-EXPLORATION -adenopatías I-EXPLORATION -inguinales I-EXPLORATION +tórax, I-EXPLORATION +encontrando I-EXPLORATION +neumomediastino I-EXPLORATION y I-EXPLORATION -paratraqueales. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -se I-EXPLORATION -halla I-EXPLORATION -una I-EXPLORATION -β-HCG I-EXPLORATION -de I-EXPLORATION -17702 I-EXPLORATION -mUI/ml I-EXPLORATION +un I-EXPLORATION +enfisema I-EXPLORATION +subcutáneo I-EXPLORATION +torácico I-EXPLORATION y I-EXPLORATION -una I-EXPLORATION -α-FP I-EXPLORATION -de I-EXPLORATION -28025 I-EXPLORATION -ng/ml. I-EXPLORATION -En B-TREATMENT -octubre I-TREATMENT -de I-TREATMENT -2002 I-TREATMENT -se I-TREATMENT -procede I-TREATMENT -a I-TREATMENT -orquiectomía I-TREATMENT -radical I-TREATMENT -derecha I-TREATMENT -con I-TREATMENT -un I-TREATMENT -resultado I-TREATMENT -anatomopatológico I-TREATMENT -de I-TREATMENT -tumor I-TREATMENT -germinal I-TREATMENT -mixto I-TREATMENT -(compuesto I-TREATMENT -de I-TREATMENT -carcinoma I-TREATMENT -embrionario, I-TREATMENT -yolk I-TREATMENT -sac I-TREATMENT -tumor, I-TREATMENT -teratoma I-TREATMENT -maduro I-TREATMENT -e I-TREATMENT -inmaduro I-TREATMENT -y I-TREATMENT -mínimos I-TREATMENT -focos I-TREATMENT -de I-TREATMENT -seminoma I-TREATMENT +cervical, I-EXPLORATION +sin I-EXPLORATION +neumotórax. I-EXPLORATION +Se B-TREATMENT +pauta I-TREATMENT +analgesia I-TREATMENT y I-TREATMENT -coriocarcinoma). I-TREATMENT -El I-TREATMENT -estadio I-TREATMENT -tumoral I-TREATMENT -fue I-TREATMENT -de I-TREATMENT -T3N3M1a I-TREATMENT -(estadio I-TREATMENT -IIIC). I-TREATMENT - I-TREATMENT -Tras I-TREATMENT -varios I-TREATMENT -ciclos I-TREATMENT -de I-TREATMENT -quimioterapia I-TREATMENT -agresiva I-TREATMENT -según I-TREATMENT -el I-TREATMENT -esquema I-TREATMENT -BOMP/EPI, I-TREATMENT -se I-TREATMENT -produce I-TREATMENT -respuesta I-TREATMENT -parcial I-TREATMENT -a I-TREATMENT -la I-TREATMENT -misma I-TREATMENT +tratamiento I-TREATMENT con I-TREATMENT -reducción I-TREATMENT -de I-TREATMENT -las I-TREATMENT -metástasis I-TREATMENT -pulmonares, I-TREATMENT -pero I-TREATMENT -presenta I-TREATMENT -una I-TREATMENT -gran I-TREATMENT -masa I-TREATMENT -residual I-TREATMENT -en I-TREATMENT -la I-TREATMENT -TAC I-TREATMENT -realizada, I-TREATMENT -que I-TREATMENT -obliga I-TREATMENT -al I-TREATMENT -planteamiento I-TREATMENT -de I-TREATMENT -cirugía I-TREATMENT -exerética I-TREATMENT -de I-TREATMENT -la I-TREATMENT -misma. I-TREATMENT - I-TREATMENT -Se I-TREATMENT -procede, I-TREATMENT -tras I-TREATMENT -adecuado I-TREATMENT -estudio I-TREATMENT -preoperatorio, I-TREATMENT -a I-TREATMENT -realizar I-TREATMENT -linfadenectomía I-TREATMENT -retroperitoneal I-TREATMENT +oxígeno, I-TREATMENT +broncodilatadores I-TREATMENT y I-TREATMENT -exéresis I-TREATMENT -de I-TREATMENT -masa I-TREATMENT -residual I-TREATMENT -mediante I-TREATMENT -abordaje I-TREATMENT -laparotómico I-TREATMENT -medio I-TREATMENT -xifopubiano. I-TREATMENT -La B-EXPLORATION -masa I-EXPLORATION -englobaba, I-EXPLORATION -como I-EXPLORATION +prednisona I-TREATMENT +oral; I-TREATMENT +experimentó B-EVOLUTION +mejoría I-EVOLUTION +progresiva, I-EVOLUTION +dándole I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +cuatro I-EVOLUTION +días I-EVOLUTION +después. I-EVOLUTION + I-EVOLUTION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +49 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +había I-PRESENT_ILLNESS +consultado I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +varias I-PRESENT_ILLNESS +ocasiones I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +médico I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +familia I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +superior I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +38º I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +acompañada I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +nauseas, I-PRESENT_ILLNESS +vómitos I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +unos I-PRESENT_ILLNESS +10 I-PRESENT_ILLNESS +kilogramos I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +peso. I-PRESENT_ILLNESS +El B-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +era I-PAST_MEDICAL_HISTORY +exfumador, I-PAST_MEDICAL_HISTORY +estaba I-PAST_MEDICAL_HISTORY +diagnosticado I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +hepatopatía I-PAST_MEDICAL_HISTORY +criptogenética, I-PAST_MEDICAL_HISTORY +taquicardia I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +vía I-PAST_MEDICAL_HISTORY +aberrante I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +realizado I-PAST_MEDICAL_HISTORY +ablación I-PAST_MEDICAL_HISTORY +10 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +atrás, I-PAST_MEDICAL_HISTORY +episodio I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +angor I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +coronariografía I-PAST_MEDICAL_HISTORY +normal, I-PAST_MEDICAL_HISTORY +síndrome I-PAST_MEDICAL_HISTORY +ansioso-depresivo I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +intervenido I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +ulcus I-PAST_MEDICAL_HISTORY +duodenal I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +apendicitis. I-PAST_MEDICAL_HISTORY +No I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +realizado I-PAST_MEDICAL_HISTORY +viajes I-PAST_MEDICAL_HISTORY +recientemente I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +refería I-PAST_MEDICAL_HISTORY +prácticas I-PAST_MEDICAL_HISTORY +sexuales I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +riesgo. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +En B-EXPLORATION +el I-EXPLORATION +examen I-EXPLORATION +clínico I-EXPLORATION se I-EXPLORATION -puede I-EXPLORATION -observar I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -TAC, I-EXPLORATION -los I-EXPLORATION -grandes I-EXPLORATION -vasos I-EXPLORATION -desde I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -renal I-EXPLORATION -izquierda I-EXPLORATION -hasta I-EXPLORATION -la I-EXPLORATION -bifurcación I-EXPLORATION +objetivaba I-EXPLORATION +una I-EXPLORATION +temperatura I-EXPLORATION +de I-EXPLORATION +39, I-EXPLORATION +7 I-EXPLORATION +ºC, I-EXPLORATION +se I-EXPLORATION +palpaba I-EXPLORATION +hepatomegalia I-EXPLORATION +a I-EXPLORATION +unos I-EXPLORATION +3-4 I-EXPLORATION +centímetros I-EXPLORATION +del I-EXPLORATION +reborde I-EXPLORATION +costal, I-EXPLORATION +siendo I-EXPLORATION +el I-EXPLORATION +resto I-EXPLORATION de I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +normal. I-EXPLORATION +En I-EXPLORATION +cuanto I-EXPLORATION +a I-EXPLORATION las I-EXPLORATION -arterias I-EXPLORATION -iliacas I-EXPLORATION -superficial I-EXPLORATION -y I-EXPLORATION -profunda I-EXPLORATION -izquierda I-EXPLORATION +pruebas I-EXPLORATION +complementarias I-EXPLORATION +destacaban I-EXPLORATION +15.900/mm3 I-EXPLORATION +leucocitos I-EXPLORATION +con I-EXPLORATION +desviación I-EXPLORATION +izquierda, I-EXPLORATION +hemoglobina I-EXPLORATION +de I-EXPLORATION +10.5 I-EXPLORATION +g/dl I-EXPLORATION y I-EXPLORATION -en I-EXPLORATION -menor I-EXPLORATION -medida I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -lado I-EXPLORATION -derecho. I-EXPLORATION -Tras I-EXPLORATION una I-EXPLORATION -compleja I-EXPLORATION -intervención I-EXPLORATION +VSG I-EXPLORATION +de I-EXPLORATION +101 I-EXPLORATION +mm. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +bioquímica I-EXPLORATION +existía I-EXPLORATION +una I-EXPLORATION +alteración I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +parámetros I-EXPLORATION +hepáticos: I-EXPLORATION +GOT I-EXPLORATION +101 I-EXPLORATION +U/l, I-EXPLORATION +GPT I-EXPLORATION +128 I-EXPLORATION +U/l, I-EXPLORATION +FA I-EXPLORATION +208 I-EXPLORATION +U/l, I-EXPLORATION +GGT I-EXPLORATION +172 I-EXPLORATION +U/l, I-EXPLORATION +LDH I-EXPLORATION +1366 I-EXPLORATION +UI/l. I-EXPLORATION +La I-EXPLORATION +PCR I-EXPLORATION se I-EXPLORATION -consigue I-EXPLORATION -exéresis I-EXPLORATION -completa I-EXPLORATION +encontraba I-EXPLORATION +asimismo I-EXPLORATION +elevada. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +un I-EXPLORATION +sistemático I-EXPLORATION +de I-EXPLORATION +orina I-EXPLORATION +que I-EXPLORATION +fue I-EXPLORATION +normal, I-EXPLORATION +Mantoux I-EXPLORATION +negativo. I-EXPLORATION +Serologías I-EXPLORATION +de I-EXPLORATION +Brucella, I-EXPLORATION +Leishmania, I-EXPLORATION +C. I-EXPLORATION +Burnetti, I-EXPLORATION +lúes, I-EXPLORATION +Salmonella, I-EXPLORATION +virus I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -masa I-EXPLORATION -quedando I-EXPLORATION -como I-EXPLORATION -resultado I-EXPLORATION -las I-EXPLORATION -imágenes I-EXPLORATION +hepatitis I-EXPLORATION +A, I-EXPLORATION +B I-EXPLORATION +y I-EXPLORATION +C I-EXPLORATION +y I-EXPLORATION +VIH I-EXPLORATION +negativos. I-EXPLORATION +También I-EXPLORATION +se I-EXPLORATION +realizaron I-EXPLORATION +serologías I-EXPLORATION +de I-EXPLORATION +citomegalovirus, I-EXPLORATION +virus I-EXPLORATION +de I-EXPLORATION +Epstein-Barr I-EXPLORATION +y I-EXPLORATION +toxoplasma I-EXPLORATION que I-EXPLORATION -muestran I-EXPLORATION -las I-EXPLORATION -Figs. I-EXPLORATION -3 I-EXPLORATION +fueron I-EXPLORATION +IgG I-EXPLORATION ++ I-EXPLORATION y I-EXPLORATION -4. I-EXPLORATION +IgM I-EXPLORATION +negativos. I-EXPLORATION I-EXPLORATION -El I-EXPLORATION +Hemocultivos I-EXPLORATION +durante I-EXPLORATION +el I-EXPLORATION estudio I-EXPLORATION -patológico I-EXPLORATION +ambulatorio I-EXPLORATION +y I-EXPLORATION +hospitalizado I-EXPLORATION +fueron I-EXPLORATION +negativos. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +radiografía I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -masa I-EXPLORATION -revela I-EXPLORATION -tumoración I-EXPLORATION -teratomatosa I-EXPLORATION -madura. I-EXPLORATION -Actualmente B-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -es I-TREATMENT -valorado I-TREATMENT -por I-TREATMENT -Oncología I-TREATMENT -por I-TREATMENT -si I-TREATMENT -precisa I-TREATMENT -nuevos I-TREATMENT -ciclos I-TREATMENT -de I-TREATMENT -quimioterapia I-TREATMENT -postcirugía, I-TREATMENT -a I-TREATMENT -fin I-TREATMENT -de I-TREATMENT -que I-TREATMENT -remitan I-TREATMENT -las I-TREATMENT -metástasis I-TREATMENT -pulmonares. I-TREATMENT - I-TREATMENT - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -27 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -visto I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -lesión I-PRESENT_ILLNESS -nodular I-PRESENT_ILLNESS -subcutánea I-PRESENT_ILLNESS -dolorosa I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -aproximadamente I-PRESENT_ILLNESS -0, I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -cm I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -cara I-PRESENT_ILLNESS -dorsal I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -pene. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -refería I-PRESENT_ILLNESS -incremento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -citada I-PRESENT_ILLNESS -lesión I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -erección, I-PRESENT_ILLNESS -produciéndose I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -significativo I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -impedía I-PRESENT_ILLNESS -mantener I-PRESENT_ILLNESS -relaciones I-PRESENT_ILLNESS -sexuales I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -normalidad. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION +tórax I-EXPLORATION +que I-EXPLORATION +fue I-EXPLORATION +normal I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION +donde I-EXPLORATION se I-EXPLORATION -puso I-EXPLORATION +observó I-EXPLORATION +hígado, I-EXPLORATION +vía I-EXPLORATION +biliar, I-EXPLORATION +vesícula, I-EXPLORATION +porción I-EXPLORATION +visible I-EXPLORATION de I-EXPLORATION -manifiesto I-EXPLORATION +retroperitoneo I-EXPLORATION +superior I-EXPLORATION +y I-EXPLORATION +porta I-EXPLORATION +sin I-EXPLORATION +hallazgos I-EXPLORATION +ecográficos I-EXPLORATION +significativos. I-EXPLORATION +Posteriormente I-EXPLORATION +se I-EXPLORATION +efectúo I-EXPLORATION +una I-EXPLORATION +TAC I-EXPLORATION +abdominal I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +apreció I-EXPLORATION un I-EXPLORATION -nódulo I-EXPLORATION +extenso I-EXPLORATION +engrosamiento I-EXPLORATION +mamelonado I-EXPLORATION de I-EXPLORATION -localización I-EXPLORATION -subcutánea I-EXPLORATION +la I-EXPLORATION +pared I-EXPLORATION +de I-EXPLORATION +colon I-EXPLORATION +transverso I-EXPLORATION +y I-EXPLORATION +del I-EXPLORATION +ángulo I-EXPLORATION +hepático I-EXPLORATION de I-EXPLORATION aproximadamente I-EXPLORATION -4 I-EXPLORATION -mm I-EXPLORATION +12 I-EXPLORATION +cm I-EXPLORATION de I-EXPLORATION -diámetro, I-EXPLORATION +longitud, I-EXPLORATION +sugestivo I-EXPLORATION de I-EXPLORATION -elevada I-EXPLORATION -consistencia, I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -proximidades I-EXPLORATION +neoplasia I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -dorsal I-EXPLORATION -superficial. I-EXPLORATION -No I-EXPLORATION -existían I-EXPLORATION -otras I-EXPLORATION -lesiones I-EXPLORATION -significativas I-EXPLORATION -ni I-EXPLORATION -adenopatías I-EXPLORATION -locorregionales I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION +colon; I-EXPLORATION +gran I-EXPLORATION +lesión I-EXPLORATION +sólida I-EXPLORATION +con I-EXPLORATION +captación I-EXPLORATION +heterogénea I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -urológica I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION +contraste I-EXPLORATION +en I-EXPLORATION +lóbulo I-EXPLORATION +hepático I-EXPLORATION +izquierdo I-EXPLORATION +segmento I-EXPLORATION +IV, I-EXPLORATION +sugestiva I-EXPLORATION +de I-EXPLORATION +metástasis. I-EXPLORATION Ante I-EXPLORATION +estos I-EXPLORATION +hallazgos I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +un I-EXPLORATION +enema I-EXPLORATION +opaco I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +un I-EXPLORATION +defecto I-EXPLORATION +de I-EXPLORATION +repleción I-EXPLORATION +en I-EXPLORATION +"corazón I-EXPLORATION +de I-EXPLORATION +manzana" I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -sospecha I-EXPLORATION +unión I-EXPLORATION +de I-EXPLORATION +colon I-EXPLORATION +transverso I-EXPLORATION +con I-EXPLORATION +ángulo I-EXPLORATION +hepático I-EXPLORATION +en I-EXPLORATION +un I-EXPLORATION +tramo I-EXPLORATION +aproximadamente I-EXPLORATION de I-EXPLORATION +12 I-EXPLORATION +centímetros. I-EXPLORATION +Además I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +colonoscopia I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION que I-EXPLORATION se I-EXPLORATION -tratara I-EXPLORATION -de I-EXPLORATION +apreció I-EXPLORATION una I-EXPLORATION -lesión I-EXPLORATION +neoplasia I-EXPLORATION +circunferencial I-EXPLORATION +a I-EXPLORATION +110 I-EXPLORATION +cm I-EXPLORATION +del I-EXPLORATION +ano I-EXPLORATION +que I-EXPLORATION +impedía I-EXPLORATION +el I-EXPLORATION +paso I-EXPLORATION +del I-EXPLORATION +endoscopio, I-EXPLORATION +tomándose I-EXPLORATION +biopsias. I-EXPLORATION +La I-EXPLORATION +anatomía I-EXPLORATION +patológica I-EXPLORATION +fue I-EXPLORATION +informada I-EXPLORATION +como I-EXPLORATION +tejido I-EXPLORATION de I-EXPLORATION -origen I-EXPLORATION -vascular, I-EXPLORATION +granulación I-EXPLORATION +y I-EXPLORATION +tejido I-EXPLORATION +conectivo I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +que I-EXPLORATION se I-EXPLORATION -solicitó I-EXPLORATION -estudio I-EXPLORATION -doppler I-EXPLORATION -peneano I-EXPLORATION +apreciaban I-EXPLORATION +densos I-EXPLORATION +infiltrados I-EXPLORATION +linfocitarios I-EXPLORATION +con I-EXPLORATION +predominio I-EXPLORATION +CD20+ I-EXPLORATION que I-EXPLORATION -mostró I-EXPLORATION -flujo I-EXPLORATION -intralesional, I-EXPLORATION con I-EXPLORATION -aumento I-EXPLORATION -del I-EXPLORATION -mismo I-EXPLORATION -durante I-EXPLORATION -la I-EXPLORATION -erección, I-EXPLORATION +frecuencia I-EXPLORATION +expresaban I-EXPLORATION +tinción I-EXPLORATION +nuclear I-EXPLORATION +bcl-6. I-EXPLORATION +Los I-EXPLORATION +cambios I-EXPLORATION +morfológicos I-EXPLORATION +sugerían I-EXPLORATION +un I-EXPLORATION +linfoma I-EXPLORATION +tipo I-EXPLORATION +B I-EXPLORATION +aunque I-EXPLORATION +no I-EXPLORATION +era I-EXPLORATION +concluyente I-EXPLORATION por I-EXPLORATION lo I-EXPLORATION que I-EXPLORATION se I-EXPLORATION -propuso I-EXPLORATION -su I-EXPLORATION -extirpación. I-EXPLORATION - I-EXPLORATION -Durante B-TREATMENT -la I-TREATMENT -intervención I-TREATMENT -se I-TREATMENT -objetivó I-TREATMENT -la I-TREATMENT -presencia I-TREATMENT -de I-TREATMENT -una I-TREATMENT -dilatación I-TREATMENT -nodular I-TREATMENT -en I-TREATMENT -la I-TREATMENT -vena I-TREATMENT -dorsal I-TREATMENT -superficial I-TREATMENT -del I-TREATMENT -pene, I-TREATMENT -que I-TREATMENT -fue I-TREATMENT -parcialmente I-TREATMENT -resecada I-TREATMENT -2 I-TREATMENT -cm I-TREATMENT -proximal I-TREATMENT -y I-TREATMENT -distalmente I-TREATMENT -a I-TREATMENT -la I-TREATMENT -lesión. I-TREATMENT - I-TREATMENT -El B-EXPLORATION -análisis I-EXPLORATION -histológico I-EXPLORATION -demostró I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -proliferación I-EXPLORATION -intravascular I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -endoteliales I-EXPLORATION -bien I-EXPLORATION -diferenciadas, I-EXPLORATION -con I-EXPLORATION -obliteración I-EXPLORATION -parcial I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -luz I-EXPLORATION -vascular, I-EXPLORATION -acompañados I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -importante I-EXPLORATION -infiltración I-EXPLORATION -de I-EXPLORATION -linfocitos I-EXPLORATION -y I-EXPLORATION -eosinófilos. I-EXPLORATION -El I-EXPLORATION -informe I-EXPLORATION -anatomopatológico I-EXPLORATION -definitivo I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -"hiperplasia I-EXPLORATION -angiolinfoide I-EXPLORATION -con I-EXPLORATION -eosinofilia I-EXPLORATION -intravascular". I-EXPLORATION +realizó I-EXPLORATION +PAAF I-EXPLORATION +hepática I-EXPLORATION +confirmando I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +linfoma I-EXPLORATION +de I-EXPLORATION +células I-EXPLORATION +grandes I-EXPLORATION +difuso I-EXPLORATION +tipo I-EXPLORATION +B. I-EXPLORATION I-EXPLORATION +Posteriormente B-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +paciente I-DERIVED_FROM/TO +fue I-DERIVED_FROM/TO +remitido I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +hematología, I-DERIVED_FROM/TO +donde I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +inició I-DERIVED_FROM/TO +tratamiento I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +quimioterapia I-DERIVED_FROM/TO +siguiendo I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +esquema I-DERIVED_FROM/TO +CHOP I-DERIVED_FROM/TO +(ciclofosfamida, I-DERIVED_FROM/TO +doxorrubicina, I-DERIVED_FROM/TO +vincristina I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +prednisona) I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +momento I-DERIVED_FROM/TO +no I-DERIVED_FROM/TO +tenemos I-DERIVED_FROM/TO +datos I-DERIVED_FROM/TO +sobre I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +eventual I-DERIVED_FROM/TO +respuesta I-DERIVED_FROM/TO +tumoral. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO -Varón B-PRESENT_ILLNESS +Escolar B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -54 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -alergias I-PAST_MEDICAL_HISTORY -medicamentosas I-PAST_MEDICAL_HISTORY -conocidas I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -salvo I-PAST_MEDICAL_HISTORY -hábito I-PAST_MEDICAL_HISTORY -tabáquico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -paquete I-PAST_MEDICAL_HISTORY -diario. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Remitido B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nuestras I-PRESENT_ILLNESS -consultas I-PRESENT_ILLNESS +12 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +masculino I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +residencia I-PAST_MEDICAL_HISTORY +rural I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +IX I-PAST_MEDICAL_HISTORY +región. I-PAST_MEDICAL_HISTORY +Consultó B-PRESENT_ILLNESS por I-PRESENT_ILLNESS cuadro I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -hematuria I-PRESENT_ILLNESS -macroscópica I-PRESENT_ILLNESS -monosintomática I-PRESENT_ILLNESS -acompañada I-PRESENT_ILLNESS +6 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -coágulos. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -reno-vesicoprostática I-EXPLORATION +evolución I-PRESENT_ILLNESS +caracterizado I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +manifestaciones I-PRESENT_ILLNESS +clínicas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tipo I-PRESENT_ILLNESS +hipertensión I-PRESENT_ILLNESS +intracraneana I-PRESENT_ILLNESS +(cefalea I-PRESENT_ILLNESS +holocránea I-PRESENT_ILLNESS +recurrente I-PRESENT_ILLNESS +[2-3 I-PRESENT_ILLNESS +veces I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +semana], I-PRESENT_ILLNESS +mareos I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +vómitos I-PRESENT_ILLNESS +ocasionales) I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +irritativa I-PRESENT_ILLNESS +(dos I-PRESENT_ILLNESS +episodios I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +crisis I-PRESENT_ILLNESS +convulsivas I-PRESENT_ILLNESS +tónico-clónicas I-PRESENT_ILLNESS +generalizadas). I-PRESENT_ILLNESS +El B-EXPLORATION +electroencefalograma I-EXPLORATION +(EEG) I-EXPLORATION +fue I-EXPLORATION +normal I-EXPLORATION +y I-EXPLORATION se I-EXPLORATION -apreciaba I-EXPLORATION -masa I-EXPLORATION -hiperecogénica I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +tomografía I-EXPLORATION +computada I-EXPLORATION +(TC) I-EXPLORATION +cerebral I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +un I-EXPLORATION +quiste I-EXPLORATION +intraxial I-EXPLORATION +temporal I-EXPLORATION +izquierdo I-EXPLORATION de I-EXPLORATION -4 I-EXPLORATION -cm I-EXPLORATION +65 I-EXPLORATION +mm I-EXPLORATION de I-EXPLORATION -diámetro I-EXPLORATION -mayor I-EXPLORATION -en I-EXPLORATION -pared I-EXPLORATION -lateral I-EXPLORATION -derecha. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -practicó I-EXPLORATION -resección I-EXPLORATION -transuretral I-EXPLORATION -endoscópica I-EXPLORATION -que I-EXPLORATION -determinó I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -trataba I-EXPLORATION +diámetro, I-EXPLORATION +bien I-EXPLORATION +delimitado I-EXPLORATION +y I-EXPLORATION +con I-EXPLORATION +severo I-EXPLORATION +efecto I-EXPLORATION de I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -vesical I-EXPLORATION -infiltrante I-EXPLORATION +masa, I-EXPLORATION +desviación I-EXPLORATION de I-EXPLORATION -estirpe I-EXPLORATION -urotelial I-EXPLORATION -(pT2G3). I-EXPLORATION - I-EXPLORATION -Durante I-EXPLORATION +línea I-EXPLORATION +media I-EXPLORATION +de I-EXPLORATION +8 I-EXPLORATION +mm, I-EXPLORATION +herniación I-EXPLORATION +uncal I-EXPLORATION +e I-EXPLORATION +hidrocefalia. I-EXPLORATION +La I-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION +(RM) I-EXPLORATION +mostró I-EXPLORATION +además I-EXPLORATION +un I-EXPLORATION +doble I-EXPLORATION +contorno I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -cistectomía I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -biopsia I-EXPLORATION -peroperatoria I-EXPLORATION +periferia, I-EXPLORATION +por I-EXPLORATION +desprendimiento I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -uretra I-EXPLORATION -prostática I-EXPLORATION -para I-EXPLORATION -valorar I-EXPLORATION +membrana I-EXPLORATION +germinal, I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +ligera I-EXPLORATION +impregnación I-EXPLORATION +tras I-EXPLORATION la I-EXPLORATION -posibilidad I-EXPLORATION +administración I-EXPLORATION de I-EXPLORATION -realización I-EXPLORATION +gadolinio. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +examen I-EXPLORATION de I-EXPLORATION -una I-EXPLORATION -vejiga I-EXPLORATION -ortotópica; I-EXPLORATION -tras B-TREATMENT -resultar I-TREATMENT -positiva I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -derivación I-TREATMENT -urinaria I-TREATMENT -tipo I-TREATMENT -Bricker I-TREATMENT -y I-TREATMENT -uretrectomía I-TREATMENT -total I-TREATMENT -en I-TREATMENT -el I-TREATMENT -mismo I-TREATMENT -acto I-TREATMENT -quirúrgico. I-TREATMENT - I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -informó I-EXPLORATION +fondo I-EXPLORATION de I-EXPLORATION -carcinoma I-EXPLORATION -linfoepitelioma-like I-EXPLORATION -vesical I-EXPLORATION -puro I-EXPLORATION -con I-EXPLORATION -invasión I-EXPLORATION +ojo I-EXPLORATION +demostró I-EXPLORATION +edema I-EXPLORATION de I-EXPLORATION +papila I-EXPLORATION +bilateral, I-EXPLORATION +sin I-EXPLORATION +evidenciarse I-EXPLORATION +déficit I-EXPLORATION +motor I-EXPLORATION +ni I-EXPLORATION +sensitivo I-EXPLORATION +al I-EXPLORATION +examen I-EXPLORATION +físico. I-EXPLORATION +El I-EXPLORATION +hemograma I-EXPLORATION +y I-EXPLORATION +pruebas I-EXPLORATION +hepáticas I-EXPLORATION +resultaron I-EXPLORATION +normales, I-EXPLORATION +sin I-EXPLORATION +demostrarse I-EXPLORATION la I-EXPLORATION -grasa I-EXPLORATION -perivesical I-EXPLORATION -(pT3a). I-EXPLORATION -Se I-EXPLORATION -realizaron I-EXPLORATION -técnicas I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -inmunohistoquimia I-EXPLORATION -resultando I-EXPLORATION -positivas I-EXPLORATION -para I-EXPLORATION -CK I-EXPLORATION -19 I-EXPLORATION -y I-EXPLORATION -Ki I-EXPLORATION -67, I-EXPLORATION -confirmando I-EXPLORATION -el I-EXPLORATION -componente I-EXPLORATION -epitelial I-EXPLORATION -tumoral; I-EXPLORATION -y I-EXPLORATION -también I-EXPLORATION -para I-EXPLORATION -CD I-EXPLORATION -45, I-EXPLORATION -CD I-EXPLORATION -43, I-EXPLORATION -CD I-EXPLORATION -20 I-EXPLORATION -y I-EXPLORATION -bcl I-EXPLORATION -2, I-EXPLORATION -corroborando I-EXPLORATION -el I-EXPLORATION -componente I-EXPLORATION -linfoide I-EXPLORATION -tumoral. I-EXPLORATION -También I-EXPLORATION -se I-EXPLORATION -objetivó I-EXPLORATION -intensa I-EXPLORATION -positividad I-EXPLORATION -citoplasmática I-EXPLORATION +lesiones I-EXPLORATION +quísticas I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -80% I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -células I-EXPLORATION -epiteliales I-EXPLORATION -para I-EXPLORATION -el I-EXPLORATION -virus I-EXPLORATION +la I-EXPLORATION +radiografía I-EXPLORATION +(Rx) I-EXPLORATION de I-EXPLORATION -Epstein-Barr. I-EXPLORATION -Asimismo I-EXPLORATION -se I-EXPLORATION -constató I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -prostático I-EXPLORATION -un I-EXPLORATION -adenocarcinoma I-EXPLORATION -moderadamente I-EXPLORATION -diferenciado I-EXPLORATION -gleason I-EXPLORATION -6/10. I-EXPLORATION - I-EXPLORATION -A B-EVOLUTION -los I-EVOLUTION -12 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -el I-EVOLUTION +tórax I-EXPLORATION +ni I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +ecotomografía I-EXPLORATION +abdominal. I-EXPLORATION +Se B-TREATMENT +planteó I-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT +de I-TREATMENT +hidatidosis I-TREATMENT +cerebral I-TREATMENT +y I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +la I-TREATMENT +exéresis I-TREATMENT +completa I-TREATMENT +e I-TREATMENT +intacta I-TREATMENT +del I-TREATMENT +quiste, I-TREATMENT +confirmando I-TREATMENT +el I-TREATMENT +estudio I-TREATMENT +histopatológico I-TREATMENT +la I-TREATMENT +etiología I-TREATMENT +hidatídica I-TREATMENT +de I-TREATMENT +la I-TREATMENT +lesión. I-TREATMENT + I-TREATMENT +El B-EVOLUTION paciente I-EVOLUTION -requirió I-EVOLUTION -de I-EVOLUTION -ingreso I-EVOLUTION -en I-EVOLUTION +evolucionó I-EVOLUTION +favorablemente, I-EVOLUTION +asintomático, I-EVOLUTION +sin I-EVOLUTION +déficit I-EVOLUTION +neurológico I-EVOLUTION +ni I-EVOLUTION +complicaciones I-EVOLUTION +post I-EVOLUTION +operatorias. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +46 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +ingresa I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +Servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Neurocirugía I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +hematoma I-PRESENT_ILLNESS +cerebral I-PRESENT_ILLNESS +secundario I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +rotura I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +aneurisma I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +arteria I-PRESENT_ILLNESS +cerebral I-PRESENT_ILLNESS +media I-PRESENT_ILLNESS +izquierda. I-PRESENT_ILLNESS +Se B-TREATMENT +realiza I-TREATMENT +un I-TREATMENT +clipaje I-TREATMENT +de I-TREATMENT +aneurisma I-TREATMENT +de I-TREATMENT +urgencia I-TREATMENT +para I-TREATMENT +la I-TREATMENT +evacuación I-TREATMENT +del I-TREATMENT +hematoma I-TREATMENT +y I-TREATMENT +una I-TREATMENT +craniectomía I-TREATMENT +frontotemporal I-TREATMENT +izquierda I-TREATMENT +descompresiva, I-TREATMENT +dejándose I-TREATMENT +un I-TREATMENT +drenaje I-TREATMENT +ventricular I-TREATMENT +externo. I-TREATMENT +Desde B-EVOLUTION el I-EVOLUTION -servicio I-EVOLUTION +día I-EVOLUTION de I-EVOLUTION -Neurología I-EVOLUTION -por I-EVOLUTION -cuadro I-EVOLUTION +la I-EVOLUTION +intervención I-EVOLUTION +presenta I-EVOLUTION +fiebre I-EVOLUTION +persistente, I-EVOLUTION +siendo I-EVOLUTION +diagnosticada I-EVOLUTION de I-EVOLUTION -múltiples I-EVOLUTION -infartos I-EVOLUTION -isquémicos I-EVOLUTION -cerebrales I-EVOLUTION +un I-EVOLUTION +posible I-EVOLUTION +Síndrome I-EVOLUTION de I-EVOLUTION -pequeño I-EVOLUTION -tamaño I-EVOLUTION -bilaterales I-EVOLUTION +Respuesta I-EVOLUTION +Inflamatoria I-EVOLUTION +Sistémica I-EVOLUTION +con I-EVOLUTION +sospecha I-EVOLUTION de I-EVOLUTION -posible I-EVOLUTION -causa I-EVOLUTION -cardioembólica. I-EVOLUTION -Actualmente I-EVOLUTION -asintomático I-EVOLUTION -bajo B-TREATMENT -tratamiento I-TREATMENT -anticoagulante. I-TREATMENT - I-TREATMENT -En B-EXPLORATION -TAC I-EXPLORATION -abdomino-pélvico I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -se I-EXPLORATION -evidenciaron I-EXPLORATION -varias I-EXPLORATION -imágenes I-EXPLORATION -ganglionares I-EXPLORATION -múltiples I-EXPLORATION -subcentimétricas. I-EXPLORATION -en I-EXPLORATION -relación I-EXPLORATION -a I-EXPLORATION -grandes I-EXPLORATION -vasos I-EXPLORATION -retroperitoneales I-EXPLORATION -y I-EXPLORATION -raíz I-EXPLORATION -de I-EXPLORATION -mesenterio. I-EXPLORATION -En B-TREATMENT -este I-TREATMENT -momento I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT +un I-EVOLUTION +foco I-EVOLUTION +pulmonar, I-EVOLUTION +posiblemente I-EVOLUTION +por I-EVOLUTION +neumonía I-EVOLUTION +aspirativa. I-EVOLUTION +Recibe B-TREATMENT tratamiento I-TREATMENT -quimioterápico I-TREATMENT -adyuvante I-TREATMENT +antibiótico I-TREATMENT con I-TREATMENT -gemcitabina I-TREATMENT +vancomicina I-TREATMENT +1.000 I-TREATMENT +mg/12 I-TREATMENT +h I-TREATMENT +durante I-TREATMENT +7 I-TREATMENT +días I-TREATMENT y I-TREATMENT -cisplatino. I-TREATMENT +meropenem I-TREATMENT +1.000 I-TREATMENT +mg/8 I-TREATMENT +h I-TREATMENT +durante I-TREATMENT +14 I-TREATMENT +días. I-TREATMENT I-TREATMENT -En B-EVOLUTION +A B-EVOLUTION +las I-EVOLUTION +dos I-EVOLUTION +semanas I-EVOLUTION +de I-EVOLUTION la I-EVOLUTION -actualidad I-EVOLUTION -y I-EVOLUTION -tras I-EVOLUTION -20 I-EVOLUTION -meses I-EVOLUTION +intervención, I-EVOLUTION +es I-EVOLUTION +diagnosticada I-EVOLUTION de I-EVOLUTION -seguimiento I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -asintomático I-EVOLUTION -y I-EVOLUTION -libre I-EVOLUTION +una I-EVOLUTION +infección I-EVOLUTION +por I-EVOLUTION +Enterococcus I-EVOLUTION +faecalis I-EVOLUTION de I-EVOLUTION -enfermedad, I-EVOLUTION -pendiente I-EVOLUTION +la I-EVOLUTION +herida I-EVOLUTION de I-EVOLUTION -próximo I-EVOLUTION -control I-EVOLUTION -radiológico. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -66 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -tumoración I-PRESENT_ILLNESS -paratesticular I-PRESENT_ILLNESS -izquierda I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -aproximadamente I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -crecimiento I-PRESENT_ILLNESS -lento I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -progresivo, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -otra I-PRESENT_ILLNESS -sintomatología. I-PRESENT_ILLNESS -La B-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -demuestra I-EXPLORATION +la I-EVOLUTION +craniectomía I-EVOLUTION +y B-EXPLORATION +7 I-EXPLORATION +días I-EXPLORATION +después I-EXPLORATION +se I-EXPLORATION +le I-EXPLORATION +practica I-EXPLORATION una I-EXPLORATION -masa I-EXPLORATION -intraescrotal I-EXPLORATION -izquierda I-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION +nuclear I-EXPLORATION +cerebral I-EXPLORATION +cuyo I-EXPLORATION +resultado I-EXPLORATION +es I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +meningoencefalitis, I-EXPLORATION +pese I-EXPLORATION +a I-EXPLORATION +que I-EXPLORATION +los I-EXPLORATION +cultivos I-EXPLORATION de I-EXPLORATION -aproximadamente I-EXPLORATION -10 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro, I-EXPLORATION -no I-EXPLORATION -dolorosa, I-EXPLORATION +líquido I-EXPLORATION +cefalorraquídeo I-EXPLORATION +(LCR) I-EXPLORATION +son I-EXPLORATION +negativos. I-EXPLORATION +La B-TREATMENT +paciente I-TREATMENT +es I-TREATMENT +tratada I-TREATMENT +con I-TREATMENT +vancomicina I-TREATMENT +1.000 I-TREATMENT +mg/8 I-TREATMENT +h I-TREATMENT +y I-TREATMENT +cefepima I-TREATMENT +2.000 I-TREATMENT +mg/8 I-TREATMENT +h I-TREATMENT +durante I-TREATMENT +23 I-TREATMENT +días. I-TREATMENT +A B-EXPLORATION +los I-EXPLORATION +45 I-EXPLORATION +días I-EXPLORATION de I-EXPLORATION -consistencia I-EXPLORATION -dura, I-EXPLORATION -con I-EXPLORATION -transiluminación I-EXPLORATION -negativa, I-EXPLORATION -no I-EXPLORATION +la I-EXPLORATION +intervención I-EXPLORATION se I-EXPLORATION -palpan I-EXPLORATION -adenopatías I-EXPLORATION -regionales; I-EXPLORATION -al I-EXPLORATION -tacto I-EXPLORATION -rectal, I-EXPLORATION +diagnostica, I-EXPLORATION +tras I-EXPLORATION +extraer I-EXPLORATION +nuevos I-EXPLORATION +cultivos I-EXPLORATION +de I-EXPLORATION +LCR, I-EXPLORATION +una I-EXPLORATION +ventriculitis I-EXPLORATION +por I-EXPLORATION +E. I-EXPLORATION +faecalis I-EXPLORATION +asociada I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -próstata I-EXPLORATION +derivación I-EXPLORATION +externa I-EXPLORATION +y I-EXPLORATION es I-EXPLORATION -grado I-EXPLORATION -I I-EXPLORATION +tratada I-EXPLORATION con I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -nódulo I-EXPLORATION -pétreo I-EXPLORATION -en I-EXPLORATION -lóbulo I-EXPLORATION -derecho. I-EXPLORATION -Estudios I-EXPLORATION -complementarios: I-EXPLORATION -PSA I-EXPLORATION -1276 I-EXPLORATION -ng/ml, I-EXPLORATION -fosfatasas I-EXPLORATION -alcalinas I-EXPLORATION -172 I-EXPLORATION -U/l, I-EXPLORATION -Bgonadotropina I-EXPLORATION +meropenem I-EXPLORATION +1.000 I-EXPLORATION +mg/8 I-EXPLORATION +h I-EXPLORATION +durante I-EXPLORATION +13 I-EXPLORATION +días I-EXPLORATION y I-EXPLORATION -Alfa-fetoproteína I-EXPLORATION -normales. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION +ampicilina I-EXPLORATION +2.000 I-EXPLORATION +mg/24 I-EXPLORATION +h I-EXPLORATION +durante I-EXPLORATION +24 I-EXPLORATION +días. I-EXPLORATION +Tras I-EXPLORATION +59 I-EXPLORATION +días I-EXPLORATION +de I-EXPLORATION +ingreso I-EXPLORATION se I-EXPLORATION -observa I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -hipoecoica, I-EXPLORATION -homogénea, I-EXPLORATION +aísla I-EXPLORATION +Candida I-EXPLORATION +albicans I-EXPLORATION +en I-EXPLORATION +LCR I-EXPLORATION con I-EXPLORATION -áreas I-EXPLORATION -de I-EXPLORATION -menor I-EXPLORATION -ecogenicidad I-EXPLORATION -e I-EXPLORATION -imágenes I-EXPLORATION +candidemia I-EXPLORATION +asociada I-EXPLORATION +y B-TREATMENT +se I-TREATMENT +añade I-TREATMENT +al I-TREATMENT +tratamiento I-TREATMENT +fluconazol I-TREATMENT +400 I-TREATMENT +mg/12 I-TREATMENT +h I-TREATMENT +durante I-TREATMENT +17 I-TREATMENT +días. I-TREATMENT + I-TREATMENT +Los B-EXPLORATION +cultivos I-EXPLORATION +posteriores I-EXPLORATION de I-EXPLORATION -baja I-EXPLORATION -vascularización I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -interior, I-EXPLORATION +LCR I-EXPLORATION +y I-EXPLORATION +sangre I-EXPLORATION +para I-EXPLORATION +los I-EXPLORATION +patógenos I-EXPLORATION +mencionados I-EXPLORATION +resultan I-EXPLORATION +negativos, I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +infiere I-EXPLORATION +la I-EXPLORATION +resolución I-EXPLORATION de I-EXPLORATION -9 I-EXPLORATION -x I-EXPLORATION -8, I-EXPLORATION -5 I-EXPLORATION -x I-EXPLORATION -12 I-EXPLORATION -cm I-EXPLORATION -sin I-EXPLORATION -poder I-EXPLORATION -establecer I-EXPLORATION las I-EXPLORATION -estructuras I-EXPLORATION +infecciones I-EXPLORATION +previas; I-EXPLORATION +sin B-EVOLUTION +embargo I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +vuelve I-EVOLUTION +a I-EVOLUTION +presentar I-EVOLUTION +fiebre I-EVOLUTION +elevada I-EVOLUTION +y B-EXPLORATION +el I-EXPLORATION +día I-EXPLORATION ++70 I-EXPLORATION +se I-EXPLORATION +aísla, I-EXPLORATION +en I-EXPLORATION +un I-EXPLORATION +cultivo I-EXPLORATION de I-EXPLORATION las I-EXPLORATION -que I-EXPLORATION -depende; I-EXPLORATION -ambos I-EXPLORATION -testículos I-EXPLORATION -son I-EXPLORATION -normales, I-EXPLORATION -estando I-EXPLORATION +secreciones I-EXPLORATION +respiratorias, I-EXPLORATION +P. I-EXPLORATION +aeruginosa I-EXPLORATION +multirresistente, I-EXPLORATION +sensible I-EXPLORATION +únicamente I-EXPLORATION +a I-EXPLORATION +ceftazidima I-EXPLORATION +(CMI I-EXPLORATION +≤ I-EXPLORATION +4 I-EXPLORATION +mg/L) I-EXPLORATION +y I-EXPLORATION +a I-EXPLORATION +colistina I-EXPLORATION +(CMI I-EXPLORATION +≤ I-EXPLORATION +2 I-EXPLORATION +mg/L) I-EXPLORATION +(EUCAST-2012, I-EXPLORATION +www.eucast.org). I-EXPLORATION +Asimismo, I-EXPLORATION el I-EXPLORATION -izquierdo I-EXPLORATION -rechazado I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -masa I-EXPLORATION -escrotal; I-EXPLORATION -la I-EXPLORATION -próstata I-EXPLORATION -tiene I-EXPLORATION -un I-EXPLORATION -volumen I-EXPLORATION +día I-EXPLORATION ++73 I-EXPLORATION +se I-EXPLORATION +aísla I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -de I-EXPLORATION -70 I-EXPLORATION -cc, I-EXPLORATION +LCR I-EXPLORATION +Stenotrophomonas I-EXPLORATION +maltophilia, I-EXPLORATION +resistente I-EXPLORATION +a I-EXPLORATION +betalactámicos, I-EXPLORATION +aminoglucósidos I-EXPLORATION +y I-EXPLORATION +fluoroquinolonas, I-EXPLORATION +sensible I-EXPLORATION +solo I-EXPLORATION +a I-EXPLORATION +cotrimoxazol I-EXPLORATION +(CMI I-EXPLORATION +≤ I-EXPLORATION +2/38 I-EXPLORATION +mg/L) I-EXPLORATION +y I-EXPLORATION con I-EXPLORATION -parénquima I-EXPLORATION -heterogéneo; I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION +una I-EXPLORATION +CMI I-EXPLORATION de I-EXPLORATION +colistina I-EXPLORATION +≤ I-EXPLORATION +2 I-EXPLORATION +mg/L. I-EXPLORATION +Debido I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -urológica I-EXPLORATION -es I-EXPLORATION -normal. I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -gammagrafía I-EXPLORATION -que I-EXPLORATION -demuestra I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION +falta I-EXPLORATION de I-EXPLORATION -metástasis I-EXPLORATION -óseas I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -fémur I-EXPLORATION -derecho, I-EXPLORATION -la I-EXPLORATION -columna I-EXPLORATION -vertebral, I-EXPLORATION -la I-EXPLORATION -parrilla I-EXPLORATION -costal, I-EXPLORATION -el I-EXPLORATION -sacro I-EXPLORATION -y I-EXPLORATION +punto I-EXPLORATION +de I-EXPLORATION +corte I-EXPLORATION +para I-EXPLORATION +este I-EXPLORATION +último I-EXPLORATION +antimicrobiano I-EXPLORATION +frente I-EXPLORATION +a I-EXPLORATION +S. I-EXPLORATION +maltophilia I-EXPLORATION +se I-EXPLORATION +utilizó I-EXPLORATION el I-EXPLORATION -hombro I-EXPLORATION -izquierdo. I-EXPLORATION -La I-EXPLORATION -biopsia I-EXPLORATION -prostática I-EXPLORATION -transrectal I-EXPLORATION -no I-EXPLORATION -es I-EXPLORATION -realizada I-EXPLORATION +definido I-EXPLORATION por I-EXPLORATION -decisión I-EXPLORATION -del I-EXPLORATION -paciente. I-EXPLORATION - I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -es I-TREATMENT -intervenido I-TREATMENT -quirúrgicamente I-TREATMENT -realizándose I-TREATMENT -orquiectomía I-TREATMENT -radical. I-TREATMENT -Se I-TREATMENT -inicia I-TREATMENT +EUCAST I-EXPLORATION +para I-EXPLORATION +Acinetobacter I-EXPLORATION +spp I-EXPLORATION +(sensibilidad, I-EXPLORATION +≤ I-EXPLORATION +2 I-EXPLORATION +mg/L). I-EXPLORATION +Tras B-TREATMENT tratamiento I-TREATMENT con I-TREATMENT -bloqueo I-TREATMENT -hormonal I-TREATMENT -completo I-TREATMENT +cotrimoxazol I-TREATMENT +iv I-TREATMENT +800/160 I-TREATMENT +mg/12 I-TREATMENT +h I-TREATMENT y I-TREATMENT +con I-TREATMENT +ceftazidima I-TREATMENT +iv I-TREATMENT +2.000 I-TREATMENT +mg/8 I-TREATMENT +h, I-TREATMENT +el I-TREATMENT +día I-TREATMENT ++75 I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +continúa I-TREATMENT +con I-TREATMENT +fiebre, I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT se I-TREATMENT -administra I-TREATMENT -radioterapia I-TREATMENT -externa I-TREATMENT -sobre I-TREATMENT -lesión I-TREATMENT -ósea I-TREATMENT -de I-TREATMENT -fémur I-TREATMENT -derecho, I-TREATMENT -sin I-TREATMENT -complicaciones. I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -describe I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -de I-EXPLORATION -12 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro, I-EXPLORATION -aspecto I-EXPLORATION -tumoral, I-EXPLORATION -encapsulada, I-EXPLORATION -color I-EXPLORATION -blanquecino-amarillento, I-EXPLORATION -con I-EXPLORATION -áreas I-EXPLORATION -centrales I-EXPLORATION -de I-EXPLORATION -color I-EXPLORATION -amarillo I-EXPLORATION -más I-EXPLORATION -intenso I-EXPLORATION -; I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -microscópico I-EXPLORATION -evidencia I-EXPLORATION -una I-EXPLORATION -neoplasia I-EXPLORATION -bien I-EXPLORATION -delimitada I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -atraviesa I-EXPLORATION -la I-EXPLORATION -cápsula, I-EXPLORATION -constituida I-EXPLORATION -por I-EXPLORATION -células I-EXPLORATION -pleomórficas I-EXPLORATION -grandes I-EXPLORATION +plantea I-TREATMENT +un I-TREATMENT +tratamiento I-TREATMENT +de I-TREATMENT +rescate I-TREATMENT +con I-TREATMENT +colistina I-TREATMENT +iv I-TREATMENT +2 I-TREATMENT +MUI/8 I-TREATMENT +h, I-TREATMENT +colistina I-TREATMENT +intraventricular I-TREATMENT +60.000 I-TREATMENT +UI/12 I-TREATMENT +h I-TREATMENT +y I-TREATMENT +cotrimoxazol I-TREATMENT +iv I-TREATMENT +1.600/320 I-TREATMENT +mg/12 I-TREATMENT +h. I-TREATMENT +Transcurridos B-EXPLORATION +7 I-EXPLORATION +días I-EXPLORATION con I-EXPLORATION -múltiples I-EXPLORATION -prolongaciones, I-EXPLORATION +dicho I-EXPLORATION +tratamiento, I-EXPLORATION el I-EXPLORATION -estroma I-EXPLORATION -es I-EXPLORATION +día I-EXPLORATION ++82 I-EXPLORATION +crece, I-EXPLORATION +en I-EXPLORATION +un I-EXPLORATION +cultivo I-EXPLORATION de I-EXPLORATION -predominio I-EXPLORATION -hialino I-EXPLORATION +LCR, I-EXPLORATION +S. I-EXPLORATION +maltophilia I-EXPLORATION +sensible I-EXPLORATION +a I-EXPLORATION +minociclina I-EXPLORATION +(CMI I-EXPLORATION +≤ I-EXPLORATION +4 I-EXPLORATION +mg/L, I-EXPLORATION +CLSI-2012) I-EXPLORATION y I-EXPLORATION -con I-EXPLORATION -escasa I-EXPLORATION -vascularización, I-EXPLORATION -sin I-EXPLORATION -observarse I-EXPLORATION -mitosis. I-EXPLORATION -La I-EXPLORATION -inmunohistoquímica I-EXPLORATION -evidencia I-EXPLORATION -positividad I-EXPLORATION +resistente I-EXPLORATION a I-EXPLORATION +colistina I-EXPLORATION +(CMI I-EXPLORATION +> I-EXPLORATION +4 I-EXPLORATION +mg/L) I-EXPLORATION +2. I-EXPLORATION +Tras I-EXPLORATION la I-EXPLORATION -vimentina I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -menor I-EXPLORATION -medida I-EXPLORATION +confirmación I-EXPLORATION +de I-EXPLORATION +este I-EXPLORATION +valor I-EXPLORATION +mediante I-EXPLORATION +una I-EXPLORATION +tira I-EXPLORATION +de I-EXPLORATION +gradiente I-EXPLORATION +preformado I-EXPLORATION +de I-EXPLORATION +CMI, I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +debe I-EXPLORATION al I-EXPLORATION -CD34 I-EXPLORATION -y, I-EXPLORATION -negatividad I-EXPLORATION -para I-EXPLORATION -el I-EXPLORATION -PSA, I-EXPLORATION -desmina, I-EXPLORATION -S-100, I-EXPLORATION -actina I-EXPLORATION -HHF35, I-EXPLORATION -actina I-EXPLORATION -músculo I-EXPLORATION -liso I-EXPLORATION -y I-EXPLORATION -myogenina I-EXPLORATION -D I-EXPLORATION -siendo I-EXPLORATION -diagnosticado I-EXPLORATION -de: I-EXPLORATION -liposarcoma I-EXPLORATION -desdiferenciado, I-EXPLORATION +crecimiento I-EXPLORATION de I-EXPLORATION -predominio I-EXPLORATION -esclerosante. I-EXPLORATION -Tras B-EVOLUTION -seguimiento I-EVOLUTION -de I-EVOLUTION -12 I-EVOLUTION -meses I-EVOLUTION -no I-EVOLUTION -existe I-EVOLUTION -evidencia I-EVOLUTION -de I-EVOLUTION -enfermedad I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -PSA I-EVOLUTION -es I-EVOLUTION -de I-EVOLUTION -0, I-EVOLUTION -2 I-EVOLUTION -ng/ml I-EVOLUTION -y I-EVOLUTION -las I-EVOLUTION -fosfatasas I-EVOLUTION -alcalinas I-EVOLUTION -de I-EVOLUTION -125 I-EVOLUTION -U/l. I-EVOLUTION +una I-EXPLORATION +subpoblación I-EXPLORATION +diferente I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +mayoritaria. I-EXPLORATION +Ante B-TREATMENT +esta I-TREATMENT +situación I-TREATMENT +se I-TREATMENT +suspende I-TREATMENT +colistina I-TREATMENT +y I-TREATMENT +se I-TREATMENT +administra I-TREATMENT +minociclina I-TREATMENT +200 I-TREATMENT +mg/12 I-TREATMENT +h I-TREATMENT +por I-TREATMENT +sonda I-TREATMENT +nasogástrica, I-TREATMENT +además I-TREATMENT +de I-TREATMENT +cotrimoxazol I-TREATMENT +iv I-TREATMENT +1.600/320 I-TREATMENT +mg/12 I-TREATMENT +h. I-TREATMENT +Posteriormente, I-TREATMENT +ante I-TREATMENT +la I-TREATMENT +necesidad I-TREATMENT +de I-TREATMENT +dieta I-TREATMENT +absoluta I-TREATMENT +como I-TREATMENT +consecuencia I-TREATMENT +de I-TREATMENT +una I-TREATMENT +hemorragia I-TREATMENT +digestiva, I-TREATMENT +el I-TREATMENT +día I-TREATMENT ++94 I-TREATMENT +se I-TREATMENT +suspende I-TREATMENT +minociclina I-TREATMENT +y I-TREATMENT +se I-TREATMENT +pauta I-TREATMENT +tigeciclina I-TREATMENT +iv I-TREATMENT +50 I-TREATMENT +mg/12 I-TREATMENT +h. I-TREATMENT +Finalmente B-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +fallece I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +95 I-EVOLUTION +días I-EVOLUTION +del I-EVOLUTION +ingreso I-EVOLUTION +por I-EVOLUTION +infecciones I-EVOLUTION +intercurrentes. I-EVOLUTION I-EVOLUTION -Niña B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -7 I-PRESENT_ILLNESS +13 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -médico-quirúrgicos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -salvo I-PAST_MEDICAL_HISTORY -varios I-PAST_MEDICAL_HISTORY -episodios I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cistitis I-PAST_MEDICAL_HISTORY -aguda I-PAST_MEDICAL_HISTORY -(al I-PAST_MEDICAL_HISTORY -nacimiento, I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -vida I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -último I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -6 I-PAST_MEDICAL_HISTORY -meses), I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS dolor I-PRESENT_ILLNESS -abdominal, I-PRESENT_ILLNESS -hematuria I-PRESENT_ILLNESS -macroscópica, I-PRESENT_ILLNESS -febrícula I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -miccional I-PRESENT_ILLNESS -irritativo I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -disuria, I-PRESENT_ILLNESS -polaquiuria I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -tenesmo I-PRESENT_ILLNESS -vesical I-PRESENT_ILLNESS +torácico I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS +incapacitante I-PRESENT_ILLNESS de I-PRESENT_ILLNESS 3 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS de I-PRESENT_ILLNESS evolución, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -mejoría I-PRESENT_ILLNESS -clínica I-PRESENT_ILLNESS -pese I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -antibiótico I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +calma I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -Amoxicilina-Clavulánico. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -presenta I-EXPLORATION -buen I-EXPLORATION -estado I-EXPLORATION -general I-EXPLORATION -y I-EXPLORATION -temperatura I-EXPLORATION -axilar I-EXPLORATION +analgésicos. I-PRESENT_ILLNESS +Sin B-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +traumático. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +La B-EXPLORATION +palpación I-EXPLORATION de I-EXPLORATION -37.2º I-EXPLORATION -C. I-EXPLORATION -En I-EXPLORATION +los I-EXPLORATION +cartílagos I-EXPLORATION +costales I-EXPLORATION +es I-EXPLORATION +dolorosa, I-EXPLORATION +refiriendo I-EXPLORATION +como I-EXPLORATION +punto I-EXPLORATION +más I-EXPLORATION +doloroso I-EXPLORATION la I-EXPLORATION -palpación I-EXPLORATION -abdominal I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -detectan I-EXPLORATION -masas I-EXPLORATION +7a I-EXPLORATION +unión I-EXPLORATION +costoesternal I-EXPLORATION +derecha, I-EXPLORATION +sin I-EXPLORATION +apreciarse I-EXPLORATION +alteraciones I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +contorno I-EXPLORATION ni I-EXPLORATION -organomegalias, I-EXPLORATION -apreciando I-EXPLORATION -leves I-EXPLORATION -molestias I-EXPLORATION +signos I-EXPLORATION +inflamatorios I-EXPLORATION +cutáneos. I-EXPLORATION +La I-EXPLORATION +maniobra I-EXPLORATION +del I-EXPLORATION +gancho, I-EXPLORATION +que I-EXPLORATION +consiste I-EXPLORATION en I-EXPLORATION +producir I-EXPLORATION +una I-EXPLORATION +elevación I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +cartílagos I-EXPLORATION +costales I-EXPLORATION +inferiores I-EXPLORATION +mediante I-EXPLORATION la I-EXPLORATION -zona I-EXPLORATION -periumbilical. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -datos I-EXPLORATION -analíticos I-EXPLORATION -sanguíneos I-EXPLORATION -son I-EXPLORATION -normales I-EXPLORATION -salvo I-EXPLORATION -leucocitosis I-EXPLORATION +introducción I-EXPLORATION de I-EXPLORATION -13.900 I-EXPLORATION -cel/mcl I-EXPLORATION -con I-EXPLORATION -neutrofilia I-EXPLORATION +los I-EXPLORATION +dedos I-EXPLORATION del I-EXPLORATION -83 I-EXPLORATION -%, I-EXPLORATION -PCR I-EXPLORATION -de I-EXPLORATION -51 I-EXPLORATION -mg/l I-EXPLORATION +explorador I-EXPLORATION +por I-EXPLORATION +debajo I-EXPLORATION +del I-EXPLORATION +último I-EXPLORATION +arco I-EXPLORATION +costal I-EXPLORATION y I-EXPLORATION -velocidad I-EXPLORATION -de I-EXPLORATION -sedimentación I-EXPLORATION -globular I-EXPLORATION +traccionando I-EXPLORATION de I-EXPLORATION -39 I-EXPLORATION -mm/h. I-EXPLORATION +él I-EXPLORATION +en I-EXPLORATION +sentido I-EXPLORATION +craneal, I-EXPLORATION +es I-EXPLORATION +muy I-EXPLORATION +dolorosa. I-EXPLORATION El I-EXPLORATION -sedimento I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION -muestra I-EXPLORATION -hematuria I-EXPLORATION -microscópica, I-EXPLORATION -siendo I-EXPLORATION -normales I-EXPLORATION -el I-EXPLORATION resto I-EXPLORATION de I-EXPLORATION -sus I-EXPLORATION -parámetros. I-EXPLORATION -El I-EXPLORATION -urinocultivo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -es I-EXPLORATION -negativo. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -practica I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -que I-EXPLORATION -evidencia I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -quística I-EXPLORATION -anfractuosa I-EXPLORATION -de I-EXPLORATION -4, I-EXPLORATION -3x2 I-EXPLORATION -cm, I-EXPLORATION -localizada I-EXPLORATION -en I-EXPLORATION +exploración I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION la I-EXPLORATION -pared I-EXPLORATION -anterior I-EXPLORATION -del I-EXPLORATION -abdomen I-EXPLORATION -llegando I-EXPLORATION -hasta I-EXPLORATION -cúpula I-EXPLORATION -vesical, I-EXPLORATION -con I-EXPLORATION -contenido I-EXPLORATION -ecogénico I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -interior I-EXPLORATION -y I-EXPLORATION -paredes I-EXPLORATION -con I-EXPLORATION -vascularización I-EXPLORATION -aumentada, I-EXPLORATION -sugestiva I-EXPLORATION -de I-EXPLORATION -quiste I-EXPLORATION +radiografía I-EXPLORATION de I-EXPLORATION -uraco I-EXPLORATION -complicado. I-EXPLORATION +tórax I-EXPLORATION +es I-EXPLORATION +normal. I-EXPLORATION I-EXPLORATION -Con B-TREATMENT +Dada B-TREATMENT la I-TREATMENT -sospecha I-TREATMENT -diagnóstica I-TREATMENT -de I-TREATMENT -quiste I-TREATMENT -de I-TREATMENT -uraco I-TREATMENT -infectado I-TREATMENT -iniciamos I-TREATMENT +exploración I-TREATMENT +tan I-TREATMENT +característica, I-TREATMENT +se I-TREATMENT +pensó I-TREATMENT +en I-TREATMENT +el I-TREATMENT +SCD I-TREATMENT +y I-TREATMENT +se I-TREATMENT +optó I-TREATMENT +por I-TREATMENT +un I-TREATMENT tratamiento I-TREATMENT -antibiótico I-TREATMENT +conservador I-TREATMENT con I-TREATMENT -Fosfomicina, I-TREATMENT -objetivándose I-TREATMENT -mejoría I-TREATMENT -clínica I-TREATMENT -evidente I-TREATMENT -a I-TREATMENT -las I-TREATMENT -pocas I-TREATMENT -horas. I-TREATMENT +antiinflamatorios I-TREATMENT +orales. I-TREATMENT I-TREATMENT -En B-EXPLORATION -el I-EXPLORATION -seguimiento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -de I-EXPLORATION -control, I-EXPLORATION -que I-EXPLORATION -muestra I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -sólida I-EXPLORATION -e I-EXPLORATION -irregular, I-EXPLORATION -situada I-EXPLORATION -encima I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -cúpula I-EXPLORATION -vesical, I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -1, I-EXPLORATION -8x1, I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -relación I-EXPLORATION -con I-EXPLORATION -resto I-EXPLORATION -del I-EXPLORATION -uraco I-EXPLORATION -persistente. I-EXPLORATION -De I-EXPLORATION -igual I-EXPLORATION -forma, I-EXPLORATION -realizamos I-EXPLORATION -uretrocistografía I-EXPLORATION -donde I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -comunicación I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -vejiga, I-EXPLORATION -ni I-EXPLORATION -detectamos I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -reflujo I-EXPLORATION -vesicoureteral. I-EXPLORATION -Confirmado B-TREATMENT +Tras I-TREATMENT +un I-TREATMENT +mes I-TREATMENT +sin I-TREATMENT +mejoría, I-TREATMENT +se I-TREATMENT +le I-TREATMENT +propuso I-TREATMENT +bloqueo I-TREATMENT +anestésico I-TREATMENT +intercostal I-TREATMENT +o I-TREATMENT +tratamiento I-TREATMENT +quirúrgico I-TREATMENT +definitivo. I-TREATMENT +Dado I-TREATMENT +que I-TREATMENT el I-TREATMENT -diagnóstico I-TREATMENT +dolor I-TREATMENT de I-TREATMENT -quiste I-TREATMENT -de I-TREATMENT -uraco, I-TREATMENT -programamos I-TREATMENT la I-TREATMENT -extirpación I-TREATMENT -quirúrgica I-TREATMENT -del I-TREATMENT -mismo. I-TREATMENT -Tras I-TREATMENT -dos I-TREATMENT -semanas I-TREATMENT -con I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -realizamos I-TREATMENT -laparotomía I-TREATMENT -media I-TREATMENT -infraumbilical-extraperitoneal, I-TREATMENT -procediendo I-TREATMENT -a I-TREATMENT +niña I-TREATMENT +cada I-TREATMENT +vez I-TREATMENT +es I-TREATMENT +más I-TREATMENT +limitante I-TREATMENT +y I-TREATMENT +que I-TREATMENT la I-TREATMENT -exéresis I-TREATMENT -completa I-TREATMENT +primera I-TREATMENT +opción I-TREATMENT +aportaría I-TREATMENT +un I-TREATMENT +alivio I-TREATMENT +temporal, I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +la I-TREATMENT +intervención I-TREATMENT +quirúrgica. I-TREATMENT +Al I-TREATMENT +año I-TREATMENT del I-TREATMENT -uraco, I-TREATMENT -incluyendo I-TREATMENT +diagnóstico, I-TREATMENT +bajo I-TREATMENT +anestesia I-TREATMENT +general I-TREATMENT +y I-TREATMENT +a I-TREATMENT +través I-TREATMENT +de I-TREATMENT +una I-TREATMENT +incisión I-TREATMENT +transversa I-TREATMENT +de I-TREATMENT +4 I-TREATMENT +cm I-TREATMENT +sobre I-TREATMENT el I-TREATMENT -quiste I-TREATMENT -uracal I-TREATMENT +arco I-TREATMENT +costal I-TREATMENT +afectado, I-TREATMENT +extirpamos I-TREATMENT +el I-TREATMENT +7o, I-TREATMENT +8o I-TREATMENT y I-TREATMENT -un I-TREATMENT -rodete I-TREATMENT -vesical. I-TREATMENT -No B-EVOLUTION -hubo I-EVOLUTION -complicaciones I-EVOLUTION -intraoperatorias I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -evolución I-EVOLUTION -posterior I-EVOLUTION -fue I-EVOLUTION -satisfactoria. I-EVOLUTION -Actualmente I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -asintomática I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -cistografía I-EVOLUTION -practicada I-EVOLUTION -al I-EVOLUTION -mes I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -intervención I-EVOLUTION -la I-EVOLUTION -vejiga I-EVOLUTION -presenta I-EVOLUTION -una I-EVOLUTION -morfología I-EVOLUTION -normal. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -26 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -adicción I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -marihuana, I-PAST_MEDICAL_HISTORY -cocaína I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -promiscuidad I-PAST_MEDICAL_HISTORY -sexual. I-PAST_MEDICAL_HISTORY -Acudió B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -verrucosas I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -pene I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -indoloras, I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -cuales I-PRESENT_ILLNESS -progresivamente I-PRESENT_ILLNESS -aumentaron I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -número I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -tamaño. I-PRESENT_ILLNESS -Negaba I-PRESENT_ILLNESS -síntomas I-PRESENT_ILLNESS -urinarios. I-PRESENT_ILLNESS -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -se I-EXPLORATION -aprecian I-EXPLORATION -múltiples I-EXPLORATION -lesiones I-EXPLORATION -verrucosas, I-EXPLORATION -friables, I-EXPLORATION -en I-EXPLORATION -glande I-EXPLORATION -y I-EXPLORATION -cuerpo I-EXPLORATION -del I-EXPLORATION -pene. I-EXPLORATION -Se B-TREATMENT -le I-TREATMENT -indicó I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -imiquimod I-TREATMENT -al I-TREATMENT -5% I-TREATMENT -en I-TREATMENT -crema I-TREATMENT -(Aldara® I-TREATMENT -3M) I-TREATMENT -tres I-TREATMENT -veces I-TREATMENT -por I-TREATMENT -semana. I-TREATMENT -El B-EXPLORATION -paciente I-EXPLORATION -acudió I-EXPLORATION -a I-EXPLORATION -consulta I-EXPLORATION -al I-EXPLORATION -completar I-EXPLORATION -dos I-EXPLORATION -semanas I-EXPLORATION -de I-EXPLORATION -tratamiento, I-EXPLORATION -encontrándose I-EXPLORATION -disminución I-EXPLORATION -importante I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -tanto I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -tamaño I-EXPLORATION -como I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -número, I-EXPLORATION -apreciándose I-EXPLORATION -eritema I-EXPLORATION -importante I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -sitios I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -sin I-EXPLORATION -referir I-EXPLORATION -prurito I-EXPLORATION -o I-EXPLORATION -dolor I-EXPLORATION -en I-EXPLORATION -dichas I-EXPLORATION -zonas. I-EXPLORATION -Se B-EVOLUTION -continuó I-EVOLUTION +9o I-TREATMENT +cartílagos I-TREATMENT +costales, I-TREATMENT +preservando I-TREATMENT +el I-TREATMENT +pericondrio. I-TREATMENT + I-TREATMENT +Transcurrido B-EVOLUTION +un I-EVOLUTION +año, I-EVOLUTION el I-EVOLUTION -tratamiento I-EVOLUTION -por I-EVOLUTION -2 I-EVOLUTION -semanas I-EVOLUTION -más, I-EVOLUTION -al I-EVOLUTION -término I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -cuales I-EVOLUTION -se I-EVOLUTION -revisó I-EVOLUTION -al I-EVOLUTION -paciente I-EVOLUTION -encontrándose I-EVOLUTION -la I-EVOLUTION -desaparición I-EVOLUTION -total I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -lesiones. I-EVOLUTION +resultado I-EVOLUTION +ha I-EVOLUTION +sido I-EVOLUTION +satisfactorio. I-EVOLUTION I-EVOLUTION -Mujer B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -75 I-PRESENT_ILLNESS +siete I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -HTA, I-PAST_MEDICAL_HISTORY -artrosis I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -histerectomía, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +es I-PRESENT_ILLNESS +llevada I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +Urgencias I-PRESENT_ILLNESS por I-PRESENT_ILLNESS un I-PRESENT_ILLNESS cuadro I-PRESENT_ILLNESS -clínico I-PRESENT_ILLNESS -caracterizado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -constitucional, I-PRESENT_ILLNESS -astenia, I-PRESENT_ILLNESS -anorexia, I-PRESENT_ILLNESS -perdida I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -peso, I-PRESENT_ILLNESS -artromialgias I-PRESENT_ILLNESS -generalizadas I-PRESENT_ILLNESS +cefalea I-PRESENT_ILLNESS +frontal, I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +máxima I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +40 I-PRESENT_ILLNESS +°C I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -molestias I-PRESENT_ILLNESS -mandibulares I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -masticación I-PRESENT_ILLNESS +vómitos I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS +tres I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -La B-EXPLORATION -exploración I-EXPLORATION -clínica I-EXPLORATION -fue I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -análisis I-EXPLORATION -realizado I-EXPLORATION -se I-EXPLORATION -detectó I-EXPLORATION -una I-EXPLORATION -anemia I-EXPLORATION -normocítica I-EXPLORATION -normocrómica, I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -hemoglobina I-EXPLORATION +evolución, I-PRESENT_ILLNESS +asociado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +cervical I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +tumefacción I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +ojo I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +últimas I-PRESENT_ILLNESS +24 I-PRESENT_ILLNESS +horas. I-PRESENT_ILLNESS +Presentaba B-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +corrección I-PAST_MEDICAL_HISTORY +quirúrgica I-PAST_MEDICAL_HISTORY +endoscópica I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +trigonocefalia I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +cuatro I-PAST_MEDICAL_HISTORY +meses. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Al B-EXPLORATION +ingreso, I-EXPLORATION +presentaba I-EXPLORATION +frecuencia I-EXPLORATION +cardiaca I-EXPLORATION de I-EXPLORATION -8, I-EXPLORATION -5 I-EXPLORATION -mg/dl, I-EXPLORATION -un I-EXPLORATION -hematocrito I-EXPLORATION +137 I-EXPLORATION +lpm, I-EXPLORATION +frecuencia I-EXPLORATION +respiratoria I-EXPLORATION de I-EXPLORATION -28, I-EXPLORATION -6%, I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -velocidad I-EXPLORATION +25 I-EXPLORATION +rpm, I-EXPLORATION +tensión I-EXPLORATION +arterial I-EXPLORATION de I-EXPLORATION -sedimentación I-EXPLORATION -globular I-EXPLORATION -(VSG) I-EXPLORATION +102/60 I-EXPLORATION +mm I-EXPLORATION +Hg I-EXPLORATION +y I-EXPLORATION +temperatura I-EXPLORATION de I-EXPLORATION -112 I-EXPLORATION -mm/h. I-EXPLORATION -Durante I-EXPLORATION -el I-EXPLORATION -ingreso I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -servicio I-EXPLORATION +36, I-EXPLORATION +8 I-EXPLORATION +°C. I-EXPLORATION +Neurológicamente I-EXPLORATION +estaba I-EXPLORATION +consciente, I-EXPLORATION +orientada I-EXPLORATION +y I-EXPLORATION +colaboradora, I-EXPLORATION +con I-EXPLORATION +Glasgow I-EXPLORATION +15/15. I-EXPLORATION +Rigidez I-EXPLORATION de I-EXPLORATION -Medicina I-EXPLORATION -Interna I-EXPLORATION -presenta I-EXPLORATION -episodios I-EXPLORATION +nuca I-EXPLORATION +con I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -cefalea I-EXPLORATION +Kernig I-EXPLORATION y I-EXPLORATION -claudicación I-EXPLORATION -mandibular I-EXPLORATION -motivo I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -cual I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -practicó I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION +Brudzinski I-EXPLORATION +positivos. I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -arteria I-EXPLORATION -temporal I-EXPLORATION +región I-EXPLORATION +periorbitaria I-EXPLORATION +derecha I-EXPLORATION +presentaba I-EXPLORATION +tumefacción I-EXPLORATION +con I-EXPLORATION +eritema, I-EXPLORATION +calor I-EXPLORATION +local I-EXPLORATION +y I-EXPLORATION +movimientos I-EXPLORATION +oculares I-EXPLORATION +conservados. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +analítica I-EXPLORATION +con I-EXPLORATION +leucocitosis I-EXPLORATION +14 I-EXPLORATION +500/mm3, I-EXPLORATION +neutrofilia I-EXPLORATION +13 I-EXPLORATION +900/mm3, I-EXPLORATION +linfopenia I-EXPLORATION +390/mm3 I-EXPLORATION +y I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION -1cm. I-EXPLORATION -La I-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -mostró I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION +reactantes I-EXPLORATION de I-EXPLORATION -células I-EXPLORATION -histiocíticas I-EXPLORATION -gigantes I-EXPLORATION -multinucleadas I-EXPLORATION +fase I-EXPLORATION +aguda: I-EXPLORATION +fibrinógeno I-EXPLORATION +881 I-EXPLORATION +mg/dl I-EXPLORATION +y I-EXPLORATION +proteína I-EXPLORATION +C I-EXPLORATION +reactiva I-EXPLORATION +241 I-EXPLORATION +mg/l. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +punción I-EXPLORATION +lumbar, I-EXPLORATION +tras I-EXPLORATION +confirmar I-EXPLORATION +normalidad I-EXPLORATION +de I-EXPLORATION +fondo I-EXPLORATION +de I-EXPLORATION +ojo, I-EXPLORATION +obteniéndose I-EXPLORATION +líquido I-EXPLORATION +cefalorraquídeo I-EXPLORATION +de I-EXPLORATION +aspecto I-EXPLORATION +turbio, I-EXPLORATION +que I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -arterial, I-EXPLORATION +el I-EXPLORATION +análisis I-EXPLORATION +citoquímico I-EXPLORATION +mostraba I-EXPLORATION +380 I-EXPLORATION +leucocitos/mm3 I-EXPLORATION con I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION +un I-EXPLORATION +38% I-EXPLORATION +de I-EXPLORATION +polimorfonucleares, I-EXPLORATION +hipoglucorraquia I-EXPLORATION +41 I-EXPLORATION +mg/dl I-EXPLORATION +e I-EXPLORATION +hiperproteinorraquia I-EXPLORATION +240 I-EXPLORATION +mg/dl; I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +tinción I-EXPLORATION +de I-EXPLORATION +Gram I-EXPLORATION +no I-EXPLORATION +mostró I-EXPLORATION +bacterias. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +hemocultivo I-EXPLORATION se I-EXPLORATION -llegó I-EXPLORATION -al I-EXPLORATION -diagnóstico I-EXPLORATION +aisló I-EXPLORATION +S. I-EXPLORATION +pyogenes. I-EXPLORATION +La I-EXPLORATION +tomografía I-EXPLORATION +computarizada I-EXPLORATION +craneal I-EXPLORATION +evidenciaba I-EXPLORATION +ocupación I-EXPLORATION +parcial I-EXPLORATION de I-EXPLORATION -Arteritis I-EXPLORATION +celdillas I-EXPLORATION +etmoidales I-EXPLORATION +izquierdas I-EXPLORATION +y I-EXPLORATION +frontales I-EXPLORATION +asociada I-EXPLORATION +a I-EXPLORATION +tumefacción I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -Temporal. I-EXPLORATION +partes I-EXPLORATION +blandas I-EXPLORATION +periorbitaria I-EXPLORATION +derecha. I-EXPLORATION + I-EXPLORATION Se B-TREATMENT inició I-TREATMENT -el I-TREATMENT tratamiento I-TREATMENT +empírico I-TREATMENT con I-TREATMENT -Prednisona I-TREATMENT -40 I-TREATMENT -mg I-TREATMENT -diarios I-TREATMENT -que I-TREATMENT -desencadena I-TREATMENT -una I-TREATMENT -hiperglucemia I-TREATMENT -secundaria, I-TREATMENT -subsidiaria I-TREATMENT -de I-TREATMENT -insulinoterapia, I-TREATMENT +cefotaxima I-TREATMENT y I-TREATMENT -agravada I-TREATMENT -por I-TREATMENT -una I-TREATMENT -arritmia I-TREATMENT -completa I-TREATMENT +vancomicina, I-TREATMENT +suspendiendo I-TREATMENT +este I-TREATMENT +último I-TREATMENT +al I-TREATMENT +aislarse I-TREATMENT +S. I-TREATMENT +pyogenes, I-TREATMENT +y I-TREATMENT +se I-TREATMENT +asoció I-TREATMENT +clindamicina I-TREATMENT por I-TREATMENT -fibrilación I-TREATMENT -auricular I-TREATMENT -que I-TREATMENT -precisó I-TREATMENT -el I-TREATMENT -inicio I-TREATMENT -de I-TREATMENT -anticoagulación I-TREATMENT -con I-TREATMENT -dicumarínicos I-TREATMENT -de I-TREATMENT -forma I-TREATMENT -indefinida. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -estabilizó I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -26 I-EVOLUTION -días I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -procedió I-EVOLUTION -al I-EVOLUTION -alta I-EVOLUTION -continuando I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -con I-EVOLUTION -dosis I-EVOLUTION -de I-EVOLUTION -Prednisona I-EVOLUTION -50 I-EVOLUTION -mg/día. I-EVOLUTION - I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -30 I-EVOLUTION -días I-EVOLUTION -acudió I-EVOLUTION -de I-EVOLUTION -nuevo I-EVOLUTION -a I-EVOLUTION -Urgencias I-EVOLUTION -por I-EVOLUTION -un I-EVOLUTION -cuadro I-EVOLUTION +presentar I-TREATMENT +exantema I-TREATMENT +escarlatiniforme. I-TREATMENT + I-TREATMENT +Al B-EVOLUTION +séptimo I-EVOLUTION +día I-EVOLUTION de I-EVOLUTION -hematuria I-EVOLUTION -franca I-EVOLUTION -que I-EVOLUTION -requirió I-EVOLUTION ingreso I-EVOLUTION -hospitalario, I-EVOLUTION -cediendo I-EVOLUTION -tras I-EVOLUTION -la I-EVOLUTION -suspensión I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -anticoagulación. I-EVOLUTION -Durante I-EVOLUTION -su I-EVOLUTION -estancia I-EVOLUTION +tuvo I-EVOLUTION +un I-EVOLUTION +episodio I-EVOLUTION +convulsivo I-EVOLUTION +tónico-clónico I-EVOLUTION +focalizado I-EVOLUTION en I-EVOLUTION el I-EVOLUTION -servicio I-EVOLUTION -de I-EVOLUTION -Urología I-EVOLUTION +hemicuerpo I-EVOLUTION +izquierdo I-EVOLUTION +que I-EVOLUTION +posteriormente I-EVOLUTION se I-EVOLUTION -objetivo I-EVOLUTION -una I-EVOLUTION -anemia I-EVOLUTION -severa I-EVOLUTION -y I-EVOLUTION -una I-EVOLUTION -elevación I-EVOLUTION -progresiva I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -VSG. I-EVOLUTION +generalizó. I-EVOLUTION Se B-EXPLORATION -le I-EXPLORATION -solicitó I-EXPLORATION +realizó I-EXPLORATION una I-EXPLORATION -ecografía I-EXPLORATION -abdominal, I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION +craneal, I-EXPLORATION +encontrando I-EXPLORATION una I-EXPLORATION -masa I-EXPLORATION -heterogénea I-EXPLORATION +imagen I-EXPLORATION +sugestiva I-EXPLORATION de I-EXPLORATION -5, I-EXPLORATION -7 I-EXPLORATION -x I-EXPLORATION -5, I-EXPLORATION -8 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -polo I-EXPLORATION -superior I-EXPLORATION +trombosis I-EXPLORATION de I-EXPLORATION -riñón I-EXPLORATION -izquierdo I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -tomografía I-EXPLORATION -(TC) I-EXPLORATION -tóraco-abdómino-pélvica I-EXPLORATION -identifica I-EXPLORATION +vena I-EXPLORATION +oftálmica I-EXPLORATION +derecha I-EXPLORATION +y I-EXPLORATION +ocupación I-EXPLORATION +parcial I-EXPLORATION +del I-EXPLORATION +seno I-EXPLORATION +cavernoso I-EXPLORATION +derecho, I-EXPLORATION +así I-EXPLORATION como I-EXPLORATION -un I-EXPLORATION -CCR I-EXPLORATION -sin I-EXPLORATION -evidencia I-EXPLORATION +persistencia I-EXPLORATION de I-EXPLORATION -adenopatías I-EXPLORATION -ni I-EXPLORATION -metástasis. I-EXPLORATION -El I-EXPLORATION -rastreo I-EXPLORATION -óseo I-EXPLORATION -descartó I-EXPLORATION -también I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -metástasis I-EXPLORATION -óseas. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -le I-TREATMENT -practicó I-TREATMENT -una I-TREATMENT -nefrectomía I-TREATMENT -radical I-TREATMENT -izquierda, I-TREATMENT -cuyo B-EXPLORATION -diagnóstico I-EXPLORATION -anatomopatológico I-EXPLORATION -reveló I-EXPLORATION -un I-EXPLORATION -carcinoma I-EXPLORATION -renal I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -granulares I-EXPLORATION -y I-EXPLORATION -fusiformes I-EXPLORATION -que I-EXPLORATION -afectaba I-EXPLORATION -al I-EXPLORATION -40% I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pieza, I-EXPLORATION -invadiendo I-EXPLORATION -grasa I-EXPLORATION -perirenal I-EXPLORATION -y I-EXPLORATION -pelvis, I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -adenopatía I-EXPLORATION -hiliar I-EXPLORATION -ipsilateral I-EXPLORATION -(pT3aN1M0). I-EXPLORATION - I-EXPLORATION -Tras B-EVOLUTION -dos I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -cirugía I-EVOLUTION +realce I-EXPLORATION +meníngeo. I-EXPLORATION +Fue B-TREATMENT +tratada I-TREATMENT +con I-TREATMENT +ácido I-TREATMENT +valpróico I-TREATMENT +y I-TREATMENT +dexametasona, I-TREATMENT +y I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +anticoagulación. I-TREATMENT +Posteriormente, B-EVOLUTION la I-EVOLUTION paciente I-EVOLUTION -precisa I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -nuevo I-EVOLUTION -ingreso I-EVOLUTION -por I-EVOLUTION -empeoramiento I-EVOLUTION -del I-EVOLUTION -estado I-EVOLUTION -general I-EVOLUTION +evolucionó I-EVOLUTION +satisfactoriamente I-EVOLUTION +manteniéndose B-TREATMENT +21 I-TREATMENT +días I-TREATMENT +de I-TREATMENT +tratamiento I-TREATMENT +antibiótico I-TREATMENT +intravenoso, I-TREATMENT +con B-EVOLUTION +controles I-EVOLUTION +clínicos, I-EVOLUTION +neurológico, I-EVOLUTION +electrocardiográfico I-EVOLUTION y I-EVOLUTION -dolor I-EVOLUTION -óseo I-EVOLUTION -generalizado I-EVOLUTION -diagnosticándose I-EVOLUTION -en I-EVOLUTION -TC I-EVOLUTION -de I-EVOLUTION -metástasis I-EVOLUTION -vertebrales I-EVOLUTION -dorsales, I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -evolución I-EVOLUTION -tórpida I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -enfermedad I-EVOLUTION -que I-EVOLUTION -ocasionó I-EVOLUTION -el I-EVOLUTION -fallecimiento I-EVOLUTION -de I-EVOLUTION -enferma I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -pocos I-EVOLUTION -meses I-EVOLUTION -del I-EVOLUTION -ingreso I-EVOLUTION -hospitalario. I-EVOLUTION +mediante I-EVOLUTION +resonancia I-EVOLUTION +magnética I-EVOLUTION +normales I-EVOLUTION +y I-EVOLUTION +sin I-EVOLUTION +secuelas I-EVOLUTION +neurológicas. I-EVOLUTION I-EVOLUTION -Presentamos B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS +Se B-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS un I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -53 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -quien I-PRESENT_ILLNESS -consulto I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -masa I-PRESENT_ILLNESS -latero I-PRESENT_ILLNESS -cervical I-PRESENT_ILLNESS -izquierda, I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS +26 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +clínica I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +hipo I-PRESENT_ILLNESS +persistente, I-PRESENT_ILLNESS +dispepsia I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -diarrea; I-PRESENT_ILLNESS -al B-EXPLORATION -realizar I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION +sensación I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +plenitud I-PRESENT_ILLNESS +postprandrial. I-PRESENT_ILLNESS +Entre B-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +destaca I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +laparotomía I-PAST_MEDICAL_HISTORY +exploradora I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +14 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +traumatismo I-PAST_MEDICAL_HISTORY +abdominal, I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +cual I-PAST_MEDICAL_HISTORY +desconocemos I-PAST_MEDICAL_HISTORY +datos I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +haberse I-PAST_MEDICAL_HISTORY +realizado I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +otro I-PAST_MEDICAL_HISTORY +centro. I-PAST_MEDICAL_HISTORY +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION se I-EXPLORATION -encontró I-EXPLORATION -mucosa I-EXPLORATION -rectal I-EXPLORATION -mamelonada, I-EXPLORATION -irregular, I-EXPLORATION -y I-EXPLORATION -próstata I-EXPLORATION +objetivó I-EXPLORATION +una I-EXPLORATION +ocupación I-EXPLORATION de I-EXPLORATION -3 I-EXPLORATION -x I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION -aprox. I-EXPLORATION -sin I-EXPLORATION -nódulos, I-EXPLORATION -indurada I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -lóbulos I-EXPLORATION -con I-EXPLORATION -surco I-EXPLORATION -medio I-EXPLORATION -borrado; I-EXPLORATION +todo I-EXPLORATION +el I-EXPLORATION +hemiabdomen I-EXPLORATION +derecho I-EXPLORATION +por I-EXPLORATION +una I-EXPLORATION masa I-EXPLORATION -cervical I-EXPLORATION -lateral I-EXPLORATION -izquierda I-EXPLORATION de I-EXPLORATION consistencia I-EXPLORATION -pétrea, I-EXPLORATION -adherida I-EXPLORATION +elástica, I-EXPLORATION a I-EXPLORATION -planos, I-EXPLORATION -no I-EXPLORATION -dolorosa. I-EXPLORATION +tensión, I-EXPLORATION +indolora I-EXPLORATION +y I-EXPLORATION +mate I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +percusión I-EXPLORATION +que I-EXPLORATION +sobrepasaba I-EXPLORATION +la I-EXPLORATION +línea I-EXPLORATION +media. I-EXPLORATION Se I-EXPLORATION -realiza I-EXPLORATION -biopsia I-EXPLORATION +realizó I-EXPLORATION +un I-EXPLORATION +hemograma I-EXPLORATION de I-EXPLORATION -adenopatía I-EXPLORATION -cervical I-EXPLORATION -reportándose I-EXPLORATION -adenocarcinoma I-EXPLORATION -prostático I-EXPLORATION -metastásico, I-EXPLORATION -con I-EXPLORATION -positividad I-EXPLORATION +rutina I-EXPLORATION +que I-EXPLORATION +puso I-EXPLORATION de I-EXPLORATION -células I-EXPLORATION -tumorales I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION +manifiesto I-EXPLORATION +un I-EXPLORATION +recuento I-EXPLORATION de I-EXPLORATION -inmuno I-EXPLORATION -histoquímica I-EXPLORATION -para I-EXPLORATION -el I-EXPLORATION -antígeno I-EXPLORATION -prostático I-EXPLORATION -específico, I-EXPLORATION -citoqueratina I-EXPLORATION -AE1/AE3 I-EXPLORATION -y I-EXPLORATION -PCNA I-EXPLORATION -(100%). I-EXPLORATION -El I-EXPLORATION -antígeno I-EXPLORATION -prostático I-EXPLORATION -especifico I-EXPLORATION -sérico I-EXPLORATION -reportó I-EXPLORATION -738, I-EXPLORATION -4 I-EXPLORATION -ng/ml I-EXPLORATION +7, I-EXPLORATION +13 I-EXPLORATION +x I-EXPLORATION +106 I-EXPLORATION +hematíes, I-EXPLORATION +20.5 I-EXPLORATION +g/dl I-EXPLORATION +de I-EXPLORATION +hemoglobina I-EXPLORATION y I-EXPLORATION -PSA I-EXPLORATION -libre I-EXPLORATION -92.8 I-EXPLORATION -ng/ml. I-EXPLORATION -Se I-EXPLORATION -realizo I-EXPLORATION -colonoscopia I-EXPLORATION -que I-EXPLORATION -muestra I-EXPLORATION -hasta I-EXPLORATION -25 I-EXPLORATION -cm I-EXPLORATION -del I-EXPLORATION -margen I-EXPLORATION -anal, I-EXPLORATION -pliegues I-EXPLORATION -gruesos I-EXPLORATION -edematizados, I-EXPLORATION -eritematosos, I-EXPLORATION -friables, I-EXPLORATION +hematocrito I-EXPLORATION de I-EXPLORATION -superficie I-EXPLORATION -irregular, I-EXPLORATION -se I-EXPLORATION -tomo I-EXPLORATION -biopsia I-EXPLORATION -cuyos I-EXPLORATION -resultados I-EXPLORATION -mostraron I-EXPLORATION -carcinoma I-EXPLORATION -poco I-EXPLORATION -diferenciado I-EXPLORATION +65.9%, I-EXPLORATION +con I-EXPLORATION +cifras I-EXPLORATION +similares I-EXPLORATION en I-EXPLORATION -foco I-EXPLORATION -necrótico I-EXPLORATION -infiltrante I-EXPLORATION -a I-EXPLORATION -recto. I-EXPLORATION +el I-EXPLORATION +preoperatorio I-EXPLORATION +inmediato. I-EXPLORATION + I-EXPLORATION La I-EXPLORATION -biopsia I-EXPLORATION -prostática I-EXPLORATION -reportó I-EXPLORATION -adenocarcionama I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +hidronefrosis I-EXPLORATION +masiva I-EXPLORATION +del I-EXPLORATION +riñón I-EXPLORATION +derecho. I-EXPLORATION +La I-EXPLORATION +TAC I-EXPLORATION +abdominal I-EXPLORATION +confirmó I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION de I-EXPLORATION -próstata I-EXPLORATION -poco I-EXPLORATION -diferenciado I-EXPLORATION -Gleason I-EXPLORATION -6 I-EXPLORATION -(3+3). I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -gamma-gramma I-EXPLORATION -óseo I-EXPLORATION +ectasia I-EXPLORATION +pielocalicial I-EXPLORATION +masiva I-EXPLORATION +con I-EXPLORATION +prácticamente I-EXPLORATION +ausencia I-EXPLORATION +de I-EXPLORATION +cortical, I-EXPLORATION que I-EXPLORATION -resultó I-EXPLORATION -positivo I-EXPLORATION +ocupaba I-EXPLORATION +la I-EXPLORATION +totalidad I-EXPLORATION +del I-EXPLORATION +hemiabdomen I-EXPLORATION +derecho, I-EXPLORATION +sobrepasando I-EXPLORATION +la I-EXPLORATION +línea I-EXPLORATION +media I-EXPLORATION +hasta I-EXPLORATION +contactar I-EXPLORATION con I-EXPLORATION -lesiones I-EXPLORATION -osteoblasticas I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION +el I-EXPLORATION +polo I-EXPLORATION +inferior I-EXPLORATION +del I-EXPLORATION +riñón I-EXPLORATION +izquierdo, I-EXPLORATION +sugestivo I-EXPLORATION de I-EXPLORATION -columna I-EXPLORATION -dorsal I-EXPLORATION -y I-EXPLORATION -lumbar. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION +riñón I-EXPLORATION +en I-EXPLORATION +herradura I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +practicó, I-TREATMENT +por I-TREATMENT +lumbotomía, I-TREATMENT +nefrectomía I-TREATMENT +derecha I-TREATMENT +de I-TREATMENT +un I-TREATMENT +gran I-TREATMENT +riñón I-TREATMENT +hidronefrótico I-TREATMENT +secundario I-TREATMENT +a I-TREATMENT +estenosis I-TREATMENT +de I-TREATMENT +la I-TREATMENT +unión I-TREATMENT +pieloureteral, I-TREATMENT +cursando I-TREATMENT +el I-TREATMENT +postoperatorio I-TREATMENT +sin I-TREATMENT +incidencias. I-TREATMENT +El B-EXPLORATION +estudio I-EXPLORATION +anatomopatológico I-EXPLORATION +informó I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -estudios I-EXPLORATION -complementarios I-EXPLORATION -incluyeron, I-EXPLORATION -ecosonograma I-EXPLORATION -abdominal, I-EXPLORATION -tomografía I-EXPLORATION -cuello, I-EXPLORATION -tórax, I-EXPLORATION -abdomen I-EXPLORATION -y I-EXPLORATION -pelvis I-EXPLORATION +riñón I-EXPLORATION +hidronefrótico I-EXPLORATION con I-EXPLORATION -doble I-EXPLORATION -contraste I-EXPLORATION -demostró I-EXPLORATION -adenopatías I-EXPLORATION -pre I-EXPLORATION -y I-EXPLORATION -para I-EXPLORATION -aorticas I-EXPLORATION -abdominales I-EXPLORATION -bilaterales, I-EXPLORATION -sin I-EXPLORATION -evidencia I-EXPLORATION +atrofia I-EXPLORATION +cortical I-EXPLORATION +marcada. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +hemograma I-EXPLORATION +al I-EXPLORATION +segundo I-EXPLORATION +día I-EXPLORATION de I-EXPLORATION -lesiones I-EXPLORATION -en I-EXPLORATION -tórax. I-EXPLORATION -En I-EXPLORATION -vista I-EXPLORATION +la I-EXPLORATION +cirugía I-EXPLORATION +presentaba I-EXPLORATION +una I-EXPLORATION +Hemoglobina I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -Hallazgos I-EXPLORATION -clínicos I-EXPLORATION +15 I-EXPLORATION +g/dl, I-EXPLORATION +4, I-EXPLORATION +6 I-EXPLORATION +millones I-EXPLORATION +de I-EXPLORATION +eritrocitos I-EXPLORATION y I-EXPLORATION -paraclínicos I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -presenta I-EXPLORATION -un I-EXPLORATION -adenocarcinoma I-EXPLORATION +43, I-EXPLORATION +7% I-EXPLORATION de I-EXPLORATION -próstata I-EXPLORATION -estadio I-EXPLORATION -T4 I-EXPLORATION -N2 I-EXPLORATION -M. I-EXPLORATION -Consecuentemente B-TREATMENT -se I-TREATMENT -indica I-TREATMENT -tratamiento I-TREATMENT -para I-TREATMENT -un I-TREATMENT -cáncer I-TREATMENT -de I-TREATMENT -próstata I-TREATMENT -avanzado I-TREATMENT -realizándose I-TREATMENT -bloqueo I-TREATMENT -androgénico I-TREATMENT -de I-TREATMENT -tipo I-TREATMENT -quirúrgico I-TREATMENT -con I-TREATMENT -orquirectomia I-TREATMENT -bilateral I-TREATMENT -considerando I-TREATMENT -la I-TREATMENT -condición I-TREATMENT -socioeconómica I-TREATMENT -del I-TREATMENT -paciente. I-TREATMENT - I-TREATMENT +hematocrito. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +practicó I-EXPLORATION +otro I-EXPLORATION +hemograma I-EXPLORATION +10 I-EXPLORATION +meses I-EXPLORATION +después I-EXPLORATION +evidenciándose I-EXPLORATION +una I-EXPLORATION +normalización I-EXPLORATION +del I-EXPLORATION +recuento I-EXPLORATION +eritrocitario. I-EXPLORATION + I-EXPLORATION -Hombre B-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -43 I-PRESENT_ILLNESS +48 I-PRESENT_ILLNESS años, I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -frecuencia I-PRESENT_ILLNESS -miccional I-PRESENT_ILLNESS -elevada I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -8/4, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -hematuria I-PRESENT_ILLNESS -macroscópica. I-PRESENT_ILLNESS -Antecedentes B-PAST_MEDICAL_HISTORY +fumadora B-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -biopsia I-PAST_MEDICAL_HISTORY -vesical I-PAST_MEDICAL_HISTORY -reciente I-PAST_MEDICAL_HISTORY -revelaba I-PAST_MEDICAL_HISTORY -cistitis I-PAST_MEDICAL_HISTORY -crónica. I-PAST_MEDICAL_HISTORY +20 I-PAST_MEDICAL_HISTORY +cigarrillos/día, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +poliquistosis I-PAST_MEDICAL_HISTORY +hepatorrenal I-PAST_MEDICAL_HISTORY +diagnosticada I-PAST_MEDICAL_HISTORY +12 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +antes, I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +enfermedad I-PAST_MEDICAL_HISTORY +renal I-PAST_MEDICAL_HISTORY +crónica I-PAST_MEDICAL_HISTORY +secundaria I-PAST_MEDICAL_HISTORY +estadio I-PAST_MEDICAL_HISTORY +3 I-PAST_MEDICAL_HISTORY +(con I-PAST_MEDICAL_HISTORY +aclaramiento I-PAST_MEDICAL_HISTORY +creatinina I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +50 I-PAST_MEDICAL_HISTORY +ml/min I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +proteinuria). I-PAST_MEDICAL_HISTORY +Sin I-PAST_MEDICAL_HISTORY +ningún I-PAST_MEDICAL_HISTORY +otro I-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +patológico I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés. I-PAST_MEDICAL_HISTORY +La B-PRESENT_ILLNESS +enfermedad I-PRESENT_ILLNESS +actual I-PRESENT_ILLNESS +comienza I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +lumbar I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS +intenso I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +requiere I-PRESENT_ILLNESS +ingreso. I-PRESENT_ILLNESS +Inicialmente I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +orienta I-PRESENT_ILLNESS +como I-PRESENT_ILLNESS +crisis I-PRESENT_ILLNESS +quística. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS Se B-EXPLORATION realiza I-EXPLORATION -pielografía I-EXPLORATION +ecografía I-EXPLORATION +reno-vesical I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +que, I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +contexto I-EXPLORATION de I-EXPLORATION -eliminación I-EXPLORATION +poliquistosis I-EXPLORATION +hepatorrenal, I-EXPLORATION +se I-EXPLORATION +aprecia I-EXPLORATION +una I-EXPLORATION +desestructuración I-EXPLORATION +parenquimatosa I-EXPLORATION +renal I-EXPLORATION +por I-EXPLORATION +quistes, I-EXPLORATION +preferentemente I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +lado I-EXPLORATION +izquierdo, I-EXPLORATION +con I-EXPLORATION +aumento I-EXPLORATION +del I-EXPLORATION +tamaño I-EXPLORATION +respecto I-EXPLORATION +al I-EXPLORATION +contralateral, I-EXPLORATION +Existe I-EXPLORATION +una I-EXPLORATION +ecogenicidad I-EXPLORATION +heterogénea I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +parénquima I-EXPLORATION +preservado I-EXPLORATION +que I-EXPLORATION +sugiere I-EXPLORATION +turgencia I-EXPLORATION +parenquimatosa I-EXPLORATION y I-EXPLORATION -tomografía I-EXPLORATION -computada I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +desdibujamiento I-EXPLORATION +sinusal I-EXPLORATION +izquierdo I-EXPLORATION +secundario I-EXPLORATION +a I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -abdomen I-EXPLORATION +un I-EXPLORATION +tejido I-EXPLORATION +ecogénico I-EXPLORATION +que I-EXPLORATION +ejerce I-EXPLORATION +efecto I-EXPLORATION +de I-EXPLORATION +masa I-EXPLORATION y I-EXPLORATION +se I-EXPLORATION +proyecta I-EXPLORATION +hacia I-EXPLORATION +la I-EXPLORATION pelvis I-EXPLORATION -que I-EXPLORATION -resultan I-EXPLORATION -normales. I-EXPLORATION -En I-EXPLORATION +renal. I-EXPLORATION +Dada I-EXPLORATION la I-EXPLORATION -cistoscopía I-EXPLORATION +poca I-EXPLORATION +especificidad I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +hallazgos I-EXPLORATION +ecográficos I-EXPLORATION se I-EXPLORATION -observa I-EXPLORATION -vejiga I-EXPLORATION -eritematosa, I-EXPLORATION +completa I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +mediante I-EXPLORATION +TC I-EXPLORATION +que I-EXPLORATION +muestra I-EXPLORATION +nuevamente I-EXPLORATION +desestructuración I-EXPLORATION +renal I-EXPLORATION +bilateral I-EXPLORATION +por I-EXPLORATION +poliquistosis, I-EXPLORATION con I-EXPLORATION -lesión I-EXPLORATION -papilar I-EXPLORATION +algunos I-EXPLORATION +quistes I-EXPLORATION +hiperdensos I-EXPLORATION en I-EXPLORATION -piso I-EXPLORATION -vesical. I-EXPLORATION -Se I-EXPLORATION -toma I-EXPLORATION -biopsia I-EXPLORATION -cuyo I-EXPLORATION -informe I-EXPLORATION -revela I-EXPLORATION -cistitis I-EXPLORATION -eosinofílica. I-EXPLORATION -Inició B-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -Hidroxicina I-TREATMENT -20 I-TREATMENT -mg. I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -h I-TREATMENT -más I-TREATMENT -Diclofenaco I-TREATMENT -sódico I-TREATMENT -50 I-TREATMENT -mg I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -h. I-TREATMENT -Hubo B-EVOLUTION -respuesta I-EVOLUTION -parcial, I-EVOLUTION -cediendo I-EVOLUTION -la I-EVOLUTION -hematuria, I-EVOLUTION -pero I-EVOLUTION -aun I-EVOLUTION -con I-EVOLUTION -frecuencia I-EVOLUTION -miccional I-EVOLUTION -de I-EVOLUTION -5/3. I-EVOLUTION -Al B-TREATMENT -agregar I-TREATMENT -prednisona I-TREATMENT -20 I-TREATMENT -mg/día I-TREATMENT -cedieron B-EVOLUTION -las I-EVOLUTION -molestias I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -normalizó I-EVOLUTION -la I-EVOLUTION -frecuencia I-EVOLUTION -miccional. I-EVOLUTION - I-EVOLUTION - -Una B-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -55 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -molestias I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -flanco I-PRESENT_ILLNESS -derecho. I-PRESENT_ILLNESS -Los B-EXPLORATION -estudios I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +basal I-EXPLORATION +realizado I-EXPLORATION +sin I-EXPLORATION +contraste I-EXPLORATION +endovenoso. I-EXPLORATION +La I-EXPLORATION +afectación I-EXPLORATION +es I-EXPLORATION +asimétrica, I-EXPLORATION +más I-EXPLORATION +intensa I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +lado I-EXPLORATION +izquierdo, I-EXPLORATION +siendo I-EXPLORATION +dicho I-EXPLORATION +riñón I-EXPLORATION de I-EXPLORATION -imagen I-EXPLORATION -iniciales I-EXPLORATION -(ecografía I-EXPLORATION -y I-EXPLORATION -tomografía I-EXPLORATION -computarizada) I-EXPLORATION -mostraron I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -quística I-EXPLORATION +mayor I-EXPLORATION +tamaño. I-EXPLORATION +La I-EXPLORATION +región I-EXPLORATION +piélica I-EXPLORATION +izquierda I-EXPLORATION +está I-EXPLORATION +ocupada I-EXPLORATION +por I-EXPLORATION +un I-EXPLORATION +tejido I-EXPLORATION de I-EXPLORATION -10 I-EXPLORATION -x I-EXPLORATION -9, I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION +densidad I-EXPLORATION de I-EXPLORATION -diámetro, I-EXPLORATION -con I-EXPLORATION -calcificaciones I-EXPLORATION -puntiformes I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -pared, I-EXPLORATION -en I-EXPLORATION -relación I-EXPLORATION -íntima I-EXPLORATION -con I-EXPLORATION +partes I-EXPLORATION +blandas I-EXPLORATION +que I-EXPLORATION +muestra I-EXPLORATION +un I-EXPLORATION +realce I-EXPLORATION +moderado I-EXPLORATION +tras I-EXPLORATION la I-EXPLORATION -suprarrenal I-EXPLORATION -derecha. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION +administración I-EXPLORATION +endovenosa I-EXPLORATION de I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -basal I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION contraste, I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -algunas I-EXPLORATION -áreas I-EXPLORATION -sólidas I-EXPLORATION +sin I-EXPLORATION +definición I-EXPLORATION +clara I-EXPLORATION de I-EXPLORATION -diferente I-EXPLORATION -grosor I-EXPLORATION +sus I-EXPLORATION +límites. I-EXPLORATION +Funcionalmente I-EXPLORATION +existe I-EXPLORATION +un I-EXPLORATION +evidente I-EXPLORATION +retraso I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -pared, I-EXPLORATION -que I-EXPLORATION -crecían I-EXPLORATION -hacia I-EXPLORATION el I-EXPLORATION -interior I-EXPLORATION -del I-EXPLORATION -quiste I-EXPLORATION +lado I-EXPLORATION +izquierdo I-EXPLORATION y I-EXPLORATION -se I-EXPLORATION -realzaban I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -contraste, I-EXPLORATION +ausencia I-EXPLORATION +de I-EXPLORATION +eliminación I-EXPLORATION +del I-EXPLORATION +contraste I-EXPLORATION +endovenoso I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +secciones I-EXPLORATION +realizadas I-EXPLORATION +de I-EXPLORATION +forma I-EXPLORATION +retardada. I-EXPLORATION +El I-EXPLORATION +conjunto I-EXPLORATION +de I-EXPLORATION hallazgos I-EXPLORATION -que I-EXPLORATION -hicieron I-EXPLORATION -pensar I-EXPLORATION +sugiere I-EXPLORATION +ocupación I-EXPLORATION +tumoral I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +pelvis I-EXPLORATION +renal I-EXPLORATION en I-EXPLORATION -un I-EXPLORATION -feocromocitoma I-EXPLORATION -quístico. I-EXPLORATION -Las I-EXPLORATION -determinaciones I-EXPLORATION +el I-EXPLORATION +contexto I-EXPLORATION de I-EXPLORATION -laboratorio I-EXPLORATION -habituales I-EXPLORATION +poliquistosis I-EXPLORATION +con I-EXPLORATION +alteración I-EXPLORATION +funcional I-EXPLORATION +secundaria. I-EXPLORATION +Se I-EXPLORATION +observan I-EXPLORATION +ganglios I-EXPLORATION +retroperitoneales I-EXPLORATION +no I-EXPLORATION +aumentados I-EXPLORATION +significativamente I-EXPLORATION +de I-EXPLORATION +tamaño I-EXPLORATION +en I-EXPLORATION +situación I-EXPLORATION +interaortocava I-EXPLORATION y I-EXPLORATION -endocrinológicas I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION +retroaórtica. I-EXPLORATION I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -exéresis I-TREATMENT -laparoscópica I-TREATMENT -transperitoneal I-TREATMENT -mediante I-TREATMENT -tres I-TREATMENT -accesos I-TREATMENT -subcostales, I-TREATMENT -extirpando I-TREATMENT +Con B-TREATMENT el I-TREATMENT -quiste I-TREATMENT -de I-TREATMENT -forma I-TREATMENT -completa, I-TREATMENT -seguido I-TREATMENT -de I-TREATMENT -su I-TREATMENT -embolsado I-TREATMENT -y I-TREATMENT -de I-TREATMENT -la I-TREATMENT -aspiración I-TREATMENT -intraabdominal I-TREATMENT -de I-TREATMENT -su I-TREATMENT -contenido I-TREATMENT -mediante I-TREATMENT -una I-TREATMENT -aguja I-TREATMENT +diagnóstico I-TREATMENT +clínico I-TREATMENT de I-TREATMENT -colecistostomía I-TREATMENT -laparoscópica I-TREATMENT -(Karl I-TREATMENT -Storz, I-TREATMENT -Alemania), I-TREATMENT +masa I-TREATMENT +renal I-TREATMENT +compatible I-TREATMENT con I-TREATMENT -la I-TREATMENT -que I-TREATMENT +proceso I-TREATMENT +neoformativo, I-TREATMENT se I-TREATMENT -evacuaron I-TREATMENT -150 I-TREATMENT -ml I-TREATMENT -de I-TREATMENT -líquido I-TREATMENT -marronáceo I-TREATMENT +realiza I-TREATMENT +nefrectomía I-TREATMENT +radical I-TREATMENT +izquierda, I-TREATMENT +con I-TREATMENT +suprarrenalectomía I-TREATMENT +izquierda I-TREATMENT +más I-TREATMENT +linfadenectomía I-TREATMENT +aortocava, I-TREATMENT sin I-TREATMENT -olor, I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -permitió I-TREATMENT -extraer I-TREATMENT -la I-TREATMENT -pieza I-TREATMENT -por I-TREATMENT -uno I-TREATMENT -de I-TREATMENT -los I-TREATMENT -orificios I-TREATMENT -de I-TREATMENT -acceso I-TREATMENT -de I-TREATMENT -12 I-TREATMENT -mm, I-TREATMENT -minimizando I-TREATMENT -de I-TREATMENT -ese I-TREATMENT -modo I-TREATMENT -las I-TREATMENT -heridas I-TREATMENT -operatorias. I-TREATMENT - I-TREATMENT -El B-EXPLORATION +incidencias I-TREATMENT +ni I-TREATMENT +complicaciones I-TREATMENT +inmediatas. I-TREATMENT +En B-EVOLUTION +el I-EVOLUTION +postoperatorio I-EVOLUTION +no I-EVOLUTION +surgen I-EVOLUTION +complicaciones, I-EVOLUTION +con I-EVOLUTION +función I-EVOLUTION +renal I-EVOLUTION +estable. I-EVOLUTION +Un I-EVOLUTION +mes I-EVOLUTION +después I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +nefrectomía, I-EVOLUTION +el I-EVOLUTION +aclaramiento I-EVOLUTION +de I-EVOLUTION +creatinina I-EVOLUTION +fue I-EVOLUTION +de I-EVOLUTION +52 I-EVOLUTION +ml/min I-EVOLUTION +y I-EVOLUTION +aparece I-EVOLUTION +proteinuria I-EVOLUTION +de I-EVOLUTION +0, I-EVOLUTION +16 I-EVOLUTION +g/24 I-EVOLUTION +h. I-EVOLUTION + I-EVOLUTION +En B-EXPLORATION +el I-EXPLORATION estudio I-EXPLORATION -macroscópico I-EXPLORATION -e I-EXPLORATION -histopatológico I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -cavitada I-EXPLORATION -benigna, I-EXPLORATION -dependiente I-EXPLORATION +anátomo-patológico I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -corteza I-EXPLORATION -adrenal, I-EXPLORATION -con I-EXPLORATION +pieza, I-EXPLORATION +macroscópicamente I-EXPLORATION +destaca I-EXPLORATION una I-EXPLORATION -pared I-EXPLORATION -fibrosa I-EXPLORATION -densa I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -había I-EXPLORATION -restos I-EXPLORATION +masa I-EXPLORATION +renal I-EXPLORATION +blanquecina, I-EXPLORATION +firme, I-EXPLORATION de I-EXPLORATION -adrenal, I-EXPLORATION -infiltrados I-EXPLORATION -linfoplasmocitarios I-EXPLORATION -y I-EXPLORATION -focos I-EXPLORATION +9 I-EXPLORATION +x I-EXPLORATION +8, I-EXPLORATION +5 I-EXPLORATION +x I-EXPLORATION +5 I-EXPLORATION +cm., I-EXPLORATION de I-EXPLORATION -calcificación I-EXPLORATION -distrófica, I-EXPLORATION -y I-EXPLORATION -sin I-EXPLORATION +bordes I-EXPLORATION +mal I-EXPLORATION +definidos, I-EXPLORATION que I-EXPLORATION +presenta I-EXPLORATION +un I-EXPLORATION +área I-EXPLORATION +central I-EXPLORATION +de I-EXPLORATION +necrosis. I-EXPLORATION +Está I-EXPLORATION +situada I-EXPLORATION en I-EXPLORATION -ningún I-EXPLORATION -momento I-EXPLORATION -se I-EXPLORATION -observara I-EXPLORATION -revestimiento I-EXPLORATION -epitelial I-EXPLORATION -destacable, I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -era I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -quiste I-EXPLORATION -hemorrágico I-EXPLORATION -adrenal I-EXPLORATION -o I-EXPLORATION -seudoquiste I-EXPLORATION -benigno. I-EXPLORATION -El I-EXPLORATION -cultivo I-EXPLORATION -del I-EXPLORATION -contenido I-EXPLORATION +la I-EXPLORATION +porción I-EXPLORATION +central I-EXPLORATION +renal, I-EXPLORATION +afectando I-EXPLORATION +la I-EXPLORATION +práctica I-EXPLORATION +totalidad I-EXPLORATION del I-EXPLORATION -quiste I-EXPLORATION -fue I-EXPLORATION -negativo. I-EXPLORATION - I-EXPLORATION - -Femenina B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -12 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -sentada I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -cinturón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -seguridad I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -parte I-PRESENT_ILLNESS -trasera I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -automóvil, I-PRESENT_ILLNESS -participó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -accidente I-PRESENT_ILLNESS -automovilístico. I-PRESENT_ILLNESS -Se I-PRESENT_ILLNESS -mantuvo I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -asiento I-PRESENT_ILLNESS -posterior I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -evento, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -conocimiento I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -momento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -arribo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -paramédicos. I-PRESENT_ILLNESS -Fue I-PRESENT_ILLNESS -transportada I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -collarín I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -inmovilizada I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -decúbito I-PRESENT_ILLNESS -dorsal I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -tabla I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -protección I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -admitida I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -DUP I-PRESENT_ILLNESS -aprox. I-PRESENT_ILLNESS -15min I-PRESENT_ILLNESS -posteriores I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -accidente. I-PRESENT_ILLNESS -Los B-EXPLORATION -signos I-EXPLORATION -vitales I-EXPLORATION -al I-EXPLORATION -ingreso: I-EXPLORATION -temperatura, I-EXPLORATION -36, I-EXPLORATION -4oC; I-EXPLORATION -pulso, I-EXPLORATION -76; I-EXPLORATION -PA, I-EXPLORATION -109/69mm I-EXPLORATION -Hg; I-EXPLORATION -y I-EXPLORATION -frecuencia I-EXPLORATION -respiratoria, I-EXPLORATION -14. I-EXPLORATION -La I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -mantuvo I-EXPLORATION -en I-EXPLORATION -calma I-EXPLORATION +parénquima, I-EXPLORATION +alcanzando I-EXPLORATION +el I-EXPLORATION +tejido I-EXPLORATION +adiposo I-EXPLORATION +perirrenal I-EXPLORATION y I-EXPLORATION -muy I-EXPLORATION -cooperadora, I-EXPLORATION -solo I-EXPLORATION -refirió I-EXPLORATION -dolor I-EXPLORATION -abdominal I-EXPLORATION -leve I-EXPLORATION -durante I-EXPLORATION +rodeando I-EXPLORATION la I-EXPLORATION -EF I-EXPLORATION -en I-EXPLORATION +glándula I-EXPLORATION +suprarrenal. I-EXPLORATION +En I-EXPLORATION el I-EXPLORATION -DUP. I-EXPLORATION +hilio I-EXPLORATION +renal I-EXPLORATION +se I-EXPLORATION +identifican I-EXPLORATION +cuatro I-EXPLORATION +ganglios I-EXPLORATION +linfáticos. I-EXPLORATION El I-EXPLORATION -ultrasonido I-EXPLORATION -inicial I-EXPLORATION +parénquima I-EXPLORATION +renal I-EXPLORATION +no I-EXPLORATION +tumoral I-EXPLORATION +está I-EXPLORATION +totalmente I-EXPLORATION +desestructurado I-EXPLORATION +y I-EXPLORATION +sustituido I-EXPLORATION +por I-EXPLORATION +múltiples I-EXPLORATION +quistes I-EXPLORATION de I-EXPLORATION -abdomen I-EXPLORATION +hasta I-EXPLORATION +2 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +diámetro, I-EXPLORATION y I-EXPLORATION -los I-EXPLORATION -rayos I-EXPLORATION -X I-EXPLORATION -fueron I-EXPLORATION -normales I-EXPLORATION -al I-EXPLORATION -igual I-EXPLORATION que I-EXPLORATION -los I-EXPLORATION -estudios I-EXPLORATION +afectan I-EXPLORATION +tanto I-EXPLORATION +corteza I-EXPLORATION +como I-EXPLORATION +médula I-EXPLORATION +renal. I-EXPLORATION +Histológicamente, I-EXPLORATION +la I-EXPLORATION +tumoración I-EXPLORATION +está I-EXPLORATION +constituida I-EXPLORATION +por I-EXPLORATION +células I-EXPLORATION de I-EXPLORATION -laboratorio I-EXPLORATION -(sangre I-EXPLORATION +citoplasma I-EXPLORATION +amplio I-EXPLORATION +y I-EXPLORATION +eosinófilo, I-EXPLORATION +con I-EXPLORATION +núcleos I-EXPLORATION +redondeados I-EXPLORATION +con I-EXPLORATION +marcada I-EXPLORATION +atipia, I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +organizan I-EXPLORATION +en I-EXPLORATION +un I-EXPLORATION +patrón I-EXPLORATION +sólido I-EXPLORATION +cohesivo, I-EXPLORATION +característico I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +carcinoma I-EXPLORATION +escamoso I-EXPLORATION +pobremente I-EXPLORATION +diferenciado. I-EXPLORATION +Son I-EXPLORATION +extensas I-EXPLORATION +las I-EXPLORATION +áreas I-EXPLORATION +de I-EXPLORATION +necrosis I-EXPLORATION +tumoral. I-EXPLORATION +El I-EXPLORATION +tumor I-EXPLORATION +afecta I-EXPLORATION +uréter I-EXPLORATION +proximal, I-EXPLORATION +pelvis I-EXPLORATION +renal, I-EXPLORATION +parénquima I-EXPLORATION +renal I-EXPLORATION y I-EXPLORATION -orina) I-EXPLORATION +tejido I-EXPLORATION +adiposo I-EXPLORATION +tanto I-EXPLORATION +perirrenal I-EXPLORATION +como I-EXPLORATION +perihiliar. I-EXPLORATION +Se I-EXPLORATION +objetiva I-EXPLORATION +infiltración I-EXPLORATION +tumoral I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +vena I-EXPLORATION +renal I-EXPLORATION y I-EXPLORATION +extensa I-EXPLORATION +infiltración I-EXPLORATION +tumoral I-EXPLORATION +perineural I-EXPLORATION +con I-EXPLORATION +afectación I-EXPLORATION +de I-EXPLORATION +ganglios I-EXPLORATION +simpáticos I-EXPLORATION +del I-EXPLORATION +hilio I-EXPLORATION +renal. I-EXPLORATION +La I-EXPLORATION +masa I-EXPLORATION +tumoral I-EXPLORATION +está I-EXPLORATION +constituida I-EXPLORATION +por I-EXPLORATION +carcinoma I-EXPLORATION +escamoso, I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -resto I-EXPLORATION +seno I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -EF. I-EXPLORATION +cual, I-EXPLORATION +se I-EXPLORATION +aprecia I-EXPLORATION +un I-EXPLORATION +área I-EXPLORATION +de I-EXPLORATION +carcinoma I-EXPLORATION +urotelial I-EXPLORATION +papilar I-EXPLORATION +intraureteral. I-EXPLORATION Se I-EXPLORATION -decidió I-EXPLORATION -mantenerla I-EXPLORATION +identifica I-EXPLORATION +metástasis I-EXPLORATION +del I-EXPLORATION +carcinoma I-EXPLORATION en I-EXPLORATION -observación. I-EXPLORATION -Después I-EXPLORATION +dos I-EXPLORATION de I-EXPLORATION -algunas I-EXPLORATION -horas, I-EXPLORATION +los I-EXPLORATION +cuatro I-EXPLORATION +ganglios I-EXPLORATION +linfáticos I-EXPLORATION +hiliares I-EXPLORATION +identificados I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -paciente I-EXPLORATION -continuó I-EXPLORATION -con I-EXPLORATION -dolor I-EXPLORATION -abdominal I-EXPLORATION -leve, I-EXPLORATION -y I-EXPLORATION +pieza. I-EXPLORATION +Los I-EXPLORATION +márgenes I-EXPLORATION +de I-EXPLORATION +resección I-EXPLORATION +quirúrgica I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +pieza, I-EXPLORATION +son I-EXPLORATION +negativos. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +linfadenectomía I-EXPLORATION +paraórtica I-EXPLORATION se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -TAC I-EXPLORATION -contrastada. I-EXPLORATION -Al B-EVOLUTION -evaluar I-EVOLUTION -la I-EVOLUTION -TAC I-EVOLUTION -el I-EVOLUTION -caso I-EVOLUTION -fue I-EVOLUTION -comentado I-EVOLUTION -con I-EVOLUTION -nuestro I-EVOLUTION -servicio. I-EVOLUTION -En I-EVOLUTION -este I-EVOLUTION -momento I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -tenía I-EVOLUTION -5hrs I-EVOLUTION -en I-EVOLUTION -observación, I-EVOLUTION -estable. I-EVOLUTION -En B-EXPLORATION -la I-EXPLORATION -TAC I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION +identifican I-EXPLORATION +6 I-EXPLORATION +ganglios I-EXPLORATION +linfáticos I-EXPLORATION +libres I-EXPLORATION +de I-EXPLORATION +infiltración I-EXPLORATION +neoplásica. I-EXPLORATION +En I-EXPLORATION +resumen, I-EXPLORATION el I-EXPLORATION -riñón I-EXPLORATION -derecho I-EXPLORATION -sin I-EXPLORATION -captación I-EXPLORATION +diagnóstico I-EXPLORATION +anátomo-patológico I-EXPLORATION de I-EXPLORATION -medio I-EXPLORATION +la I-EXPLORATION +pieza I-EXPLORATION +es I-EXPLORATION de I-EXPLORATION -contraste. I-EXPLORATION -Se B-TREATMENT -decidió I-TREATMENT -manejar I-TREATMENT -conservadoramente. I-TREATMENT -Fue B-EVOLUTION -egresada I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -36h I-EVOLUTION -de I-EVOLUTION -observación. I-EVOLUTION - I-EVOLUTION -Se I-EVOLUTION -revisaron I-EVOLUTION -106 I-EVOLUTION -artículos I-EVOLUTION -publicados I-EVOLUTION -en I-EVOLUTION -inglés I-EVOLUTION -(referencias I-EVOLUTION -no I-EVOLUTION -mostradas) I-EVOLUTION -buscando I-EVOLUTION -pacientes I-EVOLUTION -<16 I-EVOLUTION -con I-EVOLUTION -OAR I-EVOLUTION -unilateral I-EVOLUTION -tratados I-EVOLUTION -conservadoramente. I-EVOLUTION - I-EVOLUTION +carcinoma I-EXPLORATION +escamoso I-EXPLORATION +pobremente I-EXPLORATION +diferenciado I-EXPLORATION +originado I-EXPLORATION +en I-EXPLORATION +pelvis I-EXPLORATION +renal I-EXPLORATION +y I-EXPLORATION +uréter, I-EXPLORATION +categoría I-EXPLORATION +pT4pN2, I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +contexto I-EXPLORATION +de I-EXPLORATION +enfermedad I-EXPLORATION +renal I-EXPLORATION +poliquística I-EXPLORATION +autosómico-dominante I-EXPLORATION +(riñón I-EXPLORATION +poliquístico I-EXPLORATION +del I-EXPLORATION +adulto). I-EXPLORATION + B-TREATMENT +En I-TREATMENT +la I-TREATMENT +actualidad, I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +sigue I-TREATMENT +tratamiento I-TREATMENT +oncológico. I-TREATMENT + I-TREATMENT -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino I-PRESENT_ILLNESS +Primera B-PRESENT_ILLNESS +hija I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -27 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS +padres I-PRESENT_ILLNESS +sanos I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +consanguíneos, I-PRESENT_ILLNESS +sin B-FAMILY_HISTORY +antecedentes I-FAMILY_HISTORY +de I-FAMILY_HISTORY +epilepsia I-FAMILY_HISTORY +en I-FAMILY_HISTORY +familiares I-FAMILY_HISTORY +de I-FAMILY_HISTORY +primer I-FAMILY_HISTORY +grado, I-FAMILY_HISTORY +debutó B-PRESENT_ILLNESS a I-PRESENT_ILLNESS -consecuencia I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -colisión I-PRESENT_ILLNESS -frontal I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -gran I-PRESENT_ILLNESS -velocidad I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -vehículo I-PRESENT_ILLNESS -automotor I-PRESENT_ILLNESS -sufrió I-PRESENT_ILLNESS -politraumatismo I-PRESENT_ILLNESS -grave. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -momento I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -asistida I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -encontraba I-PRESENT_ILLNESS -lúcida I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -cinturón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -seguridad I-PRESENT_ILLNESS -colocado. I-PRESENT_ILLNESS -Fue I-PRESENT_ILLNESS -trasladada I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -lugar I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -accidente I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -más I-PRESENT_ILLNESS -cercano, I-PRESENT_ILLNESS -donde I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -constató I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS +CF I-PRESENT_ILLNESS +hemiclónica I-PRESENT_ILLNESS +derecha, I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -shock I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -abdomen I-PRESENT_ILLNESS -agudo, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -realizó I-PRESENT_ILLNESS -laparotomía I-PRESENT_ILLNESS -exploradora I-PRESENT_ILLNESS +15 I-PRESENT_ILLNESS +min I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -urgencia, I-PRESENT_ILLNESS -hallándose I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nivel I-PRESENT_ILLNESS +duración, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +paresia I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -pared I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -sección I-PRESENT_ILLNESS +Todd I-PRESENT_ILLNESS +posterior. I-PRESENT_ILLNESS +Las I-PRESENT_ILLNESS +recurrencias I-PRESENT_ILLNESS +fueron I-PRESENT_ILLNESS +frecuentes, I-PRESENT_ILLNESS del I-PRESENT_ILLNESS -músculo I-PRESENT_ILLNESS -recto I-PRESENT_ILLNESS -anterior I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS +tipo I-PRESENT_ILLNESS +focal I-PRESENT_ILLNESS +compleja I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -cavidad I-PRESENT_ILLNESS -estallido I-PRESENT_ILLNESS +hemiclónicas I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -colon I-PRESENT_ILLNESS -transverso, I-PRESENT_ILLNESS -realizándosele I-PRESENT_ILLNESS -lavado I-PRESENT_ILLNESS -peritoneal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -colostomía I-PRESENT_ILLNESS -transversa I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -hipocondrio I-PRESENT_ILLNESS -derecho. I-PRESENT_ILLNESS -Posteriormente I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -trasladada I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -otro I-PRESENT_ILLNESS -centro I-PRESENT_ILLNESS +más I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -mayor I-PRESENT_ILLNESS -complejidad I-PRESENT_ILLNESS -llegando I-PRESENT_ILLNESS +10 I-PRESENT_ILLNESS +min I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS al I-PRESENT_ILLNESS -mismo I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -doce I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -trauma. I-PRESENT_ILLNESS +menos I-PRESENT_ILLNESS +5 I-PRESENT_ILLNESS +SE I-PRESENT_ILLNESS +febriles I-PRESENT_ILLNESS +entre I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +3 I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +6 I-PRESENT_ILLNESS +mes, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +examen I-PRESENT_ILLNESS +normal I-PRESENT_ILLNESS +post I-PRESENT_ILLNESS +crisis. I-PRESENT_ILLNESS I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -evaluación I-EXPLORATION -inicial I-EXPLORATION +La B-EXPLORATION +RM I-EXPLORATION +cerebral3 I-EXPLORATION +fueron I-EXPLORATION +normal, I-EXPLORATION +al I-EXPLORATION +igual I-EXPLORATION +que I-EXPLORATION +múltiples I-EXPLORATION +EEG I-EXPLORATION +standard, I-EXPLORATION la I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -lúcida, I-EXPLORATION -presentaba I-EXPLORATION -frialdad I-EXPLORATION -de I-EXPLORATION -ambos I-EXPLORATION -miembros I-EXPLORATION -inferiores I-EXPLORATION -con I-EXPLORATION -impotencia I-EXPLORATION -funcional I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -mismos, I-EXPLORATION -falta I-EXPLORATION -de I-EXPLORATION -sensibilidad I-EXPLORATION -(anestesia) I-EXPLORATION -y I-EXPLORATION -ausencia I-EXPLORATION +cuantificación I-EXPLORATION de I-EXPLORATION -pulsos I-EXPLORATION -femorales I-EXPLORATION +aminoácidos I-EXPLORATION +en I-EXPLORATION +sangre, I-EXPLORATION +líquido I-EXPLORATION +cefalorraquídeo, I-EXPLORATION +ácidos I-EXPLORATION +orgánicos I-EXPLORATION y I-EXPLORATION -distales. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -estudios I-EXPLORATION -radiológicos I-EXPLORATION -solicitados I-EXPLORATION -evidenciaban I-EXPLORATION -fractura I-EXPLORATION -por I-EXPLORATION -estallido I-EXPLORATION +ultramicroscopía I-EXPLORATION de I-EXPLORATION -cabeza I-EXPLORATION -de I-EXPLORATION -húmero I-EXPLORATION -derecho, I-EXPLORATION -fractura I-EXPLORATION +piel. I-EXPLORATION +A I-EXPLORATION +los I-EXPLORATION +6 I-EXPLORATION +meses I-EXPLORATION +se I-EXPLORATION +solicitó I-EXPLORATION +estudio I-EXPLORATION +molecular I-EXPLORATION del I-EXPLORATION -tercio I-EXPLORATION -medio I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -diáfisis I-EXPLORATION -humeral I-EXPLORATION -derecha, I-EXPLORATION -fractura I-EXPLORATION -de I-EXPLORATION -diáfisis I-EXPLORATION -media I-EXPLORATION +gen I-EXPLORATION +SCN1A I-EXPLORATION +confirmándose I-EXPLORATION +mutación I-EXPLORATION +c.5347G>A I-EXPLORATION +(p.Ala1783Thr) I-EXPLORATION +en I-EXPLORATION +estado I-EXPLORATION +heterocigoto I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +exón I-EXPLORATION +26 I-EXPLORATION del I-EXPLORATION -fémur I-EXPLORATION -derecho I-EXPLORATION -y I-EXPLORATION -neumotórax I-EXPLORATION -izquierdo I-EXPLORATION -grado I-EXPLORATION -I, I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -drenado. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -nuclear I-EXPLORATION +gen. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +molecular I-EXPLORATION de I-EXPLORATION -columna I-EXPLORATION -lumbosacra I-EXPLORATION -que I-EXPLORATION -descartó I-EXPLORATION -lesiones I-EXPLORATION -medulares, I-EXPLORATION -hallándose I-EXPLORATION -como I-EXPLORATION -única I-EXPLORATION -lesión I-EXPLORATION -una I-EXPLORATION -fractura I-EXPLORATION -del I-EXPLORATION -sacro. I-EXPLORATION -Tras I-EXPLORATION -la I-EXPLORATION -reanimación I-EXPLORATION -inicial I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -tomografía I-EXPLORATION -abdominal I-EXPLORATION -con I-EXPLORATION -contraste I-EXPLORATION -endovenoso I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -descartaron I-EXPLORATION -lesiones I-EXPLORATION -de I-EXPLORATION -órganos I-EXPLORATION -sólidos. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -visualizaron I-EXPLORATION -anormalidades I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -aórtico, I-EXPLORATION -pero I-EXPLORATION -debido I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -semiología I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -angiografía I-EXPLORATION -de I-EXPLORATION -aorta I-EXPLORATION -abdominal I-EXPLORATION -y I-EXPLORATION -miembros I-EXPLORATION -inferiores, I-EXPLORATION -que I-EXPLORATION -demostró I-EXPLORATION -oclusión I-EXPLORATION -aórtica I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -infrarrenal I-EXPLORATION -sin I-EXPLORATION -circulación I-EXPLORATION -distal. I-EXPLORATION +ambos I-EXPLORATION +padres I-EXPLORATION +fue I-EXPLORATION +normal. I-EXPLORATION I-EXPLORATION -Con B-TREATMENT -diagnóstico I-TREATMENT +El B-TREATMENT +uso I-TREATMENT de I-TREATMENT -oclusión I-TREATMENT +fenobarbital, I-TREATMENT +clobazam, I-TREATMENT +levetiracetam I-TREATMENT +y I-TREATMENT +topiramato, I-TREATMENT +no I-TREATMENT +logró I-TREATMENT +control I-TREATMENT de I-TREATMENT -aorta I-TREATMENT -abdominal I-TREATMENT -postraumática I-TREATMENT +crisis. I-TREATMENT +A I-TREATMENT +los I-TREATMENT +9 I-TREATMENT +meses I-TREATMENT se I-TREATMENT -decidió I-TREATMENT -realizar I-TREATMENT -cirugía I-TREATMENT -vascular I-TREATMENT -(habiendo I-TREATMENT -pasado I-TREATMENT -15 I-TREATMENT -horas I-TREATMENT -desde I-TREATMENT -el I-TREATMENT -momento I-TREATMENT -del I-TREATMENT -accidente). I-TREATMENT +inició I-TREATMENT +stiripentol I-TREATMENT +dosis I-TREATMENT +50 I-TREATMENT +mg I-TREATMENT +kp I-TREATMENT +día, I-TREATMENT +asociado I-TREATMENT +a I-TREATMENT +topiramato I-TREATMENT +y I-TREATMENT +ácido I-TREATMENT +valproico I-TREATMENT +sin I-TREATMENT +resultados. I-TREATMENT +Entre B-EVOLUTION +los I-EVOLUTION +12-18 I-EVOLUTION +meses I-EVOLUTION +los I-EVOLUTION +múltiples I-EVOLUTION +SE I-EVOLUTION +y I-EVOLUTION +crisis I-EVOLUTION +frecuentes I-EVOLUTION +deterioraron I-EVOLUTION +su I-EVOLUTION +desarrollo I-EVOLUTION +perdiendo I-EVOLUTION +marcha, I-EVOLUTION +control I-EVOLUTION +de I-EVOLUTION +tronco I-EVOLUTION +y I-EVOLUTION +control I-EVOLUTION +cefálico. I-EVOLUTION +Se B-TREATMENT +inició I-TREATMENT +dieta I-TREATMENT +cetogénica I-TREATMENT +la I-TREATMENT +que I-TREATMENT +se I-TREATMENT +asoció I-TREATMENT +a I-TREATMENT +una I-TREATMENT +pancreatitis I-TREATMENT +grave I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +discontinuó. I-TREATMENT + I-TREATMENT La I-TREATMENT -técnica I-TREATMENT -quirúrgica I-TREATMENT -consistió I-TREATMENT -en I-TREATMENT -trombectomía I-TREATMENT -aórtica I-TREATMENT -con I-TREATMENT -catéter I-TREATMENT +certificación I-TREATMENT de I-TREATMENT -Fogarty, I-TREATMENT -bajo I-TREATMENT -control I-TREATMENT -visual I-TREATMENT +alteración I-TREATMENT +deglución I-TREATMENT y I-TREATMENT -manual I-TREATMENT +cuadros I-TREATMENT +respiratorios I-TREATMENT +recurrentes I-TREATMENT +febriles I-TREATMENT +que I-TREATMENT +precipitaban I-TREATMENT +los I-TREATMENT +SE I-TREATMENT +plantearon I-TREATMENT +gastrostomía I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +logró I-TREATMENT +disminución I-TREATMENT de I-TREATMENT -aorta I-TREATMENT -abdominal, I-TREATMENT -más I-TREATMENT -embolectomía I-TREATMENT -distal I-TREATMENT +episodios I-TREATMENT +febriles I-TREATMENT +y I-TREATMENT +mejor I-TREATMENT +manejo I-TREATMENT de I-TREATMENT las I-TREATMENT -arterias I-TREATMENT -femorales I-TREATMENT -comunes. I-TREATMENT -En B-EVOLUTION -la I-EVOLUTION -laparotomía I-EVOLUTION -para I-EVOLUTION -abordar I-EVOLUTION -aorta I-EVOLUTION -se I-EVOLUTION -constató I-EVOLUTION -hipoperfusión I-EVOLUTION -del I-EVOLUTION -intestino I-EVOLUTION -delgado, I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -interpretó I-EVOLUTION -como I-EVOLUTION -consecuencia I-EVOLUTION -del I-EVOLUTION -compromiso I-EVOLUTION -del I-EVOLUTION -flujo I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -ramas I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -arteria I-EVOLUTION -mesentérica I-EVOLUTION -inferior I-EVOLUTION -secundarias I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -trombosis. I-EVOLUTION -Este I-EVOLUTION -cuadro I-EVOLUTION -revirtió I-EVOLUTION -tras I-EVOLUTION -la I-EVOLUTION -intervención. I-EVOLUTION - I-EVOLUTION -A B-TREATMENT -las I-TREATMENT -24 I-TREATMENT -horas I-TREATMENT -la I-TREATMENT -enferma I-TREATMENT -desarrolló I-TREATMENT -criterios I-TREATMENT +crisis. I-TREATMENT + I-TREATMENT +Posterior I-TREATMENT +a I-TREATMENT +una I-TREATMENT +serie I-TREATMENT de I-TREATMENT -síndrome I-TREATMENT +adecuaciones I-TREATMENT de I-TREATMENT -distrés I-TREATMENT -respiratorio I-TREATMENT -agudo I-TREATMENT -secundario I-TREATMENT -a I-TREATMENT -contusión I-TREATMENT -pulmonar I-TREATMENT +fármacos I-TREATMENT +antiepilépticos I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +triasociado I-TREATMENT +con I-TREATMENT +clobazam, I-TREATMENT +topiramato I-TREATMENT y I-TREATMENT -signos I-TREATMENT +lacosamida I-TREATMENT +permitió I-TREATMENT +un I-TREATMENT +control I-TREATMENT +parcial I-TREATMENT de I-TREATMENT -isquemia I-TREATMENT +crisis, I-TREATMENT +sin I-TREATMENT +SE I-TREATMENT en I-TREATMENT -pierna I-TREATMENT -derecha I-TREATMENT -distal I-TREATMENT -a I-TREATMENT -la I-TREATMENT -patela, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -cual I-TREATMENT -fue I-TREATMENT -reintervenida I-TREATMENT -realizándose I-TREATMENT -embolectomía I-TREATMENT +18 I-TREATMENT +meses, I-TREATMENT con I-TREATMENT -catéter I-TREATMENT -de I-TREATMENT -Fogarty I-TREATMENT -poplíteo I-TREATMENT -y I-TREATMENT -del I-TREATMENT -tronco I-TREATMENT -tibioperoneo. I-TREATMENT -A B-EVOLUTION -pesar I-EVOLUTION -de I-EVOLUTION -este I-EVOLUTION -procedimiento I-EVOLUTION -persistieron I-EVOLUTION -los I-EVOLUTION -signos I-EVOLUTION -de I-EVOLUTION -isquemia I-EVOLUTION -distal, I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -interpretó I-EVOLUTION -como I-EVOLUTION -secundario I-EVOLUTION -a I-EVOLUTION -barro I-EVOLUTION -distal. I-EVOLUTION -Se I-EVOLUTION -descartó I-EVOLUTION -la I-EVOLUTION -posibilidad I-EVOLUTION -de I-EVOLUTION -realizarle I-EVOLUTION -tratamiento I-EVOLUTION -trombolítico I-EVOLUTION -por I-EVOLUTION -las I-EVOLUTION -cirugías I-EVOLUTION -previas. I-EVOLUTION -En B-EXPLORATION -la I-EXPLORATION -arteriografía I-EXPLORATION -intraoperatoria I-EXPLORATION -se I-EXPLORATION -constató I-EXPLORATION -la I-EXPLORATION -permeabilidad I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -ramas I-EXPLORATION -tibial I-EXPLORATION -anterior I-EXPLORATION -y I-EXPLORATION -del I-EXPLORATION -tronco I-EXPLORATION -tibioperoneo. I-EXPLORATION -Los B-TREATMENT -signos I-TREATMENT +crisis I-TREATMENT de I-TREATMENT -isquemia I-TREATMENT -permanecieron, I-TREATMENT -acompañados I-TREATMENT -de I-TREATMENT -acidosis I-TREATMENT -metabólica I-TREATMENT -en I-TREATMENT -ascenso I-TREATMENT -y I-TREATMENT -trombocitopenia I-TREATMENT -por I-TREATMENT -consumo, I-TREATMENT +corta I-TREATMENT +duración I-TREATMENT +(segundos) I-TREATMENT +3-5 I-TREATMENT por I-TREATMENT -lo I-TREATMENT +semana I-TREATMENT que I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -la I-TREATMENT -amputación I-TREATMENT -infrarrotuliana I-TREATMENT +no I-TREATMENT +requerían I-TREATMENT +uso I-TREATMENT +diazepam I-TREATMENT +ni I-TREATMENT +provocaban I-TREATMENT +alteración I-TREATMENT +en I-TREATMENT +actividades I-TREATMENT de I-TREATMENT -la I-TREATMENT -pierna I-TREATMENT -comprometida, I-TREATMENT -maniobra I-TREATMENT -que I-TREATMENT -corrigió I-TREATMENT -las I-TREATMENT -alteraciones I-TREATMENT -del I-TREATMENT -medio I-TREATMENT -interno. I-TREATMENT +vida I-TREATMENT +diaria. I-TREATMENT I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -permaneció I-EVOLUTION -once I-EVOLUTION -días I-EVOLUTION -en I-EVOLUTION -asistencia I-EVOLUTION -respiratoria I-EVOLUTION -mecánica I-EVOLUTION -con I-EVOLUTION -evolución I-EVOLUTION -satisfactoria, I-EVOLUTION -siendo I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -unidad I-EVOLUTION -al I-EVOLUTION -cabo I-EVOLUTION -de I-EVOLUTION -veinticinco I-EVOLUTION -días. I-EVOLUTION - I-EVOLUTION -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -43 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS +femenino, I-PRESENT_ILLNESS +previamente I-PRESENT_ILLNESS +sano, I-PRESENT_ILLNESS con B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -miomatosis I-PAST_MEDICAL_HISTORY -uterina I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -múltiples I-PAST_MEDICAL_HISTORY -ingresos I-PAST_MEDICAL_HISTORY -hospitalarios I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -dermatología I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -psoriasis I-PAST_MEDICAL_HISTORY -pustulosa, I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -cursaron I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -eritrodermia, I-PAST_MEDICAL_HISTORY -lesiones I-PAST_MEDICAL_HISTORY -ampollosas I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -disfagia, I-PAST_MEDICAL_HISTORY -previamente I-PAST_MEDICAL_HISTORY -tratada I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -corticoides, I-PAST_MEDICAL_HISTORY -acitretina, I-PAST_MEDICAL_HISTORY -ciclosporina, I-PAST_MEDICAL_HISTORY -etanercept I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -antibióticos I-PAST_MEDICAL_HISTORY -(siempre I-PAST_MEDICAL_HISTORY -ha I-PAST_MEDICAL_HISTORY -mejorado I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -ciclosporina); I-PAST_MEDICAL_HISTORY -a B-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -seis I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -haber I-PRESENT_ILLNESS -ingerido I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -comprimido I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -amoxicilina-clavulánico, I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -eritrodermia I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS +embarazo I-PAST_MEDICAL_HISTORY +controlado, I-PAST_MEDICAL_HISTORY +nacido I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +término I-PAST_MEDICAL_HISTORY +38 I-PAST_MEDICAL_HISTORY +semanas, I-PAST_MEDICAL_HISTORY +pequeña I-PAST_MEDICAL_HISTORY +para I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +edad I-PAST_MEDICAL_HISTORY +gestacional I-PAST_MEDICAL_HISTORY +(2.670 I-PAST_MEDICAL_HISTORY +kg). I-PAST_MEDICAL_HISTORY +Consultó B-PRESENT_ILLNESS a I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -ampollosas I-PRESENT_ILLNESS -generalizadas I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -afectaban I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -85% I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -superficie I-PRESENT_ILLNESS -corporal. I-PRESENT_ILLNESS -Se B-TREATMENT -inició I-TREATMENT -de I-TREATMENT -forma I-TREATMENT -precoz I-TREATMENT -ciclosporina I-TREATMENT -A; I-TREATMENT -a B-EVOLUTION -las I-EVOLUTION -48 I-EVOLUTION -h I-EVOLUTION -del I-EVOLUTION -ingreso I-EVOLUTION -desapareció I-EVOLUTION -la I-EVOLUTION -eritrodermia I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -desepitelizó I-EVOLUTION -la I-EVOLUTION -piel I-EVOLUTION -afecta. I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -siete I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -evolución, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -presentaba I-EVOLUTION -reepitelización I-EVOLUTION -subtotal I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -lesiones I-EVOLUTION -iniciales I-EVOLUTION -y I-EVOLUTION -fue I-EVOLUTION -posible I-EVOLUTION -su I-EVOLUTION -alta I-EVOLUTION -a I-EVOLUTION -planta. I-EVOLUTION - I-EVOLUTION - -La B-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -(P) I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +47 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -62 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -sufrir I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -coronario I-PRESENT_ILLNESS -agudo I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -enero I-PRESENT_ILLNESS +vida I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -2003, I-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -Hospital I-PRESENT_ILLNESS -Universitario I-PRESENT_ILLNESS -Príncipe I-PRESENT_ILLNESS +20 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -Asturias I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +caracterizado I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +ictericia I-PRESENT_ILLNESS +progresiva I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -presenta, I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -hospitalización, I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS +coluria, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +buen I-PRESENT_ILLNESS +incremento I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -hemiparesia I-PRESENT_ILLNESS -izquierda. I-PRESENT_ILLNESS -Se B-EXPLORATION -realiza I-EXPLORATION -un I-EXPLORATION -estudio I-EXPLORATION -neurológico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION +peso, I-PRESENT_ILLNESS +siendo I-PRESENT_ILLNESS +derivada I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +hospital I-PRESENT_ILLNESS +regional I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +estudio. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Exámenes B-EXPLORATION +con I-EXPLORATION +patrón I-EXPLORATION +colestásico, I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -refieren I-EXPLORATION los I-EXPLORATION -siguientes I-EXPLORATION -hallazgos: I-EXPLORATION - I-EXPLORATION --Funciones I-EXPLORATION -corticales I-EXPLORATION -normales I-EXPLORATION -aunque I-EXPLORATION -con I-EXPLORATION -quejas I-EXPLORATION -verbalizadas I-EXPLORATION +cuales I-EXPLORATION +destacaba I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION -pérdida I-EXPLORATION +bilirrubina I-EXPLORATION +total I-EXPLORATION +(BT), I-EXPLORATION +a I-EXPLORATION +expensas I-EXPLORATION de I-EXPLORATION -memoria I-EXPLORATION -continua I-EXPLORATION -desde I-EXPLORATION -que I-EXPLORATION -ha I-EXPLORATION -ingresado. I-EXPLORATION - I-EXPLORATION --Hemiparesia I-EXPLORATION -izquierda I-EXPLORATION -no I-EXPLORATION -congruente I-EXPLORATION -por: I-EXPLORATION - I-EXPLORATION -• I-EXPLORATION -No I-EXPLORATION -distribución I-EXPLORATION -piramidal. I-EXPLORATION - I-EXPLORATION -• I-EXPLORATION -Fluctuaciones I-EXPLORATION -durante I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -siendo I-EXPLORATION -las I-EXPLORATION -gesticulación I-EXPLORATION -manual I-EXPLORATION -aceptable. I-EXPLORATION - I-EXPLORATION -• I-EXPLORATION -Prácticamente I-EXPLORATION -anestesia I-EXPLORATION -global I-EXPLORATION -hemicorporal I-EXPLORATION -izquierda I-EXPLORATION -hasta I-EXPLORATION -línea I-EXPLORATION -media I-EXPLORATION -independiente. I-EXPLORATION - I-EXPLORATION -Por I-EXPLORATION -tanto, I-EXPLORATION -en I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -neurológica I-EXPLORATION -se I-EXPLORATION -concluye I-EXPLORATION -que I-EXPLORATION -existen I-EXPLORATION -datos I-EXPLORATION -discordantes I-EXPLORATION -que I-EXPLORATION -hacen I-EXPLORATION -sospechar I-EXPLORATION -origen I-EXPLORATION -no I-EXPLORATION -orgánico, I-EXPLORATION -al I-EXPLORATION -menos, I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -explicaría I-EXPLORATION +bilirrubina I-EXPLORATION +directa I-EXPLORATION +(BD) I-EXPLORATION +(12, I-EXPLORATION +75 I-EXPLORATION +mg/dl-10, I-EXPLORATION +18 I-EXPLORATION +mg/dl) I-EXPLORATION +y I-EXPLORATION +pruebas I-EXPLORATION +hepáticas I-EXPLORATION +elevadas, I-EXPLORATION +sobre I-EXPLORATION todo I-EXPLORATION -el I-EXPLORATION -cuadro. I-EXPLORATION - I-EXPLORATION -También I-EXPLORATION -presentaba I-EXPLORATION -cefalea I-EXPLORATION -resistente I-EXPLORATION -de I-EXPLORATION -características I-EXPLORATION -tensionales. I-EXPLORATION +la I-EXPLORATION +gamma I-EXPLORATION +glutamil I-EXPLORATION +transpeptidasa I-EXPLORATION +(GGT) I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +fosfatasa I-EXPLORATION +alcalina I-EXPLORATION +(FA). I-EXPLORATION I-EXPLORATION -Por I-EXPLORATION -ello, I-EXPLORATION +En I-EXPLORATION +Hospital I-EXPLORATION +regional I-EXPLORATION se I-EXPLORATION -solicita I-EXPLORATION -valoración I-EXPLORATION -psicológica I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -paciente. I-EXPLORATION -P. I-EXPLORATION +sospechó I-EXPLORATION +hepatitis I-EXPLORATION +viral, I-EXPLORATION +y I-EXPLORATION se I-EXPLORATION -encuentra I-EXPLORATION -levemente I-EXPLORATION -confusa I-EXPLORATION +tomó I-EXPLORATION +serología I-EXPLORATION +para I-EXPLORATION +hepatitis I-EXPLORATION +A, I-EXPLORATION +B I-EXPLORATION y I-EXPLORATION -angustiada I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -situación I-EXPLORATION +C I-EXPLORATION +que I-EXPLORATION +resultaron I-EXPLORATION +negativas. I-EXPLORATION +Evolucionó B-EVOLUTION +favorablemente I-EVOLUTION +pero I-EVOLUTION +se I-EVOLUTION +constataron I-EVOLUTION +deposiciones I-EVOLUTION +acólicas. I-EVOLUTION +Se B-DERIVED_FROM/TO +derivó I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +gastroenterología I-DERIVED_FROM/TO +previos B-EXPLORATION +exámenes I-EXPLORATION de I-EXPLORATION -estar I-EXPLORATION -ingresada. I-EXPLORATION -No I-EXPLORATION -aparenta I-EXPLORATION -estar I-EXPLORATION -muy I-EXPLORATION -preocupada I-EXPLORATION -por I-EXPLORATION -los I-EXPLORATION -síntomas I-EXPLORATION +control I-EXPLORATION que I-EXPLORATION -presenta I-EXPLORATION +mantenían I-EXPLORATION +patrón I-EXPLORATION +colestásico I-EXPLORATION +con I-EXPLORATION +elevación I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +BD I-EXPLORATION y I-EXPLORATION -verbaliza I-EXPLORATION -en I-EXPLORATION -varias I-EXPLORATION -ocasiones I-EXPLORATION -sus I-EXPLORATION -deseos I-EXPLORATION de I-EXPLORATION -ser I-EXPLORATION -dada I-EXPLORATION +las I-EXPLORATION +transaminasas: I-EXPLORATION +BT I-EXPLORATION +10, I-EXPLORATION +58, I-EXPLORATION +BD I-EXPLORATION +7, I-EXPLORATION +88, I-EXPLORATION +GOT I-EXPLORATION +204, I-EXPLORATION +GPT I-EXPLORATION +109, I-EXPLORATION +GGT I-EXPLORATION +550. I-EXPLORATION + I-EXPLORATION +A I-EXPLORATION +los I-EXPLORATION +52 I-EXPLORATION +días I-EXPLORATION de I-EXPLORATION -alta. I-EXPLORATION -Al I-EXPLORATION -inicio I-EXPLORATION +vida I-EXPLORATION +se I-EXPLORATION +le I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +dilatación I-EXPLORATION +arrosariada I-EXPLORATION de I-EXPLORATION +vía I-EXPLORATION +biliar I-EXPLORATION +intrahepática I-EXPLORATION +y I-EXPLORATION +vesícula I-EXPLORATION +biliar I-EXPLORATION +presente I-EXPLORATION +pero I-EXPLORATION +colapsada I-EXPLORATION +a I-EXPLORATION +pesar I-EXPLORATION +del I-EXPLORATION +ayuno. I-EXPLORATION + I-EXPLORATION +Por I-EXPLORATION la I-EXPLORATION -primera I-EXPLORATION -entrevista, I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +vesícula I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +gran I-EXPLORATION +dilatación I-EXPLORATION +de I-EXPLORATION +vía I-EXPLORATION +biliar I-EXPLORATION +intrahepática, I-EXPLORATION se I-EXPLORATION -muestra I-EXPLORATION -reticente I-EXPLORATION -a I-EXPLORATION -ser I-EXPLORATION -evaluada, I-EXPLORATION -afirmando I-EXPLORATION -que I-EXPLORATION -su I-EXPLORATION -problema I-EXPLORATION -es I-EXPLORATION -exclusivamente I-EXPLORATION -físico I-EXPLORATION +decidió I-EXPLORATION +diferir I-EXPLORATION +la I-EXPLORATION +biopsia I-EXPLORATION +hepática I-EXPLORATION y I-EXPLORATION -que I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +colangio-resonancia. I-EXPLORATION +Esta I-EXPLORATION +mostró I-EXPLORATION +un I-EXPLORATION +hígado I-EXPLORATION +normal I-EXPLORATION +con I-EXPLORATION +parénquima I-EXPLORATION +conservado, I-EXPLORATION +leve I-EXPLORATION +dilatación I-EXPLORATION +de I-EXPLORATION +ductos I-EXPLORATION +biliares I-EXPLORATION +intrahepáticos I-EXPLORATION +hasta I-EXPLORATION +nivel I-EXPLORATION +de I-EXPLORATION +su I-EXPLORATION +confluencia, I-EXPLORATION +hacia I-EXPLORATION +distal I-EXPLORATION no I-EXPLORATION -entiende I-EXPLORATION -el I-EXPLORATION -sentido I-EXPLORATION +se I-EXPLORATION +logró I-EXPLORATION +visualizar I-EXPLORATION +vía I-EXPLORATION +biliar I-EXPLORATION +extrahepática. I-EXPLORATION + I-EXPLORATION +Con B-TREATMENT +el I-TREATMENT +resultado I-TREATMENT +de I-TREATMENT +la I-TREATMENT +colangio-resonancia I-TREATMENT +se I-TREATMENT +sospechó I-TREATMENT +atresia I-TREATMENT +de I-TREATMENT +vía I-TREATMENT +biliar I-TREATMENT +y I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +cirugía I-TREATMENT +de I-TREATMENT +derivación I-TREATMENT +bilio-digestiva I-TREATMENT +(Kasai). I-TREATMENT +Llamaba B-EXPLORATION +la I-EXPLORATION +atención I-EXPLORATION +que I-EXPLORATION +en I-EXPLORATION +exámenes I-EXPLORATION +seriados I-EXPLORATION +la I-EXPLORATION +bilirrubina I-EXPLORATION +había I-EXPLORATION +ido I-EXPLORATION +en I-EXPLORATION +disminución I-EXPLORATION +al I-EXPLORATION +igual I-EXPLORATION +que I-EXPLORATION +la I-EXPLORATION +ictericia. I-EXPLORATION +Por I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -una I-EXPLORATION +deposiciones I-EXPLORATION +acólicas I-EXPLORATION +se I-EXPLORATION +decidió I-EXPLORATION exploración I-EXPLORATION -psicológica. I-EXPLORATION +quirúrgica. I-EXPLORATION I-EXPLORATION -Evaluación B-PAST_MEDICAL_HISTORY -psicológica I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -• I-PAST_MEDICAL_HISTORY -Historia I-PAST_MEDICAL_HISTORY -clínica I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Antecedentes I-PAST_MEDICAL_HISTORY -biográficos I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Nace I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -ambiente I-PAST_MEDICAL_HISTORY -rural I-PAST_MEDICAL_HISTORY -siendo I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -novena I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -11 I-PAST_MEDICAL_HISTORY -hermanos. I-PAST_MEDICAL_HISTORY -Acerca I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -niñez I-PAST_MEDICAL_HISTORY -comenta I-PAST_MEDICAL_HISTORY -"no I-PAST_MEDICAL_HISTORY -haber I-PAST_MEDICAL_HISTORY -tenido I-PAST_MEDICAL_HISTORY -infancia I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -haber I-PAST_MEDICAL_HISTORY -tenido I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -trabajar I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -campo I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -9 I-PAST_MEDICAL_HISTORY -años". I-PAST_MEDICAL_HISTORY -Esta I-PAST_MEDICAL_HISTORY -situación I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -impidió I-PAST_MEDICAL_HISTORY -aprender I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -leer I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -escribir, I-PAST_MEDICAL_HISTORY -circunstancia I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -da I-PAST_MEDICAL_HISTORY -mucha I-PAST_MEDICAL_HISTORY -importancia I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -actualidad, I-PAST_MEDICAL_HISTORY -sintiéndose I-PAST_MEDICAL_HISTORY -frustrada I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -ello. I-PAST_MEDICAL_HISTORY -Con I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -excepción I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -varones I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -hermanas, I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -cuales I-PAST_MEDICAL_HISTORY -fueron I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -escuela, I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -resto I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -hermanos I-PAST_MEDICAL_HISTORY -(mujeres) I-PAST_MEDICAL_HISTORY -compartieron I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -situación I-PAST_MEDICAL_HISTORY -similar. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Señala I-PAST_MEDICAL_HISTORY -cómo I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -ocasiones I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -intensas I-PAST_MEDICAL_HISTORY -jornadas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -trabajo I-PAST_MEDICAL_HISTORY -sólo I-PAST_MEDICAL_HISTORY -podía I-PAST_MEDICAL_HISTORY -ausentarse I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -caso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -alguna I-PAST_MEDICAL_HISTORY -ocasión I-PAST_MEDICAL_HISTORY -experimentó I-PAST_MEDICAL_HISTORY -mareos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -desmayos. I-PAST_MEDICAL_HISTORY -Refiere I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -largo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -vida I-PAST_MEDICAL_HISTORY -ha I-PAST_MEDICAL_HISTORY -vuelto I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -sufrir I-PAST_MEDICAL_HISTORY -esos I-PAST_MEDICAL_HISTORY -síntomas I-PAST_MEDICAL_HISTORY -ante I-PAST_MEDICAL_HISTORY -diferentes I-PAST_MEDICAL_HISTORY -dificultades I-PAST_MEDICAL_HISTORY -(por I-PAST_MEDICAL_HISTORY -ejemplo, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -funeral I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -muerte I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -padre). I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -cuanto I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -relaciones I-PAST_MEDICAL_HISTORY -sociales, I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -tuvo I-PAST_MEDICAL_HISTORY -relaciones I-PAST_MEDICAL_HISTORY -significativas I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -iguales I-PAST_MEDICAL_HISTORY -aparte I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -tenía I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -hermanos. I-PAST_MEDICAL_HISTORY -Está I-PAST_MEDICAL_HISTORY -casada I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -describe I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -relación I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -esposo I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -buena, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -conflictos I-PAST_MEDICAL_HISTORY -importantes. I-PAST_MEDICAL_HISTORY -Tiene I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -hijas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -38 I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -30 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -edad, I-PAST_MEDICAL_HISTORY -ambas I-PAST_MEDICAL_HISTORY -casadas I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -hijos. I-PAST_MEDICAL_HISTORY -Refiere I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -relación I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -ellas I-PAST_MEDICAL_HISTORY -siempre I-PAST_MEDICAL_HISTORY -ha I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -"de I-PAST_MEDICAL_HISTORY -amigas" I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -siempre I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -han I-PAST_MEDICAL_HISTORY -contado I-PAST_MEDICAL_HISTORY -todo; I-PAST_MEDICAL_HISTORY -aunque I-PAST_MEDICAL_HISTORY -reconoce I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -ocasiones I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -tachan I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -sobreprotectora. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -ha I-PAST_MEDICAL_HISTORY -recibido I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -psiquiátrico I-PAST_MEDICAL_HISTORY -o I-PAST_MEDICAL_HISTORY -psicológico I-PAST_MEDICAL_HISTORY -previo. I-PAST_MEDICAL_HISTORY -Hace I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -demandó I-PAST_MEDICAL_HISTORY -asistencia I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -Atención I-PAST_MEDICAL_HISTORY -Primaria I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -insomnio I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -pautó I-PAST_MEDICAL_HISTORY -mianserina, I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -estuvo I-PAST_MEDICAL_HISTORY -tomando I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -año, I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -médico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Atención I-PAST_MEDICAL_HISTORY -Primaria I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -cambió I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -paroxetina I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -bromazepam. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -alguna I-PAST_MEDICAL_HISTORY -ocasión I-PAST_MEDICAL_HISTORY -refiere I-PAST_MEDICAL_HISTORY -haber I-PAST_MEDICAL_HISTORY -tomado I-PAST_MEDICAL_HISTORY -hipnóticos, I-PAST_MEDICAL_HISTORY -también I-PAST_MEDICAL_HISTORY -pautados I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -Centro I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Salud, I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -insomnio. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Asimismo, I-PAST_MEDICAL_HISTORY -P. I-PAST_MEDICAL_HISTORY -ha I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hipotiroidismo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -ha I-PAST_MEDICAL_HISTORY -sufrido I-PAST_MEDICAL_HISTORY -numerosas I-PAST_MEDICAL_HISTORY -intervenciones I-PAST_MEDICAL_HISTORY -quirúrgicas. I-PAST_MEDICAL_HISTORY -Este B-PRESENT_ILLNESS -último I-PRESENT_ILLNESS -aspecto I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS -muy I-PRESENT_ILLNESS -relevante I-PRESENT_ILLNESS -considerando I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -ha I-PRESENT_ILLNESS -tenido I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -anteriores I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hemiparesia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -todos I-PRESENT_ILLNESS -han I-PRESENT_ILLNESS -coincidido I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -períodos I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -ha I-PRESENT_ILLNESS -estado I-PRESENT_ILLNESS -hospitalizada. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Antecedentes B-FAMILY_HISTORY -familiares I-FAMILY_HISTORY - I-FAMILY_HISTORY -El I-FAMILY_HISTORY -único I-FAMILY_HISTORY -miembro I-FAMILY_HISTORY -familiar I-FAMILY_HISTORY -que I-FAMILY_HISTORY -tiene I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -personales I-FAMILY_HISTORY -psíquicos I-FAMILY_HISTORY -de I-FAMILY_HISTORY -interés I-FAMILY_HISTORY -es I-FAMILY_HISTORY -la I-FAMILY_HISTORY -hija I-FAMILY_HISTORY -menor I-FAMILY_HISTORY -de I-FAMILY_HISTORY -la I-FAMILY_HISTORY -paciente I-FAMILY_HISTORY -que I-FAMILY_HISTORY -en I-FAMILY_HISTORY -la I-FAMILY_HISTORY -actualidad I-FAMILY_HISTORY -se I-FAMILY_HISTORY -encuentra I-FAMILY_HISTORY -en I-FAMILY_HISTORY -tratamiento I-FAMILY_HISTORY -en I-FAMILY_HISTORY -el I-FAMILY_HISTORY -Centro I-FAMILY_HISTORY -de I-FAMILY_HISTORY -Salud I-FAMILY_HISTORY -Mental I-FAMILY_HISTORY -por I-FAMILY_HISTORY -episodios I-FAMILY_HISTORY -de I-FAMILY_HISTORY -ataques I-FAMILY_HISTORY -de I-FAMILY_HISTORY -pánico. I-FAMILY_HISTORY - I-FAMILY_HISTORY -Por I-FAMILY_HISTORY -otro I-FAMILY_HISTORY -lado, I-FAMILY_HISTORY -como I-FAMILY_HISTORY -se I-FAMILY_HISTORY -aprecia I-FAMILY_HISTORY -en I-FAMILY_HISTORY -la I-FAMILY_HISTORY -figura I-FAMILY_HISTORY -1, I-FAMILY_HISTORY -hay I-FAMILY_HISTORY -varios I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -de I-FAMILY_HISTORY -hemiplejías I-FAMILY_HISTORY -izquierdas I-FAMILY_HISTORY -en I-FAMILY_HISTORY -la I-FAMILY_HISTORY -familia. I-FAMILY_HISTORY -En I-FAMILY_HISTORY -primer I-FAMILY_HISTORY -lugar, I-FAMILY_HISTORY -el I-FAMILY_HISTORY -padre, I-FAMILY_HISTORY -a I-FAMILY_HISTORY -quien I-FAMILY_HISTORY -P. I-FAMILY_HISTORY -describe I-FAMILY_HISTORY -como I-FAMILY_HISTORY -una I-FAMILY_HISTORY -persona I-FAMILY_HISTORY -muy I-FAMILY_HISTORY -autoritaria I-FAMILY_HISTORY -y I-FAMILY_HISTORY -rígida I-FAMILY_HISTORY -("era I-FAMILY_HISTORY -un I-FAMILY_HISTORY -dictador"), I-FAMILY_HISTORY -a I-FAMILY_HISTORY -la I-FAMILY_HISTORY -vez I-FAMILY_HISTORY -que I-FAMILY_HISTORY -lo I-FAMILY_HISTORY -disculpa I-FAMILY_HISTORY -y I-FAMILY_HISTORY -justifica I-FAMILY_HISTORY -aclarando I-FAMILY_HISTORY -que I-FAMILY_HISTORY -la I-FAMILY_HISTORY -situación I-FAMILY_HISTORY -que I-FAMILY_HISTORY -les I-FAMILY_HISTORY -tocó I-FAMILY_HISTORY -vivir I-FAMILY_HISTORY -fue I-FAMILY_HISTORY -muy I-FAMILY_HISTORY -dura. I-FAMILY_HISTORY -En I-FAMILY_HISTORY -segundo I-FAMILY_HISTORY -lugar, I-FAMILY_HISTORY -dos I-FAMILY_HISTORY -de I-FAMILY_HISTORY -sus I-FAMILY_HISTORY -hermanas, I-FAMILY_HISTORY -las I-FAMILY_HISTORY -únicas I-FAMILY_HISTORY -que, I-FAMILY_HISTORY -según I-FAMILY_HISTORY -la I-FAMILY_HISTORY -paciente, I-FAMILY_HISTORY -se I-FAMILY_HISTORY -revelaron I-FAMILY_HISTORY -y I-FAMILY_HISTORY -enfrentaron I-FAMILY_HISTORY -a I-FAMILY_HISTORY -su I-FAMILY_HISTORY -padre I-FAMILY_HISTORY -y I-FAMILY_HISTORY -que I-FAMILY_HISTORY -tenían I-FAMILY_HISTORY -un I-FAMILY_HISTORY -carácter I-FAMILY_HISTORY -más I-FAMILY_HISTORY -fuerte. I-FAMILY_HISTORY -El I-FAMILY_HISTORY -resto I-FAMILY_HISTORY -de I-FAMILY_HISTORY -las I-FAMILY_HISTORY -hermanas, I-FAMILY_HISTORY -son I-FAMILY_HISTORY -más I-FAMILY_HISTORY -sumisas I-FAMILY_HISTORY -y I-FAMILY_HISTORY -aceptaban I-FAMILY_HISTORY -las I-FAMILY_HISTORY -normas I-FAMILY_HISTORY -del I-FAMILY_HISTORY -padre I-FAMILY_HISTORY -aunque I-FAMILY_HISTORY -todas I-FAMILY_HISTORY -coincidieron I-FAMILY_HISTORY -en I-FAMILY_HISTORY -que I-FAMILY_HISTORY -se I-FAMILY_HISTORY -casaron I-FAMILY_HISTORY -a I-FAMILY_HISTORY -edades I-FAMILY_HISTORY -muy I-FAMILY_HISTORY -tempranas I-FAMILY_HISTORY -para I-FAMILY_HISTORY -salir I-FAMILY_HISTORY -de I-FAMILY_HISTORY -casa I-FAMILY_HISTORY -lo I-FAMILY_HISTORY -más I-FAMILY_HISTORY -pronto I-FAMILY_HISTORY -posible. I-FAMILY_HISTORY - I-FAMILY_HISTORY -• B-EXPLORATION -Proceso I-EXPLORATION -de I-EXPLORATION -evaluación I-EXPLORATION - I-EXPLORATION -Instrumentos I-EXPLORATION -de I-EXPLORATION -evaluación I-EXPLORATION - I-EXPLORATION -Para I-EXPLORATION -la I-EXPLORATION -evaluación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -paciente, I-EXPLORATION -además I-EXPLORATION -de I-EXPLORATION +Durante I-EXPLORATION la I-EXPLORATION -entrevista I-EXPLORATION -psicológica I-EXPLORATION +cirugía I-EXPLORATION se I-EXPLORATION -emplearon I-EXPLORATION -los I-EXPLORATION -siguientes I-EXPLORATION -instrumentos: I-EXPLORATION - I-EXPLORATION --Escala I-EXPLORATION -de I-EXPLORATION -Síntomas, I-EXPLORATION -SCL-90-R I-EXPLORATION -(Derogatis, I-EXPLORATION -1977) I-EXPLORATION -(3), I-EXPLORATION -nos I-EXPLORATION -permite I-EXPLORATION -una I-EXPLORATION -evaluación I-EXPLORATION -general I-EXPLORATION -de I-EXPLORATION -síntomas I-EXPLORATION -psicopatológicos. I-EXPLORATION -Es I-EXPLORATION -un I-EXPLORATION -listado I-EXPLORATION -de I-EXPLORATION -comprobación I-EXPLORATION -de I-EXPLORATION -síntomas I-EXPLORATION -recogidos I-EXPLORATION -en I-EXPLORATION -9 I-EXPLORATION -dimensiones I-EXPLORATION +visualizó I-EXPLORATION +superficie I-EXPLORATION +hepática I-EXPLORATION +lisa, I-EXPLORATION +hígado I-EXPLORATION +congestivo I-EXPLORATION +(confirmado I-EXPLORATION +por I-EXPLORATION +biopsia), I-EXPLORATION +vesícula I-EXPLORATION +biliar I-EXPLORATION +presente, I-EXPLORATION con I-EXPLORATION -datos I-EXPLORATION -normativos I-EXPLORATION -españoles I-EXPLORATION +lumen I-EXPLORATION y I-EXPLORATION -propiedades I-EXPLORATION -psicométricas I-EXPLORATION -aceptables I-EXPLORATION -(4). I-EXPLORATION -En I-EXPLORATION -cuanto I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -fiabilidad, I-EXPLORATION -ha I-EXPLORATION -presentado I-EXPLORATION -una I-EXPLORATION -buena I-EXPLORATION -consistencia I-EXPLORATION -interna I-EXPLORATION +bilis I-EXPLORATION en I-EXPLORATION -todas I-EXPLORATION -las I-EXPLORATION -subescalas I-EXPLORATION -(oscilando I-EXPLORATION -la I-EXPLORATION +su I-EXPLORATION +interior. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +colangiografía I-EXPLORATION +intraoperatoria I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +visualizó I-EXPLORATION +una I-EXPLORATION +zona I-EXPLORATION +estenótica I-EXPLORATION +crítica I-EXPLORATION a I-EXPLORATION +nivel I-EXPLORATION +del I-EXPLORATION +conducto I-EXPLORATION +hepático I-EXPLORATION +común I-EXPLORATION +logrando I-EXPLORATION +paso I-EXPLORATION de I-EXPLORATION -Cronbach I-EXPLORATION -de I-EXPLORATION -0, I-EXPLORATION -78 I-EXPLORATION -a I-EXPLORATION -0, I-EXPLORATION -90), I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -una I-EXPLORATION -adecuada I-EXPLORATION -validez I-EXPLORATION -predictiva I-EXPLORATION -(5). I-EXPLORATION -También I-EXPLORATION -ha I-EXPLORATION -demostrado I-EXPLORATION -adecuada I-EXPLORATION -validez I-EXPLORATION -discriminativa, I-EXPLORATION -la I-EXPLORATION -validez I-EXPLORATION -concurrente I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -IIP-C I-EXPLORATION +contraste I-EXPLORATION +hacia I-EXPLORATION +proximal I-EXPLORATION y I-EXPLORATION -el I-EXPLORATION -GHQ-12) I-EXPLORATION -(6). I-EXPLORATION +distal I-EXPLORATION +(intra I-EXPLORATION +y I-EXPLORATION +extra I-EXPLORATION +hepático), I-EXPLORATION +con I-EXPLORATION +vía I-EXPLORATION +biliar I-EXPLORATION +intrahepática I-EXPLORATION +dilatada. I-EXPLORATION I-EXPLORATION --MCMI-II I-EXPLORATION -(Millon, I-EXPLORATION -1987), I-EXPLORATION -es I-EXPLORATION -un I-EXPLORATION -cuestionario I-EXPLORATION -que I-EXPLORATION -consta I-EXPLORATION -de I-EXPLORATION -175 I-EXPLORATION -ítems I-EXPLORATION +Se B-TREATMENT +realizó I-TREATMENT +colecistectomía I-TREATMENT +y I-TREATMENT +disección I-TREATMENT +de I-TREATMENT +conducto I-TREATMENT +hepático I-TREATMENT +común I-TREATMENT +demostrando I-TREATMENT +una I-TREATMENT +estenosis I-TREATMENT +a I-TREATMENT +nivel I-TREATMENT +de I-TREATMENT +éste, I-TREATMENT +causado I-TREATMENT +por I-TREATMENT +un I-TREATMENT +anillo I-TREATMENT +vascular I-TREATMENT +proveniente I-TREATMENT +de I-TREATMENT +arteria I-TREATMENT +hepática I-TREATMENT +derecha. I-TREATMENT +Se I-TREATMENT +seccionó I-TREATMENT +la I-TREATMENT +vía I-TREATMENT +biliar I-TREATMENT +a I-TREATMENT +nivel I-TREATMENT +proximal I-TREATMENT +de I-TREATMENT +la I-TREATMENT +estenosis I-TREATMENT +realizando I-TREATMENT +una I-TREATMENT +hepático-duodeno I-TREATMENT +anastomosis. I-TREATMENT +Se I-TREATMENT +dejó I-TREATMENT +drenaje I-TREATMENT +abdominal I-TREATMENT +y I-TREATMENT +sonda I-TREATMENT +nasogástrica I-TREATMENT +instalada. I-TREATMENT + B-EVOLUTION +La I-EVOLUTION +paciente I-EVOLUTION +evolucionó I-EVOLUTION +favorablemente, I-EVOLUTION +con I-EVOLUTION +débito I-EVOLUTION +en I-EVOLUTION +disminución I-EVOLUTION +por I-EVOLUTION +el I-EVOLUTION +drenaje I-EVOLUTION +retirándose I-EVOLUTION +al I-EVOLUTION +6 I-EVOLUTION +día I-EVOLUTION +y I-EVOLUTION +alimentándose I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +4 I-EVOLUTION +días. I-EVOLUTION +Se I-EVOLUTION +dio I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +8 I-EVOLUTION +días I-EVOLUTION +post I-EVOLUTION +operatorio I-EVOLUTION +con I-EVOLUTION +pruebas I-EVOLUTION +hepáticas I-EVOLUTION +en I-EVOLUTION +disminución I-EVOLUTION +(BT I-EVOLUTION +3, I-EVOLUTION +98, I-EVOLUTION +BD I-EVOLUTION +3, I-EVOLUTION +46, I-EVOLUTION +GOT I-EVOLUTION +266, I-EVOLUTION +GPT I-EVOLUTION +134, I-EVOLUTION +FA I-EVOLUTION +431, I-EVOLUTION +GGT I-EVOLUTION +586). I-EVOLUTION +En I-EVOLUTION +controles I-EVOLUTION +ambulatorios I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +se I-EVOLUTION +encontraba I-EVOLUTION +asintomática, I-EVOLUTION +con I-EVOLUTION +buena I-EVOLUTION +tolerancia I-EVOLUTION +oral, I-EVOLUTION +deposiciones I-EVOLUTION +teñidas I-EVOLUTION +y I-EVOLUTION +exámenes I-EVOLUTION +hepáticos I-EVOLUTION +y I-EVOLUTION +generales I-EVOLUTION +normalizados. I-EVOLUTION + I-EVOLUTION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +71 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con B-EXPLORATION +presencia I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION de I-EXPLORATION -respuesta I-EXPLORATION -verdadero-falso I-EXPLORATION +una I-EXPLORATION +tumoración I-EXPLORATION +excrecente, I-EXPLORATION +ulcerada I-EXPLORATION y I-EXPLORATION -que I-EXPLORATION -informan I-EXPLORATION -sobre I-EXPLORATION -8 I-EXPLORATION -patrones I-EXPLORATION -clínicos I-EXPLORATION -de I-EXPLORATION -personalidad, I-EXPLORATION -3 I-EXPLORATION -formas I-EXPLORATION -graves I-EXPLORATION -de I-EXPLORATION -patología I-EXPLORATION de I-EXPLORATION -personalidad, I-EXPLORATION -6 I-EXPLORATION -síndromes I-EXPLORATION -clínicos I-EXPLORATION +consistencia I-EXPLORATION +dura I-EXPLORATION +en I-EXPLORATION +flanco I-EXPLORATION +derecho I-EXPLORATION de I-EXPLORATION -intensidad I-EXPLORATION -moderada, I-EXPLORATION -y I-EXPLORATION +aproximadamente I-EXPLORATION 3 I-EXPLORATION -síndromes I-EXPLORATION -clínicos I-EXPLORATION -graves. I-EXPLORATION -Las I-EXPLORATION -puntuaciones I-EXPLORATION -se I-EXPLORATION -convierten I-EXPLORATION -en I-EXPLORATION -tasas I-EXPLORATION -base, I-EXPLORATION -cuyo I-EXPLORATION -punto I-EXPLORATION +cm I-EXPLORATION +acompañada I-EXPLORATION de I-EXPLORATION -corte I-EXPLORATION -se I-EXPLORATION -sitúa I-EXPLORATION +otra I-EXPLORATION +similar I-EXPLORATION +de I-EXPLORATION +2, I-EXPLORATION +5 I-EXPLORATION +cm I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -valor I-EXPLORATION +zona I-EXPLORATION +infraclavicular I-EXPLORATION +izquierda. I-EXPLORATION +Presenta I-EXPLORATION +disfagia I-EXPLORATION +a I-EXPLORATION +sólidos I-EXPLORATION +y I-EXPLORATION +líquidos I-EXPLORATION +semanas I-EXPLORATION +después I-EXPLORATION de I-EXPLORATION -75, I-EXPLORATION -siendo I-EXPLORATION -los I-EXPLORATION -valores I-EXPLORATION -superiores I-EXPLORATION -sugestivos I-EXPLORATION +la I-EXPLORATION +aparición I-EXPLORATION de I-EXPLORATION -algún I-EXPLORATION -problema I-EXPLORATION -clínico. I-EXPLORATION -Cuenta I-EXPLORATION +dichas I-EXPLORATION +lesiones, I-EXPLORATION +junto I-EXPLORATION con I-EXPLORATION -medidas I-EXPLORATION +pérdida I-EXPLORATION de I-EXPLORATION -validez I-EXPLORATION -y I-EXPLORATION -sinceridad I-EXPLORATION -(7). I-EXPLORATION - I-EXPLORATION -Resultados I-EXPLORATION +20 I-EXPLORATION +kg I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -evaluación I-EXPLORATION - I-EXPLORATION +peso. I-EXPLORATION En I-EXPLORATION -la I-EXPLORATION -entrevista, I-EXPLORATION -P. I-EXPLORATION -resulta I-EXPLORATION -colaboradora. I-EXPLORATION -No I-EXPLORATION -muestra I-EXPLORATION -total I-EXPLORATION -indiferencia I-EXPLORATION -por I-EXPLORATION -su I-EXPLORATION -hemiparesia, I-EXPLORATION -pero I-EXPLORATION -le I-EXPLORATION -resta I-EXPLORATION -excesiva I-EXPLORATION -importancia, I-EXPLORATION -centrándose I-EXPLORATION -más I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -secuelas I-EXPLORATION -del I-EXPLORATION -síntoma I-EXPLORATION -que I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -etiología. I-EXPLORATION -Se I-EXPLORATION -aprecia I-EXPLORATION -cierta I-EXPLORATION -tendencia I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -somatización I-EXPLORATION -ante I-EXPLORATION -conflictos I-EXPLORATION -personales I-EXPLORATION -y I-EXPLORATION -familiares, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -una I-EXPLORATION -latencia I-EXPLORATION -de I-EXPLORATION -respuesta I-EXPLORATION -larga I-EXPLORATION -y I-EXPLORATION -dificultades I-EXPLORATION -para I-EXPLORATION el I-EXPLORATION -recuerdo I-EXPLORATION -de I-EXPLORATION -nombres I-EXPLORATION -propios I-EXPLORATION +estudio I-EXPLORATION +endoscópico I-EXPLORATION +se I-EXPLORATION +objetiva I-EXPLORATION +una I-EXPLORATION +neoplasia I-EXPLORATION +excrecente I-EXPLORATION y I-EXPLORATION -fechas, I-EXPLORATION -que I-EXPLORATION -mejoran I-EXPLORATION +ulcerada, I-EXPLORATION a I-EXPLORATION -lo I-EXPLORATION -largo I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -entrevista. I-EXPLORATION -Refiere I-EXPLORATION -ciertos I-EXPLORATION -sentimientos I-EXPLORATION +22 I-EXPLORATION +cm I-EXPLORATION de I-EXPLORATION -culpa I-EXPLORATION -en I-EXPLORATION -relación I-EXPLORATION -a I-EXPLORATION la I-EXPLORATION -preocupación I-EXPLORATION +arcada I-EXPLORATION +dental, I-EXPLORATION que I-EXPLORATION -su I-EXPLORATION -estado I-EXPLORATION -de I-EXPLORATION -salud I-EXPLORATION -pueda I-EXPLORATION -producir I-EXPLORATION -en I-EXPLORATION -sus I-EXPLORATION -familiares. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -cuanto I-EXPLORATION -a I-EXPLORATION -su I-EXPLORATION -personalidad, I-EXPLORATION +ocluye I-EXPLORATION +casi I-EXPLORATION +completamente I-EXPLORATION la I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -describe I-EXPLORATION -como I-EXPLORATION -una I-EXPLORATION -persona I-EXPLORATION -sociable, I-EXPLORATION -ansiosa, I-EXPLORATION -muy I-EXPLORATION -activa, I-EXPLORATION -autoexigente I-EXPLORATION -y I-EXPLORATION -controladora. I-EXPLORATION -Asimismo, I-EXPLORATION -coincide I-EXPLORATION +luz I-EXPLORATION +del I-EXPLORATION +esófago I-EXPLORATION con I-EXPLORATION +resultado I-EXPLORATION +histológico I-EXPLORATION +de I-EXPLORATION +carcinoma I-EXPLORATION +epidermoide I-EXPLORATION +infiltrante. I-EXPLORATION +La I-EXPLORATION +anatomía I-EXPLORATION +patológica I-EXPLORATION +de I-EXPLORATION las I-EXPLORATION -características I-EXPLORATION -definitorias I-EXPLORATION -del I-EXPLORATION -patrón I-EXPLORATION +lesiones I-EXPLORATION +dérmicas I-EXPLORATION +revela I-EXPLORATION +infiltración I-EXPLORATION +cutánea I-EXPLORATION +metastásica I-EXPLORATION +por I-EXPLORATION +carcinoma I-EXPLORATION +epidermoide, I-EXPLORATION +inmunohistoquimica I-EXPLORATION +más I-EXPLORATION +paracitoqueratina I-EXPLORATION +alto I-EXPLORATION +peso I-EXPLORATION +molecular I-EXPLORATION +y I-EXPLORATION +vimentina. I-EXPLORATION +El I-EXPLORATION +resto I-EXPLORATION de I-EXPLORATION -conducta I-EXPLORATION -tipo-A I-EXPLORATION -(impaciencia, I-EXPLORATION -competitividad, I-EXPLORATION -hostilidad), I-EXPLORATION -teniendo I-EXPLORATION -en I-EXPLORATION -cuenta I-EXPLORATION +pruebas I-EXPLORATION +complementarias I-EXPLORATION +indicaron I-EXPLORATION la I-EXPLORATION -forma I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +enfermedad I-EXPLORATION +metastásica I-EXPLORATION +ósea I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +costal I-EXPLORATION +izquierdo, I-EXPLORATION +cuerpo I-EXPLORATION +vertebral I-EXPLORATION +D9 I-EXPLORATION +y I-EXPLORATION +hueso I-EXPLORATION +iliaco I-EXPLORATION +derecho. I-EXPLORATION +Finalmente B-TREATMENT +se I-TREATMENT +optó I-TREATMENT +por I-TREATMENT +colocación I-TREATMENT +de I-TREATMENT +prótesis I-TREATMENT +y I-TREATMENT +tratamiento I-TREATMENT +quimioterápico. I-TREATMENT + I-TREATMENT + +Paciente, B-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +masculino, I-PRESENT_ILLNESS +29 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +derivado B-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +año I-DERIVED_FROM/TO +2004 I-DERIVED_FROM/TO +desde I-DERIVED_FROM/TO +endocrinología I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +cirugía I-DERIVED_FROM/TO +maxilofacial I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +diagnóstico I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +tumor I-DERIVED_FROM/TO +maxilar I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +estudio. I-DERIVED_FROM/TO +Sus B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +mórbidos I-PAST_MEDICAL_HISTORY +incluyen I-PAST_MEDICAL_HISTORY +insuficiencia I-PAST_MEDICAL_HISTORY +renal I-PAST_MEDICAL_HISTORY +crónica I-PAST_MEDICAL_HISTORY +diagnosticada I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +18 I-PAST_MEDICAL_HISTORY +años, I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +hemodiálisis I-PAST_MEDICAL_HISTORY +3 I-PAST_MEDICAL_HISTORY +veces I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +semana. I-PAST_MEDICAL_HISTORY +A I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +27 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +detecta, I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +ecotomografía I-PAST_MEDICAL_HISTORY +doppler, I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +presencia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +nódulos I-PAST_MEDICAL_HISTORY +bilaterales I-PAST_MEDICAL_HISTORY +compatibles I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +adenoma I-PAST_MEDICAL_HISTORY +paratiroideo I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +niveles I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +PTH I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +2.448 I-PAST_MEDICAL_HISTORY +pg/ml I-PAST_MEDICAL_HISTORY +(150-500 I-PAST_MEDICAL_HISTORY +pg/ml). I-PAST_MEDICAL_HISTORY +Con I-PAST_MEDICAL_HISTORY +estos I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +diagnosticó I-PAST_MEDICAL_HISTORY +hiperparatiroidismo I-PAST_MEDICAL_HISTORY +secundario. I-PAST_MEDICAL_HISTORY +Se I-PAST_MEDICAL_HISTORY +realiza I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +paratiroidectomía I-PAST_MEDICAL_HISTORY +parcial I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +indica I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +farmacológico I-PAST_MEDICAL_HISTORY +protocolario, I-PAST_MEDICAL_HISTORY +obteniéndose I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +normalización I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +niveles I-PAST_MEDICAL_HISTORY +séricos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +calcio, I-PAST_MEDICAL_HISTORY +pero I-PAST_MEDICAL_HISTORY +manteniéndose I-PAST_MEDICAL_HISTORY +altos I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +niveles I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +paratohormona. I-PAST_MEDICAL_HISTORY +El I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +nota I-PAST_MEDICAL_HISTORY +aumento I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +volumen I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +zona I-PAST_MEDICAL_HISTORY +maxilar I-PAST_MEDICAL_HISTORY +izquierda, I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +crecimiento I-PAST_MEDICAL_HISTORY +lento I-PAST_MEDICAL_HISTORY +pero I-PAST_MEDICAL_HISTORY +progresivo I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +2 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +evolución, I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +2002. I-PAST_MEDICAL_HISTORY +Al B-EXPLORATION +momento I-EXPLORATION +de I-EXPLORATION +consultar I-EXPLORATION en I-EXPLORATION -que I-EXPLORATION +nuestro I-EXPLORATION +servicio, I-EXPLORATION +clínicamente I-EXPLORATION se I-EXPLORATION -manifestaría I-EXPLORATION -considerando I-EXPLORATION +observa I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION +volumen I-EXPLORATION +que I-EXPLORATION +compromete I-EXPLORATION +el I-EXPLORATION +maxilar I-EXPLORATION +superior I-EXPLORATION +izquierdo I-EXPLORATION +en I-EXPLORATION su I-EXPLORATION -género, I-EXPLORATION -edad I-EXPLORATION +cara I-EXPLORATION +anterior, I-EXPLORATION +posterior I-EXPLORATION y I-EXPLORATION -nivel I-EXPLORATION -cultural I-EXPLORATION -(8). I-EXPLORATION -Por I-EXPLORATION -otro I-EXPLORATION -lado, I-EXPLORATION -manifiesta I-EXPLORATION -repetidamente I-EXPLORATION -que I-EXPLORATION -intenta I-EXPLORATION -presentarse I-EXPLORATION -como I-EXPLORATION -una I-EXPLORATION -persona I-EXPLORATION -fuerte I-EXPLORATION +paladar I-EXPLORATION +duro, I-EXPLORATION +de I-EXPLORATION +consistencia I-EXPLORATION +firme, I-EXPLORATION +de I-EXPLORATION +4 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +diámetro, I-EXPLORATION +indoloro, I-EXPLORATION +cubierto I-EXPLORATION +por I-EXPLORATION +piel I-EXPLORATION y I-EXPLORATION -evita I-EXPLORATION -pedir I-EXPLORATION -ayuda I-EXPLORATION -a I-EXPLORATION -sus I-EXPLORATION -familiares I-EXPLORATION -para I-EXPLORATION -no I-EXPLORATION -preocuparlos. I-EXPLORATION -Por I-EXPLORATION -ejemplo, I-EXPLORATION -cuando I-EXPLORATION -empieza I-EXPLORATION -a I-EXPLORATION -percibir I-EXPLORATION -pequeños I-EXPLORATION -indicios I-EXPLORATION +mucosa I-EXPLORATION de I-EXPLORATION -algún I-EXPLORATION -posible I-EXPLORATION -problema I-EXPLORATION -físico I-EXPLORATION -(síntomas I-EXPLORATION -pre-infarto), I-EXPLORATION -no I-EXPLORATION -dice I-EXPLORATION -nada I-EXPLORATION -a I-EXPLORATION -nadie I-EXPLORATION -hasta I-EXPLORATION +aspecto I-EXPLORATION +normal, I-EXPLORATION +sin I-EXPLORATION +alteración I-EXPLORATION +sensitiva, I-EXPLORATION que I-EXPLORATION -la I-EXPLORATION -situación I-EXPLORATION -requiere I-EXPLORATION -acudir I-EXPLORATION -a I-EXPLORATION -Urgencias I-EXPLORATION +produce I-EXPLORATION +asimetría I-EXPLORATION y I-EXPLORATION -el I-EXPLORATION -cuadro I-EXPLORATION -requiere I-EXPLORATION -hospitalización. I-EXPLORATION -Este I-EXPLORATION -funcionamiento, I-EXPLORATION -es I-EXPLORATION -similar I-EXPLORATION -en I-EXPLORATION -lo I-EXPLORATION -referente I-EXPLORATION -a I-EXPLORATION +deformación I-EXPLORATION +facial I-EXPLORATION +evidente. I-EXPLORATION +En I-EXPLORATION los I-EXPLORATION -estados I-EXPLORATION -emocionales. I-EXPLORATION -Paradójicamente, I-EXPLORATION -actúa I-EXPLORATION -en I-EXPLORATION -muchas I-EXPLORATION -ocasiones I-EXPLORATION -como I-EXPLORATION -una I-EXPLORATION -persona I-EXPLORATION -muy I-EXPLORATION -dependiente I-EXPLORATION -con I-EXPLORATION -aquellas I-EXPLORATION -figuras I-EXPLORATION -idealizadas. I-EXPLORATION -No I-EXPLORATION -impresiona I-EXPLORATION -de I-EXPLORATION -histrionismo I-EXPLORATION -o I-EXPLORATION -teatralidad I-EXPLORATION -aunque I-EXPLORATION -sí I-EXPLORATION +exámenes I-EXPLORATION +radiográficos I-EXPLORATION se I-EXPLORATION -advierte I-EXPLORATION -una I-EXPLORATION -actitud I-EXPLORATION -seductora I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -trato I-EXPLORATION -con I-EXPLORATION -los I-EXPLORATION -terapeutas I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION +observan I-EXPLORATION +múltiples I-EXPLORATION +imágenes I-EXPLORATION +osteolíticas I-EXPLORATION que I-EXPLORATION -tiende I-EXPLORATION -a I-EXPLORATION -idealizar, I-EXPLORATION -a I-EXPLORATION +afectan I-EXPLORATION +el I-EXPLORATION +cráneo, I-EXPLORATION la I-EXPLORATION -vez I-EXPLORATION -que I-EXPLORATION -coloca I-EXPLORATION -al I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -profesionales I-EXPLORATION -(médicos, I-EXPLORATION -enfermería) I-EXPLORATION -en I-EXPLORATION +mandíbula I-EXPLORATION +y I-EXPLORATION el I-EXPLORATION -otro I-EXPLORATION -extremo, I-EXPLORATION -desvalorizándolos. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -lo I-EXPLORATION +maxilar I-EXPLORATION +izquierdo. I-EXPLORATION +El I-EXPLORATION +TAC I-EXPLORATION +muestra I-EXPLORATION +tumoración I-EXPLORATION +exofítica I-EXPLORATION que I-EXPLORATION -se I-EXPLORATION -refiere I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -variables I-EXPLORATION -psicopatológicas, I-EXPLORATION -entre I-EXPLORATION -los I-EXPLORATION -resultados I-EXPLORATION +compromete I-EXPLORATION +maxilar I-EXPLORATION +izquierdo, I-EXPLORATION +seno I-EXPLORATION +maxilar, I-EXPLORATION +fosas I-EXPLORATION +nasales I-EXPLORATION +y I-EXPLORATION +piso I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -paciente I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -SCL-90-R I-EXPLORATION -destaca I-EXPLORATION -que I-EXPLORATION -las I-EXPLORATION -puntuaciones I-EXPLORATION -más I-EXPLORATION -altas I-EXPLORATION -se I-EXPLORATION -encuentran I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -dimensiones I-EXPLORATION +órbita I-EXPLORATION +izquierda. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +realiza I-EXPLORATION +biopsia I-EXPLORATION +incisional I-EXPLORATION de I-EXPLORATION -somatización, I-EXPLORATION -depresión I-EXPLORATION -y I-EXPLORATION -ansiedad. I-EXPLORATION -Las I-EXPLORATION -puntuaciones I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -escalas, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -índices I-EXPLORATION -globales, I-EXPLORATION -quedan I-EXPLORATION -por I-EXPLORATION -debajo I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -media I-EXPLORATION -obtenida I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -datos I-EXPLORATION -normativos I-EXPLORATION -españoles. I-EXPLORATION -Esta I-EXPLORATION -información I-EXPLORATION -coincide I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -obtenida I-EXPLORATION -por I-EXPLORATION la I-EXPLORATION -entrevista I-EXPLORATION -clínica I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -cuestionario I-EXPLORATION -de I-EXPLORATION -Millon. I-EXPLORATION - I-EXPLORATION -Respecto I-EXPLORATION -al I-EXPLORATION -perfil I-EXPLORATION -obtenido I-EXPLORATION -por I-EXPLORATION -P. I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -MCMI-II, I-EXPLORATION -comentar I-EXPLORATION -lo I-EXPLORATION -siguiente; I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -escalas I-EXPLORATION -de I-EXPLORATION -validación, I-EXPLORATION -es I-EXPLORATION +lesión. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +histopatológico I-EXPLORATION +describe I-EXPLORATION +múltiples I-EXPLORATION +trabéculas I-EXPLORATION de I-EXPLORATION -resaltar I-EXPLORATION -el I-EXPLORATION -alto I-EXPLORATION -valor I-EXPLORATION -obtenido I-EXPLORATION -en I-EXPLORATION -"deseabilidad", I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -aunque I-EXPLORATION -es I-EXPLORATION -sincera I-EXPLORATION -contestando I-EXPLORATION -la I-EXPLORATION -prueba I-EXPLORATION -tiende I-EXPLORATION -a I-EXPLORATION -hacer I-EXPLORATION -lo I-EXPLORATION -posible I-EXPLORATION -por I-EXPLORATION -presentar I-EXPLORATION -su I-EXPLORATION -mejor I-EXPLORATION -imagen, I-EXPLORATION -a I-EXPLORATION -parecer I-EXPLORATION -sana I-EXPLORATION +tejido I-EXPLORATION +óseo I-EXPLORATION +inmaduro I-EXPLORATION y I-EXPLORATION -causar I-EXPLORATION una I-EXPLORATION -buena I-EXPLORATION -impresión I-EXPLORATION -negando I-EXPLORATION -tener I-EXPLORATION -alguna I-EXPLORATION -problemática I-EXPLORATION -en I-EXPLORATION -particular. I-EXPLORATION -En I-EXPLORATION -lo I-EXPLORATION -referente I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -escalas I-EXPLORATION -clínicas I-EXPLORATION -de I-EXPLORATION -personalidad I-EXPLORATION +matriz I-EXPLORATION +fibrosa I-EXPLORATION +donde I-EXPLORATION se I-EXPLORATION observan I-EXPLORATION -elevaciones I-EXPLORATION -significativas I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -escalas: I-EXPLORATION -"dependiente" I-EXPLORATION -(T: I-EXPLORATION -B I-EXPLORATION -= I-EXPLORATION -98), I-EXPLORATION -"histriónica" I-EXPLORATION -(T: I-EXPLORATION -B= I-EXPLORATION -84), I-EXPLORATION -"compulsiva" I-EXPLORATION -(T.B=87). I-EXPLORATION -Es I-EXPLORATION -decir, I-EXPLORATION -estamos I-EXPLORATION -ante I-EXPLORATION -una I-EXPLORATION -persona I-EXPLORATION -que I-EXPLORATION -necesita I-EXPLORATION -constantemente I-EXPLORATION -aprobación, I-EXPLORATION -atención I-EXPLORATION -y I-EXPLORATION -afecto I-EXPLORATION -por I-EXPLORATION -parte I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -rodean, I-EXPLORATION -esto I-EXPLORATION -lo I-EXPLORATION -conseguiría I-EXPLORATION -por I-EXPLORATION -una I-EXPLORATION -parte I-EXPLORATION -comportándose I-EXPLORATION -de I-EXPLORATION -manera I-EXPLORATION -sumisa, I-EXPLORATION -mostrando I-EXPLORATION -escasa I-EXPLORATION -autonomía I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -notable I-EXPLORATION -falta I-EXPLORATION +células I-EXPLORATION +gigantes I-EXPLORATION +multinucleadas. I-EXPLORATION +Los I-EXPLORATION +exámenes I-EXPLORATION de I-EXPLORATION -asertividad I-EXPLORATION -(escala I-EXPLORATION -"dependiente"). I-EXPLORATION -Y I-EXPLORATION -por I-EXPLORATION -otra, I-EXPLORATION -mediante I-EXPLORATION -cierta I-EXPLORATION -tendencia I-EXPLORATION -a I-EXPLORATION -llamar I-EXPLORATION -la I-EXPLORATION -atención I-EXPLORATION +laboratorio I-EXPLORATION +muestran I-EXPLORATION +valores I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -dem��s I-EXPLORATION -mediante I-EXPLORATION -la I-EXPLORATION -autodramatización I-EXPLORATION -(escala I-EXPLORATION -"histriónica"). I-EXPLORATION -La I-EXPLORATION -puntuación I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -escala I-EXPLORATION -"compulsiva" I-EXPLORATION -podría I-EXPLORATION -indicar I-EXPLORATION -ese I-EXPLORATION -autocontrol I-EXPLORATION +calcio I-EXPLORATION +sérico I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -ante I-EXPLORATION -hacer I-EXPLORATION -aflorar I-EXPLORATION -sus I-EXPLORATION -deseos I-EXPLORATION +12, I-EXPLORATION +6 I-EXPLORATION +mg/dl I-EXPLORATION +(8,1-10,3), I-EXPLORATION +fosfatasa I-EXPLORATION +alcalina: I-EXPLORATION +218 I-EXPLORATION +UI/L I-EXPLORATION +(73-189 I-EXPLORATION +UI/L), I-EXPLORATION +fósforo I-EXPLORATION +inorgánico: I-EXPLORATION +56, I-EXPLORATION +7 I-EXPLORATION +mg/dl I-EXPLORATION +(2, I-EXPLORATION +5-5 I-EXPLORATION +mg/dl) I-EXPLORATION y I-EXPLORATION -sentimientos I-EXPLORATION -reales I-EXPLORATION -ante I-EXPLORATION -determinadas I-EXPLORATION -situaciones I-EXPLORATION -(en I-EXPLORATION -especial I-EXPLORATION -ante I-EXPLORATION -aquellas I-EXPLORATION -que I-EXPLORATION -le I-EXPLORATION -provocan I-EXPLORATION -ira I-EXPLORATION -o I-EXPLORATION -enfado). I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -cuanto I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -escalas I-EXPLORATION -que I-EXPLORATION -indican I-EXPLORATION -síndromes I-EXPLORATION -clínicos I-EXPLORATION -de I-EXPLORATION -intensidad I-EXPLORATION -moderada: I-EXPLORATION -vemos I-EXPLORATION -que I-EXPLORATION -P. I-EXPLORATION -se I-EXPLORATION -encuentra I-EXPLORATION -tensa, I-EXPLORATION -nerviosa I-EXPLORATION -e I-EXPLORATION -inquieta I-EXPLORATION -(escala I-EXPLORATION -de I-EXPLORATION -"ansiedad" I-EXPLORATION -=109), I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -estado I-EXPLORATION -de I-EXPLORATION -ánimo I-EXPLORATION -bajo I-EXPLORATION -crónico I-EXPLORATION -(duración I-EXPLORATION -mayor I-EXPLORATION -de I-EXPLORATION -dos I-EXPLORATION -años) I-EXPLORATION -con I-EXPLORATION -sentimientos I-EXPLORATION -de I-EXPLORATION -desanimo, I-EXPLORATION -apatía, I-EXPLORATION -baja I-EXPLORATION -autoestima I-EXPLORATION -(escala I-EXPLORATION -de I-EXPLORATION -"distimia"=92). I-EXPLORATION -Y I-EXPLORATION -a I-EXPLORATION -ello I-EXPLORATION +PTH I-EXPLORATION +intacta: I-EXPLORATION +2, I-EXPLORATION +448 I-EXPLORATION +pg/ml I-EXPLORATION +(150-500 I-EXPLORATION +pg/ml). I-EXPLORATION +Con I-EXPLORATION +todos I-EXPLORATION +estos I-EXPLORATION +antecedentes I-EXPLORATION se I-EXPLORATION -le I-EXPLORATION -añade I-EXPLORATION -su I-EXPLORATION -tendencia I-EXPLORATION -a I-EXPLORATION -expresar I-EXPLORATION -las I-EXPLORATION -dificultades I-EXPLORATION -psicológicas I-EXPLORATION -a I-EXPLORATION -través I-EXPLORATION -de I-EXPLORATION -canales I-EXPLORATION -somáticos I-EXPLORATION -(escala I-EXPLORATION -"histeriforme" I-EXPLORATION -=105). I-EXPLORATION -Por I-EXPLORATION -último, I-EXPLORATION -respecto I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -escalas I-EXPLORATION -que I-EXPLORATION -indican I-EXPLORATION -trastornos I-EXPLORATION -graves I-EXPLORATION -de I-EXPLORATION -personalidad I-EXPLORATION -(esquizotipica, I-EXPLORATION -límite I-EXPLORATION -y I-EXPLORATION -paranoide) I-EXPLORATION -y I-EXPLORATION -síndromes I-EXPLORATION -clínicos I-EXPLORATION -graves I-EXPLORATION -(pensamiento I-EXPLORATION -psicótico, I-EXPLORATION -depresión I-EXPLORATION -mayor I-EXPLORATION -y I-EXPLORATION -trastorno I-EXPLORATION -delirante) I-EXPLORATION -ninguna I-EXPLORATION -de I-EXPLORATION -ellas I-EXPLORATION -sobrepasa I-EXPLORATION -una I-EXPLORATION -puntuación I-EXPLORATION -Tasa I-EXPLORATION -Base I-EXPLORATION -de I-EXPLORATION -75, I-EXPLORATION -siendo I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -tanto I-EXPLORATION -no I-EXPLORATION -significativas. I-EXPLORATION - I-EXPLORATION - -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -58 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -nuestra I-PRESENT_ILLNESS -unidad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -rehabilitación I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -unidad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -subagudos I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -diagnóstico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Trastorno I-PRESENT_ILLNESS -Esquizofrénico. I-PRESENT_ILLNESS -Su B-PAST_MEDICAL_HISTORY -único I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -54 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -era I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -intervención I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hernia I-PAST_MEDICAL_HISTORY -discal I-PAST_MEDICAL_HISTORY -lumbar. I-PAST_MEDICAL_HISTORY -Es I-PAST_MEDICAL_HISTORY -diestro I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -escritura I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -precisa I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -corrección I-PAST_MEDICAL_HISTORY -óptica I-PAST_MEDICAL_HISTORY +diagnosticó I-EXPLORATION +tumor I-EXPLORATION +pardo I-EXPLORATION +del I-EXPLORATION +maxilar I-EXPLORATION +superior I-EXPLORATION +izquierdo. I-EXPLORATION +Se B-TREATMENT +decide I-TREATMENT +realizar I-TREATMENT +la I-TREATMENT +paratiroidectomía I-TREATMENT +total I-TREATMENT +y I-TREATMENT +mantener I-TREATMENT +conducta I-TREATMENT +expectante I-TREATMENT +respecto I-TREATMENT +al I-TREATMENT +tumor I-TREATMENT +pardo, I-TREATMENT +esperando I-TREATMENT +una I-TREATMENT +eventual I-TREATMENT +remisión I-TREATMENT +espontánea I-TREATMENT +con I-TREATMENT +la I-TREATMENT +normalización I-TREATMENT +de I-TREATMENT +los I-TREATMENT +valores I-TREATMENT +de I-TREATMENT +PTH, I-TREATMENT +calcio, I-TREATMENT +fósforo I-TREATMENT +y I-TREATMENT +fosfatasa I-TREATMENT +alcalina. I-TREATMENT +El I-TREATMENT +plan I-TREATMENT +de I-TREATMENT +tratamiento I-TREATMENT +incluye I-TREATMENT +también I-TREATMENT +controles I-TREATMENT +periódicos I-TREATMENT +clínicos, I-TREATMENT +radiográficos I-TREATMENT +y I-TREATMENT +de I-TREATMENT +laboratorio I-TREATMENT +para I-TREATMENT +evaluar I-TREATMENT +el I-TREATMENT +comportamiento I-TREATMENT +de I-TREATMENT +las I-TREATMENT +lesiones I-TREATMENT +craneomaxilofaciales. I-TREATMENT + I-TREATMENT +Tras B-EVOLUTION +2 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +efectuada I-EVOLUTION +la I-EVOLUTION +paratiroidectomía I-EVOLUTION +total I-EVOLUTION +y I-EVOLUTION +alcanzados I-EVOLUTION +los I-EVOLUTION +valores I-EVOLUTION +normales I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +función I-EVOLUTION +de I-EVOLUTION +PTH, I-EVOLUTION +no I-EVOLUTION +se I-EVOLUTION +evidencia I-EVOLUTION +remisión I-EVOLUTION +tumoral I-EVOLUTION +maxilar. I-EVOLUTION +Considerando B-TREATMENT +el I-TREATMENT +compromiso I-TREATMENT +de I-TREATMENT +las I-TREATMENT +estructuras I-TREATMENT +anatómicas I-TREATMENT +vecinas I-TREATMENT +y I-TREATMENT +las I-TREATMENT +posibles I-TREATMENT +complicaciones I-TREATMENT +se I-TREATMENT +decide I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +quirúrgico I-TREATMENT +de I-TREATMENT +la I-TREATMENT +lesión. I-TREATMENT + I-TREATMENT +Bajo I-TREATMENT +anestesia I-TREATMENT +general I-TREATMENT +e I-TREATMENT +intubación I-TREATMENT +nasotraqueal I-TREATMENT +se I-TREATMENT +realiza I-TREATMENT +incisión I-TREATMENT +en I-TREATMENT +la I-TREATMENT +cara I-TREATMENT +interna I-TREATMENT +del I-TREATMENT +labio I-TREATMENT +superior I-TREATMENT +desde I-TREATMENT +la I-TREATMENT +línea I-TREATMENT +media I-TREATMENT +hasta I-TREATMENT +la I-TREATMENT +tuberosidad. I-TREATMENT +Se I-TREATMENT +levanta I-TREATMENT +colgajo I-TREATMENT +mucoperióstico I-TREATMENT +hasta I-TREATMENT +el I-TREATMENT +penacho I-TREATMENT +suborbitario, I-TREATMENT +exponiéndose I-TREATMENT +ampliamente I-TREATMENT +el I-TREATMENT +tumor. I-TREATMENT +Se I-TREATMENT +realiza I-TREATMENT +exéresis I-TREATMENT +de I-TREATMENT +gran I-TREATMENT +parte I-TREATMENT +de I-TREATMENT +la I-TREATMENT +lesión I-TREATMENT +a I-TREATMENT +través I-TREATMENT +de I-TREATMENT +osteotomía I-TREATMENT +con I-TREATMENT +sierra I-TREATMENT +reciprocante I-TREATMENT +en I-TREATMENT +zona I-TREATMENT +pediculada I-TREATMENT +que I-TREATMENT +se I-TREATMENT +encuentra I-TREATMENT +adosa I-TREATMENT +a I-TREATMENT +la I-TREATMENT +pared I-TREATMENT +anterior I-TREATMENT +y I-TREATMENT +lateral I-TREATMENT +del I-TREATMENT +seno I-TREATMENT +maxilar, I-TREATMENT +a I-TREATMENT +continuación I-TREATMENT +se I-TREATMENT +realiza I-TREATMENT +la I-TREATMENT +remodelación I-TREATMENT +ósea I-TREATMENT +con I-TREATMENT +fresas I-TREATMENT +tipo I-TREATMENT +pimpollo, I-TREATMENT +conservando I-TREATMENT +la I-TREATMENT +pared I-TREATMENT +de I-TREATMENT +seno I-TREATMENT +maxilar I-TREATMENT +y I-TREATMENT +penacho I-TREATMENT +suborbitario, I-TREATMENT +sin I-TREATMENT +necesidad I-TREATMENT +de I-TREATMENT +injerto I-TREATMENT +óseo. I-TREATMENT +Se I-TREATMENT +logra I-TREATMENT +cierre I-TREATMENT +por I-TREATMENT +primera I-TREATMENT +intención. I-TREATMENT +La B-EVOLUTION +evolución I-EVOLUTION +postoperatoria I-EVOLUTION +es I-EVOLUTION +satisfactoria, I-EVOLUTION +siendo I-EVOLUTION +dado I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +a I-EVOLUTION +las I-EVOLUTION +72 I-EVOLUTION +h. I-EVOLUTION + I-EVOLUTION +Se I-EVOLUTION +realizan I-EVOLUTION +controles I-EVOLUTION +postoperatorios I-EVOLUTION +clínicos I-EVOLUTION +y I-EVOLUTION +radiográficos, I-EVOLUTION +se I-EVOLUTION +evidencia I-EVOLUTION +clínicamente I-EVOLUTION +simetría I-EVOLUTION +facial, I-EVOLUTION +sin I-EVOLUTION +compromiso I-EVOLUTION +de I-EVOLUTION +sensibilidad I-EVOLUTION +y I-EVOLUTION +ausencia I-EVOLUTION +de I-EVOLUTION +recurrencia I-EVOLUTION +durante I-EVOLUTION +los I-EVOLUTION +7 I-EVOLUTION +años I-EVOLUTION +desde I-EVOLUTION +la I-EVOLUTION +resección I-EVOLUTION +del I-EVOLUTION +tumor. I-EVOLUTION + I-EVOLUTION + +La B-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +índice I-PRESENT_ILLNESS +(PAF19) I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +femenino I-PRESENT_ILLNESS +consultó I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +41 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +(2004) I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +síndrome I-PRESENT_ILLNESS +anémico. I-PRESENT_ILLNESS +Como B-EXPLORATION +parte I-EXPLORATION +de I-EXPLORATION +su I-EXPLORATION +estudio I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +endoscopia I-EXPLORATION +digestiva I-EXPLORATION +alta I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +mostró I-EXPLORATION +hallazgos I-EXPLORATION +patológicos I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +colonoscopia I-EXPLORATION +completa I-EXPLORATION +que I-EXPLORATION +demostró I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +múltiples I-EXPLORATION +pólipos I-EXPLORATION +sésiles I-EXPLORATION +(más I-EXPLORATION +de I-EXPLORATION +100) I-EXPLORATION +y I-EXPLORATION +pediculados I-EXPLORATION +(más I-EXPLORATION +de I-EXPLORATION +15), I-EXPLORATION +desde I-EXPLORATION +el I-EXPLORATION +margen I-EXPLORATION +anal I-EXPLORATION +hasta I-EXPLORATION +el I-EXPLORATION +ciego. I-EXPLORATION +A I-EXPLORATION +nivel I-EXPLORATION +cecal I-EXPLORATION +se I-EXPLORATION +evidenció I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +proliferativa I-EXPLORATION +de I-EXPLORATION +aproximadamente I-EXPLORATION +2, I-EXPLORATION +5 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +diámetro I-EXPLORATION +mayor, I-EXPLORATION +cuya I-EXPLORATION +biopsia I-EXPLORATION +confirmó I-EXPLORATION +un I-EXPLORATION +adenocarcinoma I-EXPLORATION +tubular I-EXPLORATION +moderadamente I-EXPLORATION +diferenciado. I-EXPLORATION +El I-EXPLORATION +diagnóstico I-EXPLORATION +preliminar I-EXPLORATION +fue I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +PAF I-EXPLORATION +asociada I-EXPLORATION +a I-EXPLORATION +un I-EXPLORATION +adenocarcinoma I-EXPLORATION +cecal. I-EXPLORATION +El B-TREATMENT +estudio I-TREATMENT +de I-TREATMENT +etapificación I-TREATMENT +con I-TREATMENT +TAC I-TREATMENT +(tomografía I-TREATMENT +abdominal I-TREATMENT +computarizada) I-TREATMENT +de I-TREATMENT +abdomen I-TREATMENT +y I-TREATMENT +pelvis I-TREATMENT +no I-TREATMENT +mostró I-TREATMENT +signos I-TREATMENT +de I-TREATMENT +diseminación I-TREATMENT +tumoral, I-TREATMENT +realizándose I-TREATMENT +una I-TREATMENT +colectomía I-TREATMENT +total I-TREATMENT +con I-TREATMENT +íleorrectoanastomosis. I-TREATMENT +El B-EXPLORATION +estudio I-EXPLORATION +anatomopatológico I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +pieza I-EXPLORATION +quirúrgica I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +tumoral I-EXPLORATION +de I-EXPLORATION +3 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +diámetro I-EXPLORATION +con I-EXPLORATION +invasión I-EXPLORATION +hasta I-EXPLORATION +la I-EXPLORATION +subserosa I-EXPLORATION +y I-EXPLORATION +compromiso I-EXPLORATION +linfonodal. I-EXPLORATION +La I-EXPLORATION +mucosa I-EXPLORATION +del I-EXPLORATION +resto I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +pieza I-EXPLORATION +resecada I-EXPLORATION +presentaba I-EXPLORATION +un I-EXPLORATION +centenar I-EXPLORATION +de I-EXPLORATION +pólipos I-EXPLORATION +sésiles I-EXPLORATION +y I-EXPLORATION +pediculados, I-EXPLORATION +abollonados I-EXPLORATION +y I-EXPLORATION +lisos I-EXPLORATION +de I-EXPLORATION +0, I-EXPLORATION +2 I-EXPLORATION +a I-EXPLORATION +2 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +diámetro I-EXPLORATION +mayor. I-EXPLORATION +Por B-TREATMENT +tratarse I-TREATMENT +de I-TREATMENT +una I-TREATMENT +paciente I-TREATMENT +en I-TREATMENT +etapa I-TREATMENT +III I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +un I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +quimioterapia I-TREATMENT +adyuvante I-TREATMENT +en I-TREATMENT +base I-TREATMENT +a I-TREATMENT +5-fluorouracilo I-TREATMENT +y I-TREATMENT +leucovorina. I-TREATMENT +Hasta B-EVOLUTION +la I-EVOLUTION +fecha I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +ha I-EVOLUTION +completado I-EVOLUTION +70 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +seguimiento I-EVOLUTION +sin I-EVOLUTION +evidencia I-EVOLUTION +de I-EVOLUTION +enfermedad. I-EVOLUTION + I-EVOLUTION +Debido B-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +su I-DERIVED_FROM/TO +historia I-DERIVED_FROM/TO +clínica I-DERIVED_FROM/TO +(poliposis I-DERIVED_FROM/TO +colónica I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +CCR I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +edad I-DERIVED_FROM/TO +temprana), I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +paciente I-DERIVED_FROM/TO +fue I-DERIVED_FROM/TO +derivada I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +registro I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +tumores I-DERIVED_FROM/TO +hereditarios I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +definir I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +estudio I-DERIVED_FROM/TO +genético I-DERIVED_FROM/TO +apropiado. I-DERIVED_FROM/TO +Este I-DERIVED_FROM/TO +registro I-DERIVED_FROM/TO +incorpora I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +pacientes I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +sospecha I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +enfermedades I-DERIVED_FROM/TO +hereditarias I-DERIVED_FROM/TO +(poliposis I-DERIVED_FROM/TO +adenomatosa I-DERIVED_FROM/TO +familiar, I-DERIVED_FROM/TO +síndrome I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Lynch, I-DERIVED_FROM/TO +síndrome I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Peutz-Jeghers, I-DERIVED_FROM/TO +entre I-DERIVED_FROM/TO +otros) I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +finalidad I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +educar I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +los I-DERIVED_FROM/TO +pacientes I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +familiares I-DERIVED_FROM/TO +respecto I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +su I-DERIVED_FROM/TO +enfermedad, I-DERIVED_FROM/TO +predisposición I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +desarrollarla I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +transmitirla I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +su I-DERIVED_FROM/TO +descendencia, I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +este I-DERIVED_FROM/TO +modo I-DERIVED_FROM/TO +prevenir I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +desarrollo I-DERIVED_FROM/TO +del I-DERIVED_FROM/TO +CCR I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +aquellos I-DERIVED_FROM/TO +familiares I-DERIVED_FROM/TO +asintomáticos. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +El B-FAMILY_HISTORY +análisis I-FAMILY_HISTORY +de I-FAMILY_HISTORY +la I-FAMILY_HISTORY +genealogía I-FAMILY_HISTORY +de I-FAMILY_HISTORY +la I-FAMILY_HISTORY +paciente I-FAMILY_HISTORY +índice I-FAMILY_HISTORY +demostró I-FAMILY_HISTORY +consanguinidad I-FAMILY_HISTORY +de I-FAMILY_HISTORY +los I-FAMILY_HISTORY +padres, I-FAMILY_HISTORY +sin I-FAMILY_HISTORY +historia I-FAMILY_HISTORY +de I-FAMILY_HISTORY +poliposis I-FAMILY_HISTORY +o I-FAMILY_HISTORY +CCR I-FAMILY_HISTORY +en I-FAMILY_HISTORY +ellos. I-FAMILY_HISTORY +Además I-FAMILY_HISTORY +permitió I-FAMILY_HISTORY +identificar I-FAMILY_HISTORY +a I-FAMILY_HISTORY +una I-FAMILY_HISTORY +hermana I-FAMILY_HISTORY +(de I-FAMILY_HISTORY +un I-FAMILY_HISTORY +total I-FAMILY_HISTORY +de I-FAMILY_HISTORY +12 I-FAMILY_HISTORY +hermanos) I-FAMILY_HISTORY +que I-FAMILY_HISTORY +presentó I-FAMILY_HISTORY +CCR, I-FAMILY_HISTORY +a I-FAMILY_HISTORY +la I-FAMILY_HISTORY +que I-FAMILY_HISTORY +identificamos I-FAMILY_HISTORY +como I-FAMILY_HISTORY +PAF585. I-FAMILY_HISTORY +Ella I-FAMILY_HISTORY +presentó I-FAMILY_HISTORY +un I-FAMILY_HISTORY +cáncer I-FAMILY_HISTORY +de I-FAMILY_HISTORY +colon I-FAMILY_HISTORY +derecho I-FAMILY_HISTORY +con I-FAMILY_HISTORY +invasión I-FAMILY_HISTORY +hasta I-FAMILY_HISTORY +la I-FAMILY_HISTORY +subserosa I-FAMILY_HISTORY +y I-FAMILY_HISTORY +compromiso I-FAMILY_HISTORY +linfonodal I-FAMILY_HISTORY +a I-FAMILY_HISTORY +los I-FAMILY_HISTORY +53 I-FAMILY_HISTORY +años I-FAMILY_HISTORY +que I-FAMILY_HISTORY +fue I-FAMILY_HISTORY +tratado I-FAMILY_HISTORY +con I-FAMILY_HISTORY +cirugía I-FAMILY_HISTORY +y I-FAMILY_HISTORY +quimioterapia I-FAMILY_HISTORY +adyuvante. I-FAMILY_HISTORY +Un I-FAMILY_HISTORY +año I-FAMILY_HISTORY +después, I-FAMILY_HISTORY +la I-FAMILY_HISTORY +colonoscopia I-FAMILY_HISTORY +de I-FAMILY_HISTORY +control I-FAMILY_HISTORY +mostró I-FAMILY_HISTORY +dos I-FAMILY_HISTORY +nuevos I-FAMILY_HISTORY +tumores I-FAMILY_HISTORY +sincrónicos, I-FAMILY_HISTORY +uno I-FAMILY_HISTORY +en I-FAMILY_HISTORY +colon I-FAMILY_HISTORY +sigmoides I-FAMILY_HISTORY +a I-FAMILY_HISTORY +35 I-FAMILY_HISTORY +cm I-FAMILY_HISTORY +del I-FAMILY_HISTORY +margen I-FAMILY_HISTORY +anal I-FAMILY_HISTORY +y I-FAMILY_HISTORY +otro I-FAMILY_HISTORY +cáncer I-FAMILY_HISTORY +en I-FAMILY_HISTORY +recto I-FAMILY_HISTORY +inferior I-FAMILY_HISTORY +(adenocarcinoma I-FAMILY_HISTORY +tubular I-FAMILY_HISTORY +invasor). I-FAMILY_HISTORY +Cabe I-FAMILY_HISTORY +destacar I-FAMILY_HISTORY +que I-FAMILY_HISTORY +el I-FAMILY_HISTORY +informe I-FAMILY_HISTORY +médico I-FAMILY_HISTORY +de I-FAMILY_HISTORY +la I-FAMILY_HISTORY +paciente I-FAMILY_HISTORY +no I-FAMILY_HISTORY +registra I-FAMILY_HISTORY +la I-FAMILY_HISTORY +presencia I-FAMILY_HISTORY +de I-FAMILY_HISTORY +poliposis I-FAMILY_HISTORY +adenomatosa I-FAMILY_HISTORY +colónica. I-FAMILY_HISTORY +La I-FAMILY_HISTORY +paciente I-FAMILY_HISTORY +evolucionó I-FAMILY_HISTORY +tórpidamente I-FAMILY_HISTORY +falleciendo I-FAMILY_HISTORY +a I-FAMILY_HISTORY +los I-FAMILY_HISTORY +4 I-FAMILY_HISTORY +meses I-FAMILY_HISTORY +posterior I-FAMILY_HISTORY +a I-FAMILY_HISTORY +la I-FAMILY_HISTORY +cirugía I-FAMILY_HISTORY +debido I-FAMILY_HISTORY +a I-FAMILY_HISTORY +un I-FAMILY_HISTORY +cuadro I-FAMILY_HISTORY +séptico I-FAMILY_HISTORY +secundario. I-FAMILY_HISTORY + I-FAMILY_HISTORY +Con I-FAMILY_HISTORY +respecto I-FAMILY_HISTORY +a I-FAMILY_HISTORY +los I-FAMILY_HISTORY +demás I-FAMILY_HISTORY +hermanos, I-FAMILY_HISTORY +cinco I-FAMILY_HISTORY +de I-FAMILY_HISTORY +ellos I-FAMILY_HISTORY +fallecieron I-FAMILY_HISTORY +en I-FAMILY_HISTORY +la I-FAMILY_HISTORY +infancia I-FAMILY_HISTORY +por I-FAMILY_HISTORY +accidentes I-FAMILY_HISTORY +y I-FAMILY_HISTORY +enfermedades I-FAMILY_HISTORY +no I-FAMILY_HISTORY +relacionadas I-FAMILY_HISTORY +al I-FAMILY_HISTORY +cáncer. I-FAMILY_HISTORY +En I-FAMILY_HISTORY +los I-FAMILY_HISTORY +cinco I-FAMILY_HISTORY +hermanos I-FAMILY_HISTORY +vivos, I-FAMILY_HISTORY +la I-FAMILY_HISTORY +paciente I-FAMILY_HISTORY +índice I-FAMILY_HISTORY +no I-FAMILY_HISTORY +declara I-FAMILY_HISTORY +más I-FAMILY_HISTORY +casos I-FAMILY_HISTORY +afectados I-FAMILY_HISTORY +de I-FAMILY_HISTORY +poliposis I-FAMILY_HISTORY +o I-FAMILY_HISTORY +CCR, I-FAMILY_HISTORY +sin I-FAMILY_HISTORY +embargo, I-FAMILY_HISTORY +desconocemos I-FAMILY_HISTORY +si I-FAMILY_HISTORY +ellos I-FAMILY_HISTORY +se I-FAMILY_HISTORY +han I-FAMILY_HISTORY +realizado I-FAMILY_HISTORY +estudios I-FAMILY_HISTORY +colonoscópicos. I-FAMILY_HISTORY + I-FAMILY_HISTORY +Estudio B-EXPLORATION +genético I-EXPLORATION + I-EXPLORATION +Obtención I-EXPLORATION +del I-EXPLORATION +ADN I-EXPLORATION +genómico I-EXPLORATION +desde I-EXPLORATION +sangre I-EXPLORATION +periférica: I-EXPLORATION +el I-EXPLORATION +ADN I-EXPLORATION +genómico I-EXPLORATION +fue I-EXPLORATION +aislado I-EXPLORATION +a I-EXPLORATION +partir I-EXPLORATION +de I-EXPLORATION +10 I-EXPLORATION +ml I-EXPLORATION +de I-EXPLORATION +sangre I-EXPLORATION +venosa I-EXPLORATION +periférica, I-EXPLORATION +utilizando I-EXPLORATION +el I-EXPLORATION +protocolo I-EXPLORATION +descrito I-EXPLORATION +por I-EXPLORATION +Lahiri I-EXPLORATION +y I-EXPLORATION +Nurnberger I-EXPLORATION +(1991 I-EXPLORATION +) I-EXPLORATION +9. I-EXPLORATION + I-EXPLORATION +Este I-EXPLORATION +ADN I-EXPLORATION +fue I-EXPLORATION +previamente I-EXPLORATION +estudiado I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +análisis I-EXPLORATION +molecular I-EXPLORATION +del I-EXPLORATION +gen I-EXPLORATION +APC, I-EXPLORATION +el I-EXPLORATION +cual I-EXPLORATION +resultó I-EXPLORATION +negativo8. I-EXPLORATION + I-EXPLORATION +Análisis I-EXPLORATION +mutacional I-EXPLORATION +del I-EXPLORATION +gen I-EXPLORATION +MUTYH: I-EXPLORATION +Los I-EXPLORATION +16 I-EXPLORATION +exones I-EXPLORATION +del I-EXPLORATION +gen I-EXPLORATION +MUTYH I-EXPLORATION +fueron I-EXPLORATION +amplificados I-EXPLORATION +mediante I-EXPLORATION +la I-EXPLORATION +técnica I-EXPLORATION +de I-EXPLORATION +PCR I-EXPLORATION +(reacción I-EXPLORATION +en I-EXPLORATION +cadena I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +polimerasa) I-EXPLORATION +usando I-EXPLORATION +los I-EXPLORATION +partidores I-EXPLORATION +descritos I-EXPLORATION +por I-EXPLORATION +Kim I-EXPLORATION +y I-EXPLORATION +colaboradores, I-EXPLORATION +en I-EXPLORATION +200610. I-EXPLORATION +Reacciones I-EXPLORATION +de I-EXPLORATION +PCR I-EXPLORATION +fueron I-EXPLORATION +realizadas I-EXPLORATION +en I-EXPLORATION +un I-EXPLORATION +volumen I-EXPLORATION +total I-EXPLORATION +de I-EXPLORATION +50 I-EXPLORATION +Ql I-EXPLORATION +que I-EXPLORATION +contiene I-EXPLORATION +100 I-EXPLORATION +ng I-EXPLORATION +de I-EXPLORATION +ADN I-EXPLORATION +genómico, I-EXPLORATION +25 I-EXPLORATION +pmoles I-EXPLORATION +de I-EXPLORATION +cada I-EXPLORATION +partidor, I-EXPLORATION +0, I-EXPLORATION +2 I-EXPLORATION +mM I-EXPLORATION +de I-EXPLORATION +cada I-EXPLORATION +uno I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +dNTPs, I-EXPLORATION +1, I-EXPLORATION +5 I-EXPLORATION +mM I-EXPLORATION +MgCl2 I-EXPLORATION +1X I-EXPLORATION +del I-EXPLORATION +amortiguador I-EXPLORATION +suministrado I-EXPLORATION +por I-EXPLORATION +la I-EXPLORATION +enzima I-EXPLORATION +y I-EXPLORATION +1U I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +enzima I-EXPLORATION +Platinum I-EXPLORATION +Taq I-EXPLORATION +ADN I-EXPLORATION +polimerasa I-EXPLORATION +(Invitrogen, I-EXPLORATION +Sao I-EXPLORATION +Paulo, I-EXPLORATION +Brasil). I-EXPLORATION +La I-EXPLORATION +amplificación I-EXPLORATION +fue I-EXPLORATION +realizada I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +siguiente I-EXPLORATION +protocolo: I-EXPLORATION +una I-EXPLORATION +desnaturación I-EXPLORATION +inicial I-EXPLORATION +de I-EXPLORATION +1 I-EXPLORATION +min I-EXPLORATION +a I-EXPLORATION +95°C, I-EXPLORATION +seguido I-EXPLORATION +por I-EXPLORATION +30 I-EXPLORATION +ciclos I-EXPLORATION +de I-EXPLORATION +30 I-EXPLORATION +seg I-EXPLORATION +a I-EXPLORATION +95°C, I-EXPLORATION +30 I-EXPLORATION +seg I-EXPLORATION +a I-EXPLORATION +una I-EXPLORATION +temperatura I-EXPLORATION +de I-EXPLORATION +apareamiento I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +partidores I-EXPLORATION +(rango I-EXPLORATION +50-58°C), I-EXPLORATION +30 I-EXPLORATION +seg I-EXPLORATION +a I-EXPLORATION +72°C, I-EXPLORATION +y I-EXPLORATION +un I-EXPLORATION +paso I-EXPLORATION +de I-EXPLORATION +extensión I-EXPLORATION +final I-EXPLORATION +de I-EXPLORATION +10 I-EXPLORATION +min I-EXPLORATION +a I-EXPLORATION +72°C. I-EXPLORATION +Los I-EXPLORATION +productos I-EXPLORATION +amplificados I-EXPLORATION +fueron I-EXPLORATION +posteriormente I-EXPLORATION +analizados I-EXPLORATION +mediante I-EXPLORATION +dos I-EXPLORATION +técnicas I-EXPLORATION +de I-EXPLORATION +alta I-EXPLORATION +sensibilidad I-EXPLORATION +para I-EXPLORATION +la I-EXPLORATION +detección I-EXPLORATION +de I-EXPLORATION +alteraciones I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +secuencia I-EXPLORATION +del I-EXPLORATION +ADN, I-EXPLORATION +que I-EXPLORATION +incluye I-EXPLORATION +la I-EXPLORATION +técnica I-EXPLORATION +de I-EXPLORATION +SSCP I-EXPLORATION +(single I-EXPLORATION +strand I-EXPLORATION +conformation I-EXPLORATION +polymorphism) I-EXPLORATION +y I-EXPLORATION +secuenciación I-EXPLORATION +de I-EXPLORATION +ADN. I-EXPLORATION +Brevemente, I-EXPLORATION +los I-EXPLORATION +productos I-EXPLORATION +de I-EXPLORATION +PCR I-EXPLORATION +fueron I-EXPLORATION +desnaturados I-EXPLORATION +a I-EXPLORATION +95°C I-EXPLORATION +por I-EXPLORATION +5 I-EXPLORATION +min, I-EXPLORATION +enfriados I-EXPLORATION +en I-EXPLORATION +hielo I-EXPLORATION +por I-EXPLORATION +5 I-EXPLORATION +min, I-EXPLORATION +y I-EXPLORATION +resueltos I-EXPLORATION +por I-EXPLORATION +electroforesis I-EXPLORATION +en I-EXPLORATION +geles I-EXPLORATION +de I-EXPLORATION +poliacrilamida I-EXPLORATION +MDE I-EXPLORATION +0, I-EXPLORATION +5X I-EXPLORATION + I-EXPLORATION +(FMC I-EXPLORATION +Bioproducts), I-EXPLORATION +aplicando I-EXPLORATION +una I-EXPLORATION +corriente I-EXPLORATION +de I-EXPLORATION +3 I-EXPLORATION +W I-EXPLORATION +a I-EXPLORATION +18°C I-EXPLORATION +por I-EXPLORATION +12 I-EXPLORATION +h. I-EXPLORATION +Después I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +electroforesis, I-EXPLORATION +los I-EXPLORATION +geles I-EXPLORATION +fueron I-EXPLORATION +teñidos I-EXPLORATION +con I-EXPLORATION +nitrato I-EXPLORATION +de I-EXPLORATION +plata I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +fin I-EXPLORATION +de I-EXPLORATION +visualizar I-EXPLORATION +las I-EXPLORATION +bandas I-EXPLORATION +de I-EXPLORATION +ADN. I-EXPLORATION +Los I-EXPLORATION +productos I-EXPLORATION +de I-EXPLORATION +PCR I-EXPLORATION +que I-EXPLORATION +presentaron I-EXPLORATION +una I-EXPLORATION +migración I-EXPLORATION +anormal I-EXPLORATION +en I-EXPLORATION +relación I-EXPLORATION +al I-EXPLORATION +control, I-EXPLORATION +fueron I-EXPLORATION +secuenciados. I-EXPLORATION +Las I-EXPLORATION +mutaciones I-EXPLORATION +fueron I-EXPLORATION +analizadas I-EXPLORATION +y I-EXPLORATION +confirmadas I-EXPLORATION +por I-EXPLORATION +dos I-EXPLORATION +reacciones I-EXPLORATION +de I-EXPLORATION +PCR I-EXPLORATION +independientes I-EXPLORATION +y I-EXPLORATION +por I-EXPLORATION +secuenciación I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +dos I-EXPLORATION +hebras I-EXPLORATION +de I-EXPLORATION +ADN. I-EXPLORATION +La I-EXPLORATION +mutación I-EXPLORATION +se I-EXPLORATION +nombró I-EXPLORATION +de I-EXPLORATION +acuerdo I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +nomenclatura I-EXPLORATION +propuesta I-EXPLORATION +por I-EXPLORATION +la I-EXPLORATION +Human I-EXPLORATION +Genome I-EXPLORATION +Variation I-EXPLORATION +Society I-EXPLORATION +(www. I-EXPLORATION +hgvs.org/mutnomen/). I-EXPLORATION + I-EXPLORATION + +Paciente B-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +21 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +sin B-FAMILY_HISTORY +historia I-FAMILY_HISTORY +familiar I-FAMILY_HISTORY +de I-FAMILY_HISTORY +interés, I-FAMILY_HISTORY +y B-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +intervención I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +estrabismo I-PAST_MEDICAL_HISTORY +6 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +antes I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +ex-fumadora I-PAST_MEDICAL_HISTORY +(10 I-PAST_MEDICAL_HISTORY +cigarrillos/día). I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Inicia B-PRESENT_ILLNESS +estudio I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +otorrinolaringólogo I-PRESENT_ILLNESS +(ORL) I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dificultad I-PRESENT_ILLNESS +respiratoria I-PRESENT_ILLNESS +nasal I-PRESENT_ILLNESS +derecha I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +gusto, I-PRESENT_ILLNESS +anosmia, I-PRESENT_ILLNESS +epístaxis I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +epífora I-PRESENT_ILLNESS +derecha I-PRESENT_ILLNESS +ocasional, I-PRESENT_ILLNESS +asociado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +intensa I-PRESENT_ILLNESS +cefalea, I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +ingresa I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +iniciar I-PRESENT_ILLNESS +estudio. I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +ORL I-EXPLORATION +se I-EXPLORATION +aprecia I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +que I-EXPLORATION +ocupa I-EXPLORATION +toda I-EXPLORATION +la I-EXPLORATION +fosa I-EXPLORATION +nasal I-EXPLORATION +derecha I-EXPLORATION +e I-EXPLORATION +impide I-EXPLORATION +el I-EXPLORATION +paso I-EXPLORATION +del I-EXPLORATION +endoscopio I-EXPLORATION +con I-EXPLORATION +desplazamiento I-EXPLORATION +septal I-EXPLORATION +a I-EXPLORATION +fosa I-EXPLORATION +nasal I-EXPLORATION +izquierda, I-EXPLORATION +con I-EXPLORATION +biopsia I-EXPLORATION +sospechosa I-EXPLORATION +de I-EXPLORATION +tumor I-EXPLORATION +indiferenciado. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +detectan I-EXPLORATION +adenopatías I-EXPLORATION +palpables. I-EXPLORATION +Se I-EXPLORATION +realiza I-EXPLORATION +analítica I-EXPLORATION +y I-EXPLORATION +Radiografía I-EXPLORATION +de I-EXPLORATION +tórax I-EXPLORATION +sin I-EXPLORATION +alteraciones. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +solicitan I-EXPLORATION +Tomografía I-EXPLORATION +axial I-EXPLORATION +computerizada I-EXPLORATION +(TAC) I-EXPLORATION +y I-EXPLORATION +Resonancia I-EXPLORATION +nuclear I-EXPLORATION +magnética I-EXPLORATION +(RNM) I-EXPLORATION +craneofacial I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +objetiva I-EXPLORATION +una I-EXPLORATION +tumoración I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +de I-EXPLORATION +seno I-EXPLORATION +maxilar I-EXPLORATION +derecho I-EXPLORATION +que I-EXPLORATION +desplaza I-EXPLORATION +el I-EXPLORATION +septum I-EXPLORATION +y I-EXPLORATION +afecta I-EXPLORATION +celdillas I-EXPLORATION +etmoidales I-EXPLORATION +y I-EXPLORATION +coanas I-EXPLORATION +del I-EXPLORATION +mismo I-EXPLORATION +lado. I-EXPLORATION + I-EXPLORATION +Es B-TREATMENT +intervenida I-TREATMENT +quirúrgicamente I-TREATMENT +mediante I-TREATMENT +resección I-TREATMENT +craneofacial I-TREATMENT +de I-TREATMENT +etmoides I-TREATMENT +y I-TREATMENT +translocación I-TREATMENT +facial I-TREATMENT +medial, I-TREATMENT +que I-TREATMENT +permite I-TREATMENT +apreciar I-TREATMENT +que I-TREATMENT +la I-TREATMENT +tumoración I-TREATMENT +ocupaba I-TREATMENT +todo I-TREATMENT +el I-TREATMENT +seno I-TREATMENT +maxilar I-TREATMENT +derecho I-TREATMENT +y I-TREATMENT +celdas I-TREATMENT +etmoidales, I-TREATMENT +a I-TREATMENT +las I-TREATMENT +cuales I-TREATMENT +desplaza I-TREATMENT +por I-TREATMENT +compresión, I-TREATMENT +con I-TREATMENT +disrupción I-TREATMENT +de I-TREATMENT +partes I-TREATMENT +de I-TREATMENT +la I-TREATMENT +pared I-TREATMENT +ósea I-TREATMENT +posterior I-TREATMENT +y I-TREATMENT +medial I-TREATMENT +del I-TREATMENT +seno I-TREATMENT +maxilar. I-TREATMENT +El I-TREATMENT +tumor I-TREATMENT +rellenaba I-TREATMENT +submucosamente I-TREATMENT +toda I-TREATMENT +la I-TREATMENT +fosa I-TREATMENT +nasal I-TREATMENT +derecha I-TREATMENT +y I-TREATMENT +parte I-TREATMENT +del I-TREATMENT +seno I-TREATMENT +esfenoidal. I-TREATMENT + I-TREATMENT +El B-EXPLORATION +estudio I-EXPLORATION +Anatomo-patológico I-EXPLORATION +informa I-EXPLORATION +de I-EXPLORATION +Neuroestesioblastoma, I-EXPLORATION +estadio I-EXPLORATION +B I-EXPLORATION +de I-EXPLORATION +Kádish. I-EXPLORATION +En B-EVOLUTION +el I-EVOLUTION +postoperatorio I-EVOLUTION +inmediato I-EVOLUTION +sufrió I-EVOLUTION +una I-EVOLUTION +meningitis I-EVOLUTION +bacteriana I-EVOLUTION +con I-EVOLUTION +evolución I-EVOLUTION +satisfactoria. I-EVOLUTION +En B-EXPLORATION +la I-EXPLORATION +RNM I-EXPLORATION +posquirúrgica I-EXPLORATION +solo I-EXPLORATION +se I-EXPLORATION +visualizan I-EXPLORATION +cambios I-EXPLORATION +postcirugía. I-EXPLORATION + I-EXPLORATION +Tras B-TREATMENT +valoración I-TREATMENT +en I-TREATMENT +Subcomité I-TREATMENT +de I-TREATMENT +tumores I-TREATMENT +de I-TREATMENT +cabeza I-TREATMENT +y I-TREATMENT +cuello I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +Radioterapia I-TREATMENT +postoperatoria, I-TREATMENT +recibiendo I-TREATMENT +una I-TREATMENT +dosis I-TREATMENT +total I-TREATMENT +sobre I-TREATMENT +lecho I-TREATMENT +tumoral I-TREATMENT +de I-TREATMENT +60 I-TREATMENT +Gy I-TREATMENT +con I-TREATMENT +técnica I-TREATMENT +de I-TREATMENT +simulación I-TREATMENT +virtual I-TREATMENT +y I-TREATMENT +planificación I-TREATMENT +tridimensional I-TREATMENT +(3D) I-TREATMENT +sobre I-TREATMENT +tomografía I-TREATMENT +computarizada I-TREATMENT +(TC) I-TREATMENT +helicoidal I-TREATMENT +individualizada I-TREATMENT +(cortes I-TREATMENT +cada I-TREATMENT +5 I-TREATMENT +mm), I-TREATMENT +con I-TREATMENT +protección I-TREATMENT +plomada I-TREATMENT +personalizada I-TREATMENT +de I-TREATMENT +órganos I-TREATMENT +sanos, I-TREATMENT +fraccionamiento I-TREATMENT +de I-TREATMENT +2 I-TREATMENT +Gy/fracción, I-TREATMENT +5 I-TREATMENT +fracciones I-TREATMENT +semana I-TREATMENT +mediante I-TREATMENT +fotones I-TREATMENT +de I-TREATMENT +6 I-TREATMENT +Megavoltios I-TREATMENT +(MV) I-TREATMENT +procedentes I-TREATMENT +de I-TREATMENT +Acelerador I-TREATMENT +Lineal. I-TREATMENT +Se I-TREATMENT +emplea I-TREATMENT +sistema I-TREATMENT +de I-TREATMENT +homogeneización I-TREATMENT +de I-TREATMENT +dosis I-TREATMENT +con I-TREATMENT +cuñas I-TREATMENT +de I-TREATMENT +compensación I-TREATMENT +tisular, I-TREATMENT +e I-TREATMENT +inmovilización I-TREATMENT +con I-TREATMENT +máscara I-TREATMENT +termoplástica I-TREATMENT +facial I-TREATMENT +para I-TREATMENT +una I-TREATMENT +adecuada I-TREATMENT +reproductibilidad I-TREATMENT +a I-TREATMENT +lo I-TREATMENT +largo I-TREATMENT +del I-TREATMENT +tratamiento. I-TREATMENT +La B-EVOLUTION +tolerancia I-EVOLUTION +es I-EVOLUTION +buena, I-EVOLUTION +con I-EVOLUTION +toxicidad I-EVOLUTION +aguda I-EVOLUTION +dérmica I-EVOLUTION +grado I-EVOLUTION +1 I-EVOLUTION +(G1), I-EVOLUTION +y I-EVOLUTION +en I-EVOLUTION +mucosa I-EVOLUTION +grado I-EVOLUTION +2 I-EVOLUTION +(G2). I-EVOLUTION +A B-TREATMENT +las I-TREATMENT +4 I-TREATMENT +semanas I-TREATMENT +de I-TREATMENT +finalizada I-TREATMENT +la I-TREATMENT +irradiación I-TREATMENT +es I-TREATMENT +reintervenida I-TREATMENT +por I-TREATMENT +fístula I-TREATMENT +oroantral I-TREATMENT +en I-TREATMENT +el I-TREATMENT +surco I-TREATMENT +gingival I-TREATMENT +derecho I-TREATMENT +a I-TREATMENT +nivel I-TREATMENT +del I-TREATMENT +primer I-TREATMENT +molar. I-TREATMENT +Siete I-TREATMENT +meses I-TREATMENT +después, I-TREATMENT +es I-TREATMENT +reintervenida I-TREATMENT +con I-TREATMENT +abordaje I-TREATMENT +craneofacial I-TREATMENT +por I-TREATMENT +granuloma I-TREATMENT +a I-TREATMENT +cuerpo I-TREATMENT +extraño I-TREATMENT +en I-TREATMENT +cavidad I-TREATMENT +frontal I-TREATMENT +izquierda I-TREATMENT +sin I-TREATMENT +datos I-TREATMENT +histológicos I-TREATMENT +de I-TREATMENT +recidiva. I-TREATMENT + I-TREATMENT +En B-EVOLUTION +la I-EVOLUTION +actualidad, I-EVOLUTION +tras I-EVOLUTION +26 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +primera I-EVOLUTION +intervención, I-EVOLUTION +no I-EVOLUTION +existe I-EVOLUTION +evidencia I-EVOLUTION +de I-EVOLUTION +recidiva I-EVOLUTION +local, I-EVOLUTION +hallándose I-EVOLUTION +en I-EVOLUTION +remisión I-EVOLUTION +completa, I-EVOLUTION +realizando I-EVOLUTION +vida I-EVOLUTION +normal I-EVOLUTION +activa. I-EVOLUTION + I-EVOLUTION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +57 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +visto I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +vez I-PRESENT_ILLNESS +primera I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +nuestras I-PRESENT_ILLNESS +consultas I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +marzo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2003. I-PRESENT_ILLNESS +Fue B-DERIVED_FROM/TO +remitido I-DERIVED_FROM/TO +desde I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +Servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Nefrología I-DERIVED_FROM/TO +tras I-DERIVED_FROM/TO +diagnosticarse I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +tumor I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +músculo I-DERIVED_FROM/TO +liso I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +potencial I-DERIVED_FROM/TO +maligno I-DERIVED_FROM/TO +incierto. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +Entre B-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +sólo I-PAST_MEDICAL_HISTORY +refería I-PAST_MEDICAL_HISTORY +cólico I-PAST_MEDICAL_HISTORY +nefrítico I-PAST_MEDICAL_HISTORY +derecho I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +era I-PAST_MEDICAL_HISTORY +estudiado I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +dicho I-PAST_MEDICAL_HISTORY +Servicio I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +haberse I-PAST_MEDICAL_HISTORY +detectado I-PAST_MEDICAL_HISTORY +insuficiencia I-PAST_MEDICAL_HISTORY +renal. I-PAST_MEDICAL_HISTORY +En B-EXPLORATION +la I-EXPLORATION +TAC I-EXPLORATION +se I-EXPLORATION +describió I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +abdominal I-EXPLORATION +polilobulada I-EXPLORATION +de I-EXPLORATION +8 I-EXPLORATION +x I-EXPLORATION +6 I-EXPLORATION +cm I-EXPLORATION +que I-EXPLORATION +realzaba I-EXPLORATION +en I-EXPLORATION +parte I-EXPLORATION +con I-EXPLORATION +contraste I-EXPLORATION +y I-EXPLORATION +presentaba I-EXPLORATION +zonas I-EXPLORATION +de I-EXPLORATION +necrosis I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +interior I-EXPLORATION +y I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +extendía I-EXPLORATION +desde I-EXPLORATION +el I-EXPLORATION +espacio I-EXPLORATION +subfrénico I-EXPLORATION +hasta I-EXPLORATION +hilio I-EXPLORATION +esplénico I-EXPLORATION +y I-EXPLORATION +cola I-EXPLORATION +pancreática. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +13-2-03 I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +ecoendoscopia: I-EXPLORATION +gran I-EXPLORATION +tumoración I-EXPLORATION +con I-EXPLORATION +áreas I-EXPLORATION +de I-EXPLORATION +necrosis I-EXPLORATION +de I-EXPLORATION +probable I-EXPLORATION +localización I-EXPLORATION +en I-EXPLORATION +retroperitoneo, I-EXPLORATION +independiente I-EXPLORATION +del I-EXPLORATION +riñón I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +cola I-EXPLORATION +del I-EXPLORATION +páncreas I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +extendía I-EXPLORATION +hacia I-EXPLORATION +el I-EXPLORATION +polo I-EXPLORATION +superior I-EXPLORATION +del I-EXPLORATION +bazo I-EXPLORATION +del I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +podía I-EXPLORATION +independizar. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +observaron I-EXPLORATION +adenopatías. I-EXPLORATION +Se B-TREATMENT +intervino I-TREATMENT +el I-TREATMENT +6-3-03 I-TREATMENT +encontrándose I-TREATMENT +tumoración I-TREATMENT +multilobulada I-TREATMENT +entre I-TREATMENT +fornix I-TREATMENT +e I-TREATMENT +hilio I-TREATMENT +esplénico, I-TREATMENT +realizándose I-TREATMENT +extirpación I-TREATMENT +total I-TREATMENT +junto I-TREATMENT +a I-TREATMENT +bazo I-TREATMENT +y I-TREATMENT +pared I-TREATMENT +gástrica I-TREATMENT +a I-TREATMENT +la I-TREATMENT +que I-TREATMENT +se I-TREATMENT +adhiere. I-TREATMENT + I-TREATMENT +Anatomía B-EXPLORATION +Patológica I-EXPLORATION +: I-EXPLORATION +Macroscópicamente I-EXPLORATION +y I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +del I-EXPLORATION +hilio I-EXPLORATION +esplénico I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +una I-EXPLORATION +tumoración I-EXPLORATION +multinodular I-EXPLORATION +de I-EXPLORATION +11x9x6 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +consistencia I-EXPLORATION +firme I-EXPLORATION +y I-EXPLORATION +coloración I-EXPLORATION +pardusca I-EXPLORATION +que I-EXPLORATION +al I-EXPLORATION +corte I-EXPLORATION +presenta I-EXPLORATION +frecuentes I-EXPLORATION +áreas I-EXPLORATION +hemorrágicas. I-EXPLORATION +Microscópicamente, I-EXPLORATION +el I-EXPLORATION +bazo I-EXPLORATION +no I-EXPLORATION +muestra I-EXPLORATION +infiltración I-EXPLORATION +tumoral. I-EXPLORATION +Fragmento I-EXPLORATION +de I-EXPLORATION +pared I-EXPLORATION +gástrica I-EXPLORATION +sin I-EXPLORATION +alteraciones. I-EXPLORATION +El I-EXPLORATION +tumor I-EXPLORATION +descrito I-EXPLORATION +previamente I-EXPLORATION +está I-EXPLORATION +bien I-EXPLORATION +delimitado I-EXPLORATION +por I-EXPLORATION +una I-EXPLORATION +delgada I-EXPLORATION +cápsula I-EXPLORATION +fibrosa I-EXPLORATION +y I-EXPLORATION +está I-EXPLORATION +constituido I-EXPLORATION +por I-EXPLORATION +células I-EXPLORATION +fusiformes I-EXPLORATION +isomorfas, I-EXPLORATION +sin I-EXPLORATION +atipia I-EXPLORATION +ni I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +necrosis, I-EXPLORATION +presentado I-EXPLORATION +un I-EXPLORATION +índice I-EXPLORATION +mitótico I-EXPLORATION +de I-EXPLORATION +2 I-EXPLORATION +mitosis I-EXPLORATION +por I-EXPLORATION +10 I-EXPLORATION +campos I-EXPLORATION +de I-EXPLORATION +gran I-EXPLORATION +aumento. I-EXPLORATION +La I-EXPLORATION +inmunohistoquímica I-EXPLORATION +(IMH) I-EXPLORATION +fue I-EXPLORATION +positiva I-EXPLORATION +para I-EXPLORATION +actina I-EXPLORATION +de I-EXPLORATION +músculo I-EXPLORATION +liso I-EXPLORATION +y I-EXPLORATION +negativa I-EXPLORATION +para I-EXPLORATION +desmina, I-EXPLORATION +S-100, I-EXPLORATION +CD I-EXPLORATION +57, I-EXPLORATION +EMA, I-EXPLORATION +CD68 I-EXPLORATION +y I-EXPLORATION +neurofilamentos. I-EXPLORATION +El I-EXPLORATION +diagnóstico I-EXPLORATION +fue I-EXPLORATION +"Tumor I-EXPLORATION +de I-EXPLORATION +musculo I-EXPLORATION +liso I-EXPLORATION +de I-EXPLORATION +potencial I-EXPLORATION +maligno I-EXPLORATION +incierto" I-EXPLORATION +(11 I-EXPLORATION +cm). I-EXPLORATION + I-EXPLORATION +Tras I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +extensión, I-EXPLORATION +que I-EXPLORATION +fue I-EXPLORATION +negativo, I-EXPLORATION +se I-EXPLORATION +solicitó I-EXPLORATION +una I-EXPLORATION +revisión I-EXPLORATION +del I-EXPLORATION +caso I-EXPLORATION +para I-EXPLORATION +catalogación I-EXPLORATION +definitiva I-EXPLORATION +mediante I-EXPLORATION +determinación I-EXPLORATION +de I-EXPLORATION +IMH I-EXPLORATION +que I-EXPLORATION +en I-EXPLORATION +esta I-EXPLORATION +ocasión I-EXPLORATION +incluyera I-EXPLORATION +CD I-EXPLORATION +117; I-EXPLORATION +ésta I-EXPLORATION +fue I-EXPLORATION +intensamente I-EXPLORATION +positiva. I-EXPLORATION + I-EXPLORATION +Resultados: I-EXPLORATION +Actina I-EXPLORATION +de I-EXPLORATION +músculo I-EXPLORATION +liso I-EXPLORATION +y I-EXPLORATION +Actina I-EXPLORATION +muscular I-EXPLORATION +específica: I-EXPLORATION +inmunotinción I-EXPLORATION +débil I-EXPLORATION +y I-EXPLORATION +focal; I-EXPLORATION +CD34 I-EXPLORATION +y I-EXPLORATION +c-kit I-EXPLORATION +(CD I-EXPLORATION +117): I-EXPLORATION +inmunotinción I-EXPLORATION +intensa I-EXPLORATION +con I-EXPLORATION +control I-EXPLORATION +negativo I-EXPLORATION +y I-EXPLORATION +positivo I-EXPLORATION +para I-EXPLORATION +CD I-EXPLORATION +117; I-EXPLORATION +S-100 I-EXPLORATION +y I-EXPLORATION +desmina: I-EXPLORATION +ausencia I-EXPLORATION +de I-EXPLORATION +inmunotinción; I-EXPLORATION +Ki67: I-EXPLORATION +10%. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +diagnóstico I-EXPLORATION +definitivo I-EXPLORATION +fue I-EXPLORATION +tumor I-EXPLORATION +estromal I-EXPLORATION +de I-EXPLORATION +localización I-EXPLORATION +en I-EXPLORATION +retroperitoneo I-EXPLORATION + I-EXPLORATION + +Hombre B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +34 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +antecedente I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +visión I-PRESENT_ILLNESS +borrosa I-PRESENT_ILLNESS +hacía I-PRESENT_ILLNESS +ya I-PRESENT_ILLNESS +seis I-PRESENT_ILLNESS +meses, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +sífilis. I-PAST_MEDICAL_HISTORY +Al B-EXPLORATION +examen I-EXPLORATION +oftalmológico I-EXPLORATION +destacaba I-EXPLORATION +AVMC I-EXPLORATION +de I-EXPLORATION +0, I-EXPLORATION +025 I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +OD I-EXPLORATION +y I-EXPLORATION +0, I-EXPLORATION +05 I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +Oí. I-EXPLORATION +Pupilas I-EXPLORATION +isocóricas I-EXPLORATION +reactivas I-EXPLORATION +y I-EXPLORATION +simétricas. I-EXPLORATION +Disociación I-EXPLORATION +luz-cerca I-EXPLORATION +positiva, I-EXPLORATION +con I-EXPLORATION +DPAR I-EXPLORATION +(+) I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +OD. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +examen I-EXPLORATION +al I-EXPLORATION +biomicroscopio I-EXPLORATION +mostraba I-EXPLORATION +una I-EXPLORATION +cornea I-EXPLORATION +clara, I-EXPLORATION +cámara I-EXPLORATION +anterior I-EXPLORATION +amplia I-EXPLORATION +y I-EXPLORATION +cristalino I-EXPLORATION +claro. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +fondo I-EXPLORATION +de I-EXPLORATION +ojo I-EXPLORATION +se I-EXPLORATION +observaban I-EXPLORATION +papilas I-EXPLORATION +pálidas, I-EXPLORATION +excavación I-EXPLORATION +0, I-EXPLORATION +8 I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +OD I-EXPLORATION +y I-EXPLORATION +0, I-EXPLORATION +4 I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +Oí. I-EXPLORATION +Los I-EXPLORATION +exámenes I-EXPLORATION +de I-EXPLORATION +laboratorio I-EXPLORATION +revelaron I-EXPLORATION +concentraciones I-EXPLORATION +de I-EXPLORATION +vitamina I-EXPLORATION +B-12 I-EXPLORATION +normales, I-EXPLORATION +VDRL I-EXPLORATION +en I-EXPLORATION +sangre I-EXPLORATION +(+), I-EXPLORATION +título I-EXPLORATION +1/32, I-EXPLORATION +FTA-ABS I-EXPLORATION +(+), I-EXPLORATION +VDRL I-EXPLORATION +en I-EXPLORATION +LCR I-EXPLORATION +(+), I-EXPLORATION +ELISA I-EXPLORATION +para I-EXPLORATION +VIH I-EXPLORATION +(-). I-EXPLORATION +RM I-EXPLORATION +cerebral I-EXPLORATION +normal. I-EXPLORATION +Campo I-EXPLORATION +visual I-EXPLORATION +de I-EXPLORATION +Goldmann I-EXPLORATION +mostró I-EXPLORATION +un I-EXPLORATION +defecto I-EXPLORATION +altitudinal I-EXPLORATION +bilateral. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +diagnosticó I-EXPLORATION +una I-EXPLORATION +neuritis I-EXPLORATION +óptica I-EXPLORATION +bilateral I-EXPLORATION +luética. I-EXPLORATION +Se B-TREATMENT +hospitalizó I-TREATMENT +e I-TREATMENT +indicó I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +penicilina I-TREATMENT +en I-TREATMENT +esquema I-TREATMENT +habitual. I-TREATMENT +Evolucionó B-EVOLUTION +con I-EVOLUTION +mejoría I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +AV I-EVOLUTION +(AVMC: I-EVOLUTION +0, I-EVOLUTION +2 I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +OD I-EVOLUTION +y I-EVOLUTION +0, I-EVOLUTION +3 I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +Oí) I-EVOLUTION +y I-EVOLUTION +del I-EVOLUTION +campo I-EVOLUTION +visual I-EVOLUTION +al I-EVOLUTION +mes I-EVOLUTION +de I-EVOLUTION +iniciado I-EVOLUTION +el I-EVOLUTION +tratamiento. I-EVOLUTION + I-EVOLUTION + +Se B-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +hombre I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +54 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que B-PAST_MEDICAL_HISTORY +presentaba I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +asma I-PAST_MEDICAL_HISTORY +bronquial I-PAST_MEDICAL_HISTORY +extrínseco I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +estaba I-PAST_MEDICAL_HISTORY +diagnosticado I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +hacía I-PAST_MEDICAL_HISTORY +4 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +eco-transtorácico I-PAST_MEDICAL_HISTORY +(ETT) I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +miocardiopatía I-PAST_MEDICAL_HISTORY +hipertrófica I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +obstructiva, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +insuficiencia I-PAST_MEDICAL_HISTORY +mitral I-PAST_MEDICAL_HISTORY +leve-moderada. I-PAST_MEDICAL_HISTORY +Realizaba I-PAST_MEDICAL_HISTORY +vida I-PAST_MEDICAL_HISTORY +activa I-PAST_MEDICAL_HISTORY +encontrándose I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +grado I-PAST_MEDICAL_HISTORY +funcional I-PAST_MEDICAL_HISTORY +I. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Acudió B-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +Urgencias I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +precordial I-PRESENT_ILLNESS +tras I-PRESENT_ILLNESS +realizar I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +esfuerzo I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +aparición I-PRESENT_ILLNESS +posterior I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +palpitaciones. I-PRESENT_ILLNESS +En B-EXPLORATION +un I-EXPLORATION +primer I-EXPLORATION +electrocardiograma I-EXPLORATION +(ECG) I-EXPLORATION +se I-EXPLORATION +apreció I-EXPLORATION +una I-EXPLORATION +taquicardia I-EXPLORATION +regular I-EXPLORATION +con I-EXPLORATION +QRS I-EXPLORATION +ancho I-EXPLORATION +a I-EXPLORATION +210 I-EXPLORATION +lpm, I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +respondió I-EXPLORATION +al I-EXPLORATION +tratamiento I-EXPLORATION +con I-EXPLORATION +adenosina I-EXPLORATION +ni I-EXPLORATION +a I-EXPLORATION +maniobras I-EXPLORATION +vagales. I-EXPLORATION +Se B-TREATMENT +procedió I-TREATMENT +a I-TREATMENT +realizar I-TREATMENT +una I-TREATMENT +cardioversión I-TREATMENT +eléctrica I-TREATMENT +con I-TREATMENT +100 I-TREATMENT +J I-TREATMENT +que I-TREATMENT +derivó I-TREATMENT +en I-TREATMENT +fibrilación I-TREATMENT +ventricular I-TREATMENT +(FV) I-TREATMENT +revertida I-TREATMENT +con I-TREATMENT +dos I-TREATMENT +choques I-TREATMENT +de I-TREATMENT +360 I-TREATMENT +J. I-TREATMENT +Se I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +amiodarona I-TREATMENT +intravenosa, I-TREATMENT +pero I-TREATMENT +fue I-TREATMENT +preciso I-TREATMENT +suspenderla I-TREATMENT +poco I-TREATMENT +después I-TREATMENT +por I-TREATMENT +la I-TREATMENT +aparición I-TREATMENT +de I-TREATMENT +disfunción I-TREATMENT +sinusal, I-TREATMENT +con I-TREATMENT +ritmo I-TREATMENT +de I-TREATMENT +la I-TREATMENT +unión I-TREATMENT +a I-TREATMENT +40 I-TREATMENT +latidos/ I-TREATMENT +minuto. I-TREATMENT +Se I-TREATMENT +le I-TREATMENT +administró I-TREATMENT +de I-TREATMENT +forma I-TREATMENT +empírica I-TREATMENT +sulfato I-TREATMENT +de I-TREATMENT +magnesio I-TREATMENT +y I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +ingresó I-TREATMENT +en I-TREATMENT +la I-TREATMENT +Unidad I-TREATMENT +Coronaria. I-TREATMENT + I-TREATMENT +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +destacaba I-EXPLORATION +una I-EXPLORATION +presión I-EXPLORATION +arterial I-EXPLORATION +sistémica I-EXPLORATION +de I-EXPLORATION +130/70 I-EXPLORATION +mmHg. I-EXPLORATION +Se I-EXPLORATION +auscultaba I-EXPLORATION +un I-EXPLORATION +soplo I-EXPLORATION +sistólico, I-EXPLORATION +en I-EXPLORATION +ápex I-EXPLORATION +y I-EXPLORATION +borde I-EXPLORATION +esternal I-EXPLORATION +izquierdo, I-EXPLORATION +y I-EXPLORATION +no I-EXPLORATION +presentaba I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +congestión I-EXPLORATION +pulmonar. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +ECG I-EXPLORATION +se I-EXPLORATION +apreciaba I-EXPLORATION +disfunción I-EXPLORATION +sinusal, I-EXPLORATION +QRS I-EXPLORATION +ancho I-EXPLORATION +con I-EXPLORATION +morfología I-EXPLORATION +de I-EXPLORATION +bloqueo I-EXPLORATION +completo I-EXPLORATION +de I-EXPLORATION +rama I-EXPLORATION +izquierda I-EXPLORATION +e I-EXPLORATION +intervalo I-EXPLORATION +QT I-EXPLORATION +normal. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +analítica I-EXPLORATION +a I-EXPLORATION +las I-EXPLORATION +30 I-EXPLORATION +horas I-EXPLORATION +de I-EXPLORATION +evolución I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +síntomas I-EXPLORATION +destacaba I-EXPLORATION +una I-EXPLORATION +CPK I-EXPLORATION +total I-EXPLORATION +de I-EXPLORATION +2.657 I-EXPLORATION +U/l I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +troponina I-EXPLORATION +I I-EXPLORATION +de I-EXPLORATION +2, I-EXPLORATION +21 I-EXPLORATION +ng/ml. I-EXPLORATION +Los I-EXPLORATION +iones I-EXPLORATION +séricos I-EXPLORATION +fueron I-EXPLORATION +normales. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +ecocardiograma I-EXPLORATION +realizado I-EXPLORATION +al I-EXPLORATION +ingreso I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +equipo I-EXPLORATION +portátil I-EXPLORATION +se I-EXPLORATION +apreció I-EXPLORATION +un I-EXPLORATION +ventrículo I-EXPLORATION +izquierdo I-EXPLORATION +(VI) I-EXPLORATION +muy I-EXPLORATION +dilatado I-EXPLORATION +y I-EXPLORATION +globalmente I-EXPLORATION +hipoquinético, I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +miocardio I-EXPLORATION +muy I-EXPLORATION +hipertrófico, I-EXPLORATION +con I-EXPLORATION +trabeculaciones. I-EXPLORATION + I-EXPLORATION +Como I-EXPLORATION +parte I-EXPLORATION +del I-EXPLORATION +protocolo I-EXPLORATION +de I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +taquicardias I-EXPLORATION +ventriculares I-EXPLORATION +(TV), I-EXPLORATION +con I-EXPLORATION +sospecha I-EXPLORATION +clínica I-EXPLORATION +de I-EXPLORATION +miocardiopatía I-EXPLORATION +dilatada, I-EXPLORATION +se I-EXPLORATION +le I-EXPLORATION +realizó I-EXPLORATION +un I-EXPLORATION +estudio I-EXPLORATION +hemodinámico. I-EXPLORATION +La I-EXPLORATION +ventriculografía I-EXPLORATION +izquierda I-EXPLORATION +mostró I-EXPLORATION +un I-EXPLORATION +ventrículo I-EXPLORATION +con I-EXPLORATION +fracción I-EXPLORATION +de I-EXPLORATION +eyección I-EXPLORATION +(FE) I-EXPLORATION +del I-EXPLORATION +20%, I-EXPLORATION +con I-EXPLORATION +defectos I-EXPLORATION +generalizados I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +contractilidad I-EXPLORATION +y I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +imagen I-EXPLORATION +de I-EXPLORATION +importante I-EXPLORATION +trabeculación I-EXPLORATION +que I-EXPLORATION +sugirió I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +miocardiopatía I-EXPLORATION +no I-EXPLORATION +compactada I-EXPLORATION +(MNC) I-EXPLORATION +o I-EXPLORATION +miocardiopatía I-EXPLORATION +espongiforme I-EXPLORATION +(ME). I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +detectó I-EXPLORATION +insuficiencia I-EXPLORATION +mitral I-EXPLORATION +angiográficamente I-EXPLORATION +significativa. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +cateterismo I-EXPLORATION +derecho I-EXPLORATION +las I-EXPLORATION +presiones I-EXPLORATION +fueron: I-EXPLORATION +aurícula I-EXPLORATION +derecha I-EXPLORATION +(AD) I-EXPLORATION +10 I-EXPLORATION +mmHg, I-EXPLORATION +ventrículo I-EXPLORATION +derecho I-EXPLORATION +(VD) I-EXPLORATION +70/4 I-EXPLORATION +mmHg, I-EXPLORATION +arteria I-EXPLORATION +pulmonar I-EXPLORATION +(AP) I-EXPLORATION +70/15 I-EXPLORATION +mmHg, I-EXPLORATION +enclavamiento I-EXPLORATION +capilar I-EXPLORATION +pulmonar I-EXPLORATION +(PECP) I-EXPLORATION +15 I-EXPLORATION +mmHg. I-EXPLORATION +Índice I-EXPLORATION +cardíaco I-EXPLORATION +2 I-EXPLORATION +litros/minuto/m2; I-EXPLORATION +presión I-EXPLORATION +telediastólica I-EXPLORATION +VI I-EXPLORATION +(PTDVI) I-EXPLORATION +30 I-EXPLORATION +mmHg; I-EXPLORATION +gradiente I-EXPLORATION +mitral I-EXPLORATION +invertido I-EXPLORATION +(PTDVI I-EXPLORATION +> I-EXPLORATION +PECP). I-EXPLORATION +La I-EXPLORATION +coronariografía I-EXPLORATION +mostró I-EXPLORATION +unas I-EXPLORATION +arterias I-EXPLORATION +epicárdicas I-EXPLORATION +angiográficamente I-EXPLORATION +normales. I-EXPLORATION + I-EXPLORATION +Con I-EXPLORATION +la I-EXPLORATION +sospecha I-EXPLORATION +diagnóstica I-EXPLORATION +de I-EXPLORATION +MNC I-EXPLORATION +al I-EXPLORATION +paciente I-EXPLORATION +se I-EXPLORATION +le I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +segunda I-EXPLORATION +ecocardiografía I-EXPLORATION +por I-EXPLORATION +personal I-EXPLORATION +especializado. I-EXPLORATION +La I-EXPLORATION +ecocardiografía-2D I-EXPLORATION +confirmó I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +marcada I-EXPLORATION +trabeculación I-EXPLORATION +del I-EXPLORATION +VI, I-EXPLORATION +localizada I-EXPLORATION +en I-EXPLORATION +ápex I-EXPLORATION +y I-EXPLORATION +segmentos I-EXPLORATION +medios I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +pared I-EXPLORATION +lateral I-EXPLORATION +e I-EXPLORATION +inferior, I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +relación I-EXPLORATION +telesistólica I-EXPLORATION +de I-EXPLORATION +2, I-EXPLORATION +5 I-EXPLORATION +entre I-EXPLORATION +la I-EXPLORATION +gruesa I-EXPLORATION +capa I-EXPLORATION +interna I-EXPLORATION +de I-EXPLORATION +miocardio I-EXPLORATION +no I-EXPLORATION +compactado I-EXPLORATION +(NC) I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +fina I-EXPLORATION +capa I-EXPLORATION +externa I-EXPLORATION +de I-EXPLORATION +miocardio I-EXPLORATION +compactado I-EXPLORATION +(NC/C I-EXPLORATION +> I-EXPLORATION +2). I-EXPLORATION +Con I-EXPLORATION +doppler I-EXPLORATION +color I-EXPLORATION +se I-EXPLORATION +visualizó I-EXPLORATION +el I-EXPLORATION +flujo I-EXPLORATION +de I-EXPLORATION +sangre I-EXPLORATION +en I-EXPLORATION +comunicación I-EXPLORATION +entre I-EXPLORATION +los I-EXPLORATION +profundos I-EXPLORATION +recesos I-EXPLORATION +intertrabeculares I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +cavidad I-EXPLORATION +ventricular. I-EXPLORATION +El I-EXPLORATION +flujo I-EXPLORATION +diastólico I-EXPLORATION +mitral I-EXPLORATION +mostró I-EXPLORATION +un I-EXPLORATION +patrón I-EXPLORATION +restrictivo. I-EXPLORATION +El I-EXPLORATION +VI I-EXPLORATION +tenía I-EXPLORATION +morfología I-EXPLORATION +esferoidal I-EXPLORATION +y I-EXPLORATION +medía I-EXPLORATION +en I-EXPLORATION +telediástole I-EXPLORATION +70 I-EXPLORATION +mm, I-EXPLORATION +la I-EXPLORATION +aurícula I-EXPLORATION +izquierda I-EXPLORATION +47 I-EXPLORATION +mm I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +VD I-EXPLORATION +30 I-EXPLORATION +mm. I-EXPLORATION +Un I-EXPLORATION +flujo I-EXPLORATION +de I-EXPLORATION +regurgitación I-EXPLORATION +mitral I-EXPLORATION +fue I-EXPLORATION +valorado I-EXPLORATION +como I-EXPLORATION +insuficiencia I-EXPLORATION +mitral I-EXPLORATION +moderada, I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +insuficiencia I-EXPLORATION +tricuspídea I-EXPLORATION +permitió I-EXPLORATION +calcular I-EXPLORATION +un I-EXPLORATION +gradiente I-EXPLORATION +AD-VD I-EXPLORATION +de I-EXPLORATION +55 I-EXPLORATION +mmHg, I-EXPLORATION +estimándose I-EXPLORATION +una I-EXPLORATION +presión I-EXPLORATION +de I-EXPLORATION +AP I-EXPLORATION +de I-EXPLORATION +65 I-EXPLORATION +mmHg. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +detectaron I-EXPLORATION +anomalías I-EXPLORATION +valvulares I-EXPLORATION +estructurales. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +consideró I-EXPLORATION +necesario I-EXPLORATION +realizar I-EXPLORATION +una I-EXPLORATION +ecocardiografía I-EXPLORATION +con I-EXPLORATION +contraste I-EXPLORATION +dada I-EXPLORATION +la I-EXPLORATION +buena I-EXPLORATION +calidad I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +imágenes I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +bidimensional1. I-EXPLORATION + I-EXPLORATION +Con B-EVOLUTION +estos I-EVOLUTION +hallazgos I-EVOLUTION +ecocardiográficos I-EVOLUTION +se I-EVOLUTION +realizó I-EVOLUTION +el I-EVOLUTION +diagnóstico I-EVOLUTION +de I-EVOLUTION +MNC I-EVOLUTION +según I-EVOLUTION +los I-EVOLUTION +criterios I-EVOLUTION +de I-EVOLUTION +Jenni, I-EVOLUTION +por I-EVOLUTION +ausencia I-EVOLUTION +de I-EVOLUTION +compactación I-EVOLUTION +del I-EVOLUTION +miocardio I-EVOLUTION +ventricular I-EVOLUTION +izquierdo I-EVOLUTION +sin I-EVOLUTION +otras I-EVOLUTION +anomalías I-EVOLUTION +cardíacas I-EVOLUTION +asociadas2, I-EVOLUTION +3. I-EVOLUTION +Aunque I-EVOLUTION +hubiera I-EVOLUTION +sido I-EVOLUTION +interesante I-EVOLUTION +una I-EVOLUTION +cardiorresonancia, I-EVOLUTION +no I-EVOLUTION +se I-EVOLUTION +pudo I-EVOLUTION +realizar I-EVOLUTION +por I-EVOLUTION +no I-EVOLUTION +disponer I-EVOLUTION +de I-EVOLUTION +esta I-EVOLUTION +técnica I-EVOLUTION +en I-EVOLUTION +nuestro I-EVOLUTION +hospital4, I-EVOLUTION +5. I-EVOLUTION + I-EVOLUTION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +47 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +diabético B-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +II. I-PAST_MEDICAL_HISTORY +Bebedor I-PAST_MEDICAL_HISTORY +diagnosticado I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +pancreatitis I-PAST_MEDICAL_HISTORY +crónica. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Acude B-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +epigástrico, I-PRESENT_ILLNESS +náuseas I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +vómitos. I-PRESENT_ILLNESS +A B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +el I-EXPLORATION +abdomen I-EXPLORATION +es I-EXPLORATION +blando I-EXPLORATION +y I-EXPLORATION +depresible, I-EXPLORATION +no I-EXPLORATION +presenta I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +irritación I-EXPLORATION +peritoneal I-EXPLORATION +ni I-EXPLORATION +alteraciones I-EXPLORATION +analíticas. I-EXPLORATION + I-EXPLORATION +Ingresa I-EXPLORATION +en I-EXPLORATION +observación I-EXPLORATION +practicándose I-EXPLORATION +una I-EXPLORATION +TC I-EXPLORATION +que I-EXPLORATION +mostraba I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +pancreatitis I-EXPLORATION +crónica I-EXPLORATION +con I-EXPLORATION +múltiples I-EXPLORATION +calcificaciones. I-EXPLORATION +Existen I-EXPLORATION +dos I-EXPLORATION +formaciones I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +páncreas: I-EXPLORATION +una I-EXPLORATION +de I-EXPLORATION +11 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +diámetro I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +cola I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +pseudoquiste I-EXPLORATION +y I-EXPLORATION +otra I-EXPLORATION +de I-EXPLORATION +2 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +aspecto I-EXPLORATION +sólido I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +cabeza I-EXPLORATION +que I-EXPLORATION +corresponde I-EXPLORATION +a I-EXPLORATION +un I-EXPLORATION +pseudoaneurisma I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +arteria I-EXPLORATION +gastroduodenal. I-EXPLORATION +Evoluciona B-EVOLUTION +favorablemente I-EVOLUTION +mejorando I-EVOLUTION +del I-EVOLUTION +dolor I-EVOLUTION +y I-EVOLUTION +presentando I-EVOLUTION +una I-EVOLUTION +ligera I-EVOLUTION +anemización. I-EVOLUTION +A I-EVOLUTION +los I-EVOLUTION +10 I-EVOLUTION +días I-EVOLUTION +presenta I-EVOLUTION +dolor I-EVOLUTION +abdominal I-EVOLUTION +muy I-EVOLUTION +intenso I-EVOLUTION +asociado I-EVOLUTION +a I-EVOLUTION +hematemesis I-EVOLUTION +y I-EVOLUTION +rectorragia I-EVOLUTION +masiva. I-EVOLUTION +Se I-EVOLUTION +produce I-EVOLUTION +un I-EVOLUTION +shock I-EVOLUTION +hemodinámico I-EVOLUTION +mejorando I-EVOLUTION +posteriormente I-EVOLUTION +del I-EVOLUTION +dolor I-EVOLUTION +y I-EVOLUTION +persistiendo I-EVOLUTION +el I-EVOLUTION +sangrado. I-EVOLUTION +Una B-EXPLORATION +nueva I-EXPLORATION +TC I-EXPLORATION +muestra I-EXPLORATION +la I-EXPLORATION +desaparición I-EXPLORATION +del I-EXPLORATION +pseudoquiste I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +cola I-EXPLORATION +y I-EXPLORATION +un I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +masa I-EXPLORATION +de I-EXPLORATION +cabeza I-EXPLORATION +pancreática I-EXPLORATION +con I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +sangrado I-EXPLORATION +arterial I-EXPLORATION +activo I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +interior. I-EXPLORATION +El I-EXPLORATION +cuadro I-EXPLORATION +es I-EXPLORATION +interpretado I-EXPLORATION +como I-EXPLORATION +un I-EXPLORATION +drenaje I-EXPLORATION +espontáneo I-EXPLORATION +del I-EXPLORATION +pseudoquiste I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +cavidad I-EXPLORATION +gástrica I-EXPLORATION +y I-EXPLORATION +un I-EXPLORATION +sangrado I-EXPLORATION +digestivo I-EXPLORATION +ocasionado I-EXPLORATION +por I-EXPLORATION +el I-EXPLORATION +pseudoaneurisma I-EXPLORATION +en I-EXPLORATION +comunicación I-EXPLORATION +a I-EXPLORATION +través I-EXPLORATION +del I-EXPLORATION +pseudoquiste I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +tubo I-EXPLORATION +digestivo. I-EXPLORATION +Ante B-TREATMENT +tal I-TREATMENT +situación I-TREATMENT +se I-TREATMENT +desaconseja I-TREATMENT +el I-TREATMENT +traslado I-TREATMENT +y I-TREATMENT +se I-TREATMENT +interveniene I-TREATMENT +quirúrgicamente. I-TREATMENT + I-TREATMENT +En I-TREATMENT +la I-TREATMENT +intervención I-TREATMENT +se I-TREATMENT +aprecia I-TREATMENT +una I-TREATMENT +masa I-TREATMENT +del I-TREATMENT +tamaño I-TREATMENT +de I-TREATMENT +un I-TREATMENT +puño I-TREATMENT +a I-TREATMENT +nivel I-TREATMENT +de I-TREATMENT +la I-TREATMENT +cabeza I-TREATMENT +pancreática. I-TREATMENT +Se I-TREATMENT +aborda I-TREATMENT +la I-TREATMENT +arteria I-TREATMENT +gastroduodenal I-TREATMENT +que I-TREATMENT +se I-TREATMENT +liga I-TREATMENT +en I-TREATMENT +el I-TREATMENT +origen I-TREATMENT +para I-TREATMENT +detener I-TREATMENT +la I-TREATMENT +principal I-TREATMENT +fuente I-TREATMENT +de I-TREATMENT +sangre I-TREATMENT +que I-TREATMENT +alimenta I-TREATMENT +el I-TREATMENT +aneurisma. I-TREATMENT +Se I-TREATMENT +realiza I-TREATMENT +una I-TREATMENT +gastrotomía I-TREATMENT +comprobando I-TREATMENT +la I-TREATMENT +comunicación I-TREATMENT +del I-TREATMENT +pseudoquiste I-TREATMENT +de I-TREATMENT +la I-TREATMENT +cola I-TREATMENT +con I-TREATMENT +la I-TREATMENT +pared I-TREATMENT +gástrica I-TREATMENT +posterior I-TREATMENT +y I-TREATMENT +comprobando I-TREATMENT +que I-TREATMENT +no I-TREATMENT +existe I-TREATMENT +sangrado. I-TREATMENT + I-TREATMENT +La B-EVOLUTION +evolución I-EVOLUTION +es I-EVOLUTION +favorable. I-EVOLUTION +A B-DERIVED_FROM/TO +los I-DERIVED_FROM/TO +pocos I-DERIVED_FROM/TO +días I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +intervención, I-DERIVED_FROM/TO +tras I-DERIVED_FROM/TO +haber I-DERIVED_FROM/TO +repuesto I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +las I-DERIVED_FROM/TO +primeras I-DERIVED_FROM/TO +horas I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +hematocrito, I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +aprecia I-DERIVED_FROM/TO +una I-DERIVED_FROM/TO +disminución I-DERIVED_FROM/TO +progresiva I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +los I-DERIVED_FROM/TO +valores I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +hemoglobina, I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +lo I-DERIVED_FROM/TO +que I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +remite I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +enfermo I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +unidad I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +radiología I-DERIVED_FROM/TO +intervencionista. I-DERIVED_FROM/TO +Se B-EXPLORATION +realiza I-EXPLORATION +una I-EXPLORATION +arteriografía I-EXPLORATION +selectiva I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +cual I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +puede I-EXPLORATION +acceder I-EXPLORATION +al I-EXPLORATION +pseudoaneurisma I-EXPLORATION +a I-EXPLORATION +través I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +arteria I-EXPLORATION +principal I-EXPLORATION +que I-EXPLORATION +lo I-EXPLORATION +nutre, I-EXPLORATION +que I-EXPLORATION +es I-EXPLORATION +la I-EXPLORATION +gastroduodenal, I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +accede I-EXPLORATION +a I-EXPLORATION +través I-EXPLORATION +de I-EXPLORATION +ramas I-EXPLORATION +arteriales I-EXPLORATION +secundarias I-EXPLORATION +que I-EXPLORATION +proceden I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +pancreático-yeyunal. I-EXPLORATION +Se B-TREATMENT +consigue I-TREATMENT +excluir I-TREATMENT +por I-TREATMENT +completo I-TREATMENT +el I-TREATMENT +pseudoaneurisma. I-TREATMENT +En B-EVOLUTION +los I-EVOLUTION +días I-EVOLUTION +siguientes I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +permanece I-EVOLUTION +estable I-EVOLUTION +y I-EVOLUTION +no I-EVOLUTION +se I-EVOLUTION +evidencian I-EVOLUTION +nuevos I-EVOLUTION +signos I-EVOLUTION +de I-EVOLUTION +sangrado. I-EVOLUTION +Tras I-EVOLUTION +seis I-EVOLUTION +meses I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +se I-EVOLUTION +encuentra I-EVOLUTION +asintomático. I-EVOLUTION + I-EVOLUTION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +50 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +80 I-PRESENT_ILLNESS +Kg I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +peso, I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +ADPV, I-PRESENT_ILLNESS +diagnosticado I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +hepatopatía I-PRESENT_ILLNESS +crónica I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +VHC I-PRESENT_ILLNESS +(genotipo I-PRESENT_ILLNESS +1a, I-PRESENT_ILLNESS +polimorfismo I-PRESENT_ILLNESS +IL-B28 I-PRESENT_ILLNESS +CC), I-PRESENT_ILLNESS +fibrosis I-PRESENT_ILLNESS +grado I-PRESENT_ILLNESS +F4 I-PRESENT_ILLNESS +(Fibroscan I-PRESENT_ILLNESS +36, I-PRESENT_ILLNESS +8 I-PRESENT_ILLNESS +KPa), I-PRESENT_ILLNESS +carga I-PRESENT_ILLNESS +viral I-PRESENT_ILLNESS +(CV) I-PRESENT_ILLNESS +14.440 I-PRESENT_ILLNESS +UI I-PRESENT_ILLNESS +RNA/ml, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +datos I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +hipertensión I-PRESENT_ILLNESS +portal, I-PRESENT_ILLNESS +probable I-PRESENT_ILLNESS +esteatohepatitis I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +origen I-PRESENT_ILLNESS +mixto, I-PRESENT_ILLNESS +Child I-PRESENT_ILLNESS +A5 I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +elevación I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +alfafetoproteína. I-PRESENT_ILLNESS +Entre B-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +destacan I-PAST_MEDICAL_HISTORY +hemocromatosis I-PAST_MEDICAL_HISTORY +(mutación I-PAST_MEDICAL_HISTORY +H63D I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +heterocigosis) I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +sobrecarga I-PAST_MEDICAL_HISTORY +férrica I-PAST_MEDICAL_HISTORY +controlada I-PAST_MEDICAL_HISTORY +mediante I-PAST_MEDICAL_HISTORY +realización I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +sangrías, I-PAST_MEDICAL_HISTORY +diabetes I-PAST_MEDICAL_HISTORY +mellitus I-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +II I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +insulina I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +metformina, I-PAST_MEDICAL_HISTORY +esofagitis I-PAST_MEDICAL_HISTORY +grado I-PAST_MEDICAL_HISTORY +A I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +presencia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +pequeño I-PAST_MEDICAL_HISTORY +cordón I-PAST_MEDICAL_HISTORY +varicoso I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +ansiedad. I-PAST_MEDICAL_HISTORY +En B-EXPLORATION +los I-EXPLORATION +datos I-EXPLORATION +analíticos I-EXPLORATION +se I-EXPLORATION +objetivan I-EXPLORATION +los I-EXPLORATION +siguientes I-EXPLORATION +valores: I-EXPLORATION +Hemoglobina I-EXPLORATION +13, I-EXPLORATION +2 I-EXPLORATION +g/dl, I-EXPLORATION +Hematocrito I-EXPLORATION +39, I-EXPLORATION +3%, I-EXPLORATION +Leucocitos I-EXPLORATION +6070, I-EXPLORATION +Plaquetas I-EXPLORATION +90000, I-EXPLORATION +INR I-EXPLORATION +1, I-EXPLORATION +04, I-EXPLORATION +Creatinina I-EXPLORATION +0, I-EXPLORATION +9 I-EXPLORATION +mg/dl, I-EXPLORATION +Bilirrubina I-EXPLORATION +total I-EXPLORATION +1, I-EXPLORATION +4 I-EXPLORATION +mg/dl, I-EXPLORATION +Albúmina I-EXPLORATION +3, I-EXPLORATION +1 I-EXPLORATION +g/dl, I-EXPLORATION +ASAT I-EXPLORATION +106 I-EXPLORATION +UI/L, I-EXPLORATION +ALAT I-EXPLORATION +108 I-EXPLORATION +UI/L, I-EXPLORATION +Fosfatasa I-EXPLORATION +alcalina I-EXPLORATION +144 I-EXPLORATION +UI/L, I-EXPLORATION +Gamma-GT I-EXPLORATION +553 I-EXPLORATION +UI/L I-EXPLORATION +y I-EXPLORATION +un I-EXPLORATION +índice I-EXPLORATION +MELD I-EXPLORATION +(Model I-EXPLORATION +for I-EXPLORATION +End I-EXPLORATION +Stage I-EXPLORATION +Liver I-EXPLORATION +Disease) I-EXPLORATION +de I-EXPLORATION +8. I-EXPLORATION + I-EXPLORATION +Respondedor B-TREATMENT +nulo I-TREATMENT +a I-TREATMENT +IFN I-TREATMENT +en I-TREATMENT +monoterapia I-TREATMENT +y I-TREATMENT +posteriormente I-TREATMENT +a I-TREATMENT +P-INF I-TREATMENT +asociado I-TREATMENT +a I-TREATMENT +RBV I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +es I-TREATMENT +candidato I-TREATMENT +a I-TREATMENT +triple I-TREATMENT +terapia I-TREATMENT +con I-TREATMENT +boceprevir. I-TREATMENT +Inicia I-TREATMENT +lead I-TREATMENT +in I-TREATMENT +con I-TREATMENT +RBV I-TREATMENT +oral I-TREATMENT +1000 I-TREATMENT +mg/día I-TREATMENT +y I-TREATMENT +P-INF I-TREATMENT +α2b I-TREATMENT +subcutáneo I-TREATMENT +120 I-TREATMENT +mcg/semana. I-TREATMENT +No I-TREATMENT +superó I-TREATMENT +la I-TREATMENT +fase I-TREATMENT +de I-TREATMENT +lead I-TREATMENT +in I-TREATMENT +(CV=33.680 I-TREATMENT +UI I-TREATMENT +RNA/ml), I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +suspendió I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +a I-TREATMENT +la I-TREATMENT +5a I-TREATMENT +semana, I-TREATMENT +sin I-TREATMENT +haber I-TREATMENT +iniciado I-TREATMENT +boceprevir. I-TREATMENT + I-TREATMENT +Tras B-EVOLUTION +la I-EVOLUTION +última I-EVOLUTION +inyección I-EVOLUTION +de I-EVOLUTION +P-INF I-EVOLUTION +α2b I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +acudió I-EVOLUTION +a I-EVOLUTION +urgencias I-EVOLUTION +objetivando I-EVOLUTION +hematoma I-EVOLUTION +y I-EVOLUTION +dolor I-EVOLUTION +local I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +cara I-EVOLUTION +anterior I-EVOLUTION +del I-EVOLUTION +muslo I-EVOLUTION +derecho I-EVOLUTION +con I-EVOLUTION +aumento I-EVOLUTION +de I-EVOLUTION +volumen I-EVOLUTION +y I-EVOLUTION +temperatura I-EVOLUTION +local, I-EVOLUTION +y I-EVOLUTION +dolor I-EVOLUTION +al I-EVOLUTION +mover I-EVOLUTION +la I-EVOLUTION +cadera I-EVOLUTION +derecha, I-EVOLUTION +administrándose I-EVOLUTION +analgésicos I-EVOLUTION +y I-EVOLUTION +antibióticos I-EVOLUTION +(amoxicilina-clavulánico I-EVOLUTION +1g/62, I-EVOLUTION +5mg/8 I-EVOLUTION +horas I-EVOLUTION +oral). I-EVOLUTION +Dos I-EVOLUTION +días I-EVOLUTION +después I-EVOLUTION +regresó I-EVOLUTION +a I-EVOLUTION +urgencias I-EVOLUTION +presentando I-EVOLUTION +impotencia I-EVOLUTION +funcional I-EVOLUTION +y I-EVOLUTION +sensación I-EVOLUTION +distérmica. I-EVOLUTION +Mediante B-EXPLORATION +ecografía I-EXPLORATION +se I-EXPLORATION +visualizó I-EXPLORATION +una I-EXPLORATION +imagen I-EXPLORATION +hipoecogénica I-EXPLORATION +ovoidea I-EXPLORATION +de I-EXPLORATION +21x19x9 I-EXPLORATION +mm. I-EXPLORATION +Posteriormente I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +tomografía I-EXPLORATION +axial I-EXPLORATION +computarizada I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +imagen I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +infección I-EXPLORATION +de I-EXPLORATION +partes I-EXPLORATION +blandas, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +un I-EXPLORATION +absceso I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +espesor I-EXPLORATION +del I-EXPLORATION +musculo I-EXPLORATION +abductor I-EXPLORATION +largo I-EXPLORATION +del I-EXPLORATION +muslo I-EXPLORATION +derecho I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +extendía I-EXPLORATION +inferiormente I-EXPLORATION +entre I-EXPLORATION +el I-EXPLORATION +compartimento I-EXPLORATION +anterior I-EXPLORATION +y I-EXPLORATION +medio I-EXPLORATION +del I-EXPLORATION +mismo. I-EXPLORATION +Se B-TREATMENT +trató I-TREATMENT +con I-TREATMENT +antibióticos I-TREATMENT +(piperacilina/tazobactam I-TREATMENT +4g/0, I-TREATMENT +5g/8 I-TREATMENT +horas I-TREATMENT +y I-TREATMENT +daptomicina I-TREATMENT +500mg/24 I-TREATMENT +horas I-TREATMENT +intravenosos, I-TREATMENT +durante I-TREATMENT +3 I-TREATMENT +días) I-TREATMENT +y I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +desbridamiento I-TREATMENT +quirúrgico. I-TREATMENT +Tras B-EVOLUTION +una I-EVOLUTION +cirugía I-EVOLUTION +con I-EVOLUTION +complicaciones, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +no I-EVOLUTION +evolucionó I-EVOLUTION +favorablemente I-EVOLUTION +por I-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +ingresó I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +unidad I-EVOLUTION +de I-EVOLUTION +cuidados I-EVOLUTION +intensivos I-EVOLUTION +(UCI). I-EVOLUTION + I-EVOLUTION +En I-EVOLUTION +UCI I-EVOLUTION +presentó I-EVOLUTION +shock I-EVOLUTION +séptico I-EVOLUTION +complicado I-EVOLUTION +con I-EVOLUTION +síndrome I-EVOLUTION +de I-EVOLUTION +disfunción I-EVOLUTION +multiorgánica. I-EVOLUTION +En B-EXPLORATION +los I-EXPLORATION +cultivos I-EXPLORATION +del I-EXPLORATION +absceso I-EXPLORATION +muscular I-EXPLORATION +se I-EXPLORATION +aisló I-EXPLORATION +Staphylococcus I-EXPLORATION +aureus I-EXPLORATION +meticilin-sensible, I-EXPLORATION +que B-TREATMENT +se I-TREATMENT +trató I-TREATMENT +con I-TREATMENT +linezolid I-TREATMENT +(600mg/12 I-TREATMENT +horas I-TREATMENT +intravenoso) I-TREATMENT +y I-TREATMENT +posteriormente I-TREATMENT +con I-TREATMENT +cloxacilina I-TREATMENT +(1g/6 I-TREATMENT +horas I-TREATMENT +intravenoso) I-TREATMENT +durante I-TREATMENT +15 I-TREATMENT +días. I-TREATMENT + I-TREATMENT +Posteriormente B-EVOLUTION +desarrolló I-EVOLUTION +síndrome I-EVOLUTION +de I-EVOLUTION +distress I-EVOLUTION +respiratorio I-EVOLUTION +agudo I-EVOLUTION +que B-TREATMENT +precisó I-TREATMENT +ventilación I-TREATMENT +mecánica I-TREATMENT +invasiva; I-TREATMENT +neumonía B-EVOLUTION +por I-EVOLUTION +Escherichia I-EVOLUTION +Coli I-EVOLUTION +asociada I-EVOLUTION +a I-EVOLUTION +ventilación I-EVOLUTION +mecánica I-EVOLUTION +que I-EVOLUTION +evolucionó I-EVOLUTION +favorablemente I-EVOLUTION +con B-TREATMENT +meropenem I-TREATMENT +(1000mg/8 I-TREATMENT +horas I-TREATMENT +intravenoso) I-TREATMENT +y I-TREATMENT +levofloxacino I-TREATMENT +(500 I-TREATMENT +mg/24 I-TREATMENT +horas I-TREATMENT +intravenoso) I-TREATMENT +durante I-TREATMENT +10 I-TREATMENT +días; I-TREATMENT +insuficiencia B-EVOLUTION +renal I-EVOLUTION +(IR) I-EVOLUTION +con I-EVOLUTION +oliguria I-EVOLUTION +que B-TREATMENT +requirió I-TREATMENT +hemofiltración I-TREATMENT +venosa I-TREATMENT +continua; I-TREATMENT +anemia B-EVOLUTION +y I-EVOLUTION +trombopenia I-EVOLUTION +graves I-EVOLUTION +que B-TREATMENT +requirieron I-TREATMENT +transfusiones I-TREATMENT +de I-TREATMENT +concentrados I-TREATMENT +de I-TREATMENT +hematíes I-TREATMENT +y I-TREATMENT +plaquetas; I-TREATMENT +hiperfosfatemia; B-EVOLUTION +hiperglucemia I-EVOLUTION +que B-TREATMENT +requirió I-TREATMENT +perfusión I-TREATMENT +de I-TREATMENT +insulina; I-TREATMENT +colonización B-EVOLUTION +por I-EVOLUTION +Candida I-EVOLUTION +Albicans I-EVOLUTION +en I-EVOLUTION +orina, I-EVOLUTION +secreciones I-EVOLUTION +y I-EVOLUTION +heces; I-EVOLUTION +hemorragia I-EVOLUTION +digestiva I-EVOLUTION +alta I-EVOLUTION +(HDA) I-EVOLUTION +y I-EVOLUTION +melenas; I-EVOLUTION +varices I-EVOLUTION +esofágicas I-EVOLUTION +grado I-EVOLUTION +III I-EVOLUTION +que I-EVOLUTION +no I-EVOLUTION +mostraban I-EVOLUTION +signos I-EVOLUTION +de I-EVOLUTION +sangrado I-EVOLUTION +activo I-EVOLUTION +pero B-TREATMENT +que I-TREATMENT +requirieron I-TREATMENT +ligadura I-TREATMENT +con I-TREATMENT +bandas I-TREATMENT +elásticas I-TREATMENT +y I-TREATMENT +aumento I-TREATMENT +transitorio I-TREATMENT +de I-TREATMENT +enzimas I-TREATMENT +hepáticas I-TREATMENT +y I-TREATMENT +bilirrubina I-TREATMENT +(17, I-TREATMENT +2 I-TREATMENT +mg/dL). I-TREATMENT + I-TREATMENT +El B-EVOLUTION +paciente I-EVOLUTION +continuó I-EVOLUTION +con I-EVOLUTION +deterioro I-EVOLUTION +gasométrico I-EVOLUTION +y I-EVOLUTION +radiológico, I-EVOLUTION +con I-EVOLUTION +infiltrados I-EVOLUTION +alveolo-intersticiales I-EVOLUTION +basales I-EVOLUTION +y I-EVOLUTION +bilaterales I-EVOLUTION +en I-EVOLUTION +los I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +aisló I-EVOLUTION +Klebsiella I-EVOLUTION +Pneumoniae I-EVOLUTION +productora I-EVOLUTION +de I-EVOLUTION +betalactamasas I-EVOLUTION +de I-EVOLUTION +amplio I-EVOLUTION +espectro I-EVOLUTION +sensible I-EVOLUTION +a I-EVOLUTION +colistina. I-EVOLUTION +A I-EVOLUTION +pesar I-EVOLUTION +del I-EVOLUTION +tratamiento I-EVOLUTION +dirigido I-EVOLUTION +(colistina I-EVOLUTION +intravenosa I-EVOLUTION +e I-EVOLUTION +inhalada I-EVOLUTION +ajustada I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +función I-EVOLUTION +renal) I-EVOLUTION +durante I-EVOLUTION +4 I-EVOLUTION +días I-EVOLUTION +más, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +presentó I-EVOLUTION +insuficiencia I-EVOLUTION +respiratoria I-EVOLUTION +aguda I-EVOLUTION +grave, I-EVOLUTION +disfunción I-EVOLUTION +multiorgánica I-EVOLUTION +con I-EVOLUTION +acidosis I-EVOLUTION +láctica I-EVOLUTION +grave I-EVOLUTION +y I-EVOLUTION +shock I-EVOLUTION +séptico I-EVOLUTION +refractario I-EVOLUTION +siendo I-EVOLUTION +finalmente I-EVOLUTION +exitus. I-EVOLUTION + I-EVOLUTION + +Se B-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +58 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +masculino, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +más I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +10 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +evolución, I-PAST_MEDICAL_HISTORY +tratado I-PAST_MEDICAL_HISTORY +pero I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +controlado. I-PAST_MEDICAL_HISTORY +Como I-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +patológico I-PAST_MEDICAL_HISTORY +relevante I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +habia I-PAST_MEDICAL_HISTORY +advertido I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +masa I-PAST_MEDICAL_HISTORY +abdominal I-PAST_MEDICAL_HISTORY +palpable I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +pulsátil I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +último I-PAST_MEDICAL_HISTORY +mes. I-PAST_MEDICAL_HISTORY +Diez B-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +antes I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +ingreso I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +nuestro I-PRESENT_ILLNESS +centro I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +intenso. I-PRESENT_ILLNESS +La B-EXPLORATION +tomografía I-EXPLORATION +computarizada I-EXPLORATION +abdominal I-EXPLORATION +demostró I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +aneurisma I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +aorta I-EXPLORATION +infrarrenal, I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +proceso I-EXPLORATION +inflamatorio I-EXPLORATION +que I-EXPLORATION +involucra I-EXPLORATION +y I-EXPLORATION +lo I-EXPLORATION +adhiere I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +tercera I-EXPLORATION +porción I-EXPLORATION +del I-EXPLORATION +duodeno. I-EXPLORATION +El B-TREATMENT +paciente I-TREATMENT +solicitó I-TREATMENT +el I-TREATMENT +alta I-TREATMENT +voluntaria I-TREATMENT +ante I-TREATMENT +la I-TREATMENT +propuesta I-TREATMENT +quirúrgica. I-TREATMENT +Cinco B-EVOLUTION +días I-EVOLUTION +después I-EVOLUTION +reingresó I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +Servicio I-EVOLUTION +de I-EVOLUTION +Terapia I-EVOLUTION +Intensiva I-EVOLUTION +por I-EVOLUTION +presentar I-EVOLUTION +hemorragia I-EVOLUTION +digestiva I-EVOLUTION +alta I-EVOLUTION +manifestada I-EVOLUTION +por I-EVOLUTION +hematemesis I-EVOLUTION +y I-EVOLUTION +melena I-EVOLUTION +de I-EVOLUTION +48 I-EVOLUTION +horas I-EVOLUTION +de I-EVOLUTION +evolución, I-EVOLUTION +cuadro I-EVOLUTION +de I-EVOLUTION +shock I-EVOLUTION +hipovolémico, I-EVOLUTION +tensión I-EVOLUTION +arterial I-EVOLUTION +media I-EVOLUTION +(TAM) I-EVOLUTION +30 I-EVOLUTION +mmHg, I-EVOLUTION +frecuencia I-EVOLUTION +cardíaca I-EVOLUTION +(FC): I-EVOLUTION +140 I-EVOLUTION +lpm I-EVOLUTION +y I-EVOLUTION +hematocrito I-EVOLUTION +del I-EVOLUTION +18%. I-EVOLUTION +Una B-EXPLORATION +vez I-EXPLORATION +compensado I-EXPLORATION +el I-EXPLORATION +trastorno I-EXPLORATION +hemodinámico, I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +fibroendoscopia I-EXPLORATION +digestiva I-EXPLORATION +alta, I-EXPLORATION +constatándose I-EXPLORATION +sangrado I-EXPLORATION +activo I-EXPLORATION +en I-EXPLORATION +cara I-EXPLORATION +posterior I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +tercera I-EXPLORATION +porción I-EXPLORATION +duodenal. I-EXPLORATION +Se B-TREATMENT +decidió I-TREATMENT +entonces I-TREATMENT +la I-TREATMENT +intervención I-TREATMENT +quirúrgica I-TREATMENT +por I-TREATMENT +resangrado I-TREATMENT +masivo, I-TREATMENT +con I-TREATMENT +el I-TREATMENT +hallazgo I-TREATMENT +intraoperatorio I-TREATMENT +de I-TREATMENT +aneurisma I-TREATMENT +de I-TREATMENT +aorta I-TREATMENT +abdominal I-TREATMENT +infrarrenal I-TREATMENT +sacular I-TREATMENT +adherido I-TREATMENT +a I-TREATMENT +la I-TREATMENT +cara I-TREATMENT +posterior I-TREATMENT +de I-TREATMENT +la I-TREATMENT +tercera I-TREATMENT +porción I-TREATMENT +duodenal I-TREATMENT +con I-TREATMENT +comunicación I-TREATMENT +a I-TREATMENT +la I-TREATMENT +luz I-TREATMENT +de I-TREATMENT +dicho I-TREATMENT +órgano I-TREATMENT +por I-TREATMENT +un I-TREATMENT +orificio I-TREATMENT +de I-TREATMENT +unos I-TREATMENT +4 I-TREATMENT +cm I-TREATMENT +de I-TREATMENT +diámetro. I-TREATMENT +Se I-TREATMENT +realizó I-TREATMENT +un I-TREATMENT +by-pass I-TREATMENT +aorto-bifemoral. I-TREATMENT +Debido B-EVOLUTION +al I-EVOLUTION +grave I-EVOLUTION +compromiso I-EVOLUTION +hemodinámico I-EVOLUTION +presentó I-EVOLUTION +paro I-EVOLUTION +cardiorrespiratorio I-EVOLUTION +en I-EVOLUTION +quirófano, I-EVOLUTION +falleciendo I-EVOLUTION +pocas I-EVOLUTION +horas I-EVOLUTION +después I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +Servicio I-EVOLUTION +de I-EVOLUTION +Terapia I-EVOLUTION +Intensiva. I-EVOLUTION + I-EVOLUTION + +Paciente B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +femenino, I-PRESENT_ILLNESS +52 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +TEC I-PAST_MEDICAL_HISTORY +simple I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +20 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +secuelas I-PAST_MEDICAL_HISTORY +y B-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +rinorrea I-PRESENT_ILLNESS +acuosa I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tres I-PRESENT_ILLNESS +semanas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +ni I-PRESENT_ILLNESS +cefalea. I-PRESENT_ILLNESS +Consultó I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +otorrinolaringología I-PRESENT_ILLNESS +donde I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +le I-PRESENT_ILLNESS +diagnosticó I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +probable I-PRESENT_ILLNESS +rinitis I-PRESENT_ILLNESS +vasomotora. I-PRESENT_ILLNESS +Se B-TREATMENT +prescribió I-TREATMENT +corticoides I-TREATMENT +intranasales I-TREATMENT +y I-TREATMENT +sistémicos I-TREATMENT +(prednisona I-TREATMENT +10 I-TREATMENT +mg I-TREATMENT +al I-TREATMENT +día) I-TREATMENT +y I-TREATMENT +azitromicina I-TREATMENT +por I-TREATMENT +siete I-TREATMENT +días. I-TREATMENT + I-TREATMENT +Luego B-EVOLUTION +de I-EVOLUTION +una I-EVOLUTION +mejoría I-EVOLUTION +transitoria I-EVOLUTION +del I-EVOLUTION +cuadro I-EVOLUTION +presentó I-EVOLUTION +una I-EVOLUTION +cefalea I-EVOLUTION +holocránea I-EVOLUTION +de I-EVOLUTION +inicio I-EVOLUTION +súbito, I-EVOLUTION +asociado I-EVOLUTION +a I-EVOLUTION +un I-EVOLUTION +dolor I-EVOLUTION +cervical, I-EVOLUTION +compromiso I-EVOLUTION +de I-EVOLUTION +conciencia I-EVOLUTION +sin I-EVOLUTION +focalidad I-EVOLUTION +neurológica I-EVOLUTION +evidente I-EVOLUTION +y I-EVOLUTION +calofríos, I-EVOLUTION +por I-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +consultó I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +Servicio I-EVOLUTION +de I-EVOLUTION +Urgencia I-EVOLUTION +de I-EVOLUTION +nuestro I-EVOLUTION +hospital. I-EVOLUTION +Al B-EXPLORATION +ingreso I-EXPLORATION +destacaban I-EXPLORATION +cifras I-EXPLORATION +tensionales I-EXPLORATION +límites I-EXPLORATION +(presión I-EXPLORATION +arterial I-EXPLORATION +108/70 I-EXPLORATION +mm I-EXPLORATION +Hg) I-EXPLORATION +que I-EXPLORATION +respondieron I-EXPLORATION +a I-EXPLORATION +volumen, I-EXPLORATION +fiebre I-EXPLORATION +(T° I-EXPLORATION +38, I-EXPLORATION +5°C), I-EXPLORATION +desorientación I-EXPLORATION +temporo-espacial, I-EXPLORATION +agitación I-EXPLORATION +psicomotora I-EXPLORATION +y I-EXPLORATION +signos I-EXPLORATION +meníngeos. I-EXPLORATION +Se I-EXPLORATION +tomaron I-EXPLORATION +hemocultivos I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +efectuó I-EXPLORATION +una I-EXPLORATION +punción I-EXPLORATION +lumbar I-EXPLORATION +que I-EXPLORATION +dio I-EXPLORATION +salida I-EXPLORATION +a I-EXPLORATION +LCR I-EXPLORATION +turbio, I-EXPLORATION +citoquímico: I-EXPLORATION +8.480 I-EXPLORATION +céls/mm3, I-EXPLORATION +100% I-EXPLORATION +polimorfonucleares, I-EXPLORATION +proteínas I-EXPLORATION +370 I-EXPLORATION +mg/dl I-EXPLORATION +y I-EXPLORATION +glucosa I-EXPLORATION +2 I-EXPLORATION +mg/dl. I-EXPLORATION +Con B-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT +de I-TREATMENT +una I-TREATMENT +MBA I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +empírico I-TREATMENT +con I-TREATMENT +ceftriaxona I-TREATMENT +2 I-TREATMENT +g, I-TREATMENT +dos I-TREATMENT +veces I-TREATMENT +al I-TREATMENT +día I-TREATMENT +y I-TREATMENT +dexametasona I-TREATMENT +i.v. I-TREATMENT +10 I-TREATMENT +mg, I-TREATMENT +4 I-TREATMENT +veces I-TREATMENT +al I-TREATMENT +día, I-TREATMENT +esta I-TREATMENT +última I-TREATMENT +por I-TREATMENT +4 I-TREATMENT +días. I-TREATMENT +La B-EXPLORATION +tomografía I-EXPLORATION +axial I-EXPLORATION +computada I-EXPLORATION +(TAC) I-EXPLORATION +de I-EXPLORATION +cerebro I-EXPLORATION +no I-EXPLORATION +mostró I-EXPLORATION +alteraciones I-EXPLORATION +significativas. I-EXPLORATION +Fue B-EVOLUTION +admitida I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +Unidad I-EVOLUTION +de I-EVOLUTION +Pacientes I-EVOLUTION +Críticos, I-EVOLUTION +donde I-EVOLUTION +evolucionó I-EVOLUTION +sin I-EVOLUTION +requerimiento I-EVOLUTION +de I-EVOLUTION +fármacos I-EVOLUTION +vasoactivos, I-EVOLUTION +con I-EVOLUTION +caída I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +curva I-EVOLUTION +febril I-EVOLUTION +y I-EVOLUTION +recuperación I-EVOLUTION +en I-EVOLUTION +su I-EVOLUTION +condición I-EVOLUTION +neurológica I-EVOLUTION +en I-EVOLUTION +menos I-EVOLUTION +de I-EVOLUTION +24 I-EVOLUTION +h. I-EVOLUTION + I-EVOLUTION +En B-EXPLORATION +la I-EXPLORATION +tinción I-EXPLORATION +de I-EXPLORATION +Gram I-EXPLORATION +del I-EXPLORATION +LCR I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +observaron I-EXPLORATION +bacterias I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +tinción I-EXPLORATION +naranja I-EXPLORATION +de I-EXPLORATION +acridina I-EXPLORATION +mostró I-EXPLORATION +formas I-EXPLORATION +cocoides. I-EXPLORATION +Tanto I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +LCR I-EXPLORATION +como I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +hemocultivos I-EXPLORATION +hubo I-EXPLORATION +identificación I-EXPLORATION +de I-EXPLORATION +S. I-EXPLORATION +agalactiae I-EXPLORATION +susceptible I-EXPLORATION +a I-EXPLORATION +penicilina, I-EXPLORATION +eritromicina I-EXPLORATION +y I-EXPLORATION +clindamicina. I-EXPLORATION +El I-EXPLORATION +laboratorio I-EXPLORATION +de I-EXPLORATION +referencia I-EXPLORATION +(Instituto I-EXPLORATION +de I-EXPLORATION +Salud I-EXPLORATION +Pública I-EXPLORATION +de I-EXPLORATION +Chile) I-EXPLORATION +confirmó I-EXPLORATION +posteriormente I-EXPLORATION +los I-EXPLORATION +hallazgos I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +cultivos, I-EXPLORATION +informando I-EXPLORATION +además I-EXPLORATION +que I-EXPLORATION +correspondía I-EXPLORATION +al I-EXPLORATION +serotipo I-EXPLORATION +Ib. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +paciente I-EXPLORATION +fue I-EXPLORATION +evaluada I-EXPLORATION +por I-EXPLORATION +ginecología I-EXPLORATION +encontrándose I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +vulvovaginitis I-EXPLORATION +y I-EXPLORATION +miomas I-EXPLORATION +uterinos, I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +estudio I-EXPLORATION +microbiológico. I-EXPLORATION +Al I-EXPLORATION +examen I-EXPLORATION +otorrino-laringológico I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +una I-EXPLORATION +rinorrea I-EXPLORATION +acuosa I-EXPLORATION +abundante I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +fosa I-EXPLORATION +nasal I-EXPLORATION +izquierda I-EXPLORATION +evidenciada I-EXPLORATION +con I-EXPLORATION +la I-EXPLORATION +maniobra I-EXPLORATION +de I-EXPLORATION +Valsalva. I-EXPLORATION +Por I-EXPLORATION +la I-EXPLORATION +sospecha I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +fístula I-EXPLORATION +de I-EXPLORATION +LCR I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +TAC I-EXPLORATION +de I-EXPLORATION +cavidades I-EXPLORATION +paranasales I-EXPLORATION +de I-EXPLORATION +alta I-EXPLORATION +resolución I-EXPLORATION +que I-EXPLORATION +reveló I-EXPLORATION +pérdida I-EXPLORATION +de I-EXPLORATION +continuidad I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +lámina I-EXPLORATION +cribosa I-EXPLORATION +del I-EXPLORATION +etmoides I-EXPLORATION +izquierdo I-EXPLORATION +y I-EXPLORATION +adelgazamiento I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +pared I-EXPLORATION +postero-lateral I-EXPLORATION +del I-EXPLORATION +hemiseno I-EXPLORATION +esfenoidal I-EXPLORATION +izquierdo I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +aspecto I-EXPLORATION +más I-EXPLORATION +craneal I-EXPLORATION +con I-EXPLORATION +engrasamiento I-EXPLORATION +mucoso. I-EXPLORATION +Se I-EXPLORATION +solicitó I-EXPLORATION +un I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +β2-transferrina I-EXPLORATION +del I-EXPLORATION +líquido I-EXPLORATION +nasal, I-EXPLORATION +que I-EXPLORATION +resultó I-EXPLORATION +positivo. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +además I-EXPLORATION +una I-EXPLORATION +TAC I-EXPLORATION +de I-EXPLORATION +abdomen I-EXPLORATION +y I-EXPLORATION +pelvis I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +reveló I-EXPLORATION +hallazgos I-EXPLORATION +de I-EXPLORATION +importancia. I-EXPLORATION + I-EXPLORATION +Su B-EVOLUTION +evolución I-EVOLUTION +clínica I-EVOLUTION +fue I-EVOLUTION +favorable, I-EVOLUTION +con I-EVOLUTION +disminución I-EVOLUTION +progresiva I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +parámetros I-EVOLUTION +inflamatorios, I-EVOLUTION +completando I-EVOLUTION +14 I-EVOLUTION +días I-EVOLUTION +con I-EVOLUTION +ceftriaxona. I-EVOLUTION +Se I-EVOLUTION +decidió I-EVOLUTION +el I-EVOLUTION +alta I-EVOLUTION +con I-EVOLUTION +una I-EVOLUTION +programación I-EVOLUTION +diferida I-EVOLUTION +de I-EVOLUTION +resolución I-EVOLUTION +quirúrgica I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +fístula I-EVOLUTION +de I-EVOLUTION +LCR. I-EVOLUTION +Se B-TREATMENT +recomendó I-TREATMENT +la I-TREATMENT +vacunación I-TREATMENT +antineumocócica I-TREATMENT +polisacárida I-TREATMENT +y I-TREATMENT +antimeningocócica I-TREATMENT +cuadrivalente I-TREATMENT +conjugada. I-TREATMENT + I-TREATMENT +En B-PAST_MEDICAL_HISTORY +forma I-PAST_MEDICAL_HISTORY +dirigida I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +refirió I-PAST_MEDICAL_HISTORY +golpes I-PAST_MEDICAL_HISTORY +menores I-PAST_MEDICAL_HISTORY +recurrentes I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +cabeza I-PAST_MEDICAL_HISTORY +varias I-PAST_MEDICAL_HISTORY +semanas I-PAST_MEDICAL_HISTORY +previas I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +ingreso I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +muro I-PAST_MEDICAL_HISTORY +debajo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +escalera I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +le I-PAST_MEDICAL_HISTORY +permitía I-PAST_MEDICAL_HISTORY +acceder I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +patio I-PAST_MEDICAL_HISTORY +común I-PAST_MEDICAL_HISTORY +para I-PAST_MEDICAL_HISTORY +tender I-PAST_MEDICAL_HISTORY +ropa. I-PAST_MEDICAL_HISTORY +La I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +reconoció I-PAST_MEDICAL_HISTORY +además I-PAST_MEDICAL_HISTORY +haber I-PAST_MEDICAL_HISTORY +ocupado I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +mismo I-PAST_MEDICAL_HISTORY +papel I-PAST_MEDICAL_HISTORY +higiénico I-PAST_MEDICAL_HISTORY para I-PAST_MEDICAL_HISTORY +limpiarse I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +zona I-PAST_MEDICAL_HISTORY +genital I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +nasal I-PAST_MEDICAL_HISTORY +unos I-PAST_MEDICAL_HISTORY +días I-PAST_MEDICAL_HISTORY +antes I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +ingreso I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +escasez I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +éste I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +baño, I-PAST_MEDICAL_HISTORY +durante I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +visita I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +unos I-PAST_MEDICAL_HISTORY +familiares I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +atendiendo I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +intensa I-PAST_MEDICAL_HISTORY +rinorrea. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Tras B-EVOLUTION +el I-EVOLUTION +alta I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +no I-EVOLUTION +volvió I-EVOLUTION +a I-EVOLUTION +presentar I-EVOLUTION +salida I-EVOLUTION +de I-EVOLUTION +LCR I-EVOLUTION +por I-EVOLUTION +la I-EVOLUTION +nariz. I-EVOLUTION +A B-TREATMENT +pesar I-TREATMENT +de I-TREATMENT +esto, I-TREATMENT +debido I-TREATMENT +a I-TREATMENT +que I-TREATMENT +presentaba I-TREATMENT +una I-TREATMENT +fístula I-TREATMENT +de I-TREATMENT +probable I-TREATMENT +origen I-TREATMENT +espontáneo I-TREATMENT +y I-TREATMENT +que I-TREATMENT +ya I-TREATMENT +había I-TREATMENT +tenido I-TREATMENT +un I-TREATMENT +episodio I-TREATMENT +de I-TREATMENT +MBA, I-TREATMENT +se I-TREATMENT +le I-TREATMENT +aconsejó I-TREATMENT +someterse I-TREATMENT +a I-TREATMENT +una I-TREATMENT +cirugía I-TREATMENT +endoscópica I-TREATMENT +nasal I-TREATMENT +para I-TREATMENT +reparar I-TREATMENT +la I-TREATMENT +zona I-TREATMENT +dehiscente I-TREATMENT +en I-TREATMENT +la I-TREATMENT +base I-TREATMENT +del I-TREATMENT +cráneo I-TREATMENT +anterior. I-TREATMENT + I-TREATMENT + +Paciente B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +51 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +diagnosticado B-PAST_MEDICAL_HISTORY +20 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +antes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Neurolues, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +secuelas I-PAST_MEDICAL_HISTORY +establecidas I-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +trastornos I-PAST_MEDICAL_HISTORY +mnésicos I-PAST_MEDICAL_HISTORY +visuales I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +verbales, I-PAST_MEDICAL_HISTORY +así I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +radiculoneuropatía I-PAST_MEDICAL_HISTORY +múltiple. I-PAST_MEDICAL_HISTORY +En B-EXPLORATION +la I-EXPLORATION +radiología I-EXPLORATION +de I-EXPLORATION +tórax I-EXPLORATION +presentaba I-EXPLORATION +elongación I-EXPLORATION +aórtica I-EXPLORATION +sin I-EXPLORATION +repercusión I-EXPLORATION +clínica. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +electroencefalograma I-EXPLORATION +con I-EXPLORATION +trazado I-EXPLORATION +normal, I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +TC I-EXPLORATION +craneal I-EXPLORATION +con I-EXPLORATION +y I-EXPLORATION +sin I-EXPLORATION +contraste I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +morfología I-EXPLORATION +cerebral I-EXPLORATION +dentro I-EXPLORATION +de I-EXPLORATION +límites I-EXPLORATION +normales. I-EXPLORATION +La I-EXPLORATION +serología I-EXPLORATION +para I-EXPLORATION +Lues I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +test I-EXPLORATION +RPR I-EXPLORATION +y I-EXPLORATION +TPHA I-EXPLORATION +fueron I-EXPLORATION +positivos. I-EXPLORATION +El I-EXPLORATION +ácido I-EXPLORATION +fólico I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +vitamina I-EXPLORATION +B12 I-EXPLORATION +estaban I-EXPLORATION +dentro I-EXPLORATION +del I-EXPLORATION +rango I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +normalidad. I-EXPLORATION + I-EXPLORATION +El B-DERIVED_FROM/TO +paciente I-DERIVED_FROM/TO +fue I-DERIVED_FROM/TO +derivado I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +nuestras I-DERIVED_FROM/TO +consultas I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Urodinámica I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +trastornos I-DERIVED_FROM/TO +miccionales I-DERIVED_FROM/TO +refiriendo I-DERIVED_FROM/TO +incontinencia I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +urgencia, I-DERIVED_FROM/TO +no I-DERIVED_FROM/TO +precisando I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +prensa I-DERIVED_FROM/TO +abdominal I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +vaciado I-DERIVED_FROM/TO +vesical. I-DERIVED_FROM/TO +Se B-EXPLORATION +realizó I-EXPLORATION +estudio I-EXPLORATION +urodinámico I-EXPLORATION +objetivándose I-EXPLORATION +un I-EXPLORATION +detrusor I-EXPLORATION +hiperrefléxico I-EXPLORATION +con I-EXPLORATION +presiones I-EXPLORATION +altas I-EXPLORATION +y I-EXPLORATION +contracciones I-EXPLORATION +involuntarias I-EXPLORATION +no I-EXPLORATION +inhibidas I-EXPLORATION +que I-EXPLORATION +ocasionaban I-EXPLORATION +escapes; I-EXPLORATION +la I-EXPLORATION +curva I-EXPLORATION +de I-EXPLORATION +Presión/ I-EXPLORATION +Flujo I-EXPLORATION +no I-EXPLORATION +mostraba I-EXPLORATION +alteraciones. I-EXPLORATION +Con B-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT +de I-TREATMENT +detrusor I-TREATMENT +hiperactivo I-TREATMENT +de I-TREATMENT +causa I-TREATMENT +neurogénica I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +anticolinérgicos, I-TREATMENT +estando B-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +actualidad I-EVOLUTION +estable I-EVOLUTION +clínicamente I-EVOLUTION +con I-EVOLUTION +urgencia I-EVOLUTION +ocasional I-EVOLUTION +sin I-EVOLUTION +incontinencia. I-EVOLUTION + I-EVOLUTION + +Hombre B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +37 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +fumador B-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +60 I-PAST_MEDICAL_HISTORY +cigarrillos/día I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +adolescencia, I-PAST_MEDICAL_HISTORY +hospitalizado B-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +síncope I-PRESENT_ILLNESS +recurrente. I-PRESENT_ILLNESS +Al B-EXPLORATION +ingreso, I-EXPLORATION +se I-EXPLORATION +registró I-EXPLORATION +TV I-EXPLORATION +monoforma I-EXPLORATION +con I-EXPLORATION +frecuencia I-EXPLORATION +de I-EXPLORATION +233 I-EXPLORATION +lpm I-EXPLORATION +en I-EXPLORATION +trazado I-EXPLORATION +de I-EXPLORATION +monitor, I-EXPLORATION +que I-EXPLORATION +convirtió I-EXPLORATION +espontáneamente I-EXPLORATION +a I-EXPLORATION +ritmo I-EXPLORATION +sinusal. I-EXPLORATION +El B-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +consumidor I-PAST_MEDICAL_HISTORY +ocasional I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +cocaína I-PAST_MEDICAL_HISTORY +hasta I-PAST_MEDICAL_HISTORY +3 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +antes I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +ingreso. I-PAST_MEDICAL_HISTORY +Negó B-PRESENT_ILLNESS +tener I-PRESENT_ILLNESS +angina I-PRESENT_ILLNESS +o I-PRESENT_ILLNESS +disnea. I-PRESENT_ILLNESS +En B-EXPLORATION +el I-EXPLORATION +ECG I-EXPLORATION +post-conversión I-EXPLORATION +a I-EXPLORATION +ritmo I-EXPLORATION +sinusal I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +ondas I-EXPLORATION +T I-EXPLORATION +(-) I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +derivaciones I-EXPLORATION +precordiales I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +pared I-EXPLORATION +inferior. I-EXPLORATION +La I-EXPLORATION +troponina I-EXPLORATION +I I-EXPLORATION +alcanzó I-EXPLORATION +un I-EXPLORATION +valor I-EXPLORATION +máximo I-EXPLORATION +de I-EXPLORATION +0, I-EXPLORATION +8 I-EXPLORATION +ng/ml I-EXPLORATION +[VN I-EXPLORATION +< I-EXPLORATION +0, I-EXPLORATION +4 I-EXPLORATION +ng/ml]. I-EXPLORATION +Un I-EXPLORATION +ecocardiograma I-EXPLORATION +reveló I-EXPLORATION +leve I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +diámetros I-EXPLORATION +internos I-EXPLORATION +del I-EXPLORATION +VI, I-EXPLORATION +disquinesia I-EXPLORATION +apical I-EXPLORATION +y I-EXPLORATION +lateroapical I-EXPLORATION +con I-EXPLORATION +función I-EXPLORATION +sistólica I-EXPLORATION +global I-EXPLORATION +levemente I-EXPLORATION +disminuida I-EXPLORATION +[FE I-EXPLORATION +45%, I-EXPLORATION +Simpson]. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +evaluación I-EXPLORATION +del I-EXPLORATION +VD I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +encontró I-EXPLORATION +anormalidades. I-EXPLORATION +Con I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +presuntivo I-EXPLORATION +de I-EXPLORATION +enfermedad I-EXPLORATION +coronaria, I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +estudio I-EXPLORATION +angiográfico I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +arterias I-EXPLORATION +coronarias I-EXPLORATION +normales. I-EXPLORATION +Para I-EXPLORATION +avanzar I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +diagnóstico, I-EXPLORATION +se I-EXPLORATION +solicitó I-EXPLORATION +RC. I-EXPLORATION +Las I-EXPLORATION +imágenes I-EXPLORATION +con I-EXPLORATION +secuencias I-EXPLORATION +de I-EXPLORATION +eco-gradiente I-EXPLORATION +en I-EXPLORATION +4-cavidades I-EXPLORATION +y I-EXPLORATION +eje I-EXPLORATION +corto, I-EXPLORATION +mostraron I-EXPLORATION +dilatación I-EXPLORATION +del I-EXPLORATION +VD I-EXPLORATION +[VDVD/ASC I-EXPLORATION +122/m2] I-EXPLORATION +con I-EXPLORATION +acentuada I-EXPLORATION +disminución I-EXPLORATION +del I-EXPLORATION +espesor I-EXPLORATION +parietal I-EXPLORATION +especialmente I-EXPLORATION +en I-EXPLORATION +pared I-EXPLORATION +lateral, I-EXPLORATION +microaneurismas I-EXPLORATION +(flechas I-EXPLORATION +amarillas), I-EXPLORATION +disquinesia I-EXPLORATION +de I-EXPLORATION +pared I-EXPLORATION +lateral I-EXPLORATION +basal I-EXPLORATION +e I-EXPLORATION +inferior I-EXPLORATION +(flechas I-EXPLORATION +azules) I-EXPLORATION +y I-EXPLORATION +función I-EXPLORATION +global I-EXPLORATION +severamente I-EXPLORATION +disminuida I-EXPLORATION +(FE I-EXPLORATION +19%). I-EXPLORATION +Al I-EXPLORATION +mismo I-EXPLORATION +tiempo, I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +leve I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +diámetros I-EXPLORATION +internos I-EXPLORATION +del I-EXPLORATION +VI I-EXPLORATION +con I-EXPLORATION +moderada I-EXPLORATION +diminución I-EXPLORATION +de I-EXPLORATION +su I-EXPLORATION +función I-EXPLORATION +sistólica I-EXPLORATION +global I-EXPLORATION +(FE I-EXPLORATION +38%), I-EXPLORATION +dos I-EXPLORATION +zonas I-EXPLORATION +con I-EXPLORATION +disquinesia I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +región I-EXPLORATION +apical I-EXPLORATION +con I-EXPLORATION +adelgazamiento I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +pared I-EXPLORATION +miocárdica I-EXPLORATION +(flechas I-EXPLORATION +azules) I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +zona I-EXPLORATION +de I-EXPLORATION +aquinesia I-EXPLORATION +con I-EXPLORATION +miocardio I-EXPLORATION +adelgazado I-EXPLORATION +en I-EXPLORATION +pared I-EXPLORATION +lateral I-EXPLORATION +(flecha I-EXPLORATION +roja) I-EXPLORATION +e I-EXPLORATION +infiltración I-EXPLORATION +grasa I-EXPLORATION +adyacente I-EXPLORATION +(flecha I-EXPLORATION +verde). I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +imagen I-EXPLORATION +axial I-EXPLORATION +potenciada I-EXPLORATION +en I-EXPLORATION +T1, I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +infiltración I-EXPLORATION +grasa I-EXPLORATION +subepicárdica I-EXPLORATION +en I-EXPLORATION +pared I-EXPLORATION +lateral I-EXPLORATION +del I-EXPLORATION +VD, I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +pared I-EXPLORATION +lateral I-EXPLORATION +y I-EXPLORATION +ápex I-EXPLORATION +del I-EXPLORATION +VI I-EXPLORATION +(flechas I-EXPLORATION +verdes). I-EXPLORATION +A I-EXPLORATION +su I-EXPLORATION +vez, I-EXPLORATION +la I-EXPLORATION +imagen I-EXPLORATION +de I-EXPLORATION +4-cavidades I-EXPLORATION +con I-EXPLORATION +secuencias I-EXPLORATION +de I-EXPLORATION +inversión-recuperación I-EXPLORATION +para I-EXPLORATION +evaluar I-EXPLORATION +viabilidad, I-EXPLORATION +luego I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +administración I-EXPLORATION +de I-EXPLORATION +gadolinio I-EXPLORATION +endovenoso, I-EXPLORATION +mostró I-EXPLORATION +extensa I-EXPLORATION +área I-EXPLORATION +de I-EXPLORATION +fibrosis I-EXPLORATION +(realce I-EXPLORATION +tardío) I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +pared I-EXPLORATION +lateral I-EXPLORATION +del I-EXPLORATION +VD I-EXPLORATION +y I-EXPLORATION +región I-EXPLORATION +subtricuspídea I-EXPLORATION +(flechas I-EXPLORATION +naranjas). I-EXPLORATION + I-EXPLORATION +Los I-EXPLORATION +hallazgos I-EXPLORATION +descritos I-EXPLORATION +son I-EXPLORATION +diagnósticos I-EXPLORATION +para I-EXPLORATION +DAVD I-EXPLORATION +con I-EXPLORATION +compromiso I-EXPLORATION +de I-EXPLORATION +VI, I-EXPLORATION +en I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +tres I-EXPLORATION +criterios I-EXPLORATION +diagnósticos I-EXPLORATION +mayores: I-EXPLORATION +ondas I-EXPLORATION +T I-EXPLORATION +invertidas I-EXPLORATION +en I-EXPLORATION +derivaciones I-EXPLORATION +precordiales I-EXPLORATION +derechas I-EXPLORATION +(V1 I-EXPLORATION +a I-EXPLORATION +V6) I-EXPLORATION +en I-EXPLORATION +individuo I-EXPLORATION +> I-EXPLORATION +14 I-EXPLORATION +años I-EXPLORATION +sin I-EXPLORATION +bloqueo I-EXPLORATION +de I-EXPLORATION +rama I-EXPLORATION +derecho, I-EXPLORATION +disquinesia I-EXPLORATION +regionales I-EXPLORATION +del I-EXPLORATION +VD I-EXPLORATION +más I-EXPLORATION +cociente I-EXPLORATION +de I-EXPLORATION +volumen I-EXPLORATION +telediastólico I-EXPLORATION +del I-EXPLORATION +VD I-EXPLORATION +> I-EXPLORATION +110 I-EXPLORATION +ml/m2 I-EXPLORATION +(varones); I-EXPLORATION +TV I-EXPLORATION +documentada. I-EXPLORATION +El B-TREATMENT +tratamiento I-TREATMENT +de I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +incluyó I-TREATMENT +la I-TREATMENT +implantación I-TREATMENT +de I-TREATMENT +un I-TREATMENT +CDI. I-TREATMENT + I-TREATMENT + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +83 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +histerectomía, I-PAST_MEDICAL_HISTORY +cólicos I-PAST_MEDICAL_HISTORY +renales, I-PAST_MEDICAL_HISTORY +hepatitis I-PAST_MEDICAL_HISTORY +B, I-PAST_MEDICAL_HISTORY +anemia I-PAST_MEDICAL_HISTORY +megaloblástica I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +cólicos I-PAST_MEDICAL_HISTORY +biliares I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +repetición, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +ingresa I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +urgencia I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +difuso, I-PRESENT_ILLNESS +náuseas I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +vómitos I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +varios I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +abdominal I-EXPLORATION +se I-EXPLORATION +aprecia I-EXPLORATION +dolor I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación I-EXPLORATION +superficial I-EXPLORATION +y I-EXPLORATION +profunda I-EXPLORATION +en I-EXPLORATION +todo I-EXPLORATION +el I-EXPLORATION +hemiabdomen I-EXPLORATION +superior, I-EXPLORATION +especialmente I-EXPLORATION +en I-EXPLORATION +hipocondrio I-EXPLORATION +derecho. I-EXPLORATION +Analítica I-EXPLORATION +al I-EXPLORATION +ingreso: I-EXPLORATION +17 I-EXPLORATION +x I-EXPLORATION +109/l I-EXPLORATION +leucocitos I-EXPLORATION +con I-EXPLORATION +86% I-EXPLORATION +de I-EXPLORATION +neutrofilia; I-EXPLORATION +amilasemia I-EXPLORATION +5.203 I-EXPLORATION +U/l; I-EXPLORATION +amilasuria I-EXPLORATION +43.703 I-EXPLORATION +U/l; I-EXPLORATION +LDH I-EXPLORATION +675 I-EXPLORATION +U/l; I-EXPLORATION +bilirubina I-EXPLORATION +total I-EXPLORATION +1, I-EXPLORATION +55 I-EXPLORATION +mg/dl; I-EXPLORATION +GOT I-EXPLORATION +111 I-EXPLORATION +U/L; I-EXPLORATION +GPT I-EXPLORATION +152 I-EXPLORATION +U/l; I-EXPLORATION +GGT I-EXPLORATION +203 I-EXPLORATION +U/l; I-EXPLORATION +PH I-EXPLORATION +7.222, I-EXPLORATION +PCO2 I-EXPLORATION +28, I-EXPLORATION +8 I-EXPLORATION +mmHg; I-EXPLORATION +PO2 I-EXPLORATION +80 I-EXPLORATION +mmHg; I-EXPLORATION +bicarbonato I-EXPLORATION +13, I-EXPLORATION +7 I-EXPLORATION +mmol/l; I-EXPLORATION +fosfatasa I-EXPLORATION +alcalina I-EXPLORATION +y I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +coagulación I-EXPLORATION +normales. I-EXPLORATION +A I-EXPLORATION +las I-EXPLORATION +48 I-EXPLORATION +horas I-EXPLORATION +del I-EXPLORATION +ingreso I-EXPLORATION +mantiene I-EXPLORATION +cifras I-EXPLORATION +similares I-EXPLORATION +de I-EXPLORATION +amilasemia I-EXPLORATION +y I-EXPLORATION +amilasuria I-EXPLORATION +con I-EXPLORATION +alteraciones I-EXPLORATION +graves I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +coagulación: I-EXPLORATION +tiempo I-EXPLORATION +de I-EXPLORATION +protrombina I-EXPLORATION +50%; I-EXPLORATION +tiempo I-EXPLORATION +de I-EXPLORATION +cefalina I-EXPLORATION +48, I-EXPLORATION +2 I-EXPLORATION +s. I-EXPLORATION +Por I-EXPLORATION +tomografía I-EXPLORATION +axial I-EXPLORATION +computerizada I-EXPLORATION +del I-EXPLORATION +abdomen I-EXPLORATION +se I-EXPLORATION +aprecia: I-EXPLORATION +colecistitis I-EXPLORATION +aguda I-EXPLORATION +litiásica, I-EXPLORATION +coledocolitiasis, I-EXPLORATION +aumento I-EXPLORATION +difuso I-EXPLORATION +de I-EXPLORATION +tamaño I-EXPLORATION +del I-EXPLORATION +páncreas I-EXPLORATION +y I-EXPLORATION +ascitis, I-EXPLORATION +apreciándose I-EXPLORATION +en I-EXPLORATION +bazo I-EXPLORATION +múltiples I-EXPLORATION +áreas I-EXPLORATION +de I-EXPLORATION +infarto. I-EXPLORATION +A B-TREATMENT +los I-TREATMENT +tres I-TREATMENT +días I-TREATMENT +del I-TREATMENT +ingreso I-TREATMENT +se I-TREATMENT +practica I-TREATMENT +esfinterotomía I-TREATMENT +endoscópica. I-TREATMENT +La B-EVOLUTION +paciente I-EVOLUTION +evoluciona I-EVOLUTION +de I-EVOLUTION +forma I-EVOLUTION +tórpida, I-EVOLUTION +falleciendo I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +17 I-EVOLUTION +días I-EVOLUTION +por I-EVOLUTION +cuadro I-EVOLUTION +de I-EVOLUTION +shock I-EVOLUTION +hemorrágico I-EVOLUTION +de I-EVOLUTION +origen I-EVOLUTION +digestivo. I-EVOLUTION + I-EVOLUTION + +Niño B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cuatro I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +afebril, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +amigdalitis I-PRESENT_ILLNESS +pultácea, I-PRESENT_ILLNESS +frotis I-PRESENT_ILLNESS +faríngeo I-PRESENT_ILLNESS +negativo I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +estreptococo, I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +resto I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +exploración I-PRESENT_ILLNESS +física I-PRESENT_ILLNESS +normal. I-PRESENT_ILLNESS +Dos I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +antes I-PRESENT_ILLNESS +tuvo I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +diarrea. I-PRESENT_ILLNESS +Por B-TREATMENT +todo I-TREATMENT +ello I-TREATMENT +se I-TREATMENT +orienta I-TREATMENT +como I-TREATMENT +un I-TREATMENT +cuadro I-TREATMENT +vírico, I-TREATMENT +realizando I-TREATMENT +tratamiento I-TREATMENT +sintomático. I-TREATMENT +A B-EXPLORATION +los I-EXPLORATION +dos I-EXPLORATION +días, I-EXPLORATION +por I-EXPLORATION +persistencia I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +deposiciones I-EXPLORATION +líquidas, I-EXPLORATION +se I-EXPLORATION +solicita I-EXPLORATION +coprocultivo I-EXPLORATION +que I-EXPLORATION +es I-EXPLORATION +positivo I-EXPLORATION +a I-EXPLORATION +Salmonella I-EXPLORATION +typhimurium. I-EXPLORATION +A B-EVOLUTION +los I-EVOLUTION +15 I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +inicio I-EVOLUTION +del I-EVOLUTION +cuadro, I-EVOLUTION +el I-EVOLUTION +niño I-EVOLUTION +presenta I-EVOLUTION +unas I-EVOLUTION +lesiones I-EVOLUTION +eritematosas I-EVOLUTION +y I-EVOLUTION +algunos I-EVOLUTION +nódulos I-EVOLUTION +pretibiales, I-EVOLUTION +dolorosas, I-EVOLUTION +en I-EVOLUTION +ambas I-EVOLUTION +extremidades I-EVOLUTION +inferiores, I-EVOLUTION +en I-EVOLUTION +número I-EVOLUTION +de I-EVOLUTION +8-9, I-EVOLUTION +de I-EVOLUTION +tamaño I-EVOLUTION +de I-EVOLUTION +2-3 I-EVOLUTION +cm I-EVOLUTION +de I-EVOLUTION +diámetro, I-EVOLUTION +sin I-EVOLUTION +otros I-EVOLUTION +signos I-EVOLUTION +ni I-EVOLUTION +síntomas. I-EVOLUTION + I-EVOLUTION +Ante B-EXPLORATION +la I-EXPLORATION +clínica, I-EXPLORATION +orientamos I-EXPLORATION +el I-EXPLORATION +cuadro I-EXPLORATION +como I-EXPLORATION +EN I-EXPLORATION +secundario I-EXPLORATION +a I-EXPLORATION +S. I-EXPLORATION +typhimurium. I-EXPLORATION +Solicitamos I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +tórax I-EXPLORATION +y I-EXPLORATION +analítica I-EXPLORATION +con I-EXPLORATION +hemograma, I-EXPLORATION +bioquímica, I-EXPLORATION +velocidad I-EXPLORATION +de I-EXPLORATION +sedimentación I-EXPLORATION +globular I-EXPLORATION +(VSG), I-EXPLORATION +factor I-EXPLORATION +reumatoide, I-EXPLORATION +antiestreptolisinas I-EXPLORATION +y I-EXPLORATION +anticuerpos I-EXPLORATION +antinucleares I-EXPLORATION +(ANA), I-EXPLORATION +para I-EXPLORATION +descartar I-EXPLORATION +otras I-EXPLORATION +posibles I-EXPLORATION +etiologías1. I-EXPLORATION +La I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +tórax I-EXPLORATION +no I-EXPLORATION +objetiva I-EXPLORATION +alteraciones I-EXPLORATION +radiológicas I-EXPLORATION +y I-EXPLORATION +las I-EXPLORATION +determinaciones I-EXPLORATION +analíticas I-EXPLORATION +son I-EXPLORATION +normales. I-EXPLORATION + I-EXPLORATION +A B-EVOLUTION +la I-EVOLUTION +semana I-EVOLUTION +desaparecen I-EVOLUTION +los I-EVOLUTION +nódulos, I-EVOLUTION +con I-EVOLUTION +curación I-EVOLUTION +completa. I-EVOLUTION + I-EVOLUTION + +Una B-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +66 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +es B-DERIVED_FROM/TO +remitida I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +nuestro I-DERIVED_FROM/TO +servicio I-DERIVED_FROM/TO +ante I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +hallazgo I-DERIVED_FROM/TO +ambulatorio I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +TAC I-DERIVED_FROM/TO +abdominal I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +una I-DERIVED_FROM/TO +lesión I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +7 I-DERIVED_FROM/TO +cm I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +lóbulo I-DERIVED_FROM/TO +hepático I-DERIVED_FROM/TO +izquierdo. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +Se B-PAST_MEDICAL_HISTORY +trata I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +sana I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +había I-PRESENT_ILLNESS +acudido I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +médico I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cabecera I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +realizarse I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +chequeo I-PRESENT_ILLNESS +rutinario I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +este I-PRESENT_ILLNESS +detectó I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +analítica I-PRESENT_ILLNESS +convencional I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +discreta I-PRESENT_ILLNESS +elevación I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +transaminasas, I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +decidió I-PRESENT_ILLNESS +completar I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +estudio I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +prueba I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +imagen. I-PRESENT_ILLNESS +No I-PRESENT_ILLNESS +presentaba I-PRESENT_ILLNESS +ninguna I-PRESENT_ILLNESS +otra I-PRESENT_ILLNESS +clínica I-PRESENT_ILLNESS +reseñable I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +aparatos. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +A B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +la I-EXPLORATION +paciente I-EXPLORATION +presentaba I-EXPLORATION +un I-EXPLORATION +buen I-EXPLORATION +estado I-EXPLORATION +general I-EXPLORATION +llamando I-EXPLORATION +únicamente I-EXPLORATION +la I-EXPLORATION +atención I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +discreta I-EXPLORATION +molestia I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación I-EXPLORATION +en I-EXPLORATION +hipocondrio I-EXPLORATION +derecho. I-EXPLORATION + I-EXPLORATION +A I-EXPLORATION +su I-EXPLORATION +ingreso I-EXPLORATION +en I-EXPLORATION +nuestra I-EXPLORATION +unidad I-EXPLORATION +se I-EXPLORATION +realizaron I-EXPLORATION +las I-EXPLORATION +siguientes I-EXPLORATION +pruebas I-EXPLORATION +complementarias: I-EXPLORATION + I-EXPLORATION +Hemograma I-EXPLORATION +y I-EXPLORATION +coagulación: I-EXPLORATION +sin I-EXPLORATION +alteraciones. I-EXPLORATION + I-EXPLORATION +Bioquímica: I-EXPLORATION +bilirrubina I-EXPLORATION +total I-EXPLORATION +1, I-EXPLORATION +12, I-EXPLORATION +fosfatasa I-EXPLORATION +alcalina I-EXPLORATION +690 I-EXPLORATION +(n I-EXPLORATION +< I-EXPLORATION +258), I-EXPLORATION +LDH I-EXPLORATION +359, I-EXPLORATION +GOT I-EXPLORATION +(AST) I-EXPLORATION +185 I-EXPLORATION +(n I-EXPLORATION +< I-EXPLORATION +40), I-EXPLORATION +GPT I-EXPLORATION +(ALT) I-EXPLORATION +211 I-EXPLORATION +(n I-EXPLORATION +< I-EXPLORATION +40), I-EXPLORATION +GGT I-EXPLORATION +673 I-EXPLORATION +(n I-EXPLORATION +< I-EXPLORATION +36), I-EXPLORATION +resto I-EXPLORATION +normal. I-EXPLORATION + I-EXPLORATION +Marcadores I-EXPLORATION +tumorales: I-EXPLORATION +CA I-EXPLORATION +19.9, I-EXPLORATION +10.9, I-EXPLORATION +alfafetoproteína I-EXPLORATION +386, I-EXPLORATION +9 I-EXPLORATION +(n I-EXPLORATION +< I-EXPLORATION +10), I-EXPLORATION +CEA I-EXPLORATION +1.12. I-EXPLORATION + I-EXPLORATION +EKG: I-EXPLORATION +ritmo I-EXPLORATION +sinusal I-EXPLORATION +sin I-EXPLORATION +alteraciones I-EXPLORATION +significativas. I-EXPLORATION + I-EXPLORATION +Radiografía I-EXPLORATION +de I-EXPLORATION +tórax: I-EXPLORATION +sin I-EXPLORATION +alteraciones. I-EXPLORATION + I-EXPLORATION +TAC I-EXPLORATION +abdominal: I-EXPLORATION +tumoración I-EXPLORATION +de I-EXPLORATION +7 I-EXPLORATION +cm, I-EXPLORATION +de I-EXPLORATION +bordes I-EXPLORATION +bien I-EXPLORATION +delimitados, I-EXPLORATION +centrada I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +segmento I-EXPLORATION +medial I-EXPLORATION +del I-EXPLORATION +lóbulo I-EXPLORATION +hepático I-EXPLORATION +izquierdo, I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +extiende I-EXPLORATION +al I-EXPLORATION +lóbulo I-EXPLORATION +hepático I-EXPLORATION +derecho. I-EXPLORATION +La I-EXPLORATION +masa I-EXPLORATION +produce I-EXPLORATION +compresión I-EXPLORATION +del I-EXPLORATION +tronco I-EXPLORATION +principal I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +porta I-EXPLORATION +y, I-EXPLORATION +sobre I-EXPLORATION +todo, I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +rama I-EXPLORATION +izquierda I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +misma, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +discreta I-EXPLORATION +dilatación I-EXPLORATION +del I-EXPLORATION +árbol I-EXPLORATION +biliar I-EXPLORATION +izquierdo. I-EXPLORATION +La I-EXPLORATION +lesión I-EXPLORATION +está I-EXPLORATION +poco I-EXPLORATION +vascularizada I-EXPLORATION +y I-EXPLORATION +muestra I-EXPLORATION +importantes I-EXPLORATION +áreas I-EXPLORATION +necróticas. I-EXPLORATION + I-EXPLORATION +Biopsia I-EXPLORATION +hepática: I-EXPLORATION +cambios I-EXPLORATION +de I-EXPLORATION +hiperplasia I-EXPLORATION +nodular I-EXPLORATION +con I-EXPLORATION +marcada I-EXPLORATION +esteatosis, I-EXPLORATION +no I-EXPLORATION +evidencia I-EXPLORATION +de I-EXPLORATION +malignidad I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +material I-EXPLORATION +remitido. I-EXPLORATION + I-EXPLORATION +Ante I-EXPLORATION +la I-EXPLORATION +discordancia I-EXPLORATION +entre I-EXPLORATION +las I-EXPLORATION +pruebas I-EXPLORATION +de I-EXPLORATION +imagen I-EXPLORATION +y I-EXPLORATION +analíticas, I-EXPLORATION +que I-EXPLORATION +orientaban I-EXPLORATION +hacia I-EXPLORATION +un I-EXPLORATION +proceso I-EXPLORATION +neoplásico, I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +anatomía I-EXPLORATION +patológica I-EXPLORATION +(no I-EXPLORATION +concluyente I-EXPLORATION +de I-EXPLORATION +malignidad) I-EXPLORATION +se I-EXPLORATION +decide I-EXPLORATION +explicar I-EXPLORATION +la I-EXPLORATION +situación I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +paciente I-EXPLORATION +ofreciéndole I-EXPLORATION +la I-EXPLORATION +posibilidad I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +cirugía. I-EXPLORATION +La B-TREATMENT +paciente I-TREATMENT +acepta I-TREATMENT +la I-TREATMENT +intervención I-TREATMENT +practicándosele I-TREATMENT +una I-TREATMENT +resección I-TREATMENT +de I-TREATMENT +los I-TREATMENT +segmentos I-TREATMENT +IV I-TREATMENT +y I-TREATMENT +V I-TREATMENT +hepáticos. I-TREATMENT + I-TREATMENT +Durante B-EXPLORATION +la I-EXPLORATION +operación I-EXPLORATION +se I-EXPLORATION +envía I-EXPLORATION +una I-EXPLORATION +biopsia I-EXPLORATION +intraoperatoria I-EXPLORATION +que I-EXPLORATION +es I-EXPLORATION +informada I-EXPLORATION +nuevamente I-EXPLORATION +como I-EXPLORATION +biopsia I-EXPLORATION +no I-EXPLORATION +concluyente I-EXPLORATION +de I-EXPLORATION +malignidad I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +material I-EXPLORATION +remitido, I-EXPLORATION +pero I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +pieza I-EXPLORATION +de I-EXPLORATION +resección I-EXPLORATION +macroscópicamente I-EXPLORATION +se I-EXPLORATION +diferencia I-EXPLORATION +un I-EXPLORATION +nódulo I-EXPLORATION +mayor I-EXPLORATION +de I-EXPLORATION +6 I-EXPLORATION +x I-EXPLORATION +6 I-EXPLORATION +cm, I-EXPLORATION +bien I-EXPLORATION +delimitado I-EXPLORATION +y I-EXPLORATION +encapsulado, I-EXPLORATION +que I-EXPLORATION +presenta I-EXPLORATION +un I-EXPLORATION +nódulo I-EXPLORATION +central I-EXPLORATION +de I-EXPLORATION +pequeño I-EXPLORATION +tamaño, I-EXPLORATION +necrosado I-EXPLORATION +y I-EXPLORATION +multilobulado. I-EXPLORATION +Microscópicamente I-EXPLORATION +se I-EXPLORATION +diferencian I-EXPLORATION +áreas I-EXPLORATION +extensas I-EXPLORATION +sin I-EXPLORATION +atipias, I-EXPLORATION +con I-EXPLORATION +abundantes I-EXPLORATION +vacuolas I-EXPLORATION +lipídicas I-EXPLORATION +y I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +��ndice I-EXPLORATION +de I-EXPLORATION +proliferación I-EXPLORATION +muy I-EXPLORATION +bajo I-EXPLORATION +y I-EXPLORATION +otras I-EXPLORATION +áreas I-EXPLORATION +con I-EXPLORATION +alta I-EXPLORATION +celuraridad, I-EXPLORATION +núcleos I-EXPLORATION +atípicos, I-EXPLORATION +mitosis I-EXPLORATION +e I-EXPLORATION +índice I-EXPLORATION +de I-EXPLORATION +proliferación I-EXPLORATION +en I-EXPLORATION +torno I-EXPLORATION +al I-EXPLORATION +15%. I-EXPLORATION +Finalmente I-EXPLORATION +el I-EXPLORATION +tumor I-EXPLORATION +es I-EXPLORATION +catalogado I-EXPLORATION +como I-EXPLORATION +hepatocarcinoma I-EXPLORATION +bien I-EXPLORATION +diferenciado I-EXPLORATION +(grado I-EXPLORATION +II) I-EXPLORATION +rico I-EXPLORATION +en I-EXPLORATION +lípidos. I-EXPLORATION + I-EXPLORATION +En B-EVOLUTION +el I-EVOLUTION +postoperatorio I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +no I-EVOLUTION +presentó I-EVOLUTION +ninguna I-EVOLUTION +complicación I-EVOLUTION +reseñable I-EVOLUTION +y I-EVOLUTION +fue I-EVOLUTION +dada I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +con I-EVOLUTION +posterior I-EVOLUTION +seguimiento I-EVOLUTION +en I-EVOLUTION +consultas I-EVOLUTION +externas. I-EVOLUTION +Actualmente B-EXPLORATION +se I-EXPLORATION +encuentra I-EXPLORATION +asintomática I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION +una I-EXPLORATION +analítica I-EXPLORATION +de I-EXPLORATION +control I-EXPLORATION +se I-EXPLORATION +ha I-EXPLORATION +comprobado I-EXPLORATION +la I-EXPLORATION +normalización I-EXPLORATION +tanto I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +transaminasas I-EXPLORATION +como I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +alfafetoproteína. I-EXPLORATION + I-EXPLORATION + +Niña B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +12 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +vómitos I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +abdominalgia I-PRESENT_ILLNESS +generalizada I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +año I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +predominio I-PRESENT_ILLNESS +horario I-PRESENT_ILLNESS +ni I-PRESENT_ILLNESS +relación I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +ingesta I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +incluso I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +despierta I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +noche. I-PRESENT_ILLNESS +No I-PRESENT_ILLNESS +asocia I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +peso I-PRESENT_ILLNESS +ni I-PRESENT_ILLNESS +cambios I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +hábito I-PRESENT_ILLNESS +deposicional. I-PRESENT_ILLNESS +Antecedentes B-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +interés. I-PAST_MEDICAL_HISTORY +Se B-EXPLORATION +realiza I-EXPLORATION +hemograma I-EXPLORATION +con I-EXPLORATION +hemoglobina I-EXPLORATION +12, I-EXPLORATION +6 I-EXPLORATION +g/dl, I-EXPLORATION +volumen I-EXPLORATION +corpuscular I-EXPLORATION +medio I-EXPLORATION +79, I-EXPLORATION +6 I-EXPLORATION +fl. I-EXPLORATION +El I-EXPLORATION +resto I-EXPLORATION +del I-EXPLORATION +hemograma I-EXPLORATION +es I-EXPLORATION +normal. I-EXPLORATION +Además, I-EXPLORATION +presenta I-EXPLORATION +función I-EXPLORATION +hepática I-EXPLORATION +con I-EXPLORATION +AST, I-EXPLORATION +ALT I-EXPLORATION +y I-EXPLORATION +GGT I-EXPLORATION +normales I-EXPLORATION +y I-EXPLORATION +función I-EXPLORATION +renal I-EXPLORATION +sin I-EXPLORATION +alteraciones. I-EXPLORATION +Destaca I-EXPLORATION +ferropenia I-EXPLORATION +con I-EXPLORATION +ferritina I-EXPLORATION +de I-EXPLORATION +9 I-EXPLORATION +ng/ml I-EXPLORATION +(20-200 I-EXPLORATION +ng/ml) I-EXPLORATION +sin I-EXPLORATION +elevación I-EXPLORATION +de I-EXPLORATION +reactantes I-EXPLORATION +de I-EXPLORATION +fase I-EXPLORATION +aguda I-EXPLORATION +(proteína I-EXPLORATION +C I-EXPLORATION +reactiva I-EXPLORATION +y I-EXPLORATION +velocidad I-EXPLORATION +de I-EXPLORATION +sedimentación I-EXPLORATION +globular). I-EXPLORATION +Se I-EXPLORATION +realiza I-EXPLORATION +despistaje I-EXPLORATION +de I-EXPLORATION +enfermedad I-EXPLORATION +celiaca I-EXPLORATION +con I-EXPLORATION +IgA I-EXPLORATION +total, I-EXPLORATION +anticuerpos I-EXPLORATION +antitransglutaminasa I-EXPLORATION +(IgA-AAT), I-EXPLORATION +anticuerpos I-EXPLORATION +antipéptido I-EXPLORATION +deaminado I-EXPLORATION +de I-EXPLORATION +gliadina I-EXPLORATION +que I-EXPLORATION +son I-EXPLORATION +negativos I-EXPLORATION +y I-EXPLORATION +HLA I-EXPLORATION +DQ2-DQ8 I-EXPLORATION +asociado I-EXPLORATION +a I-EXPLORATION +enfermedad I-EXPLORATION +celiaca. I-EXPLORATION +Además I-EXPLORATION +se I-EXPLORATION +solicita I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +sensibilización I-EXPLORATION +alimentaria I-EXPLORATION +con I-EXPLORATION +IgE I-EXPLORATION +total I-EXPLORATION +y I-EXPLORATION +específica I-EXPLORATION +a I-EXPLORATION +proteínas I-EXPLORATION +de I-EXPLORATION +leche I-EXPLORATION +de I-EXPLORATION +vaca I-EXPLORATION +(PLV) I-EXPLORATION +y I-EXPLORATION +a I-EXPLORATION +huevo I-EXPLORATION +que I-EXPLORATION +fueron I-EXPLORATION +negativos. I-EXPLORATION +Tras I-EXPLORATION +los I-EXPLORATION +resultados I-EXPLORATION +normales, I-EXPLORATION +se I-EXPLORATION +había I-EXPLORATION +realizado I-EXPLORATION +endoscopia I-EXPLORATION +digestiva I-EXPLORATION +alta I-EXPLORATION +en I-EXPLORATION +otro I-EXPLORATION +centro I-EXPLORATION +hospitalario I-EXPLORATION +con I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +gastritis, I-EXPLORATION +con I-EXPLORATION +test I-EXPLORATION +rápido I-EXPLORATION +de I-EXPLORATION +ureasa I-EXPLORATION +en I-EXPLORATION +biopsia I-EXPLORATION +antral I-EXPLORATION +negativa I-EXPLORATION +para I-EXPLORATION +infección I-EXPLORATION +por I-EXPLORATION +Helicobacter I-EXPLORATION +pylori. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +tomaron I-EXPLORATION +otras I-EXPLORATION +muestras I-EXPLORATION +gástricas I-EXPLORATION +para I-EXPLORATION +estudio I-EXPLORATION +anatomopatológico. I-EXPLORATION +Se B-TREATMENT +inicia I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +IBP I-TREATMENT +a I-TREATMENT +dosis I-TREATMENT +altas I-TREATMENT +(2 I-TREATMENT +mg/ I-TREATMENT +kg/día) I-TREATMENT +con I-TREATMENT +mejoría I-TREATMENT +inicial I-TREATMENT +presentando I-TREATMENT +recaída I-TREATMENT +al I-TREATMENT +suspender I-TREATMENT +IBP I-TREATMENT +a I-TREATMENT +los I-TREATMENT +2 I-TREATMENT +meses. I-TREATMENT + I-TREATMENT +Reconsulta B-EVOLUTION +en I-EVOLUTION +nuestro I-EVOLUTION +centro I-EVOLUTION +por I-EVOLUTION +persistencia I-EVOLUTION +de I-EVOLUTION +sintomatología, I-EVOLUTION +dolor I-EVOLUTION +más I-EVOLUTION +localizado I-EVOLUTION +e I-EVOLUTION +intensificado I-EVOLUTION +en I-EVOLUTION +epigastrio I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +último I-EVOLUTION +mes. I-EVOLUTION +Se B-EXPLORATION +decide I-EXPLORATION +nueva I-EXPLORATION +endoscopia I-EXPLORATION +digestiva I-EXPLORATION +alta I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +únicamente I-EXPLORATION +imagen I-EXPLORATION +nodular I-EXPLORATION +en I-EXPLORATION +antro I-EXPLORATION +gástrico. I-EXPLORATION +Se I-EXPLORATION +toman I-EXPLORATION +muestras I-EXPLORATION +de I-EXPLORATION +antro I-EXPLORATION +gástrico I-EXPLORATION +para I-EXPLORATION +test I-EXPLORATION +rápido I-EXPLORATION +de I-EXPLORATION +ureasa I-EXPLORATION +para I-EXPLORATION +Helicobacter I-EXPLORATION +pylori I-EXPLORATION +que I-EXPLORATION +es I-EXPLORATION +negativo I-EXPLORATION +y I-EXPLORATION +estudio I-EXPLORATION +anatomopatológico. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +descripción I-EXPLORATION +histológica I-EXPLORATION +destaca I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +mucosa I-EXPLORATION +gástrica I-EXPLORATION +con I-EXPLORATION +moderado I-EXPLORATION +componente I-EXPLORATION +inflamatorio I-EXPLORATION +linfoplasmocitario I-EXPLORATION +junto I-EXPLORATION +con I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +fibrosis I-EXPLORATION +colágena I-EXPLORATION +subepitelial I-EXPLORATION +de I-EXPLORATION +distribución I-EXPLORATION +parcheada I-EXPLORATION +con I-EXPLORATION +áreas I-EXPLORATION +que I-EXPLORATION +superan I-EXPLORATION +las I-EXPLORATION +10 I-EXPLORATION +micras I-EXPLORATION +de I-EXPLORATION +espesor I-EXPLORATION +y I-EXPLORATION +que I-EXPLORATION +también I-EXPLORATION +se I-EXPLORATION +distribuyen I-EXPLORATION +alrededor I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +glándulas. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +linfocitosis I-EXPLORATION +intraepitelial I-EXPLORATION +significativa, I-EXPLORATION +ni I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +Helicobacter I-EXPLORATION +pylori. I-EXPLORATION +Las I-EXPLORATION +muestras I-EXPLORATION +de I-EXPLORATION +esófago I-EXPLORATION +y I-EXPLORATION +duodeno I-EXPLORATION +no I-EXPLORATION +presentan I-EXPLORATION +alteraciones I-EXPLORATION +histológicas. I-EXPLORATION + I-EXPLORATION +Orientada I-EXPLORATION +como I-EXPLORATION +GC I-EXPLORATION +se I-EXPLORATION +realiza I-EXPLORATION +colonoscopia I-EXPLORATION +para I-EXPLORATION +descartar I-EXPLORATION +colitis I-EXPLORATION +colágena I-EXPLORATION +asociada I-EXPLORATION +que I-EXPLORATION +es I-EXPLORATION +normal I-EXPLORATION +tanto I-EXPLORATION +la I-EXPLORATION +imagen I-EXPLORATION +como I-EXPLORATION +histológicamente. I-EXPLORATION +Se B-TREATMENT +reinicia I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +esomeprazol I-TREATMENT +oral I-TREATMENT +40 I-TREATMENT +mg I-TREATMENT +cada I-TREATMENT +24 I-TREATMENT +horas, I-TREATMENT +desapareciendo I-TREATMENT +la I-TREATMENT +sintomatología I-TREATMENT +a I-TREATMENT +los I-TREATMENT +pocos I-TREATMENT +días I-TREATMENT +junto I-TREATMENT +suplemento I-TREATMENT +de I-TREATMENT +hierro I-TREATMENT +oral. I-TREATMENT +A I-TREATMENT +los I-TREATMENT +3 I-TREATMENT +meses I-TREATMENT +de I-TREATMENT +inicio I-TREATMENT +del I-TREATMENT +tratamiento I-TREATMENT +se I-TREATMENT +puede I-TREATMENT +disminuir I-TREATMENT +la I-TREATMENT +dosis I-TREATMENT +de I-TREATMENT +IBP I-TREATMENT +a I-TREATMENT +la I-TREATMENT +mitad I-TREATMENT +permaneciendo B-EVOLUTION +asintomática I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +6 I-EVOLUTION +meses I-EVOLUTION +del I-EVOLUTION +diagnóstico. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +23 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +estudiada I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +episodios I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +epigastralgia I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +4 I-PRESENT_ILLNESS +ó I-PRESENT_ILLNESS +5 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +relación I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +ingesta I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +mejoran I-PRESENT_ILLNESS +tras I-PRESENT_ILLNESS +emesis. I-PRESENT_ILLNESS +Como B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +relevancia I-PAST_MEDICAL_HISTORY +destaca I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +consumo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +anticonceptivos I-PAST_MEDICAL_HISTORY +orales I-PAST_MEDICAL_HISTORY +durante I-PAST_MEDICAL_HISTORY +3 I-PAST_MEDICAL_HISTORY +años. I-PAST_MEDICAL_HISTORY +En B-EXPLORATION +la I-EXPLORATION +analítica I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +tan I-EXPLORATION +sólo, I-EXPLORATION +leucocitos I-EXPLORATION +en I-EXPLORATION +3.570 I-EXPLORATION +x I-EXPLORATION +109/l, I-EXPLORATION +Hb I-EXPLORATION +115 I-EXPLORATION +g/l I-EXPLORATION +con I-EXPLORATION +VCM I-EXPLORATION +de I-EXPLORATION +78 I-EXPLORATION +fl. I-EXPLORATION +Resto I-EXPLORATION +en I-EXPLORATION +límites I-EXPLORATION +normales. I-EXPLORATION +Entre I-EXPLORATION +episodios I-EXPLORATION +se I-EXPLORATION +encuentra I-EXPLORATION +asintomática I-EXPLORATION +con I-EXPLORATION +hábito I-EXPLORATION +intestinal I-EXPLORATION +normal I-EXPLORATION +sin I-EXPLORATION +productos I-EXPLORATION +patológicos. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +radiografía I-EXPLORATION +simple I-EXPLORATION +de I-EXPLORATION +abdomen I-EXPLORATION +se I-EXPLORATION +objetivan I-EXPLORATION +imágenes I-EXPLORATION +heterogéneas I-EXPLORATION +de I-EXPLORATION +densidad I-EXPLORATION +calcio I-EXPLORATION +de I-EXPLORATION +4-5 I-EXPLORATION +cm I-EXPLORATION +proyectadas I-EXPLORATION +sobre I-EXPLORATION +flexura I-EXPLORATION +hepática I-EXPLORATION +del I-EXPLORATION +colon. I-EXPLORATION +La I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION +objetiva I-EXPLORATION +barro I-EXPLORATION +biliar I-EXPLORATION +y I-EXPLORATION +adyacente I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +vesícula I-EXPLORATION +una I-EXPLORATION +imagen I-EXPLORATION +de I-EXPLORATION +45 I-EXPLORATION +mm, I-EXPLORATION +heterogénea I-EXPLORATION +con I-EXPLORATION +áreas I-EXPLORATION +hiperecogénicas I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +quiste I-EXPLORATION +hidatídico. I-EXPLORATION +A I-EXPLORATION +pesar I-EXPLORATION +de I-EXPLORATION +referir I-EXPLORATION +convivencia I-EXPLORATION +continuada I-EXPLORATION +con I-EXPLORATION +perros I-EXPLORATION +en I-EXPLORATION +un I-EXPLORATION +área I-EXPLORATION +endémica I-EXPLORATION +de I-EXPLORATION +hidatidosis I-EXPLORATION +como I-EXPLORATION +es I-EXPLORATION +España I-EXPLORATION +(1,2), I-EXPLORATION +y I-EXPLORATION +orientar I-EXPLORATION +inicialmente I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +hacia I-EXPLORATION +esta I-EXPLORATION +patología, I-EXPLORATION +la I-EXPLORATION +serología I-EXPLORATION +para I-EXPLORATION +hidatidosis I-EXPLORATION +resulta I-EXPLORATION +negativa. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +TAC I-EXPLORATION +de I-EXPLORATION +abdomen I-EXPLORATION +se I-EXPLORATION +objetiva I-EXPLORATION +hepatomegalia I-EXPLORATION +con I-EXPLORATION +LOE I-EXPLORATION +parcialmente I-EXPLORATION +calcificada I-EXPLORATION +en I-EXPLORATION +segmento I-EXPLORATION +V I-EXPLORATION +de I-EXPLORATION +50 I-EXPLORATION +mm I-EXPLORATION +y I-EXPLORATION +morfología I-EXPLORATION +redondeada I-EXPLORATION +con I-EXPLORATION +bordes I-EXPLORATION +lobulados I-EXPLORATION +e I-EXPLORATION +imágenes I-EXPLORATION +redondeadas I-EXPLORATION +de I-EXPLORATION +menor I-EXPLORATION +tamaño I-EXPLORATION +en I-EXPLORATION +periferia. I-EXPLORATION +La I-EXPLORATION +imagen I-EXPLORATION +es I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +quiste I-EXPLORATION +hidatídico I-EXPLORATION +sin I-EXPLORATION +descartar I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +diagnóstico I-EXPLORATION +diferencial I-EXPLORATION +la I-EXPLORATION +posibilidad I-EXPLORATION +de I-EXPLORATION +hemangioma I-EXPLORATION +parcialmente I-EXPLORATION +calcificado. I-EXPLORATION +La I-EXPLORATION +imagen I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +vesícula I-EXPLORATION +es I-EXPLORATION +de I-EXPLORATION +numerosas I-EXPLORATION +microlitiasis I-EXPLORATION +sin I-EXPLORATION +signos I-EXPLORATION +inflamatorios. I-EXPLORATION +Se I-EXPLORATION +objetiva I-EXPLORATION +del I-EXPLORATION +mismo I-EXPLORATION +modo I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +TAC I-EXPLORATION +un I-EXPLORATION +hemangioma I-EXPLORATION +de I-EXPLORATION +31 I-EXPLORATION +mm I-EXPLORATION +en I-EXPLORATION +segmento I-EXPLORATION +IV I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +quistes I-EXPLORATION +corticales I-EXPLORATION +en I-EXPLORATION +ambos I-EXPLORATION +riñones. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +programa I-TREATMENT +colecistectomía I-TREATMENT +más I-TREATMENT +quistoperiquistectomía I-TREATMENT +con I-TREATMENT +diagnóstico I-TREATMENT +de I-TREATMENT +presunción I-TREATMENT +de I-TREATMENT +quiste I-TREATMENT +hidatídico I-TREATMENT +más I-TREATMENT +colelitiasis. I-TREATMENT +Se I-TREATMENT +realiza I-TREATMENT +abordaje I-TREATMENT +mediante I-TREATMENT +laparotomía I-TREATMENT +subcostal I-TREATMENT +derecha. I-TREATMENT +Se I-TREATMENT +objetiva I-TREATMENT +vesícula I-TREATMENT +biliar I-TREATMENT +con I-TREATMENT +tumoración I-TREATMENT +intravesicular I-TREATMENT +de I-TREATMENT +consistencia I-TREATMENT +pétrea I-TREATMENT +que I-TREATMENT +no I-TREATMENT +infiltra I-TREATMENT +parénquima I-TREATMENT +hepático, I-TREATMENT +sin I-TREATMENT +LOE I-TREATMENT +en I-TREATMENT +segmento I-TREATMENT +V. I-TREATMENT +Mediante B-EXPLORATION +biopsia I-EXPLORATION +intraoperatoria I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +masa I-EXPLORATION +se I-EXPLORATION +diagnostica I-EXPLORATION +como I-EXPLORATION +angiomioma I-EXPLORATION +vesicular I-EXPLORATION +benigno, I-EXPLORATION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +procede I-TREATMENT +a I-TREATMENT +realizar I-TREATMENT +colecistectomía I-TREATMENT +simple, I-TREATMENT +que I-TREATMENT +incluye I-TREATMENT +la I-TREATMENT +totalidad I-TREATMENT +de I-TREATMENT +la I-TREATMENT +masa I-TREATMENT +tumoral. I-TREATMENT +El B-EVOLUTION +postoperatorio I-EVOLUTION +fue I-EVOLUTION +favorable, I-EVOLUTION +transcurriendo I-EVOLUTION +sin I-EVOLUTION +incidencias. I-EVOLUTION + I-EVOLUTION +El B-EXPLORATION +posterior I-EXPLORATION +estudio I-EXPLORATION +anatomopatológico I-EXPLORATION +describe I-EXPLORATION +masa I-EXPLORATION +sólida, I-EXPLORATION +de I-EXPLORATION +consistencia I-EXPLORATION +elástica I-EXPLORATION +y I-EXPLORATION +crecimiento I-EXPLORATION +expansivo I-EXPLORATION +que I-EXPLORATION +respeta I-EXPLORATION +mucosa I-EXPLORATION +y I-EXPLORATION +serosa I-EXPLORATION +císticas. I-EXPLORATION +La I-EXPLORATION +histología I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +inmunohistoquímico I-EXPLORATION +concluyeron I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +leiomioma I-EXPLORATION +intramural I-EXPLORATION +y I-EXPLORATION +endocavitario I-EXPLORATION +con I-EXPLORATION +calcificaciones I-EXPLORATION +y I-EXPLORATION +osificación I-EXPLORATION +distrófica, I-EXPLORATION +de I-EXPLORATION +carácter I-EXPLORATION +benigno I-EXPLORATION +sin I-EXPLORATION +infiltrar I-EXPLORATION +parénquima I-EXPLORATION +hepático. I-EXPLORATION +La I-EXPLORATION +muestra I-EXPLORATION +fue I-EXPLORATION +negativa I-EXPLORATION +para I-EXPLORATION +VEB I-EXPLORATION +y I-EXPLORATION +C-Kit I-EXPLORATION +/ I-EXPLORATION +CD-117. I-EXPLORATION + I-EXPLORATION +En B-EVOLUTION +la I-EVOLUTION +actualidad, I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +se I-EVOLUTION +encuentra I-EVOLUTION +asintomática, I-EVOLUTION +tras I-EVOLUTION +realización I-EVOLUTION +de I-EVOLUTION +ecografía I-EVOLUTION +abdominal I-EVOLUTION +no I-EVOLUTION +muestra I-EVOLUTION +recidiva I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +enfermedad I-EVOLUTION +ni I-EVOLUTION +otras I-EVOLUTION +alteraciones I-EVOLUTION +15 I-EVOLUTION +meses I-EVOLUTION +después. I-EVOLUTION + I-EVOLUTION + +Paciente B-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +24 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +mórbidos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +relevancia, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +consultó I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +Servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Urgencia I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +nuestro I-PRESENT_ILLNESS +hospital I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +junio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2005, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +3 I-PRESENT_ILLNESS +h I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +caracterizado I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +epigástrico, I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +carácter I-PRESENT_ILLNESS +sordo, I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +moderada I-PRESENT_ILLNESS +intensidad, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +cedió I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +antiespasmó-dicos I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +bloqueadores I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +bomba I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +protones, I-PRESENT_ILLNESS +siendo I-PRESENT_ILLNESS +dada I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +alta I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +domicilio. I-PRESENT_ILLNESS +La I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +reconsultó I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +urgencia I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +día I-PRESENT_ILLNESS +siguiente I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +persistencia I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +epigastralgia, I-PRESENT_ILLNESS +realizándose B-EXPLORATION +una I-EXPLORATION +ecotomografía I-EXPLORATION +abdominal I-EXPLORATION +que I-EXPLORATION +evidenció I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +quística I-EXPLORATION +retroperitoneal. I-EXPLORATION +La I-EXPLORATION +tomografía I-EXPLORATION +axial I-EXPLORATION +computarizada I-EXPLORATION +(TAC), I-EXPLORATION +reveló I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +quística I-EXPLORATION +multitabicada I-EXPLORATION +de I-EXPLORATION +44 I-EXPLORATION +x I-EXPLORATION +26 I-EXPLORATION +mm, I-EXPLORATION +bien I-EXPLORATION +delimitada, I-EXPLORATION +que I-EXPLORATION +contactaba I-EXPLORATION +caudalmente I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +cuerpo I-EXPLORATION +del I-EXPLORATION +páncreas. I-EXPLORATION + I-EXPLORATION +La B-TREATMENT +paciente I-TREATMENT +fue I-TREATMENT +sometida I-TREATMENT +a I-TREATMENT +una I-TREATMENT +laparotomía I-TREATMENT +exploradora I-TREATMENT +subcostal I-TREATMENT +bilateral, I-TREATMENT +encontrándose I-TREATMENT +la I-TREATMENT +lesión, I-TREATMENT +descrita I-TREATMENT +en I-TREATMENT +la I-TREATMENT +TAC, I-TREATMENT +íntimamente I-TREATMENT +adherida I-TREATMENT +al I-TREATMENT +páncreas, I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +debió I-TREATMENT +realizar I-TREATMENT +una I-TREATMENT +pancreatectomía I-TREATMENT +distal I-TREATMENT +junto I-TREATMENT +a I-TREATMENT +la I-TREATMENT +resección I-TREATMENT +del I-TREATMENT +quiste, I-TREATMENT +enviándose I-TREATMENT +la I-TREATMENT +pieza I-TREATMENT +a I-TREATMENT +anatomía I-TREATMENT +patológica. I-TREATMENT + I-TREATMENT +Hallazgos I-TREATMENT +patológicos I-TREATMENT + I-TREATMENT +El I-TREATMENT +páncreas I-TREATMENT +mostraba I-TREATMENT +acinos I-TREATMENT +e I-TREATMENT +islotes I-TREATMENT +pancreáticos I-TREATMENT +de I-TREATMENT +arquitectura I-TREATMENT +normal. I-TREATMENT +Se I-TREATMENT +identificaban I-TREATMENT +además I-TREATMENT +dos I-TREATMENT +ganglios I-TREATMENT +linfáticos I-TREATMENT +peripancreáticos I-TREATMENT +sin I-TREATMENT +alteraciones. I-TREATMENT + I-TREATMENT +El I-TREATMENT +diagnóstico I-TREATMENT +histológico I-TREATMENT +fue I-TREATMENT +compatible I-TREATMENT +con I-TREATMENT +un I-TREATMENT +quiste I-TREATMENT +broncogénico I-TREATMENT +retroperitoneal. I-TREATMENT +La B-EVOLUTION +paciente I-EVOLUTION +evolucionó I-EVOLUTION +favorablemente I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +posopera-torio, I-EVOLUTION +siendo I-EVOLUTION +dada I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +al I-EVOLUTION +décimo I-EVOLUTION +día I-EVOLUTION +posoperatorio. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +Colombiana B-PAST_MEDICAL_HISTORY +de B-PRESENT_ILLNESS +65 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +sintomatología I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +1 I-PRESENT_ILLNESS +año I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +9 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +episódico I-PRESENT_ILLNESS +tipo I-PRESENT_ILLNESS +punzada I-PRESENT_ILLNESS +localizado I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +hipocondrio I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +flanco I-PRESENT_ILLNESS +izquierdo, I-PRESENT_ILLNESS +asociado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +hematuria, I-PRESENT_ILLNESS +nauseas I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +peso. I-PRESENT_ILLNESS +Con B-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +patológico I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +enfermedad I-PAST_MEDICAL_HISTORY +pulmonar I-PAST_MEDICAL_HISTORY +obstructiva I-PAST_MEDICAL_HISTORY +crónica I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +quirúrgico I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +histerectomía. I-PAST_MEDICAL_HISTORY +Al B-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +la I-EXPLORATION +paciente I-EXPLORATION +no I-EXPLORATION +tenía I-EXPLORATION +alteraciones I-EXPLORATION +en I-EXPLORATION +sus I-EXPLORATION +signos I-EXPLORATION +vitales, I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +índice I-EXPLORATION +de I-EXPLORATION +masa I-EXPLORATION +corporal I-EXPLORATION +de I-EXPLORATION +20kg/Mts2, I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +único I-EXPLORATION +signo I-EXPLORATION +que I-EXPLORATION +presentaba I-EXPLORATION +era I-EXPLORATION +dolor I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación I-EXPLORATION +de I-EXPLORATION +flanco I-EXPLORATION +izquierdo. I-EXPLORATION +Se B-TREATMENT +inicia I-TREATMENT +manejo I-TREATMENT +médico I-TREATMENT +considerando I-TREATMENT +pielonefritis, I-TREATMENT +sin B-EVOLUTION +resolución I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +sintomatología, I-EVOLUTION +por B-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +toma I-EXPLORATION +Tomografía I-EXPLORATION +Axial I-EXPLORATION +Computarizada, I-EXPLORATION +la I-EXPLORATION +cual I-EXPLORATION +informa I-EXPLORATION +masa I-EXPLORATION +dependiente I-EXPLORATION +de I-EXPLORATION +riñón I-EXPLORATION +izquierdo I-EXPLORATION +de I-EXPLORATION +9 I-EXPLORATION +x I-EXPLORATION +10 I-EXPLORATION +cms, I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +realiza I-EXPLORATION +nefrectomía. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +muestra I-EXPLORATION +quirúrgica I-EXPLORATION +del I-EXPLORATION +tumor I-EXPLORATION +renal I-EXPLORATION +fue I-EXPLORATION +fijada I-EXPLORATION +luego I-EXPLORATION +de I-EXPLORATION +extraerse I-EXPLORATION +con I-EXPLORATION +formaldehído I-EXPLORATION +al I-EXPLORATION +10% I-EXPLORATION +y I-EXPLORATION +embebido I-EXPLORATION +en I-EXPLORATION +parafina I-EXPLORATION +para I-EXPLORATION +su I-EXPLORATION +preparación I-EXPLORATION +y I-EXPLORATION +análisis I-EXPLORATION +microscópico, I-EXPLORATION +la I-EXPLORATION +coloración I-EXPLORATION +empleada I-EXPLORATION +fue I-EXPLORATION +Hematoxilina I-EXPLORATION +y I-EXPLORATION +Eosina. I-EXPLORATION + I-EXPLORATION + +Se B-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +54 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +masculino, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +antes, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +manejo I-PAST_MEDICAL_HISTORY +farmacológico, I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +alcoholismo, I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +presentó I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +cuadro I-PAST_MEDICAL_HISTORY +clínico I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +inicio I-PAST_MEDICAL_HISTORY +súbito I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +sensación I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +mareo; I-PAST_MEDICAL_HISTORY +cuatro B-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +después I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +disartria I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +hemiparesia I-PRESENT_ILLNESS +izquierda. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Consultó B-EXPLORATION +al I-EXPLORATION +servicio I-EXPLORATION +de I-EXPLORATION +urgencias I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +le I-EXPLORATION +encontró I-EXPLORATION +presión I-EXPLORATION +arterial I-EXPLORATION +de I-EXPLORATION +120/70 I-EXPLORATION +mm I-EXPLORATION +Hg I-EXPLORATION +y I-EXPLORATION +frecuencia I-EXPLORATION +cardiaca I-EXPLORATION +de I-EXPLORATION +100 I-EXPLORATION +por I-EXPLORATION +minuto; I-EXPLORATION +el I-EXPLORATION +resto I-EXPLORATION +del I-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +general I-EXPLORATION +fue I-EXPLORATION +normal. I-EXPLORATION +Estaba I-EXPLORATION +alerta, I-EXPLORATION +orientado I-EXPLORATION +en I-EXPLORATION +persona, I-EXPLORATION +tiempo I-EXPLORATION +y I-EXPLORATION +espacio, I-EXPLORATION +con I-EXPLORATION +disartria, I-EXPLORATION +sin I-EXPLORATION +alteraciones I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +esfera I-EXPLORATION +mental, I-EXPLORATION +sin I-EXPLORATION +signos I-EXPLORATION +meníngeos; I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +encontraron I-EXPLORATION +alteraciones I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +cráneo I-EXPLORATION +ni I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +columna I-EXPLORATION +vertebral; I-EXPLORATION +había I-EXPLORATION +isocoria I-EXPLORATION +de I-EXPLORATION +2 I-EXPLORATION +mm I-EXPLORATION +de I-EXPLORATION +diámetro, I-EXPLORATION +pupila I-EXPLORATION +de I-EXPLORATION +Argyll I-EXPLORATION +Robertson, I-EXPLORATION +parálisis I-EXPLORATION +facial I-EXPLORATION +izquierda, I-EXPLORATION +con I-EXPLORATION +escasa I-EXPLORATION +elevación I-EXPLORATION +del I-EXPLORATION +velo I-EXPLORATION +del I-EXPLORATION +paladar I-EXPLORATION +y I-EXPLORATION +trastornos I-EXPLORATION +dinámicos I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +deglución, I-EXPLORATION +sin I-EXPLORATION +otras I-EXPLORATION +alteraciones I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +nervios I-EXPLORATION +craneales. I-EXPLORATION + I-EXPLORATION +Presentaba I-EXPLORATION +hemiparesia I-EXPLORATION +izquierda, I-EXPLORATION +con I-EXPLORATION +disminución I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +fuerza I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +miembro I-EXPLORATION +superior I-EXPLORATION +(3/5) I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +inferior I-EXPLORATION +(4/5), I-EXPLORATION +con I-EXPLORATION +hiperreflexia I-EXPLORATION +generalizada I-EXPLORATION +simétrica, I-EXPLORATION +con I-EXPLORATION +respuesta I-EXPLORATION +plantar I-EXPLORATION +izquierda I-EXPLORATION +neutra I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +flexión I-EXPLORATION +contralateral; I-EXPLORATION +además, I-EXPLORATION +se I-EXPLORATION +encontró I-EXPLORATION +temblor I-EXPLORATION +de I-EXPLORATION +acción I-EXPLORATION +y I-EXPLORATION +postural I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +mano I-EXPLORATION +derecha, I-EXPLORATION +sin I-EXPLORATION +alteración I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +sensibilidad. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +practicó I-EXPLORATION +una I-EXPLORATION +tomografía I-EXPLORATION +computadorizada I-EXPLORATION +(TC) I-EXPLORATION +de I-EXPLORATION +cráneo I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +que I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +observaba I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +hipodensa, I-EXPLORATION +lacunar, I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +cápsula I-EXPLORATION +interna. I-EXPLORATION +Ese I-EXPLORATION +mismo I-EXPLORATION +día I-EXPLORATION +se I-EXPLORATION +practicó I-EXPLORATION +una I-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION +(RM) I-EXPLORATION +cerebral I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +apreciaba I-EXPLORATION +un I-EXPLORATION +infarto I-EXPLORATION +póntico I-EXPLORATION +extenso, I-EXPLORATION +con I-EXPLORATION +estenosis I-EXPLORATION +crítica I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +arteria I-EXPLORATION +basilar I-EXPLORATION +y I-EXPLORATION +trombosis I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +arteria I-EXPLORATION +vertebral I-EXPLORATION +izquierda, I-EXPLORATION +sin I-EXPLORATION +lesiones I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +circulación I-EXPLORATION +anterior. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +sometió I-TREATMENT +a I-TREATMENT +tratamiento I-TREATMENT +endovascular I-TREATMENT +en I-TREATMENT +el I-TREATMENT +que I-TREATMENT +se I-TREATMENT +encontró I-TREATMENT +estenosis I-TREATMENT +completa I-TREATMENT +del I-TREATMENT +tercio I-TREATMENT +inferior I-TREATMENT +de I-TREATMENT +la I-TREATMENT +arteria I-TREATMENT +basilar, I-TREATMENT +sin I-TREATMENT +flujo I-TREATMENT +distal, I-TREATMENT +y I-TREATMENT +se I-TREATMENT +colocó I-TREATMENT +un I-TREATMENT +stent I-TREATMENT +sin I-TREATMENT +complicaciones, I-TREATMENT +quedando I-TREATMENT +con I-TREATMENT +una I-TREATMENT +estenosis I-TREATMENT +residual I-TREATMENT +de I-TREATMENT +24 I-TREATMENT +%. I-TREATMENT + I-TREATMENT +Durante B-EXPLORATION +la I-EXPLORATION +hospitalización I-EXPLORATION +se I-EXPLORATION +hicieron I-EXPLORATION +estudios I-EXPLORATION +para I-EXPLORATION +accidente I-EXPLORATION +cerebrovascular I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +encontró I-EXPLORATION +que I-EXPLORATION +el I-EXPLORATION +paciente I-EXPLORATION +era I-EXPLORATION +negativo I-EXPLORATION +para I-EXPLORATION +VIH, I-EXPLORATION +el I-EXPLORATION +VDRL I-EXPLORATION +en I-EXPLORATION +suero I-EXPLORATION +fue I-EXPLORATION +positivo I-EXPLORATION +(1:256) I-EXPLORATION +con I-EXPLORATION +FTA-ABS, I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +cual I-EXPLORATION +se I-EXPLORATION +practicó I-EXPLORATION +una I-EXPLORATION +punción I-EXPLORATION +lumbar I-EXPLORATION +para I-EXPLORATION +descartar I-EXPLORATION +compromiso I-EXPLORATION +del I-EXPLORATION +sistema I-EXPLORATION +nervioso I-EXPLORATION +central. I-EXPLORATION +Se I-EXPLORATION +encontró I-EXPLORATION +pleocitosis I-EXPLORATION +de I-EXPLORATION +65 I-EXPLORATION +leucocitos I-EXPLORATION +por I-EXPLORATION +mm3 I-EXPLORATION +con I-EXPLORATION +10 I-EXPLORATION +% I-EXPLORATION +de I-EXPLORATION +polimorfonucleares I-EXPLORATION +y I-EXPLORATION +90 I-EXPLORATION +% I-EXPLORATION +de I-EXPLORATION +mononucleares, I-EXPLORATION +glucosa I-EXPLORATION +de I-EXPLORATION +71 I-EXPLORATION +mg/dl, I-EXPLORATION +proteínas I-EXPLORATION +de I-EXPLORATION +33 I-EXPLORATION +mg/dl I-EXPLORATION +y I-EXPLORATION +un I-EXPLORATION +VDRL I-EXPLORATION +reactivo I-EXPLORATION +(1:2). I-EXPLORATION + I-EXPLORATION +Con B-TREATMENT +estos I-TREATMENT +hallazgos I-TREATMENT +se I-TREATMENT +confirmó I-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT +de I-TREATMENT +neurosífilis I-TREATMENT +y I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +24 I-TREATMENT +millones I-TREATMENT +de I-TREATMENT +unidades I-TREATMENT +de I-TREATMENT +penicilina I-TREATMENT +cristalina I-TREATMENT +al I-TREATMENT +día I-TREATMENT +durante I-TREATMENT +21 I-TREATMENT +días. I-TREATMENT +Durante I-TREATMENT +su I-TREATMENT +estadía I-TREATMENT +en I-TREATMENT +la I-TREATMENT +unidad I-TREATMENT +de I-TREATMENT +cuidados I-TREATMENT +intensivos, I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +requirió I-TREATMENT +intubación I-TREATMENT +orotraqueal I-TREATMENT +por I-TREATMENT +riesgo I-TREATMENT +de I-TREATMENT +compromiso I-TREATMENT +de I-TREATMENT +la I-TREATMENT +vía I-TREATMENT +aérea I-TREATMENT +debido I-TREATMENT +a I-TREATMENT +su I-TREATMENT +infarto I-TREATMENT +en I-TREATMENT +el I-TREATMENT +tallo I-TREATMENT +cerebral. I-TREATMENT +Presentó B-EVOLUTION +una I-EVOLUTION +neumonía I-EVOLUTION +tardía I-EVOLUTION +asociada I-EVOLUTION +al I-EVOLUTION +respirador I-EVOLUTION +por I-EVOLUTION +Serratia I-EVOLUTION +marcescens, I-EVOLUTION +para B-TREATMENT +la I-TREATMENT +cual I-TREATMENT +recibió I-TREATMENT +tratamiento I-TREATMENT +antibiótico, I-TREATMENT +sin I-TREATMENT +complicaciones. I-TREATMENT + I-TREATMENT +Durante B-EVOLUTION +su I-EVOLUTION +hospitalización, I-EVOLUTION +no I-EVOLUTION +recuperó I-EVOLUTION +la I-EVOLUTION +funcionalidad I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +nervios I-EVOLUTION +craneales I-EVOLUTION +bulbares, I-EVOLUTION +por B-TREATMENT +lo I-TREATMENT +cual I-TREATMENT +fue I-TREATMENT +necesario I-TREATMENT +practicar I-TREATMENT +traqueostomía I-TREATMENT +y I-TREATMENT +gastrostomía. I-TREATMENT +Antes B-EXPLORATION +de I-EXPLORATION +dar I-EXPLORATION +de I-EXPLORATION +alta I-EXPLORATION +al I-EXPLORATION +paciente, I-EXPLORATION +se I-EXPLORATION +hizo I-EXPLORATION +una I-EXPLORATION +nueva I-EXPLORATION +punción I-EXPLORATION +lumbar I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +encontró I-EXPLORATION +importante I-EXPLORATION +disminución I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +pleocitosis I-EXPLORATION +y I-EXPLORATION +proteinorraquia; I-EXPLORATION +sin I-EXPLORATION +embargo, I-EXPLORATION +el I-EXPLORATION +VDRL I-EXPLORATION +fue I-EXPLORATION +reactivo I-EXPLORATION +(1:8), I-EXPLORATION +probablemente I-EXPLORATION +debido I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +reacción I-EXPLORATION +inflamatoria I-EXPLORATION +posterior I-EXPLORATION +al I-EXPLORATION +tratamiento. I-EXPLORATION + I-EXPLORATION +Fue B-EVOLUTION +dado I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +con I-EVOLUTION +disartria, I-EVOLUTION +parálisis I-EVOLUTION +supranuclear I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +mirada, I-EVOLUTION +hemiparesia I-EVOLUTION +izquierda, I-EVOLUTION +traqueostomía, I-EVOLUTION +gastrostomía I-EVOLUTION +percutánea I-EVOLUTION +y B-TREATMENT +manejo I-TREATMENT +ambulatorio I-TREATMENT +dual I-TREATMENT +con I-TREATMENT +antiagregación I-TREATMENT +plaquetaria. I-TREATMENT + I-TREATMENT + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +83 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +procedente B-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +departamento I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +San I-PAST_MEDICAL_HISTORY +Martín I-PAST_MEDICAL_HISTORY +(Amazonía I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +Perú), I-PAST_MEDICAL_HISTORY +agricultor. I-PAST_MEDICAL_HISTORY +Tenía I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +anemia I-PAST_MEDICAL_HISTORY +crónica I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +episodio I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +malaria, I-PAST_MEDICAL_HISTORY +hacía I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +años. I-PAST_MEDICAL_HISTORY +Sin I-PAST_MEDICAL_HISTORY +otros I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +médicos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +relevancia. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +El B-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +clínico I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +inició I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +previos I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +ingreso, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +cólico I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +mesogastrio, I-PRESENT_ILLNESS +asociado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +falta I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +apetito, I-PRESENT_ILLNESS +náuseas I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +vómitos. I-PRESENT_ILLNESS +Finalmente I-PRESENT_ILLNESS +consultó I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +Servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Urgencias I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +intensificación I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal, I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +extendía I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +todo I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +abdomen, I-PRESENT_ILLNESS +asociado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +vómitos I-PRESENT_ILLNESS +incoercibles, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +ausencia I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +eliminación I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +gases I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +deposiciones. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Al B-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +se I-EXPLORATION +encontraba I-EXPLORATION +quejumbroso, I-EXPLORATION +taquicárdico I-EXPLORATION +y I-EXPLORATION +con I-EXPLORATION +ictericia I-EXPLORATION +de I-EXPLORATION +escleras. I-EXPLORATION +La I-EXPLORATION +auscultación I-EXPLORATION +reveló I-EXPLORATION +ruidos I-EXPLORATION +cardíacos I-EXPLORATION +arrítmicos, I-EXPLORATION +de I-EXPLORATION +intensidad I-EXPLORATION +normal. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +examen I-EXPLORATION +abdominal I-EXPLORATION +los I-EXPLORATION +ruidos I-EXPLORATION +hidroaéreos I-EXPLORATION +estaban I-EXPLORATION +disminuidos, I-EXPLORATION +la I-EXPLORATION +pared I-EXPLORATION +abdominal I-EXPLORATION +se I-EXPLORATION +encontraba I-EXPLORATION +blanda, I-EXPLORATION +depresible I-EXPLORATION +y I-EXPLORATION +dolorosa I-EXPLORATION +en I-EXPLORATION +forma I-EXPLORATION +difusa. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +evidenció I-EXPLORATION +visceromegalia. I-EXPLORATION +El I-EXPLORATION +resto I-EXPLORATION +del I-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +fue I-EXPLORATION +considerado I-EXPLORATION +no I-EXPLORATION +contributorio. I-EXPLORATION + I-EXPLORATION +Ante I-EXPLORATION +la I-EXPLORATION +sospecha I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +posible I-EXPLORATION +obstrucción I-EXPLORATION +intestinal, I-EXPLORATION +se I-EXPLORATION +solicitó I-EXPLORATION +una I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +abdomen I-EXPLORATION +simple I-EXPLORATION +de I-EXPLORATION +pie I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +dilatación I-EXPLORATION +de I-EXPLORATION +asas I-EXPLORATION +intestinales I-EXPLORATION +con I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +múltiples I-EXPLORATION +niveles I-EXPLORATION +hidroaéreos. I-EXPLORATION + I-EXPLORATION +Entre I-EXPLORATION +los I-EXPLORATION +exámenes I-EXPLORATION +de I-EXPLORATION +laboratorio I-EXPLORATION +destacaba I-EXPLORATION +un I-EXPLORATION +hemograma I-EXPLORATION +con I-EXPLORATION +hemoglobina I-EXPLORATION +15, I-EXPLORATION +3 I-EXPLORATION +g/dL, I-EXPLORATION +hematocrito I-EXPLORATION +44%, I-EXPLORATION +11.570 I-EXPLORATION +leucocitos/mm3, I-EXPLORATION +segmentados I-EXPLORATION +81%, I-EXPLORATION +sin I-EXPLORATION +baciliformes I-EXPLORATION +ni I-EXPLORATION +eosinófilos, I-EXPLORATION +PCR I-EXPLORATION +de I-EXPLORATION +386 I-EXPLORATION +mg/L, I-EXPLORATION +hiperbilirrubinemia I-EXPLORATION +directa I-EXPLORATION +(bilirrubina I-EXPLORATION +total I-EXPLORATION +3, I-EXPLORATION +3 I-EXPLORATION +mg/dL I-EXPLORATION +y I-EXPLORATION +bilirrubina I-EXPLORATION +directa I-EXPLORATION +2, I-EXPLORATION +7 I-EXPLORATION +mg/dL), I-EXPLORATION +elevación I-EXPLORATION +de I-EXPLORATION +GGT I-EXPLORATION +181 I-EXPLORATION +U/L I-EXPLORATION +(GOT I-EXPLORATION +y I-EXPLORATION +GPT I-EXPLORATION +normales), I-EXPLORATION +hipoalbuminemia I-EXPLORATION +de I-EXPLORATION +1, I-EXPLORATION +4 I-EXPLORATION +g/dL, I-EXPLORATION +y I-EXPLORATION +elevación I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +niveles I-EXPLORATION +de I-EXPLORATION +urea: I-EXPLORATION +61 I-EXPLORATION +mg/dL I-EXPLORATION +y I-EXPLORATION +creatinina: I-EXPLORATION +1, I-EXPLORATION +5 I-EXPLORATION +mg/dL. I-EXPLORATION +Las I-EXPLORATION +serologías I-EXPLORATION +para I-EXPLORATION +VIH, I-EXPLORATION +HTLV I-EXPLORATION +1-2 I-EXPLORATION +y I-EXPLORATION +VHC I-EXPLORATION +fueron I-EXPLORATION +negativas. I-EXPLORATION +El I-EXPLORATION +HBsAg I-EXPLORATION +y I-EXPLORATION +RPR I-EXPLORATION +también I-EXPLORATION +fueron I-EXPLORATION +negativos. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +laparotomía I-EXPLORATION +exploratoria I-EXPLORATION +de I-EXPLORATION +urgencia I-EXPLORATION +por I-EXPLORATION +una I-EXPLORATION +probable I-EXPLORATION +obstrucción I-EXPLORATION +intestinal I-EXPLORATION +mecánica. I-EXPLORATION +Los I-EXPLORATION +hallazgos I-EXPLORATION +intraoperatorios I-EXPLORATION +mostraron I-EXPLORATION +una I-EXPLORATION +dilatación I-EXPLORATION +de I-EXPLORATION +asas I-EXPLORATION +del I-EXPLORATION +intestino I-EXPLORATION +delgado I-EXPLORATION +que I-EXPLORATION +demarcaban I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +superficie I-EXPLORATION +formas I-EXPLORATION +lineares I-EXPLORATION +sugerentes I-EXPLORATION +de I-EXPLORATION +ejemplares I-EXPLORATION +de I-EXPLORATION +A. I-EXPLORATION +lumbricoides. I-EXPLORATION +En B-TREATMENT +ese I-TREATMENT +momento I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +el I-TREATMENT +manejo I-TREATMENT +médico, I-TREATMENT +procediendo I-TREATMENT +al I-TREATMENT +cierre I-TREATMENT +de I-TREATMENT +la I-TREATMENT +pared I-TREATMENT +abdominal. I-TREATMENT + I-TREATMENT +La B-EVOLUTION +evolución I-EVOLUTION +clínica I-EVOLUTION +posquirúrgica I-EVOLUTION +fue I-EVOLUTION +desfavorable. I-EVOLUTION +El I-EVOLUTION +paciente I-EVOLUTION +evolucionó I-EVOLUTION +hacia I-EVOLUTION +un I-EVOLUTION +shock I-EVOLUTION +hipovolémico, I-EVOLUTION +observándose I-EVOLUTION +la I-EVOLUTION +salida I-EVOLUTION +espontánea I-EVOLUTION +y I-EVOLUTION +masiva I-EVOLUTION +de I-EVOLUTION +gusanos I-EVOLUTION +adultos I-EVOLUTION +a I-EVOLUTION +través I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +cavidad I-EVOLUTION +oral I-EVOLUTION +y I-EVOLUTION +fosas I-EVOLUTION +nasales. I-EVOLUTION +Se B-TREATMENT +decidió I-TREATMENT +una I-TREATMENT +re-intervención I-TREATMENT +quirúrgica I-TREATMENT +de I-TREATMENT +urgencia, I-TREATMENT +en I-TREATMENT +que I-TREATMENT +se I-TREATMENT +evidenció I-TREATMENT +una I-TREATMENT +gran I-TREATMENT +dilatación I-TREATMENT +de I-TREATMENT +asas I-TREATMENT +intestinales, I-TREATMENT +con I-TREATMENT +abundante I-TREATMENT +cantidad I-TREATMENT +de I-TREATMENT +ejemplares I-TREATMENT +adultos, I-TREATMENT +con I-TREATMENT +múltiples I-TREATMENT +zonas I-TREATMENT +de I-TREATMENT +aglomeración I-TREATMENT +en I-TREATMENT +forma I-TREATMENT +de I-TREATMENT +ovillos, I-TREATMENT +que I-TREATMENT +obstruían I-TREATMENT +la I-TREATMENT +totalidad I-TREATMENT +del I-TREATMENT +lumen I-TREATMENT +intestinal. I-TREATMENT +Se I-TREATMENT +realizó I-TREATMENT +una I-TREATMENT +enterotomía I-TREATMENT +a I-TREATMENT +nivel I-TREATMENT +del I-TREATMENT +íleon, I-TREATMENT +a I-TREATMENT +40 I-TREATMENT +cm I-TREATMENT +de I-TREATMENT +la I-TREATMENT +válvula I-TREATMENT +ileocecal, I-TREATMENT +con I-TREATMENT +extracción I-TREATMENT +de I-TREATMENT +20 I-TREATMENT +gusanos. I-TREATMENT +Se I-TREATMENT +ordeñaron I-TREATMENT +las I-TREATMENT +asas I-TREATMENT +intestinales, I-TREATMENT +desde I-TREATMENT +el I-TREATMENT +ángulo I-TREATMENT +de I-TREATMENT +Treitz I-TREATMENT +hasta I-TREATMENT +la I-TREATMENT +enterotomía, I-TREATMENT +eliminando I-TREATMENT +abundante I-TREATMENT +cantidad I-TREATMENT +de I-TREATMENT +deposiciones I-TREATMENT +con I-TREATMENT +parásitos. I-TREATMENT +En B-EXPLORATION +la I-EXPLORATION +cavidad I-EXPLORATION +abdominal I-EXPLORATION +se I-EXPLORATION +apreció I-EXPLORATION +líquido I-EXPLORATION +seroso I-EXPLORATION +claro. I-EXPLORATION +El I-EXPLORATION +apéndice I-EXPLORATION +cecal I-EXPLORATION +y I-EXPLORATION +vesícula I-EXPLORATION +biliar I-EXPLORATION +eran I-EXPLORATION +de I-EXPLORATION +características I-EXPLORATION +normales. I-EXPLORATION + I-EXPLORATION +Luego B-TREATMENT +de I-TREATMENT +la I-TREATMENT +primera I-TREATMENT +cirugía, I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +antiparasitario I-TREATMENT +con I-TREATMENT +albendazol. I-TREATMENT +Sin B-EVOLUTION +embargo, I-EVOLUTION +la I-EVOLUTION +evolución I-EVOLUTION +clínica I-EVOLUTION +fue I-EVOLUTION +insatisfactoria, I-EVOLUTION +requiriendo I-EVOLUTION +luego I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +segunda I-EVOLUTION +intervención I-EVOLUTION +quirúrgica, I-EVOLUTION +soporte I-EVOLUTION +ventilatorio I-EVOLUTION +y I-EVOLUTION +manejo I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +Unidad I-EVOLUTION +de I-EVOLUTION +Cuidados I-EVOLUTION +Intensivos I-EVOLUTION +(UCI). I-EVOLUTION +Durante B-EXPLORATION +su I-EXPLORATION +estadía I-EXPLORATION +en I-EXPLORATION +UCI, I-EXPLORATION +el I-EXPLORATION +paciente I-EXPLORATION +cursó I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +neumonía I-EXPLORATION +asociada I-EXPLORATION +a I-EXPLORATION +ventilador I-EXPLORATION +mecánico I-EXPLORATION +por I-EXPLORATION +Pseudomonas I-EXPLORATION +aeru-ginosa I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +bacteriemia I-EXPLORATION +por I-EXPLORATION +Acinetobacter I-EXPLORATION +baumannii I-EXPLORATION +multiresistentes. I-EXPLORATION +La B-EVOLUTION +eliminación I-EVOLUTION +de I-EVOLUTION +gusanos I-EVOLUTION +adultos I-EVOLUTION +por I-EVOLUTION +la I-EVOLUTION +cavidad I-EVOLUTION +oral I-EVOLUTION +continuó I-EVOLUTION +hasta I-EVOLUTION +varios I-EVOLUTION +días I-EVOLUTION +posteriores I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +última I-EVOLUTION +cirugía. I-EVOLUTION + I-EVOLUTION + +Presentamos B-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +55 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +ulcus I-PAST_MEDICAL_HISTORY +bulbar I-PAST_MEDICAL_HISTORY +(Helicobacter I-PAST_MEDICAL_HISTORY +pylori I-PAST_MEDICAL_HISTORY +positivo, I-PAST_MEDICAL_HISTORY +erradicada I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +2005), I-PAST_MEDICAL_HISTORY +tromboembolismo I-PAST_MEDICAL_HISTORY +pulmonar I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +2012 I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +intervenido I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +hernia I-PAST_MEDICAL_HISTORY +inguinal I-PAST_MEDICAL_HISTORY +derecha. I-PAST_MEDICAL_HISTORY +Fumador, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +total I-PAST_MEDICAL_HISTORY +acumulado I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +20 I-PAST_MEDICAL_HISTORY +paquetes/año. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +En B-PRESENT_ILLNESS +mayo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2011 I-PRESENT_ILLNESS +acudió I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +Servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Urgencias I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +inestabilidad I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +marcha I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +lateropulsión I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +derecha, I-PRESENT_ILLNESS +bradipsiquia I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +disnomia I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +vómitos. I-PRESENT_ILLNESS +Se B-EXPLORATION +le I-EXPLORATION +realizó I-EXPLORATION +un I-EXPLORATION +TAC I-EXPLORATION +craneal I-EXPLORATION +que I-EXPLORATION +mostraba I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +en I-EXPLORATION +hemisferio I-EXPLORATION +cerebeloso I-EXPLORATION +derecho. I-EXPLORATION +Tras I-EXPLORATION +completar I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +extensión I-EXPLORATION +con I-EXPLORATION +TAC I-EXPLORATION +toraco-abdominal, I-EXPLORATION +RM I-EXPLORATION +craneal, I-EXPLORATION +broncoscopia I-EXPLORATION +y I-EXPLORATION +PET I-EXPLORATION +fue I-EXPLORATION +diagnosticado I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +cerebral I-EXPLORATION +sugestiva I-EXPLORATION +de I-EXPLORATION +metástasis I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +contexto I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +posible I-EXPLORATION +neoplasia I-EXPLORATION +pulmonar I-EXPLORATION +localizada. I-EXPLORATION +Se B-TREATMENT +decidió I-TREATMENT +realizar I-TREATMENT +metastasectomía I-TREATMENT +cerebral I-TREATMENT +diagnóstico-terapéutica. I-TREATMENT +El B-EXPLORATION +resultado I-EXPLORATION +anatomopatológico I-EXPLORATION +fue I-EXPLORATION +de I-EXPLORATION +carcinoma I-EXPLORATION +microcítico I-EXPLORATION +de I-EXPLORATION +pulmón. I-EXPLORATION +El I-EXPLORATION +diagnóstico I-EXPLORATION +definitivo I-EXPLORATION +fue I-EXPLORATION +de I-EXPLORATION +CPCP I-EXPLORATION +T1N0M1b, I-EXPLORATION +estadio I-EXPLORATION +IV. I-EXPLORATION +Se B-TREATMENT +administró I-TREATMENT +tratamiento I-TREATMENT +adyuvante I-TREATMENT +con I-TREATMENT +radioterapia I-TREATMENT +holocraneal I-TREATMENT +hasta I-TREATMENT +alcanzar I-TREATMENT +dosis I-TREATMENT +total I-TREATMENT +de I-TREATMENT +37.5 I-TREATMENT +Gys I-TREATMENT +que I-TREATMENT +finalizó I-TREATMENT +en I-TREATMENT +julio I-TREATMENT +de I-TREATMENT +2011 I-TREATMENT +tras I-TREATMENT +lo I-TREATMENT +cual I-TREATMENT +recibió I-TREATMENT +tratamiento I-TREATMENT +de I-TREATMENT +quimioterapia I-TREATMENT +con I-TREATMENT +cisplatino I-TREATMENT +-VP16. I-TREATMENT + I-TREATMENT +Precisó I-TREATMENT +cambio I-TREATMENT +a I-TREATMENT +carboplatino I-TREATMENT +por I-TREATMENT +emesis I-TREATMENT +e I-TREATMENT +insuficiencia I-TREATMENT +renal I-TREATMENT +recibiendo I-TREATMENT +en I-TREATMENT +total I-TREATMENT +4 I-TREATMENT +ciclos I-TREATMENT +de I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +mala I-TREATMENT +tolerancia I-TREATMENT +clínica I-TREATMENT +y I-TREATMENT +hematológica I-TREATMENT +finalizando I-TREATMENT +en I-TREATMENT +octubre I-TREATMENT +de I-TREATMENT +2011. I-TREATMENT +Posteriormente, I-TREATMENT +en I-TREATMENT +diciembre I-TREATMENT +de I-TREATMENT +2011, I-TREATMENT +recibió I-TREATMENT +radioterapia I-TREATMENT +torácica I-TREATMENT +de I-TREATMENT +consolidación, I-TREATMENT +45 I-TREATMENT +Gys I-TREATMENT +en I-TREATMENT +15 I-TREATMENT +fracciones I-TREATMENT +siguiendo I-TREATMENT +las I-TREATMENT +recomendaciones I-TREATMENT +RTOG I-TREATMENT +09372, I-TREATMENT +consiguiendo I-TREATMENT +mantener I-TREATMENT +la I-TREATMENT +estabilidad I-TREATMENT +de I-TREATMENT +la I-TREATMENT +enfermedad I-TREATMENT +en I-TREATMENT +los I-TREATMENT +siguientes I-TREATMENT +controles. I-TREATMENT + I-TREATMENT +En B-EVOLUTION +julio I-EVOLUTION +de I-EVOLUTION +2012 I-EVOLUTION +ingresó I-EVOLUTION +procedente I-EVOLUTION +del I-EVOLUTION +servicio I-EVOLUTION +de I-EVOLUTION +Urgencias I-EVOLUTION +por I-EVOLUTION +pérdida I-EVOLUTION +de I-EVOLUTION +fuerza I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +extremidad I-EVOLUTION +inferior I-EVOLUTION +izquierda I-EVOLUTION +de I-EVOLUTION +varios I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +evolución. I-EVOLUTION +Se B-EXPLORATION +le I-EXPLORATION +realizó I-EXPLORATION +RM I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +objetivó I-EXPLORATION +metástasis I-EXPLORATION +leptomeníngeas I-EXPLORATION +con I-EXPLORATION +implante I-EXPLORATION +dorsal I-EXPLORATION +(D2-D3) I-EXPLORATION +que I-EXPLORATION +provocaba I-EXPLORATION +una I-EXPLORATION +compresión I-EXPLORATION +medular I-EXPLORATION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +radioterapia I-TREATMENT +sobre I-TREATMENT +niveles I-TREATMENT +D1-D4 I-TREATMENT +administrándose I-TREATMENT +20 I-TREATMENT +Gy I-TREATMENT +en I-TREATMENT +5 I-TREATMENT +fracciones I-TREATMENT +con I-TREATMENT +excelente I-TREATMENT +respuesta I-TREATMENT +clínica. I-TREATMENT + I-TREATMENT +Asimismo B-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +TAC I-EXPLORATION +toracoabdominal I-EXPLORATION +que I-EXPLORATION +mostraba I-EXPLORATION +adenopatía I-EXPLORATION +hiliar I-EXPLORATION +derecha I-EXPLORATION +de I-EXPLORATION +2 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +nueva I-EXPLORATION +aparición I-EXPLORATION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +comenzó I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +carboplatino-etopósido, I-TREATMENT +con I-TREATMENT +respuesta I-TREATMENT +parcial I-TREATMENT +tras I-TREATMENT +3 I-TREATMENT +ciclos I-TREATMENT +y I-TREATMENT +estabilización I-TREATMENT +tras I-TREATMENT +el I-TREATMENT +6o I-TREATMENT +ciclo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +administró I-TREATMENT +en I-TREATMENT +diciembre I-TREATMENT +de I-TREATMENT +2012. I-TREATMENT + I-TREATMENT +En B-EXPLORATION +RM I-EXPLORATION +de I-EXPLORATION +control, I-EXPLORATION +en I-EXPLORATION +junio I-EXPLORATION +de I-EXPLORATION +2013 I-EXPLORATION +se I-EXPLORATION +visualizaron I-EXPLORATION +múltiples I-EXPLORATION +imágenes I-EXPLORATION +de I-EXPLORATION +captación I-EXPLORATION +puntiformes I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION +diseminación I-EXPLORATION +leptomeníngea I-EXPLORATION +a I-EXPLORATION +lo I-EXPLORATION +largo I-EXPLORATION +del I-EXPLORATION +raquis, I-EXPLORATION +tanto I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +dorsal I-EXPLORATION +como I-EXPLORATION +lumbar, I-EXPLORATION +encontrándose I-EXPLORATION +los I-EXPLORATION +implantes I-EXPLORATION +más I-EXPLORATION +destacables I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +lumbar I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +planificó I-EXPLORATION +RT I-EXPLORATION +a I-EXPLORATION +ese I-EXPLORATION +nivel I-EXPLORATION +(L1-L5). I-EXPLORATION +Se B-TREATMENT +administraron I-TREATMENT +20 I-TREATMENT +Gys I-TREATMENT +en I-TREATMENT +5 I-TREATMENT +fracciones I-TREATMENT +el I-TREATMENT +mismo I-TREATMENT +mes I-TREATMENT +de I-TREATMENT +junio I-TREATMENT +de I-TREATMENT +2013. I-TREATMENT + I-TREATMENT +En B-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +control I-EXPLORATION +mediante I-EXPLORATION +TAC I-EXPLORATION +toracoabdominal I-EXPLORATION +en I-EXPLORATION +junio I-EXPLORATION +de I-EXPLORATION +ese I-EXPLORATION +año I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +que I-EXPLORATION +la I-EXPLORATION +adenopatía I-EXPLORATION +hiliar I-EXPLORATION +derecha I-EXPLORATION +había I-EXPLORATION +aumentado I-EXPLORATION +ligeramente I-EXPLORATION +de I-EXPLORATION +tamaño I-EXPLORATION +respecto I-EXPLORATION +al I-EXPLORATION +TAC I-EXPLORATION +previo I-EXPLORATION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +administrar I-TREATMENT +radioterapia I-TREATMENT +sobre I-TREATMENT +la I-TREATMENT +lesión I-TREATMENT +hiliar I-TREATMENT +con I-TREATMENT +un I-TREATMENT +esquema I-TREATMENT +de I-TREATMENT +40 I-TREATMENT +Gy I-TREATMENT +en I-TREATMENT +15 I-TREATMENT +fracciones, I-TREATMENT +finalizando I-TREATMENT +tratamiento I-TREATMENT +en I-TREATMENT +noviembre I-TREATMENT +2013. I-TREATMENT + I-TREATMENT +Desde B-EVOLUTION +entonces I-EVOLUTION +se I-EVOLUTION +encuentra I-EVOLUTION +en I-EVOLUTION +revisiones, I-EVOLUTION +con I-EVOLUTION +buen I-EVOLUTION +estado I-EVOLUTION +general, I-EVOLUTION +vida I-EVOLUTION +activa I-EVOLUTION +e I-EVOLUTION +independiente I-EVOLUTION +para I-EVOLUTION +las I-EVOLUTION +actividades I-EVOLUTION +básicas I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +vida I-EVOLUTION +diaria. I-EVOLUTION +En I-EVOLUTION +los I-EVOLUTION +estudios I-EVOLUTION +de I-EVOLUTION +control I-EVOLUTION +no I-EVOLUTION +hay I-EVOLUTION +datos I-EVOLUTION +de I-EVOLUTION +progresión I-EVOLUTION +de I-EVOLUTION +enfermedad. I-EVOLUTION +No B-EXPLORATION +se I-EXPLORATION +observan I-EXPLORATION +realces I-EXPLORATION +patológicos I-EXPLORATION +leptomeníngeos I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +última I-EXPLORATION +RM I-EXPLORATION +de I-EXPLORATION +columna I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +ha I-EXPLORATION +comprobado I-EXPLORATION +por I-EXPLORATION +TAC I-EXPLORATION +la I-EXPLORATION +disminución I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +adenopatía I-EXPLORATION +hiliar I-EXPLORATION +derecha I-EXPLORATION +que I-EXPLORATION +en I-EXPLORATION +estos I-EXPLORATION +momentos I-EXPLORATION +es I-EXPLORATION +infracentimétrica. I-EXPLORATION + I-EXPLORATION + +Paciente B-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +68 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +H.T.A. I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +cardiopatía I-PAST_MEDICAL_HISTORY +isquémica I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento. I-PAST_MEDICAL_HISTORY +No I-PAST_MEDICAL_HISTORY +alergias I-PAST_MEDICAL_HISTORY +ni I-PAST_MEDICAL_HISTORY +otros I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Consulta B-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +hematuria I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +coágulos I-PRESENT_ILLNESS +intermitente I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +otros I-PRESENT_ILLNESS +síntomas I-PRESENT_ILLNESS +urológicos I-PRESENT_ILLNESS +destacables I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +mes I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +La B-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +es I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +la I-EXPLORATION +normalidad. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +ecográfico I-EXPLORATION +no I-EXPLORATION +detecta I-EXPLORATION +anomalías I-EXPLORATION +de I-EXPLORATION +interés, I-EXPLORATION +con I-EXPLORATION +riñones I-EXPLORATION +y I-EXPLORATION +vías I-EXPLORATION +excretoras I-EXPLORATION +normales, I-EXPLORATION +próstata I-EXPLORATION +discretamente I-EXPLORATION +aumentada I-EXPLORATION +de I-EXPLORATION +tamaño I-EXPLORATION +y I-EXPLORATION +vejiga I-EXPLORATION +sin I-EXPLORATION +hallazgos. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +cistoscopia I-EXPLORATION +practicada I-EXPLORATION +se I-EXPLORATION +aprecia I-EXPLORATION +una I-EXPLORATION +tumoración I-EXPLORATION +papilar I-EXPLORATION +en I-EXPLORATION +cara I-EXPLORATION +lateral I-EXPLORATION +izquierda I-EXPLORATION +retromeatal I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +extiende I-EXPLORATION +hasta I-EXPLORATION +vertiente I-EXPLORATION +anterior I-EXPLORATION +del I-EXPLORATION +cuello I-EXPLORATION +vesical. I-EXPLORATION +Se B-TREATMENT +practica I-TREATMENT +resección I-TREATMENT +transuretral. I-TREATMENT + I-TREATMENT +El B-EXPLORATION +diagnóstico I-EXPLORATION +anatomopatológico I-EXPLORATION +fue I-EXPLORATION +de I-EXPLORATION +adenoma I-EXPLORATION +de I-EXPLORATION +Brunner I-EXPLORATION +(papiloma I-EXPLORATION +invertido) I-EXPLORATION +sobre I-EXPLORATION +varios I-EXPLORATION +fragmentos I-EXPLORATION +resecados I-EXPLORATION +que I-EXPLORATION +en I-EXPLORATION +conjunto I-EXPLORATION +miden I-EXPLORATION +10x15x5 I-EXPLORATION +mm.. I-EXPLORATION + I-EXPLORATION +El B-EVOLUTION +paciente I-EVOLUTION +permanece I-EVOLUTION +asintomático I-EVOLUTION +tras I-EVOLUTION +24 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +seguimiento. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +31 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +remitida I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +octubre I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2012 I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +prurito I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +ingresada I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +clínico-analítico I-PRESENT_ILLNESS +compatible I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +hepatitis I-PRESENT_ILLNESS +aguda I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +grave. I-PRESENT_ILLNESS +En I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +anamnesis I-PRESENT_ILLNESS +refería I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +tatuaje I-PRESENT_ILLNESS +hace I-PRESENT_ILLNESS +10 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +toma I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Inneov I-PRESENT_ILLNESS +masa I-PRESENT_ILLNESS +capilar® I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +hacía I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +mes. I-PRESENT_ILLNESS +La B-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +fue I-EXPLORATION +normal. I-EXPLORATION +Los I-EXPLORATION +resultados I-EXPLORATION +de I-EXPLORATION +laboratorio I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION +se I-EXPLORATION +resumen I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +tabla I-EXPLORATION +I. I-EXPLORATION +La I-EXPLORATION +inmunología I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +serología I-EXPLORATION +viral I-EXPLORATION +fueron I-EXPLORATION +negativas. I-EXPLORATION +Al B-EVOLUTION +quinto I-EVOLUTION +día I-EVOLUTION +de I-EVOLUTION +suspender I-EVOLUTION +Inneov I-EVOLUTION +masa I-EVOLUTION +capilar® I-EVOLUTION +se I-EVOLUTION +observó I-EVOLUTION +mejoría I-EVOLUTION +clínica, I-EVOLUTION +con I-EVOLUTION +desaparición I-EVOLUTION +del I-EVOLUTION +prurito, I-EVOLUTION +y I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +analítica, I-EVOLUTION +con I-EVOLUTION +normalización I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +pruebas I-EVOLUTION +de I-EVOLUTION +función I-EVOLUTION +hepática I-EVOLUTION +tres I-EVOLUTION +meses I-EVOLUTION +más I-EVOLUTION +tarde. I-EVOLUTION + I-EVOLUTION +La I-EVOLUTION +causalidad I-EVOLUTION +utilizando I-EVOLUTION +la I-EVOLUTION +escala I-EVOLUTION +de I-EVOLUTION +CIOMS/RUCAM I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +caso I-EVOLUTION +2 I-EVOLUTION +y I-EVOLUTION +3 I-EVOLUTION +fue I-EVOLUTION +altamente I-EVOLUTION +probable. I-EVOLUTION + I-EVOLUTION + +Escolar B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +masculino, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +10 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +9 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +mórbidos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +importancia. I-PAST_MEDICAL_HISTORY +Presentaba B-PRESENT_ILLNESS +historia I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +semana I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cefalea, I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +edema I-PRESENT_ILLNESS +periorbitario I-PRESENT_ILLNESS +derecho, I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +hospitalizó I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +otro I-PRESENT_ILLNESS +centro I-PRESENT_ILLNESS +donde I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +le I-PRESENT_ILLNESS +realizó I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +TAC I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +senos I-PRESENT_ILLNESS +paranasales I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +órbita I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +demostró I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +pansinusitis I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +sospecha I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +absceso I-PRESENT_ILLNESS +orbitario I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS +iniciándose I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +antimicrobiano I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +ceftriaxona I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +cloxacilina. I-PRESENT_ILLNESS +A B-EXPLORATION +las I-EXPLORATION +48 I-EXPLORATION +horas I-EXPLORATION +del I-EXPLORATION +ingreso, I-EXPLORATION +el I-EXPLORATION +paciente I-EXPLORATION +cursó I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +cuadro I-EXPLORATION +confusional I-EXPLORATION +agudo I-EXPLORATION +y I-EXPLORATION +crisis I-EXPLORATION +de I-EXPLORATION +agitación I-EXPLORATION +psicomotora I-EXPLORATION +asociado I-EXPLORATION +a I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +irritación I-EXPLORATION +meníngea, I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +le I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +punción I-EXPLORATION +lumbar I-EXPLORATION +obteniéndose I-EXPLORATION +LCR I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +meningitis I-EXPLORATION +(490 I-EXPLORATION +células/mm3 I-EXPLORATION +60% I-EXPLORATION +PMN, I-EXPLORATION +glucorraquia I-EXPLORATION +y I-EXPLORATION +proteínas I-EXPLORATION +normales), I-EXPLORATION +pero I-EXPLORATION +el I-EXPLORATION +cultivo I-EXPLORATION +del I-EXPLORATION +LCR I-EXPLORATION +y I-EXPLORATION +sangre I-EXPLORATION +fueron I-EXPLORATION +negativos. I-EXPLORATION +Una I-EXPLORATION +TAC I-EXPLORATION +de I-EXPLORATION +cerebro I-EXPLORATION +con I-EXPLORATION +medio I-EXPLORATION +de I-EXPLORATION +contraste I-EXPLORATION +evidenció I-EXPLORATION +edema I-EXPLORATION +cerebral I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +colección I-EXPLORATION +subdural I-EXPLORATION +bilateral I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +trasladó I-EXPLORATION +a I-EXPLORATION +nuestro I-EXPLORATION +centro I-EXPLORATION +para I-EXPLORATION +evaluación I-EXPLORATION +neuro-quirúrgica I-EXPLORATION +con I-EXPLORATION +los I-EXPLORATION +diagnósticos I-EXPLORATION +de I-EXPLORATION +pansinusitis, I-EXPLORATION +meningitis I-EXPLORATION +aguda I-EXPLORATION +secundaria I-EXPLORATION +y I-EXPLORATION +colección I-EXPLORATION +subdural. I-EXPLORATION + I-EXPLORATION +Al I-EXPLORATION +ingreso I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +unidad I-EXPLORATION +de I-EXPLORATION +cuidados I-EXPLORATION +intensivos I-EXPLORATION +pediátricos I-EXPLORATION +destacaba I-EXPLORATION +al I-EXPLORATION +examen I-EXPLORATION +físico: I-EXPLORATION +T° I-EXPLORATION +axilar I-EXPLORATION +38, I-EXPLORATION +3 I-EXPLORATION +°C, I-EXPLORATION +frecuencia I-EXPLORATION +cardíaca I-EXPLORATION +de I-EXPLORATION +65 I-EXPLORATION +por I-EXPLORATION +min, I-EXPLORATION +presión I-EXPLORATION +arterial I-EXPLORATION +140/90 I-EXPLORATION +mm I-EXPLORATION +Hg, I-EXPLORATION +escala I-EXPLORATION +de I-EXPLORATION +Glasgow: I-EXPLORATION +6, I-EXPLORATION +hiperreflexia, I-EXPLORATION +anisocoria I-EXPLORATION +midriática I-EXPLORATION +a I-EXPLORATION +derecha, I-EXPLORATION +rigidez I-EXPLORATION +de I-EXPLORATION +nuca, I-EXPLORATION +edema I-EXPLORATION +bipalpebral I-EXPLORATION +y I-EXPLORATION +quemosis, I-EXPLORATION +clonus I-EXPLORATION +bilateral I-EXPLORATION +mayor I-EXPLORATION +a I-EXPLORATION +derecha. I-EXPLORATION +La I-EXPLORATION +PCR I-EXPLORATION +fue I-EXPLORATION +de I-EXPLORATION +215 I-EXPLORATION +mg/L, I-EXPLORATION +el I-EXPLORATION +recuento I-EXPLORATION +leucocitario I-EXPLORATION +de I-EXPLORATION +15.800/mm3, I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +recuento I-EXPLORATION +de I-EXPLORATION +plaquetas I-EXPLORATION +normal. I-EXPLORATION +Se B-TREATMENT +inició I-TREATMENT +manejo I-TREATMENT +de I-TREATMENT +la I-TREATMENT +hipertensión I-TREATMENT +endocraneana I-TREATMENT +con I-TREATMENT +intubación I-TREATMENT +endotraqueal I-TREATMENT +y I-TREATMENT +conexión I-TREATMENT +a I-TREATMENT +ventilación I-TREATMENT +mecánica I-TREATMENT +asociada I-TREATMENT +a I-TREATMENT +la I-TREATMENT +administración I-TREATMENT +de I-TREATMENT +manitol, I-TREATMENT +sedoanalgesia I-TREATMENT +con I-TREATMENT +midazolam-fentanilo I-TREATMENT +y I-TREATMENT +soporte I-TREATMENT +inotrópico I-TREATMENT +con I-TREATMENT +dopamina. I-TREATMENT +Se I-TREATMENT +instauró I-TREATMENT +terapia I-TREATMENT +anticonvulsivante I-TREATMENT +con I-TREATMENT +fenitoína I-TREATMENT +y I-TREATMENT +tratamiento I-TREATMENT +antimicrobiano I-TREATMENT +triasociado I-TREATMENT +con I-TREATMENT +ceftriaxona, I-TREATMENT +metronidazol I-TREATMENT +y I-TREATMENT +vancomicina. I-TREATMENT +Una B-EXPLORATION +nueva I-EXPLORATION +TAC I-EXPLORATION +cerebral I-EXPLORATION +con I-EXPLORATION +y I-EXPLORATION +sin I-EXPLORATION +contraste I-EXPLORATION +mostró I-EXPLORATION +edema I-EXPLORATION +cerebral I-EXPLORATION +y I-EXPLORATION +progresión I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +colección I-EXPLORATION +subdural I-EXPLORATION +planteándose I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +empiema I-EXPLORATION +subdural I-EXPLORATION +con I-EXPLORATION +efecto I-EXPLORATION +de I-EXPLORATION +masa I-EXPLORATION +inicial. I-EXPLORATION +El I-EXPLORATION +paciente I-EXPLORATION +fue I-EXPLORATION +evaluado I-EXPLORATION +por I-EXPLORATION +el I-EXPLORATION +equipo I-EXPLORATION +de I-EXPLORATION +otorrinolaringología I-EXPLORATION +y I-EXPLORATION +neurocirugía I-EXPLORATION +realizándose I-EXPLORATION +exploración I-EXPLORATION +del I-EXPLORATION +meato I-EXPLORATION +medio I-EXPLORATION +y B-TREATMENT +drenaje I-TREATMENT +del I-TREATMENT +seno I-TREATMENT +maxilar I-TREATMENT +derecho I-TREATMENT +por I-TREATMENT +vía I-TREATMENT +endoscópica I-TREATMENT +y I-TREATMENT +en I-TREATMENT +las I-TREATMENT +horas I-TREATMENT +siguientes I-TREATMENT +etmoidectomía I-TREATMENT +derecha, I-TREATMENT +drenaje I-TREATMENT +de I-TREATMENT +un I-TREATMENT +absceso I-TREATMENT +orbitario I-TREATMENT +derecho I-TREATMENT +y I-TREATMENT +drenaje I-TREATMENT +de I-TREATMENT +un I-TREATMENT +empiema I-TREATMENT +subdural I-TREATMENT +izquierdo I-TREATMENT +desde I-TREATMENT +donde I-TREATMENT +se I-TREATMENT +retiró I-TREATMENT +abundante I-TREATMENT +material I-TREATMENT +purulento. I-TREATMENT +El B-EXPLORATION +cultivo I-EXPLORATION +microbiológico I-EXPLORATION +de I-EXPLORATION +estas I-EXPLORATION +zonas I-EXPLORATION +para I-EXPLORATION +aerobios I-EXPLORATION +y I-EXPLORATION +anaerobios I-EXPLORATION +estrictos, I-EXPLORATION +procesado I-EXPLORATION +en I-EXPLORATION +sistema I-EXPLORATION +BACTEC/ALERT® I-EXPLORATION +FN I-EXPLORATION +con I-EXPLORATION +bajo I-EXPLORATION +potencial I-EXPLORATION +de I-EXPLORATION +oxido I-EXPLORATION +reducción I-EXPLORATION +y I-EXPLORATION +carbón I-EXPLORATION +activado, I-EXPLORATION +fue I-EXPLORATION +negativo. I-EXPLORATION + I-EXPLORATION +El B-EVOLUTION +paciente I-EVOLUTION +permaneció I-EVOLUTION +en I-EVOLUTION +ventilación I-EVOLUTION +asistida I-EVOLUTION +durante I-EVOLUTION +siete I-EVOLUTION +días I-EVOLUTION +y I-EVOLUTION +cursó I-EVOLUTION +con I-EVOLUTION +regresión I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +signos I-EVOLUTION +de I-EVOLUTION +hipertensión I-EVOLUTION +endocraneana I-EVOLUTION +y I-EVOLUTION +recuperación I-EVOLUTION +progresiva I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +escala I-EVOLUTION +de I-EVOLUTION +Glasgow. I-EVOLUTION +Tras B-EXPLORATION +tres I-EXPLORATION +semanas I-EXPLORATION +de I-EXPLORATION +antibioterapia I-EXPLORATION +triasociada, I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +nueva I-EXPLORATION +TAC I-EXPLORATION +cerebral I-EXPLORATION +con I-EXPLORATION +medio I-EXPLORATION +de I-EXPLORATION +contraste I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +dos I-EXPLORATION +colecciones I-EXPLORATION +encefálicas I-EXPLORATION +frontales I-EXPLORATION +derechas, I-EXPLORATION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +debió I-TREATMENT +realizarse I-TREATMENT +una I-TREATMENT +nueva I-TREATMENT +intervención I-TREATMENT +quirúrgica: I-TREATMENT +cranectomía I-TREATMENT +con I-TREATMENT +vaciamiento I-TREATMENT +frontal I-TREATMENT +derecho, I-TREATMENT +drenaje I-TREATMENT +de I-TREATMENT +empiema I-TREATMENT +con I-TREATMENT +dos I-TREATMENT +agujeros I-TREATMENT +de I-TREATMENT +trépano I-TREATMENT +y I-TREATMENT +durotomía I-TREATMENT +que I-TREATMENT +dio I-TREATMENT +salida I-TREATMENT +a I-TREATMENT +pus I-TREATMENT +abundante. I-TREATMENT +Los B-EXPLORATION +cultivos I-EXPLORATION +nuevamente I-EXPLORATION +resultaron I-EXPLORATION +negativos. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +evolución I-EXPLORATION +posterior I-EXPLORATION +fue I-EXPLORATION +favorable, I-EXPLORATION +completando I-EXPLORATION +5 I-EXPLORATION +semanas I-EXPLORATION +de I-EXPLORATION +antibioterapia I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +seguimiento I-EXPLORATION +con I-EXPLORATION +TAC I-EXPLORATION +cerebral I-EXPLORATION +con I-EXPLORATION +medio I-EXPLORATION +de I-EXPLORATION +contraste I-EXPLORATION +no I-EXPLORATION +reveló I-EXPLORATION +la I-EXPLORATION +formación I-EXPLORATION +de I-EXPLORATION +nuevas I-EXPLORATION +colecciones. I-EXPLORATION +En B-EVOLUTION +los I-EVOLUTION +controles I-EVOLUTION +clínicos I-EVOLUTION +post I-EVOLUTION +egreso I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +presentaba I-EVOLUTION +una I-EVOLUTION +afasia I-EVOLUTION +de I-EVOLUTION +expresión, I-EVOLUTION +logrando I-EVOLUTION +comunicación I-EVOLUTION +en I-EVOLUTION +forma I-EVOLUTION +escrita I-EVOLUTION +y I-EVOLUTION +una I-EVOLUTION +hemiparesia I-EVOLUTION +derecha I-EVOLUTION +actualmente I-EVOLUTION +en I-EVOLUTION +regresión. I-EVOLUTION + I-EVOLUTION + +Presentamos B-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +niña I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +7 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +médico-quirúrgicos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés, I-PAST_MEDICAL_HISTORY +remitida B-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +consultas I-DERIVED_FROM/TO +externas I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Cirugía I-DERIVED_FROM/TO +Maxilofacial I-DERIVED_FROM/TO +del I-DERIVED_FROM/TO +Hospital I-DERIVED_FROM/TO +Universitario I-DERIVED_FROM/TO +Marqués I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Valdecilla I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +noviembre I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +2004 I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +una I-DERIVED_FROM/TO +masa I-DERIVED_FROM/TO +indolora I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +región I-DERIVED_FROM/TO +anterior I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +suelo I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +boca I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +meses I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +evolución. I-DERIVED_FROM/TO +A B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +se I-EXPLORATION +objetiva I-EXPLORATION +dentición I-EXPLORATION +mixta I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +tumoración I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +de I-EXPLORATION +sínfisis I-EXPLORATION +mandibular, I-EXPLORATION +con I-EXPLORATION +mucosa I-EXPLORATION +oral I-EXPLORATION +respetada I-EXPLORATION +y I-EXPLORATION +abombamiento I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +corticales I-EXPLORATION +lingual I-EXPLORATION +y I-EXPLORATION +vestibular, I-EXPLORATION +y I-EXPLORATION +dientes I-EXPLORATION +deciduos I-EXPLORATION +estables I-EXPLORATION +a I-EXPLORATION +ese I-EXPLORATION +nivel. I-EXPLORATION +La I-EXPLORATION +paciente I-EXPLORATION +no I-EXPLORATION +presenta I-EXPLORATION +alteraciones I-EXPLORATION +neurológicas I-EXPLORATION +significativas. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +ortopantomografía I-EXPLORATION +(OPG) I-EXPLORATION +revela I-EXPLORATION +una I-EXPLORATION +imagen I-EXPLORATION +radiolúcida I-EXPLORATION +de I-EXPLORATION +márgenes I-EXPLORATION +mal I-EXPLORATION +definidos I-EXPLORATION +en I-EXPLORATION +sínfisis I-EXPLORATION +mandibular I-EXPLORATION +-de I-EXPLORATION +73 I-EXPLORATION +a I-EXPLORATION +83-, I-EXPLORATION +con I-EXPLORATION +basilar I-EXPLORATION +desestructurada I-EXPLORATION +a I-EXPLORATION +ese I-EXPLORATION +nivel. I-EXPLORATION +También I-EXPLORATION +se I-EXPLORATION +observan I-EXPLORATION +3 I-EXPLORATION +dientes I-EXPLORATION +definitivos I-EXPLORATION +incluidos I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +lesión I-EXPLORATION +y I-EXPLORATION +cierto I-EXPLORATION +grado I-EXPLORATION +de I-EXPLORATION +rizólisis I-EXPLORATION +y I-EXPLORATION +desplazamientos I-EXPLORATION +dentales. I-EXPLORATION +Se I-EXPLORATION +solicita I-EXPLORATION +tomografía I-EXPLORATION +computarizada I-EXPLORATION +(TC), I-EXPLORATION +que I-EXPLORATION +confirma I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +tumoración I-EXPLORATION +osteolítica, I-EXPLORATION +insuflante I-EXPLORATION +y I-EXPLORATION +multilocular I-EXPLORATION +de I-EXPLORATION +3×1, I-EXPLORATION +8cm, I-EXPLORATION +con I-EXPLORATION +corticales I-EXPLORATION +expandidas I-EXPLORATION +y I-EXPLORATION +adelgazadas, I-EXPLORATION +pero I-EXPLORATION +sin I-EXPLORATION +afectación I-EXPLORATION +de I-EXPLORATION +partes I-EXPLORATION +blandas; I-EXPLORATION +asimismo, I-EXPLORATION +se I-EXPLORATION +describe I-EXPLORATION +el I-EXPLORATION +interior I-EXPLORATION +de I-EXPLORATION +densidad I-EXPLORATION +sólida, I-EXPLORATION +todo I-EXPLORATION +ello I-EXPLORATION +sugestivo I-EXPLORATION +de I-EXPLORATION +quiste I-EXPLORATION +óseo I-EXPLORATION +aneurismático I-EXPLORATION +sólido. I-EXPLORATION +La I-EXPLORATION +punción-aspiración I-EXPLORATION +con I-EXPLORATION +aguja I-EXPLORATION +fina I-EXPLORATION +(PAAF) I-EXPLORATION +no I-EXPLORATION +es I-EXPLORATION +concluyente. I-EXPLORATION + I-EXPLORATION +Bajo I-EXPLORATION +anestesia I-EXPLORATION +general I-EXPLORATION +se I-EXPLORATION +realiza I-EXPLORATION +abordaje I-EXPLORATION +vestibular, I-EXPLORATION +que I-EXPLORATION +permite I-EXPLORATION +visualizar I-EXPLORATION +la I-EXPLORATION +cortical I-EXPLORATION +expandida I-EXPLORATION +y I-EXPLORATION +adelgazada I-EXPLORATION +pero I-EXPLORATION +sin I-EXPLORATION +pérdida I-EXPLORATION +de I-EXPLORATION +continuidad, I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +típico I-EXPLORATION +aspecto I-EXPLORATION +en I-EXPLORATION +«cáscara I-EXPLORATION +de I-EXPLORATION +huevo». I-EXPLORATION +Una I-EXPLORATION +vez I-EXPLORATION +expuesta I-EXPLORATION +la I-EXPLORATION +lesión, I-EXPLORATION +se I-EXPLORATION +toma I-EXPLORATION +una I-EXPLORATION +biopsia I-EXPLORATION +intraoperatoria I-EXPLORATION +que I-EXPLORATION +descarta I-EXPLORATION +patología I-EXPLORATION +ósea I-EXPLORATION +maligna. I-EXPLORATION +Con B-TREATMENT +la I-TREATMENT +firme I-TREATMENT +sospecha I-TREATMENT +de I-TREATMENT +QOA I-TREATMENT +sólido, I-TREATMENT +se I-TREATMENT +realiza I-TREATMENT +curetaje I-TREATMENT +y I-TREATMENT +exodoncia I-TREATMENT +de I-TREATMENT +los I-TREATMENT +tres I-TREATMENT +dientes I-TREATMENT +definitivos I-TREATMENT +incluidos I-TREATMENT +en I-TREATMENT +la I-TREATMENT +lesión. I-TREATMENT +El I-TREATMENT +defecto I-TREATMENT +óseo I-TREATMENT +no I-TREATMENT +precisa I-TREATMENT +reconstrucción, I-TREATMENT +pero I-TREATMENT +a I-TREATMENT +fin I-TREATMENT +de I-TREATMENT +favorecer I-TREATMENT +la I-TREATMENT +remodelación I-TREATMENT +ósea I-TREATMENT +guiada I-TREATMENT +del I-TREATMENT +lecho I-TREATMENT +quirúrgico I-TREATMENT +se I-TREATMENT +emplea I-TREATMENT +una I-TREATMENT +lámina I-TREATMENT +de I-TREATMENT +hueso I-TREATMENT +desmineralizado I-TREATMENT +a I-TREATMENT +nivel I-TREATMENT +de I-TREATMENT +la I-TREATMENT +cortical I-TREATMENT +externa I-TREATMENT +mandibular. I-TREATMENT + I-TREATMENT +Al B-DERIVED_FROM/TO +alta I-DERIVED_FROM/TO +es I-DERIVED_FROM/TO +remitida I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +ortodoncista I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +ferulización I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +arcada I-DERIVED_FROM/TO +inferior, I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +objetivo I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +asegurar I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +estabilidad I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +misma, I-DERIVED_FROM/TO +dada I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +importante I-DERIVED_FROM/TO +pérdida I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +soporte I-DERIVED_FROM/TO +óseo I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +nivel I-DERIVED_FROM/TO +crestal I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +sínfisis I-DERIVED_FROM/TO +mandibular. I-DERIVED_FROM/TO +Dicha B-EVOLUTION +fijación I-EVOLUTION +es I-EVOLUTION +mantenida I-EVOLUTION +durante I-EVOLUTION +6 I-EVOLUTION +meses. I-EVOLUTION + I-EVOLUTION +El B-EXPLORATION +estudio I-EXPLORATION +histológico I-EXPLORATION +definitivo I-EXPLORATION +confirma I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +quiste I-EXPLORATION +óseo I-EXPLORATION +aneurismático I-EXPLORATION +de I-EXPLORATION +tipo I-EXPLORATION +sólido. I-EXPLORATION +A I-EXPLORATION +nivel I-EXPLORATION +macroscópico I-EXPLORATION +se I-EXPLORATION +identifican I-EXPLORATION +varios I-EXPLORATION +fragmentos I-EXPLORATION +irregulares I-EXPLORATION +de I-EXPLORATION +color I-EXPLORATION +pardo-negruzco I-EXPLORATION +y I-EXPLORATION +consistencia I-EXPLORATION +elástica I-EXPLORATION +y I-EXPLORATION +firme; I-EXPLORATION +mientras I-EXPLORATION +que I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +microscópico, I-EXPLORATION +se I-EXPLORATION +observan I-EXPLORATION +pequeños I-EXPLORATION +espacios I-EXPLORATION +vasculares I-EXPLORATION +revestidos I-EXPLORATION +por I-EXPLORATION +tejido I-EXPLORATION +celular I-EXPLORATION +fibroso, I-EXPLORATION +células I-EXPLORATION +gigantes I-EXPLORATION +y I-EXPLORATION +macrófagos, I-EXPLORATION +con I-EXPLORATION +mitosis I-EXPLORATION +ocasionales, I-EXPLORATION +ausencia I-EXPLORATION +de I-EXPLORATION +atipias I-EXPLORATION +y I-EXPLORATION +focos I-EXPLORATION +de I-EXPLORATION +hemosiderina. I-EXPLORATION + I-EXPLORATION +La B-EVOLUTION +paciente I-EVOLUTION +presenta I-EVOLUTION +una I-EVOLUTION +buena I-EVOLUTION +evolución I-EVOLUTION +postoperatoria, I-EVOLUTION +con I-EVOLUTION +una I-EVOLUTION +correcta I-EVOLUTION +apariencia I-EVOLUTION +estética I-EVOLUTION +y I-EVOLUTION +funcional. I-EVOLUTION +En I-EVOLUTION +la I-EVOLUTION +actualidad I-EVOLUTION +y I-EVOLUTION +tras I-EVOLUTION +6 I-EVOLUTION +años I-EVOLUTION +en I-EVOLUTION +seguimiento, I-EVOLUTION +no I-EVOLUTION +presenta I-EVOLUTION +signos I-EVOLUTION +clínicos I-EVOLUTION +ni I-EVOLUTION +radiológicos I-EVOLUTION +de I-EVOLUTION +recidiva I-EVOLUTION +local I-EVOLUTION +y B-TREATMENT +ha I-TREATMENT +iniciado I-TREATMENT +tratamiento I-TREATMENT +ortodóncico I-TREATMENT +para I-TREATMENT +corrección I-TREATMENT +de I-TREATMENT +la I-TREATMENT +malposición I-TREATMENT +dentaria. I-TREATMENT + I-TREATMENT + +Paciente B-PRESENT_ILLNESS +masculino I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +originario B-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Tamaulipas, I-PAST_MEDICAL_HISTORY +México, I-PAST_MEDICAL_HISTORY +evaluado B-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +xerosis I-PRESENT_ILLNESS +generalizada, I-PRESENT_ILLNESS +así I-PRESENT_ILLNESS +como I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +origen I-PRESENT_ILLNESS +incierto. I-PRESENT_ILLNESS +Producto B-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +segundo I-PAST_MEDICAL_HISTORY +embarazo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +pareja I-PAST_MEDICAL_HISTORY +sin B-FAMILY_HISTORY +antecedentes I-FAMILY_HISTORY +aparentes I-FAMILY_HISTORY +de I-FAMILY_HISTORY +consanguineidad, I-FAMILY_HISTORY +se B-PAST_MEDICAL_HISTORY +caracteriza I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +presentar I-PAST_MEDICAL_HISTORY +intolerancia I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +calor I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +ausencia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +sudoración I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +nacimiento. I-PAST_MEDICAL_HISTORY +No B-FAMILY_HISTORY +refierían I-FAMILY_HISTORY +antecedentes I-FAMILY_HISTORY +heredofamiliares I-FAMILY_HISTORY +de I-FAMILY_HISTORY +importancia. I-FAMILY_HISTORY +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +destacaba I-EXPLORATION +la I-EXPLORATION +frenteprominente, I-EXPLORATION +hipoplasia I-EXPLORATION +del I-EXPLORATION +puente I-EXPLORATION +nasal, I-EXPLORATION +dos I-EXPLORATION +incisivos I-EXPLORATION +únicos I-EXPLORATION +en I-EXPLORATION +forma I-EXPLORATION +de I-EXPLORATION +cono, I-EXPLORATION +pigmentación I-EXPLORATION +periorbitaria, I-EXPLORATION +pelo I-EXPLORATION +escaso, I-EXPLORATION +fino, I-EXPLORATION +disperso I-EXPLORATION +y I-EXPLORATION +frágil I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +cejas I-EXPLORATION +y I-EXPLORATION +pestañas. I-EXPLORATION +El I-EXPLORATION +paciente I-EXPLORATION +presentaba I-EXPLORATION +una I-EXPLORATION +dermatosis I-EXPLORATION +diseminada I-EXPLORATION +a I-EXPLORATION +cabeza, I-EXPLORATION +tronco I-EXPLORATION +y I-EXPLORATION +principalmente I-EXPLORATION +en I-EXPLORATION +extremidades I-EXPLORATION +superiores I-EXPLORATION +e I-EXPLORATION +inferiores, I-EXPLORATION +constituida I-EXPLORATION +por I-EXPLORATION +pápulas I-EXPLORATION +puntiformes I-EXPLORATION +eritematosas, I-EXPLORATION +con I-EXPLORATION +eritema I-EXPLORATION +difuso I-EXPLORATION +en I-EXPLORATION +una I-EXPLORATION +piel I-EXPLORATION +xerótica. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +biopsia I-EXPLORATION +de I-EXPLORATION +piel I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +palma I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +mano I-EXPLORATION +izquierda I-EXPLORATION +demostró I-EXPLORATION +la I-EXPLORATION +ausencia I-EXPLORATION +parcial I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +glándulas I-EXPLORATION +sudoríparas I-EXPLORATION +y I-EXPLORATION +sebáceas. I-EXPLORATION +Después I-EXPLORATION +de I-EXPLORATION +obtener I-EXPLORATION +el I-EXPLORATION +consentimiento I-EXPLORATION +informado, I-EXPLORATION +obtuvimos I-EXPLORATION +sangre I-EXPLORATION +periférica I-EXPLORATION +para I-EXPLORATION +realizar I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +cariotipo I-EXPLORATION +reportándose I-EXPLORATION +normal I-EXPLORATION +y I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +vez, I-EXPLORATION +obtuvimos I-EXPLORATION +sangre I-EXPLORATION +no I-EXPLORATION +coagulada I-EXPLORATION +en I-EXPLORATION +tubos I-EXPLORATION +de I-EXPLORATION +EDTA I-EXPLORATION +(ácido I-EXPLORATION +etilendiaminotetraacético) I-EXPLORATION +de I-EXPLORATION +todos I-EXPLORATION +los I-EXPLORATION +miembros I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +familia I-EXPLORATION +siguiendo I-EXPLORATION +los I-EXPLORATION +Principios I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +Declaración I-EXPLORATION +de I-EXPLORATION +Helsinki. I-EXPLORATION +Se I-EXPLORATION +extrajo I-EXPLORATION +ADN I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +muestras I-EXPLORATION +sanguíneas I-EXPLORATION +utilizando I-EXPLORATION +el I-EXPLORATION +equipo I-EXPLORATION +PUREGENER I-EXPLORATION +(Systema I-EXPLORATION +Gentra). I-EXPLORATION +Para I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +mutaciones I-EXPLORATION +todos I-EXPLORATION +los I-EXPLORATION +exones I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +las I-EXPLORATION +secuencias I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +uniones I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +intrones-exones I-EXPLORATION +fueron I-EXPLORATION +amplificados I-EXPLORATION +por I-EXPLORATION +medio I-EXPLORATION +de I-EXPLORATION +PCR I-EXPLORATION +(reacción I-EXPLORATION +en I-EXPLORATION +cadena I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +polimerasa) I-EXPLORATION +del I-EXPLORATION +gen I-EXPLORATION +EDA-A1 I-EXPLORATION +en I-EXPLORATION +condiciones I-EXPLORATION +reportadas I-EXPLORATION +previamente. I-EXPLORATION +Las I-EXPLORATION +condiciones I-EXPLORATION +para I-EXPLORATION +la I-EXPLORATION +amplificación I-EXPLORATION +de I-EXPLORATION +cada I-EXPLORATION +PCR I-EXPLORATION +fueron I-EXPLORATION +de I-EXPLORATION +94 I-EXPLORATION +°C I-EXPLORATION +por I-EXPLORATION +2 I-EXPLORATION +minutos, I-EXPLORATION +seguido I-EXPLORATION +por I-EXPLORATION +35 I-EXPLORATION +ciclos I-EXPLORATION +de I-EXPLORATION +94°C I-EXPLORATION +durante I-EXPLORATION +30 I-EXPLORATION +segundos, I-EXPLORATION +55°C I-EXPLORATION +por I-EXPLORATION +30 I-EXPLORATION +segundos I-EXPLORATION +y I-EXPLORATION +72°C I-EXPLORATION +por I-EXPLORATION +30 I-EXPLORATION +segundos I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +extensión I-EXPLORATION +final I-EXPLORATION +a I-EXPLORATION +72°C I-EXPLORATION +durante I-EXPLORATION +7 I-EXPLORATION +minutos. I-EXPLORATION +Los I-EXPLORATION +productos I-EXPLORATION +de I-EXPLORATION +PCR I-EXPLORATION +fueron I-EXPLORATION +colocados I-EXPLORATION +en I-EXPLORATION +un I-EXPLORATION +gel I-EXPLORATION +de I-EXPLORATION +agarosa I-EXPLORATION +al I-EXPLORATION +1% I-EXPLORATION +y I-EXPLORATION +posteriormente I-EXPLORATION +fueron I-EXPLORATION +analizados I-EXPLORATION +por I-EXPLORATION +la I-EXPLORATION +Secuenciadora I-EXPLORATION +Automática I-EXPLORATION +Directa I-EXPLORATION +ABI I-EXPLORATION +Prism I-EXPLORATION +310, I-EXPLORATION +utilizando I-EXPLORATION +el I-EXPLORATION +equipo I-EXPLORATION +de I-EXPLORATION +Reacción I-EXPLORATION +"ABI I-EXPLORATION +PRISM® I-EXPLORATION +BigDye™ I-EXPLORATION +Terminator I-EXPLORATION +Cycle I-EXPLORATION +Sequencing' I-EXPLORATION +(PE I-EXPLORATION +Biosystem) I-EXPLORATION +8. I-EXPLORATION + I-EXPLORATION +Debido I-EXPLORATION +a I-EXPLORATION +que I-EXPLORATION +comúnmente I-EXPLORATION +la I-EXPLORATION +displasia I-EXPLORATION +ectodérmica I-EXPLORATION +hipohidrótica I-EXPLORATION +se I-EXPLORATION +encuentra I-EXPLORATION +ligada I-EXPLORATION +a I-EXPLORATION +X, I-EXPLORATION +se I-EXPLORATION +decidió I-EXPLORATION +obtener I-EXPLORATION +ADN I-EXPLORATION +genómico, I-EXPLORATION +logrando I-EXPLORATION +identificar I-EXPLORATION +la I-EXPLORATION +mutación I-EXPLORATION +sinsentido I-EXPLORATION +Ala349Thr I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +gen I-EXPLORATION +EDA, I-EXPLORATION +se I-EXPLORATION +realiza I-EXPLORATION +la I-EXPLORATION +correlación I-EXPLORATION +clínico-patológica, I-EXPLORATION +concluyendo I-EXPLORATION +así I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +displasia I-EXPLORATION +ectodérmica I-EXPLORATION +hipohidrótica.. I-EXPLORATION + I-EXPLORATION + +Paciente B-PRESENT_ILLNESS +indio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +44 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +hipertenso B-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +10 I-PAST_MEDICAL_HISTORY +años, I-PAST_MEDICAL_HISTORY +fumador I-PAST_MEDICAL_HISTORY +ocasional, I-PAST_MEDICAL_HISTORY +quien B-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +levantó I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +mañana I-PRESENT_ILLNESS +previa I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +ingreso I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +debilidad I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +hemicuerpo I-PRESENT_ILLNESS +derecho, I-PRESENT_ILLNESS +así I-PRESENT_ILLNESS +como I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +sensibilidad I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +hemicara I-PRESENT_ILLNESS +derecha, I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +progresó I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +siguientes I-PRESENT_ILLNESS +24 I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +forma I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +imposibilidad I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +marcha, I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +hubo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +ingresar I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +vez I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +fue I-PRESENT_ILLNESS +llevado I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +departamento I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +emergencias, I-PRESENT_ILLNESS +donde I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +le I-PRESENT_ILLNESS +constató I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +presión I-PRESENT_ILLNESS +arterial I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +165/105 I-PRESENT_ILLNESS +mmHg, I-PRESENT_ILLNESS +pulso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +92 I-PRESENT_ILLNESS +latidos I-PRESENT_ILLNESS +x' I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +16 I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +frecuencia I-PRESENT_ILLNESS +respiratoria I-PRESENT_ILLNESS +x'. I-PRESENT_ILLNESS +El B-EXPLORATION +examen I-EXPLORATION +neurológico I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +hipoestesia I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +rama I-EXPLORATION +maxilar I-EXPLORATION +del I-EXPLORATION +trigémino I-EXPLORATION +derecho I-EXPLORATION +como I-EXPLORATION +único I-EXPLORATION +trastorno I-EXPLORATION +objetivo I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +sensibilidad. I-EXPLORATION +La I-EXPLORATION +fuerza I-EXPLORATION +muscular I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +tono I-EXPLORATION +estaba I-EXPLORATION +conservados I-EXPLORATION +a I-EXPLORATION +todos I-EXPLORATION +los I-EXPLORATION +niveles, I-EXPLORATION +pero I-EXPLORATION +se I-EXPLORATION +encontró I-EXPLORATION +una I-EXPLORATION +hiperreflexia I-EXPLORATION +osteotendinosa I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +hemicuerpo I-EXPLORATION +derecho I-EXPLORATION +con I-EXPLORATION +Babinski I-EXPLORATION +ipsilateral. I-EXPLORATION +Elementos I-EXPLORATION +de I-EXPLORATION +disfunción I-EXPLORATION +cerebelosa I-EXPLORATION +se I-EXPLORATION +evidenciaron I-EXPLORATION +al I-EXPLORATION +existir I-EXPLORATION +disdiadococinesia, I-EXPLORATION +dismetría I-EXPLORATION +y I-EXPLORATION +discronometría I-EXPLORATION +al I-EXPLORATION +movilizar I-EXPLORATION +las I-EXPLORATION +extremidades I-EXPLORATION +derechas. I-EXPLORATION +La I-EXPLORATION +marcha I-EXPLORATION +era I-EXPLORATION +imposible I-EXPLORATION +por I-EXPLORATION +la I-EXPLORATION +tendencia I-EXPLORATION +a I-EXPLORATION +caer I-EXPLORATION +hacia I-EXPLORATION +la I-EXPLORATION +derecha I-EXPLORATION +al I-EXPLORATION +tratar I-EXPLORATION +de I-EXPLORATION +hacerla I-EXPLORATION +sin I-EXPLORATION +apoyo. I-EXPLORATION +La I-EXPLORATION +analítica I-EXPLORATION +sanguínea I-EXPLORATION +mostró I-EXPLORATION +hemoglobina, I-EXPLORATION +conteo I-EXPLORATION +diferencial I-EXPLORATION +de I-EXPLORATION +leucocitos I-EXPLORATION +y I-EXPLORATION +electrolitos I-EXPLORATION +dentro I-EXPLORATION +de I-EXPLORATION +límites I-EXPLORATION +normales. I-EXPLORATION +Se I-EXPLORATION +constató I-EXPLORATION +una I-EXPLORATION +hiperlipidemia I-EXPLORATION +dada I-EXPLORATION +por I-EXPLORATION +un I-EXPLORATION +incremento I-EXPLORATION +del I-EXPLORATION +colesterol I-EXPLORATION +total I-EXPLORATION +(7, I-EXPLORATION +42 I-EXPLORATION +mm/1). I-EXPLORATION +El I-EXPLORATION +electrocardiograma I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +ecocardiograma I-EXPLORATION +transtorácico I-EXPLORATION +resultaron I-EXPLORATION +normales. I-EXPLORATION +La I-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION +(RMN) I-EXPLORATION +identificó I-EXPLORATION +un I-EXPLORATION +área I-EXPLORATION +de I-EXPLORATION +infarto I-EXPLORATION +isquémico I-EXPLORATION +subagudo I-EXPLORATION +que I-EXPLORATION +comprendía I-EXPLORATION +el I-EXPLORATION +núcleo I-EXPLORATION +lenticular I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +cápsula I-EXPLORATION +interna I-EXPLORATION +izquierdos. I-EXPLORATION + I-EXPLORATION +El B-TREATMENT +tratamiento I-TREATMENT +consistió I-TREATMENT +en I-TREATMENT +anti-agregantes I-TREATMENT +plaquetarios, I-TREATMENT +estatinas I-TREATMENT +y I-TREATMENT +fisioterapia. I-TREATMENT +El B-EVOLUTION +paciente I-EVOLUTION +fue I-EVOLUTION +egresado I-EVOLUTION +una I-EVOLUTION +semana I-EVOLUTION +después I-EVOLUTION +con I-EVOLUTION +evidente I-EVOLUTION +mejoría. I-EVOLUTION + I-EVOLUTION + +Paciente B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +68 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +obesidad, I-PAST_MEDICAL_HISTORY +brucelosis, I-PAST_MEDICAL_HISTORY +lumboartrosis, I-PAST_MEDICAL_HISTORY +litiasis I-PAST_MEDICAL_HISTORY +biliar, I-PAST_MEDICAL_HISTORY +apendicectomía I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +cesárea. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +En B-EXPLORATION +estudio I-EXPLORATION +ecográfico I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +vía I-EXPLORATION +biliar, I-EXPLORATION +se I-EXPLORATION +objetiva I-EXPLORATION +de I-EXPLORATION +forma I-EXPLORATION +casual, I-EXPLORATION +masa I-EXPLORATION +de I-EXPLORATION +6 I-EXPLORATION +cm. I-EXPLORATION +de I-EXPLORATION +diámetro I-EXPLORATION +en I-EXPLORATION +polo I-EXPLORATION +superior I-EXPLORATION +de I-EXPLORATION +riñón I-EXPLORATION +derecho. I-EXPLORATION +La I-EXPLORATION +TAC I-EXPLORATION +confirma I-EXPLORATION +este I-EXPLORATION +hallazgo I-EXPLORATION +evidenciándose I-EXPLORATION +masa I-EXPLORATION +sólida I-EXPLORATION +en I-EXPLORATION +polo I-EXPLORATION +superior I-EXPLORATION +de I-EXPLORATION +riñón I-EXPLORATION +derecho; I-EXPLORATION +comprobándose I-EXPLORATION +realce I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +misma I-EXPLORATION +tras I-EXPLORATION +la I-EXPLORATION +infusión I-EXPLORATION +de I-EXPLORATION +contraste, I-EXPLORATION +no I-EXPLORATION +objetivándose I-EXPLORATION +adenopatías I-EXPLORATION +hiliares, I-EXPLORATION +ni I-EXPLORATION +afectación I-EXPLORATION +de I-EXPLORATION +órganos I-EXPLORATION +de I-EXPLORATION +vecindad. I-EXPLORATION +Con B-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT +de I-TREATMENT +masa I-TREATMENT +sólida I-TREATMENT +compatible I-TREATMENT +con I-TREATMENT +adenocarcinoma I-TREATMENT +renal I-TREATMENT +es I-TREATMENT +intervenida, I-TREATMENT +realizándose I-TREATMENT +por I-TREATMENT +vía I-TREATMENT +lumbar I-TREATMENT +oblícua I-TREATMENT +nefrectomía I-TREATMENT +radical, I-TREATMENT +siendo I-TREATMENT +el I-TREATMENT +curso I-TREATMENT +postoperatorio I-TREATMENT +sin I-TREATMENT +incidencias. I-TREATMENT + I-TREATMENT +En B-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +microscópico I-EXPLORATION +se I-EXPLORATION +objetiva I-EXPLORATION +tumoración I-EXPLORATION +en I-EXPLORATION +polo I-EXPLORATION +superior I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +invade I-EXPLORATION +cápsula, I-EXPLORATION +su I-EXPLORATION +aspecto I-EXPLORATION +al I-EXPLORATION +corte I-EXPLORATION +es I-EXPLORATION +homogéneo, I-EXPLORATION +de I-EXPLORATION +color I-EXPLORATION +blancogrisaceo. I-EXPLORATION +La I-EXPLORATION +pelvis I-EXPLORATION +y I-EXPLORATION +cálices I-EXPLORATION +no I-EXPLORATION +están I-EXPLORATION +afectados I-EXPLORATION +por I-EXPLORATION +la I-EXPLORATION +tumoración I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +vena I-EXPLORATION +renal I-EXPLORATION +esta I-EXPLORATION +libre. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +microscópico I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +tumoración I-EXPLORATION +redondeada I-EXPLORATION +de I-EXPLORATION +márgenes I-EXPLORATION +bien I-EXPLORATION +definidos, I-EXPLORATION +que I-EXPLORATION +crece I-EXPLORATION +por I-EXPLORATION +expansión I-EXPLORATION +sin I-EXPLORATION +invadir, I-EXPLORATION +de I-EXPLORATION +naturaleza I-EXPLORATION +mesenquimal, I-EXPLORATION +compuesta I-EXPLORATION +por I-EXPLORATION +células I-EXPLORATION +dispuestas I-EXPLORATION +en I-EXPLORATION +fascículos I-EXPLORATION +entrelazados, I-EXPLORATION +los I-EXPLORATION +núcleos I-EXPLORATION +presentan I-EXPLORATION +ligera I-EXPLORATION +variación I-EXPLORATION +de I-EXPLORATION +tamaño I-EXPLORATION +y I-EXPLORATION +forma, I-EXPLORATION +la I-EXPLORATION +actividad I-EXPLORATION +mitótica I-EXPLORATION +es I-EXPLORATION +inferior I-EXPLORATION +a I-EXPLORATION +5 I-EXPLORATION +mitosis I-EXPLORATION +por I-EXPLORATION +50 I-EXPLORATION +CGA, I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +aprecian I-EXPLORATION +hemorragias I-EXPLORATION +ni I-EXPLORATION +necrosis. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +inmunohistoquímico I-EXPLORATION +se I-EXPLORATION +objetiva I-EXPLORATION +negatividad I-EXPLORATION +para I-EXPLORATION +queratinas I-EXPLORATION +(AE-1,AE-3), I-EXPLORATION +EMA I-EXPLORATION +(anfígeno I-EXPLORATION +epitelial I-EXPLORATION +de I-EXPLORATION +membrana) I-EXPLORATION +con I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +excluye I-EXPLORATION +la I-EXPLORATION +naturaleza I-EXPLORATION +epitelial I-EXPLORATION +del I-EXPLORATION +tumor. I-EXPLORATION +Negatividad I-EXPLORATION +para I-EXPLORATION +vimentina, I-EXPLORATION +HMB45, I-EXPLORATION +S-100. I-EXPLORATION +Positividad I-EXPLORATION +para I-EXPLORATION +marcadores I-EXPLORATION +vasculares I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +trama I-EXPLORATION +vascular I-EXPLORATION +y I-EXPLORATION +positividad I-EXPLORATION +para I-EXPLORATION +actino. I-EXPLORATION + I-EXPLORATION + +Presentamos B-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +40 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +consultó I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +solicitar I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +realización I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +vasectomía. I-PRESENT_ILLNESS +A B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +los I-EXPLORATION +testes I-EXPLORATION +eran I-EXPLORATION +de I-EXPLORATION +aspecto I-EXPLORATION +y I-EXPLORATION +tamaño I-EXPLORATION +normal I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +pene I-EXPLORATION +presentaba I-EXPLORATION +una I-EXPLORATION +torsión I-EXPLORATION +de I-EXPLORATION +unos I-EXPLORATION +60 I-EXPLORATION +grados. I-EXPLORATION +Hasta I-EXPLORATION +la I-EXPLORATION +fecha, I-EXPLORATION +dicha I-EXPLORATION +alteración I-EXPLORATION +no I-EXPLORATION +le I-EXPLORATION +había I-EXPLORATION +producido I-EXPLORATION +sintomatología I-EXPLORATION +alguna. I-EXPLORATION + I-EXPLORATION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +59 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +tabaquismo I-PAST_MEDICAL_HISTORY +suspendido I-PAST_MEDICAL_HISTORY +hacía I-PAST_MEDICAL_HISTORY +4 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +historia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +alergia I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +aspirina I-PAST_MEDICAL_HISTORY +caracterizado I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +eritema I-PAST_MEDICAL_HISTORY +generalizado I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +edema I-PAST_MEDICAL_HISTORY +glótico. I-PAST_MEDICAL_HISTORY +La I-PAST_MEDICAL_HISTORY +primera I-PAST_MEDICAL_HISTORY +ocasión I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +1974 I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +vuelve I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +repetir I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +dosis I-PAST_MEDICAL_HISTORY +única I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +1983, I-PAST_MEDICAL_HISTORY +motivo I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +cual I-PAST_MEDICAL_HISTORY +nunca I-PAST_MEDICAL_HISTORY +más I-PAST_MEDICAL_HISTORY +vuelve I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +recibir I-PAST_MEDICAL_HISTORY +aspirina. I-PAST_MEDICAL_HISTORY +Ingresa B-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +noviembre I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2010 I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +angina I-PRESENT_ILLNESS +inestable. I-PRESENT_ILLNESS +Se B-EXPLORATION +realiza I-EXPLORATION +coronariografía I-EXPLORATION +que I-EXPLORATION +muestra I-EXPLORATION +estenosis I-EXPLORATION +significativa I-EXPLORATION +en I-EXPLORATION +arteria I-EXPLORATION +descendente I-EXPLORATION +anterior, I-EXPLORATION +ante I-EXPLORATION +lo I-EXPLORATION +cual I-EXPLORATION +se I-EXPLORATION +procede I-EXPLORATION +a I-EXPLORATION +realizar I-EXPLORATION +una I-EXPLORATION +angioplastía I-EXPLORATION +con I-EXPLORATION +stent I-EXPLORATION +en I-EXPLORATION +dicho I-EXPLORATION +vaso. I-EXPLORATION +Por B-TREATMENT +antecedentes I-TREATMENT +de I-TREATMENT +alergia I-TREATMENT +a I-TREATMENT +la I-TREATMENT +aspirina I-TREATMENT +se I-TREATMENT +deja I-TREATMENT +con I-TREATMENT +clopidogrel I-TREATMENT +y I-TREATMENT +cilostazol. I-TREATMENT +Tres B-EVOLUTION +semanas I-EVOLUTION +posterior I-EVOLUTION +a I-EVOLUTION +su I-EVOLUTION +alta, I-EVOLUTION +presenta I-EVOLUTION +nuevo I-EVOLUTION +episodio I-EVOLUTION +de I-EVOLUTION +dolor I-EVOLUTION +torácico I-EVOLUTION +retroesternal I-EVOLUTION +opresivo I-EVOLUTION +prolongado I-EVOLUTION +y B-EXPLORATION +la I-EXPLORATION +corona-riografía I-EXPLORATION +demuestra I-EXPLORATION +una I-EXPLORATION +trombosis I-EXPLORATION +intra-stent. I-EXPLORATION +Se B-TREATMENT +trató I-TREATMENT +con I-TREATMENT +angioplastía I-TREATMENT +con I-TREATMENT +balón, I-TREATMENT +bajo I-TREATMENT +infusión I-TREATMENT +de I-TREATMENT +tirofibán I-TREATMENT +endovenoso, I-TREATMENT +consiguiendo B-EVOLUTION +un I-EVOLUTION +buen I-EVOLUTION +resultado I-EVOLUTION +clínico. I-EVOLUTION +Posterior B-TREATMENT +a I-TREATMENT +la I-TREATMENT +intervención I-TREATMENT +se I-TREATMENT +realiza I-TREATMENT +protocolo I-TREATMENT +de I-TREATMENT +desensibilización I-TREATMENT +a I-TREATMENT +aspirina, I-TREATMENT +sin I-TREATMENT +incidentes. I-TREATMENT +Desde I-TREATMENT +entonces I-TREATMENT +se I-TREATMENT +mantiene I-TREATMENT +con I-TREATMENT +aspirina I-TREATMENT +y I-TREATMENT +clopidrogel. I-TREATMENT +Completado B-EVOLUTION +1 I-EVOLUTION +año I-EVOLUTION +2 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +seguimiento, I-EVOLUTION +con I-EVOLUTION +buena I-EVOLUTION +adherencia I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +terapia, I-EVOLUTION +no I-EVOLUTION +ha I-EVOLUTION +presentado I-EVOLUTION +efectos I-EVOLUTION +adversos, I-EVOLUTION +y I-EVOLUTION +se I-EVOLUTION +mantiene I-EVOLUTION +sin I-EVOLUTION +angina I-EVOLUTION +y I-EVOLUTION +sin I-EVOLUTION +evidencias I-EVOLUTION +de I-EVOLUTION +HAAS. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +52 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +sintomatología I-PRESENT_ILLNESS +otica I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +craneofacial I-PRESENT_ILLNESS +referida I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +otalgia I-PRESENT_ILLNESS +izquierda, I-PRESENT_ILLNESS +tinitus I-PRESENT_ILLNESS +bilateral, I-PRESENT_ILLNESS +vértigo, I-PRESENT_ILLNESS +sensación I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +oído I-PRESENT_ILLNESS +tapado I-PRESENT_ILLNESS +bilateral I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +bilateral I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +nivel I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cuello I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +cuero I-PRESENT_ILLNESS +cabelludo I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +zona I-PRESENT_ILLNESS +izquierda. I-PRESENT_ILLNESS +Al B-EXPLORATION +examen I-EXPLORATION +otorrinolaringologico I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +encuentra I-EXPLORATION +patología I-EXPLORATION +localizada I-EXPLORATION +en I-EXPLORATION +oído, I-EXPLORATION +nariz I-EXPLORATION +o I-EXPLORATION +garganta. I-EXPLORATION +La I-EXPLORATION +paciente I-EXPLORATION +presenta I-EXPLORATION +compromiso I-EXPLORATION +músculo-esquelético I-EXPLORATION +con I-EXPLORATION +resentimiento I-EXPLORATION +muscular I-EXPLORATION +local I-EXPLORATION +en I-EXPLORATION +zonas I-EXPLORATION +de: I-EXPLORATION +pterigoideo I-EXPLORATION +externo I-EXPLORATION +bilateral, I-EXPLORATION +temporal I-EXPLORATION +bilateral, I-EXPLORATION +digastrico I-EXPLORATION +vientre I-EXPLORATION +posterior, I-EXPLORATION +esternocleidomastoideo I-EXPLORATION +bilateral, I-EXPLORATION +esplenio I-EXPLORATION +bilateral, I-EXPLORATION +occipitofrontal I-EXPLORATION +en I-EXPLORATION +zona I-EXPLORATION +izquierda. I-EXPLORATION +Se I-EXPLORATION +encuentran I-EXPLORATION +puntos I-EXPLORATION +gatillo I-EXPLORATION +en I-EXPLORATION +músculo I-EXPLORATION +trapecio I-EXPLORATION +bilateralmente. I-EXPLORATION +La I-EXPLORATION +paciente I-EXPLORATION +reporta I-EXPLORATION +dolor I-EXPLORATION +al I-EXPLORATION +masticar I-EXPLORATION +y I-EXPLORATION +dolor I-EXPLORATION +al I-EXPLORATION +tragar I-EXPLORATION +alimentos I-EXPLORATION +duros. I-EXPLORATION +También I-EXPLORATION +relata I-EXPLORATION +odontalgias I-EXPLORATION +fantasmas I-EXPLORATION +en I-EXPLORATION +zona I-EXPLORATION +de I-EXPLORATION +molares I-EXPLORATION +mandibulares I-EXPLORATION +izquierdos I-EXPLORATION +sin I-EXPLORATION +patología I-EXPLORATION +dental I-EXPLORATION +evidente I-EXPLORATION +al I-EXPLORATION +examen, I-EXPLORATION +igualmente I-EXPLORATION +describe I-EXPLORATION +dolor I-EXPLORATION +tipo I-EXPLORATION +hiperalgesia I-EXPLORATION +secundaria I-EXPLORATION +en I-EXPLORATION +cuero I-EXPLORATION +cabelludo I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +hace I-EXPLORATION +pensar I-EXPLORATION +en I-EXPLORATION +un I-EXPLORATION +posible I-EXPLORATION +componente I-EXPLORATION +neuropatico I-EXPLORATION +de I-EXPLORATION +su I-EXPLORATION +queja. I-EXPLORATION +Reporta I-EXPLORATION +sabores I-EXPLORATION +agrio-amargos I-EXPLORATION +periódicamente I-EXPLORATION +con I-EXPLORATION +sensación I-EXPLORATION +de I-EXPLORATION +quemadura I-EXPLORATION +en I-EXPLORATION +paladar. I-EXPLORATION +Se I-EXPLORATION +palpan I-EXPLORATION +los I-EXPLORATION +procesos I-EXPLORATION +hamulares, I-EXPLORATION +encontrando I-EXPLORATION +dolor I-EXPLORATION +intenso I-EXPLORATION +local I-EXPLORATION +del I-EXPLORATION +lado I-EXPLORATION +izquierdo I-EXPLORATION +y I-EXPLORATION +referido I-EXPLORATION +a I-EXPLORATION +oído I-EXPLORATION +y I-EXPLORATION +zona I-EXPLORATION +mandibular I-EXPLORATION +izquierda I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación. I-EXPLORATION +Se B-TREATMENT +programa I-TREATMENT +la I-TREATMENT +infiltración I-TREATMENT +de I-TREATMENT +la I-TREATMENT +zona I-TREATMENT +hamular I-TREATMENT +izquierda I-TREATMENT +con I-TREATMENT +corticoide I-TREATMENT +sintético I-TREATMENT +(Betametasona I-TREATMENT +- I-TREATMENT +suspensión I-TREATMENT +de I-TREATMENT +4 I-TREATMENT +mg) I-TREATMENT +previa I-TREATMENT +anestesia I-TREATMENT +local. I-TREATMENT +La I-TREATMENT +paciente I-TREATMENT +también I-TREATMENT +fue I-TREATMENT +manejada I-TREATMENT +con I-TREATMENT +dispositivo I-TREATMENT +intraoral I-TREATMENT +para I-TREATMENT +la I-TREATMENT +supresión I-TREATMENT +de I-TREATMENT +la I-TREATMENT +actividad I-TREATMENT +muscular I-TREATMENT +como I-TREATMENT +tratamiento I-TREATMENT +del I-TREATMENT +DTM I-TREATMENT +y I-TREATMENT +la I-TREATMENT +sintomatología I-TREATMENT +otica I-TREATMENT +referida I-TREATMENT +1 I-TREATMENT +mes I-TREATMENT +posterior I-TREATMENT +a I-TREATMENT +la I-TREATMENT +sintomatología I-TREATMENT +de I-TREATMENT +la I-TREATMENT +Bursitis I-TREATMENT +Hamular. I-TREATMENT +Se B-EVOLUTION +ha I-EVOLUTION +controlado I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +durante I-EVOLUTION +18 I-EVOLUTION +meses I-EVOLUTION +sin I-EVOLUTION +recurrencia I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +sintomatología. I-EVOLUTION +La I-EVOLUTION +presentacion I-EVOLUTION +clinica I-EVOLUTION +del I-EVOLUTION +compromiso I-EVOLUTION +músculo-esqueletico I-EVOLUTION +y I-EVOLUTION +otico, I-EVOLUTION +adicional I-EVOLUTION +al I-EVOLUTION +dolor I-EVOLUTION +en I-EVOLUTION +zona I-EVOLUTION +del I-EVOLUTION +proceso I-EVOLUTION +hamular I-EVOLUTION +y I-EVOLUTION +posible I-EVOLUTION +relacion I-EVOLUTION +concomitante I-EVOLUTION +pueden I-EVOLUTION +tener I-EVOLUTION +la I-EVOLUTION +misma I-EVOLUTION +base I-EVOLUTION +fisiopatologica I-EVOLUTION +del I-EVOLUTION +caso I-EVOLUTION +clínico I-EVOLUTION +anterior. I-EVOLUTION + I-EVOLUTION + +Paciente B-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +48 I-DERIVED_FROM/TO +años I-DERIVED_FROM/TO +remitido I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +hospital I-DERIVED_FROM/TO +tras I-DERIVED_FROM/TO +detectarse I-DERIVED_FROM/TO +ambulatoriamente I-DERIVED_FROM/TO +una I-DERIVED_FROM/TO +creatinina I-DERIVED_FROM/TO +sérica I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +7, I-DERIVED_FROM/TO +56mg/dl. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +destacaba: I-EXPLORATION +tensión I-EXPLORATION +arterial: I-EXPLORATION +163/111mmHg, I-EXPLORATION +peso: I-EXPLORATION +105kg, I-EXPLORATION +talla: I-EXPLORATION +190cm, I-EXPLORATION +índice I-EXPLORATION +de I-EXPLORATION +masa I-EXPLORATION +corporal: I-EXPLORATION +29kg/m2. I-EXPLORATION +Leve I-EXPLORATION +déficit I-EXPLORATION +cognitivo. I-EXPLORATION +Fenotipo I-EXPLORATION +corporal I-EXPLORATION +corpulento. I-EXPLORATION +Facies I-EXPLORATION +con I-EXPLORATION +prognatismo I-EXPLORATION +y I-EXPLORATION +macroglosia. I-EXPLORATION +Labios I-EXPLORATION +gruesos, I-EXPLORATION +arcos I-EXPLORATION +superciliares I-EXPLORATION +prominentes, I-EXPLORATION +voz I-EXPLORATION +grave. I-EXPLORATION +Auscultación I-EXPLORATION +normal. I-EXPLORATION +Fondo I-EXPLORATION +de I-EXPLORATION +ojo I-EXPLORATION +normal. I-EXPLORATION +El I-EXPLORATION +paciente I-EXPLORATION +no I-EXPLORATION +refería I-EXPLORATION +cambios I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +morfología I-EXPLORATION +corporal. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +ecografía I-EXPLORATION +mostraba I-EXPLORATION +riñones I-EXPLORATION +de I-EXPLORATION +dimensiones I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +límite I-EXPLORATION +inferior I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +normalidad, I-EXPLORATION +con I-EXPLORATION +espesor I-EXPLORATION +del I-EXPLORATION +parénquima I-EXPLORATION +renal I-EXPLORATION +bilateral I-EXPLORATION +marcadamente I-EXPLORATION +adelgazado, I-EXPLORATION +prácticamente I-EXPLORATION +inexistente. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +analítica I-EXPLORATION +al I-EXPLORATION +ingreso I-EXPLORATION +presentaba I-EXPLORATION +parámetros I-EXPLORATION +bioquímicos I-EXPLORATION +propios I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +uremia I-EXPLORATION +con I-EXPLORATION +serologías I-EXPLORATION +víricas I-EXPLORATION +negativas I-EXPLORATION +y I-EXPLORATION +pruebas I-EXPLORATION +inmunológicas I-EXPLORATION +normales. I-EXPLORATION +También I-EXPLORATION +se I-EXPLORATION +practicaron I-EXPLORATION +determinaciones I-EXPLORATION +hormonales: I-EXPLORATION + I-EXPLORATION +- I-EXPLORATION +Cortisol: I-EXPLORATION +23mcg/dl I-EXPLORATION +(6-28), I-EXPLORATION +TSH: I-EXPLORATION +1, I-EXPLORATION +01mcUI/ml I-EXPLORATION +(0,27-4,2). I-EXPLORATION + I-EXPLORATION +- I-EXPLORATION +Renina: I-EXPLORATION +29, I-EXPLORATION +7microUI/ml I-EXPLORATION +(2,8-39,9). I-EXPLORATION + I-EXPLORATION +- I-EXPLORATION +Aldosterona: I-EXPLORATION +152, I-EXPLORATION +8pg/ml I-EXPLORATION +(10-160). I-EXPLORATION + I-EXPLORATION +- I-EXPLORATION +FSH: I-EXPLORATION +12, I-EXPLORATION +4mUI/ml I-EXPLORATION +(1,5-12,4), I-EXPLORATION +LH: I-EXPLORATION +8, I-EXPLORATION +4mUI/ml I-EXPLORATION +(1,7-8,6). I-EXPLORATION + I-EXPLORATION +- I-EXPLORATION +Prolactina: I-EXPLORATION +553mUI/l I-EXPLORATION +(86-324), I-EXPLORATION +testosterona I-EXPLORATION +total: I-EXPLORATION +1, I-EXPLORATION +99ng/ml I-EXPLORATION +(2,5-8,4). I-EXPLORATION + I-EXPLORATION +- I-EXPLORATION +GH: I-EXPLORATION +4, I-EXPLORATION +24ng/ml I-EXPLORATION +(0-1). I-EXPLORATION + I-EXPLORATION +- I-EXPLORATION +Somatomedina I-EXPLORATION +C I-EXPLORATION +(IGF1): I-EXPLORATION +670ng/ml I-EXPLORATION +(100-358). I-EXPLORATION + I-EXPLORATION +- I-EXPLORATION +IGF1-BP3: I-EXPLORATION +7, I-EXPLORATION +59micro/ml I-EXPLORATION +(3,3-6,7). I-EXPLORATION + I-EXPLORATION +- I-EXPLORATION +ACTH: I-EXPLORATION +39pg/ml I-EXPLORATION +(8-46). I-EXPLORATION + I-EXPLORATION +La B-TREATMENT +hipertensión I-TREATMENT +se I-TREATMENT +controló I-TREATMENT +con I-TREATMENT +tratamiento I-TREATMENT +médico. I-TREATMENT +Ante I-TREATMENT +el I-TREATMENT +deterioro I-TREATMENT +de I-TREATMENT +la I-TREATMENT +función I-TREATMENT +renal, I-TREATMENT +cuya I-TREATMENT +etiología I-TREATMENT +no I-TREATMENT +se I-TREATMENT +pudo I-TREATMENT +filiar, I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +mediante I-TREATMENT +hemodiálisis I-TREATMENT +crónica. I-TREATMENT + I-TREATMENT +Se B-EXPLORATION +practicó I-EXPLORATION +un I-EXPLORATION +primer I-EXPLORATION +test I-EXPLORATION +de I-EXPLORATION +sobrecarga I-EXPLORATION +oral I-EXPLORATION +a I-EXPLORATION +glucosa I-EXPLORATION +(TSOG). I-EXPLORATION + I-EXPLORATION +Llegados I-EXPLORATION +a I-EXPLORATION +este I-EXPLORATION +punto, I-EXPLORATION +los I-EXPLORATION +clínicos I-EXPLORATION +sospechábamos, I-EXPLORATION +en I-EXPLORATION +función I-EXPLORATION +del I-EXPLORATION +fenotipo I-EXPLORATION +y I-EXPLORATION +del I-EXPLORATION +perfil I-EXPLORATION +hormonal I-EXPLORATION +(aumento I-EXPLORATION +de I-EXPLORATION +GH, I-EXPLORATION +IGF-1 I-EXPLORATION +y I-EXPLORATION +IGF1-BP3; I-EXPLORATION +TSOG I-EXPLORATION +sin I-EXPLORATION +supresión I-EXPLORATION +clara I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +GH), I-EXPLORATION +una I-EXPLORATION +acromegalia. I-EXPLORATION +No B-TREATMENT +pudo I-TREATMENT +practicarse I-TREATMENT +una I-TREATMENT +resonancia I-TREATMENT +magnética I-TREATMENT +nuclear I-TREATMENT +(RMN) I-TREATMENT +hipofisaria I-TREATMENT +ante I-TREATMENT +la I-TREATMENT +negativa I-TREATMENT +del I-TREATMENT +paciente I-TREATMENT +y I-TREATMENT +su I-TREATMENT +familia. I-TREATMENT + I-TREATMENT +Cuatro I-TREATMENT +meses I-TREATMENT +después I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +finalmente I-TREATMENT +la I-TREATMENT +RMN I-TREATMENT +sin I-TREATMENT +contraste I-TREATMENT +paramagnético. I-TREATMENT +La B-EXPLORATION +hipófisis I-EXPLORATION +presentaba I-EXPLORATION +un I-EXPLORATION +tamaño I-EXPLORATION +dentro I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +límites I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +normalidad, I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +tallo I-EXPLORATION +hipofisario I-EXPLORATION +centrado. I-EXPLORATION +Se B-TREATMENT +practicó I-TREATMENT +un I-TREATMENT +nuevo I-TREATMENT +TSOG, I-TREATMENT +mostrando I-TREATMENT +una I-TREATMENT +GH I-TREATMENT +basal I-TREATMENT +normal, I-TREATMENT +con I-TREATMENT +aumento I-TREATMENT +paradójico I-TREATMENT +a I-TREATMENT +los I-TREATMENT +30 I-TREATMENT +minutos, I-TREATMENT +pero I-TREATMENT +con I-TREATMENT +adecuada I-TREATMENT +supresión I-TREATMENT +a I-TREATMENT +las I-TREATMENT +dos I-TREATMENT +horas. I-TREATMENT + I-TREATMENT +En B-EXPLORATION +esa I-EXPLORATION +fecha I-EXPLORATION +los I-EXPLORATION +niveles I-EXPLORATION +de I-EXPLORATION +IGF-1 I-EXPLORATION +(340 I-EXPLORATION +ng/ml) I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +IGF1-BP3 I-EXPLORATION +(6, I-EXPLORATION +3 I-EXPLORATION +µg/ml) I-EXPLORATION +se I-EXPLORATION +habían I-EXPLORATION +normalizado I-EXPLORATION +también. I-EXPLORATION +La I-EXPLORATION +prolactina I-EXPLORATION +continuaba I-EXPLORATION +elevada I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +testosterona I-EXPLORATION +era I-EXPLORATION +normal. I-EXPLORATION +Actualmente B-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +sigue I-EVOLUTION +controles I-EVOLUTION +periódicos I-EVOLUTION +en I-EVOLUTION +endocrinología I-EVOLUTION +y I-EVOLUTION +continúa I-EVOLUTION +en I-EVOLUTION +hemodiálisis. I-EVOLUTION + I-EVOLUTION + +Niña B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tres I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +Urgencias I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +hace I-PRESENT_ILLNESS +12 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +episodios I-PRESENT_ILLNESS +autolimitados I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +hipotermia I-PRESENT_ILLNESS +asociados I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +sudoración I-PRESENT_ILLNESS +fría I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +palidez I-PRESENT_ILLNESS +cutánea. I-PRESENT_ILLNESS +Ocurren I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +forma I-PRESENT_ILLNESS +diaria, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +duración I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +30 I-PRESENT_ILLNESS +minutos I-PRESENT_ILLNESS +hasta I-PRESENT_ILLNESS +varias I-PRESENT_ILLNESS +horas, I-PRESENT_ILLNESS +siendo I-PRESENT_ILLNESS +más I-PRESENT_ILLNESS +frecuentes I-PRESENT_ILLNESS +durante I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +sueño. I-PRESENT_ILLNESS +No I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +acompañan I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +movimientos I-PRESENT_ILLNESS +tónico-clónicos, I-PRESENT_ILLNESS +desconexión I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +medio, I-PRESENT_ILLNESS +relajación I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +esfínteres I-PRESENT_ILLNESS +ni I-PRESENT_ILLNESS +periodo I-PRESENT_ILLNESS +poscrítico. I-PRESENT_ILLNESS +Así I-PRESENT_ILLNESS +mismo I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +asocia I-PRESENT_ILLNESS +tiritona. I-PRESENT_ILLNESS +Entre I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +episodios I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +mantiene I-PRESENT_ILLNESS +asintomática. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Entre B-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +consta I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +ingreso I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +6 I-PAST_MEDICAL_HISTORY +meses I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +vida I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +sospecha I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +crisis I-PAST_MEDICAL_HISTORY +comicial I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +confirmada, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +ecografía I-PAST_MEDICAL_HISTORY +transfontanelar I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +electroencefalograma I-PAST_MEDICAL_HISTORY +(EEG) I-PAST_MEDICAL_HISTORY +normal. I-PAST_MEDICAL_HISTORY +No B-FAMILY_HISTORY +hay I-FAMILY_HISTORY +antecedentes I-FAMILY_HISTORY +de I-FAMILY_HISTORY +epilepsia I-FAMILY_HISTORY +familiar. I-FAMILY_HISTORY +Un I-FAMILY_HISTORY +tío I-FAMILY_HISTORY +materno I-FAMILY_HISTORY +está I-FAMILY_HISTORY +afecto I-FAMILY_HISTORY +de I-FAMILY_HISTORY +migraña. I-FAMILY_HISTORY + I-FAMILY_HISTORY +A B-EXPLORATION +su I-EXPLORATION +llegada I-EXPLORATION +a I-EXPLORATION +Urgencias, I-EXPLORATION +presenta I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +y I-EXPLORATION +neurológica I-EXPLORATION +normal, I-EXPLORATION +con I-EXPLORATION +constantes I-EXPLORATION +normales, I-EXPLORATION +salvo I-EXPLORATION +una I-EXPLORATION +discreta I-EXPLORATION +disminución I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +frecuencia I-EXPLORATION +cardiaca. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +momento I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +hipotermia, I-EXPLORATION +aunque I-EXPLORATION +la I-EXPLORATION +familia I-EXPLORATION +aporta I-EXPLORATION +un I-EXPLORATION +registro I-EXPLORATION +exhaustivo I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +días I-EXPLORATION +previos, I-EXPLORATION +con I-EXPLORATION +valores I-EXPLORATION +de I-EXPLORATION +temperatura I-EXPLORATION +rectal I-EXPLORATION +de I-EXPLORATION +entre I-EXPLORATION +34 I-EXPLORATION +y I-EXPLORATION +35 I-EXPLORATION +°C. I-EXPLORATION + I-EXPLORATION +Todos I-EXPLORATION +los I-EXPLORATION +estudios I-EXPLORATION +realizados I-EXPLORATION +fueron I-EXPLORATION +normales I-EXPLORATION +(analítica I-EXPLORATION +general, I-EXPLORATION +gasometría, I-EXPLORATION +estudio I-EXPLORATION +metabólico I-EXPLORATION +y I-EXPLORATION +endocrinológico, I-EXPLORATION +tóxicos I-EXPLORATION +en I-EXPLORATION +orina, I-EXPLORATION +EEG, I-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION +[RM], I-EXPLORATION +Holter I-EXPLORATION +y I-EXPLORATION +ecocardiograma). I-EXPLORATION +Después I-EXPLORATION +de I-EXPLORATION +rehistoriar I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +familia, I-EXPLORATION +refieren I-EXPLORATION +que I-EXPLORATION +la I-EXPLORATION +niña I-EXPLORATION +padece I-EXPLORATION +desde I-EXPLORATION +hace I-EXPLORATION +unos I-EXPLORATION +meses I-EXPLORATION +episodios I-EXPLORATION +de I-EXPLORATION +dolor I-EXPLORATION +abdominal I-EXPLORATION +recurrente, I-EXPLORATION +autolimitados, I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +añade I-EXPLORATION +al I-EXPLORATION +estudio I-EXPLORATION +una I-EXPLORATION +ecografía I-EXPLORATION +abdominal, I-EXPLORATION +con I-EXPLORATION +resultado I-EXPLORATION +normal. I-EXPLORATION + I-EXPLORATION +Ante B-TREATMENT +la I-TREATMENT +sospecha I-TREATMENT +de I-TREATMENT +HPE I-TREATMENT +y I-TREATMENT +teniendo I-TREATMENT +en I-TREATMENT +cuenta I-TREATMENT +el I-TREATMENT +alto I-TREATMENT +número I-TREATMENT +de I-TREATMENT +episodios, I-TREATMENT +junto I-TREATMENT +con I-TREATMENT +el I-TREATMENT +antecedente I-TREATMENT +familiar I-TREATMENT +migrañoso, I-TREATMENT +se I-TREATMENT +inicia I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +ciproheptadina. I-TREATMENT +Sin I-TREATMENT +embargo, I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +rechaza I-TREATMENT +su I-TREATMENT +ingesta, I-TREATMENT +a B-EVOLUTION +pesar I-EVOLUTION +de I-EVOLUTION +lo I-EVOLUTION +cual I-EVOLUTION +los I-EVOLUTION +episodios I-EVOLUTION +se I-EVOLUTION +autolimitan I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +tiempo. I-EVOLUTION +A I-EVOLUTION +los I-EVOLUTION +seis I-EVOLUTION +meses I-EVOLUTION +del I-EVOLUTION +debut, I-EVOLUTION +se I-EVOLUTION +encuentra I-EVOLUTION +asintomática. I-EVOLUTION + I-EVOLUTION + +Un B-PRESENT_ILLNESS +niño I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +12 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +acudió I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +pediatra I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Atención I-PRESENT_ILLNESS +Primaria I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +malestar I-PRESENT_ILLNESS +general, I-PRESENT_ILLNESS +febrícula, I-PRESENT_ILLNESS +hiporexia I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +deposiciones I-PRESENT_ILLNESS +blandas I-PRESENT_ILLNESS +frecuentes. I-PRESENT_ILLNESS +Fue B-EXPLORATION +diagnosticado I-EXPLORATION +de I-EXPLORATION +gastroenteritis I-EXPLORATION +aguda. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +auscultación I-EXPLORATION +cardíaca, I-EXPLORATION +además I-EXPLORATION +de I-EXPLORATION +unos I-EXPLORATION +tonos I-EXPLORATION +rítmicos I-EXPLORATION +sin I-EXPLORATION +soplos I-EXPLORATION +ni I-EXPLORATION +anomalías I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +segundo I-EXPLORATION +tono, I-EXPLORATION +se I-EXPLORATION +objetivó I-EXPLORATION +un I-EXPLORATION +dato I-EXPLORATION +que I-EXPLORATION +llamó I-EXPLORATION +la I-EXPLORATION +atención. I-EXPLORATION +Se I-EXPLORATION +interrogó I-EXPLORATION +al I-EXPLORATION +niño I-EXPLORATION +sobre I-EXPLORATION +antecedentes I-EXPLORATION +de I-EXPLORATION +precordalgias, I-EXPLORATION +presíncopes, I-EXPLORATION +síncopes, I-EXPLORATION +síntomas I-EXPLORATION +relacionados I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +ejercicio I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +la I-EXPLORATION +tolerancia I-EXPLORATION +a I-EXPLORATION +éste, I-EXPLORATION +palpitaciones I-EXPLORATION +y I-EXPLORATION +sensación I-EXPLORATION +de I-EXPLORATION +disritmia I-EXPLORATION +cardíaca, I-EXPLORATION +sin I-EXPLORATION +respuestas I-EXPLORATION +sugerentes I-EXPLORATION +de I-EXPLORATION +patología. I-EXPLORATION +Tras I-EXPLORATION +realizar I-EXPLORATION +un I-EXPLORATION +electrocardiograma I-EXPLORATION +(ECG) I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +tórax, I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +vez I-EXPLORATION +que I-EXPLORATION +el I-EXPLORATION +pediatra I-EXPLORATION +confirma I-EXPLORATION +su I-EXPLORATION +sospecha, I-EXPLORATION +el I-EXPLORATION +paciente I-EXPLORATION +es I-EXPLORATION +remitido I-EXPLORATION +a I-EXPLORATION +cardiología I-EXPLORATION +infantil I-EXPLORATION +para I-EXPLORATION +completar I-EXPLORATION +el I-EXPLORATION +estudio. I-EXPLORATION + I-EXPLORATION +¿Cuál I-EXPLORATION +es I-EXPLORATION +la I-EXPLORATION +interpretación I-EXPLORATION +del I-EXPLORATION +ECG?, I-EXPLORATION +¿y I-EXPLORATION +el I-EXPLORATION +hallazgo I-EXPLORATION +auscultatorio I-EXPLORATION +que I-EXPLORATION +llamó I-EXPLORATION +la I-EXPLORATION +atención I-EXPLORATION +al I-EXPLORATION +pediatra?, I-EXPLORATION +¿y I-EXPLORATION +la I-EXPLORATION +sospecha I-EXPLORATION +diagnóstica? I-EXPLORATION +Es I-EXPLORATION +necesario I-EXPLORATION +revisar I-EXPLORATION +el I-EXPLORATION +ECG I-EXPLORATION +antes I-EXPLORATION +de I-EXPLORATION +seguir I-EXPLORATION +leyendo. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +ECG I-EXPLORATION +muestra, I-EXPLORATION +siguiendo I-EXPLORATION +la I-EXPLORATION +lectura I-EXPLORATION +sistemática, I-EXPLORATION +un I-EXPLORATION +ritmo I-EXPLORATION +auricular I-EXPLORATION +ectópico I-EXPLORATION +procedente I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +parte I-EXPLORATION +superior I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +aurícula I-EXPLORATION +izquierda I-EXPLORATION +(onda I-EXPLORATION +P I-EXPLORATION +negativa I-EXPLORATION +en I-EXPLORATION +I, I-EXPLORATION +positiva I-EXPLORATION +en I-EXPLORATION +aVF). I-EXPLORATION +Sin I-EXPLORATION +embargo, I-EXPLORATION +observamos I-EXPLORATION +un I-EXPLORATION +eje I-EXPLORATION +anómalo I-EXPLORATION +(derecho) I-EXPLORATION +de I-EXPLORATION +QRS I-EXPLORATION +y I-EXPLORATION +T I-EXPLORATION +(aproximadamente I-EXPLORATION +180o I-EXPLORATION +en I-EXPLORATION +ambos), I-EXPLORATION +pues I-EXPLORATION +tanto I-EXPLORATION +los I-EXPLORATION +complejos I-EXPLORATION +QRS I-EXPLORATION +como I-EXPLORATION +las I-EXPLORATION +ondas I-EXPLORATION +T I-EXPLORATION +son I-EXPLORATION +negativas I-EXPLORATION +donde I-EXPLORATION +habitualmente I-EXPLORATION +son I-EXPLORATION +positivas I-EXPLORATION +(I, I-EXPLORATION +II, I-EXPLORATION +aVL, I-EXPLORATION +aVF), I-EXPLORATION +y I-EXPLORATION +viceversa. I-EXPLORATION + I-EXPLORATION +Estos I-EXPLORATION +hallazgos I-EXPLORATION +electrocardiográficos I-EXPLORATION +sólo I-EXPLORATION +pueden I-EXPLORATION +deberse I-EXPLORATION +a I-EXPLORATION +una I-EXPLORATION +incorrecta I-EXPLORATION +colocación I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +totalidad I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +electrodos I-EXPLORATION +(en I-EXPLORATION +el I-EXPLORATION +hemitórax I-EXPLORATION +equivocado) I-EXPLORATION +o I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION +de I-EXPLORATION +dextrocardia I-EXPLORATION +(ubicación I-EXPLORATION +del I-EXPLORATION +corazón I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +hemitórax I-EXPLORATION +derecho). I-EXPLORATION +El I-EXPLORATION +dato I-EXPLORATION +auscultatorio I-EXPLORATION +fue I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +tonos I-EXPLORATION +cardíacos I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +hemitórax I-EXPLORATION +derecho; I-EXPLORATION +asimismo, I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +tórax I-EXPLORATION +se I-EXPLORATION +objetivó I-EXPLORATION +dextrocardia, I-EXPLORATION +hígado I-EXPLORATION +situado I-EXPLORATION +en I-EXPLORATION +hemiabdomen I-EXPLORATION +izquierdo I-EXPLORATION +y I-EXPLORATION +burbuja I-EXPLORATION +gástrica I-EXPLORATION +en I-EXPLORATION +hemiabdomen I-EXPLORATION +derecho. I-EXPLORATION +Con B-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +confirmación I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +situs I-DERIVED_FROM/TO +inversus I-DERIVED_FROM/TO +totalis, I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +niño I-DERIVED_FROM/TO +fue I-DERIVED_FROM/TO +remitido I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +cardiología I-DERIVED_FROM/TO +infantil I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +descartar I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +presencia I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +una I-DERIVED_FROM/TO +cardiopatía I-DERIVED_FROM/TO +congénita. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +37 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +fumador I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +12 I-PAST_MEDICAL_HISTORY +años/paquete, I-PAST_MEDICAL_HISTORY +consumidor I-PAST_MEDICAL_HISTORY +habitual I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +cocaína I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +drogas I-PAST_MEDICAL_HISTORY +sintéticas I-PAST_MEDICAL_HISTORY +(anfetaminas, I-PAST_MEDICAL_HISTORY +speed, I-PAST_MEDICAL_HISTORY +...) I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +25 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +edad, I-PAST_MEDICAL_HISTORY +enolismo I-PAST_MEDICAL_HISTORY +< I-PAST_MEDICAL_HISTORY +80 I-PAST_MEDICAL_HISTORY +gr. I-PAST_MEDICAL_HISTORY +etanol/día. I-PAST_MEDICAL_HISTORY +Homosexual I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +diagnosticado I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +SIDA I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +Noviembre I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +2001 I-PAST_MEDICAL_HISTORY +(estadio I-PAST_MEDICAL_HISTORY +C3), I-PAST_MEDICAL_HISTORY +según I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +criterios I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +CDC I-PAST_MEDICAL_HISTORY +(neumonía I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +P. I-PAST_MEDICAL_HISTORY +carinni I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +recuento I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +linfocitos I-PAST_MEDICAL_HISTORY +<200 I-PAST_MEDICAL_HISTORY +CD4/µL). I-PAST_MEDICAL_HISTORY +El I-PAST_MEDICAL_HISTORY +estudio I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +subpoblaciones I-PAST_MEDICAL_HISTORY +linfoides I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +sangre I-PAST_MEDICAL_HISTORY +periférica I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +aquella I-PAST_MEDICAL_HISTORY +fecha I-PAST_MEDICAL_HISTORY +mostró I-PAST_MEDICAL_HISTORY +lo I-PAST_MEDICAL_HISTORY +siguientes I-PAST_MEDICAL_HISTORY +resultados I-PAST_MEDICAL_HISTORY +CD4: I-PAST_MEDICAL_HISTORY +4, I-PAST_MEDICAL_HISTORY +5% I-PAST_MEDICAL_HISTORY +(81), I-PAST_MEDICAL_HISTORY +CD8: I-PAST_MEDICAL_HISTORY +71, I-PAST_MEDICAL_HISTORY +7% I-PAST_MEDICAL_HISTORY +(1290) I-PAST_MEDICAL_HISTORY +CD4/CD8: I-PAST_MEDICAL_HISTORY +0, I-PAST_MEDICAL_HISTORY +06 I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +carga I-PAST_MEDICAL_HISTORY +viral I-PAST_MEDICAL_HISTORY +HIV: I-PAST_MEDICAL_HISTORY +19.200 I-PAST_MEDICAL_HISTORY +copias I-PAST_MEDICAL_HISTORY +RNA/ml. I-PAST_MEDICAL_HISTORY +Con I-PAST_MEDICAL_HISTORY +estos I-PAST_MEDICAL_HISTORY +datos I-PAST_MEDICAL_HISTORY +inició I-PAST_MEDICAL_HISTORY +Tratamiento I-PAST_MEDICAL_HISTORY +Antiretroviral I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Alta I-PAST_MEDICAL_HISTORY +Eficacia I-PAST_MEDICAL_HISTORY +(HAART), I-PAST_MEDICAL_HISTORY +utilizando I-PAST_MEDICAL_HISTORY +2 I-PAST_MEDICAL_HISTORY +inhibidores I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +transcriptasa I-PAST_MEDICAL_HISTORY +inversa, I-PAST_MEDICAL_HISTORY +zidovudina I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +lamivudina, I-PAST_MEDICAL_HISTORY +más I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +inhibidor I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +proteasa, I-PAST_MEDICAL_HISTORY +abacavir, I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +cuales I-PAST_MEDICAL_HISTORY +ha I-PAST_MEDICAL_HISTORY +ido I-PAST_MEDICAL_HISTORY +cambiando I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +combinando I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +otros I-PAST_MEDICAL_HISTORY +fármacos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +misma I-PAST_MEDICAL_HISTORY +familia I-PAST_MEDICAL_HISTORY +(efavirenz, I-PAST_MEDICAL_HISTORY +estavudina, I-PAST_MEDICAL_HISTORY +ritonavir). I-PAST_MEDICAL_HISTORY +En B-PRESENT_ILLNESS +Diciembre I-PRESENT_ILLNESS +2001 I-PRESENT_ILLNESS +acudió I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +Urgencias I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +disfonía I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +15 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +a B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +ORL I-EXPLORATION +destacaba I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +rinitis I-EXPLORATION +seca-costrosa I-EXPLORATION +anterior I-EXPLORATION +y I-EXPLORATION +bilateral I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +rinitis I-EXPLORATION +por I-EXPLORATION +inhalación I-EXPLORATION +de I-EXPLORATION +cocaína, I-EXPLORATION +candidiasis I-EXPLORATION +oral I-EXPLORATION +y I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +laringoscopia I-EXPLORATION +indirecta, I-EXPLORATION +lesión I-EXPLORATION +violácea I-EXPLORATION +localizada I-EXPLORATION +en I-EXPLORATION +banda I-EXPLORATION +ventricular I-EXPLORATION +y I-EXPLORATION +repliegue I-EXPLORATION +aritenoepiglótico I-EXPLORATION +izdo., I-EXPLORATION +movilidad I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +cuerda I-EXPLORATION +vocal I-EXPLORATION +y I-EXPLORATION +aritenoides I-EXPLORATION +izdo. I-EXPLORATION +disminuida. I-EXPLORATION +Ante I-EXPLORATION +la I-EXPLORATION +sospecha I-EXPLORATION +clínica I-EXPLORATION +de I-EXPLORATION +sarcoma I-EXPLORATION +de I-EXPLORATION +Kaposi, I-EXPLORATION +y I-EXPLORATION +dada I-EXPLORATION +las I-EXPLORATION +posibles I-EXPLORATION +complicaciones I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +biopsia I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +lesión, I-EXPLORATION +no I-EXPLORATION +obstante, I-EXPLORATION +se I-EXPLORATION +practicaron I-EXPLORATION +broncoscopia I-EXPLORATION +que I-EXPLORATION +informó I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +laríngeo I-EXPLORATION +de I-EXPLORATION +placas I-EXPLORATION +de I-EXPLORATION +color I-EXPLORATION +rojo I-EXPLORATION +intenso I-EXPLORATION +que I-EXPLORATION +también I-EXPLORATION +estaban I-EXPLORATION +localizadas I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +porción I-EXPLORATION +más I-EXPLORATION +superior I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +traquea I-EXPLORATION +y I-EXPLORATION +que I-EXPLORATION +igualmente I-EXPLORATION +eran I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +sarcoma I-EXPLORATION +de I-EXPLORATION +Kaposi I-EXPLORATION +a I-EXPLORATION +dicho I-EXPLORATION +nivel; I-EXPLORATION +gastroscopia I-EXPLORATION +que I-EXPLORATION +informó I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +no I-EXPLORATION +existencia I-EXPLORATION +de I-EXPLORATION +lesiones I-EXPLORATION +y I-EXPLORATION +colonoscopia I-EXPLORATION +que I-EXPLORATION +informó I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION +de I-EXPLORATION +hemorroides I-EXPLORATION +grado I-EXPLORATION +II/IV I-EXPLORATION +con I-EXPLORATION +discreta I-EXPLORATION +estenosis I-EXPLORATION +del I-EXPLORATION +canal I-EXPLORATION +anal. I-EXPLORATION + I-EXPLORATION +Con B-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT +clínico I-TREATMENT +de I-TREATMENT +sarcoma I-TREATMENT +de I-TREATMENT +Kaposi I-TREATMENT +laringeo I-TREATMENT +el I-TREATMENT +paciente, I-TREATMENT +y I-TREATMENT +ante I-TREATMENT +el I-TREATMENT +riesgo I-TREATMENT +de I-TREATMENT +obstrucción I-TREATMENT +de I-TREATMENT +la I-TREATMENT +vía I-TREATMENT +aérea, I-TREATMENT +fue I-TREATMENT +sometido I-TREATMENT +a I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +radiaciones I-TREATMENT +ionizantes I-TREATMENT +sobre I-TREATMENT +PTV-región I-TREATMENT +laringea, I-TREATMENT +mediante I-TREATMENT +dos I-TREATMENT +campos I-TREATMENT +laterales I-TREATMENT +y I-TREATMENT +opuestos, I-TREATMENT +utilizando I-TREATMENT +mascara I-TREATMENT +termolábil I-TREATMENT +de I-TREATMENT +inmovilización I-TREATMENT +y I-TREATMENT +planificación I-TREATMENT +mediante I-TREATMENT +TAC I-TREATMENT +se I-TREATMENT +alcanzó I-TREATMENT +una I-TREATMENT +dosis I-TREATMENT +de I-TREATMENT +15 I-TREATMENT +Gy I-TREATMENT +a I-TREATMENT +la I-TREATMENT +isodosis I-TREATMENT +del I-TREATMENT +95% I-TREATMENT +a I-TREATMENT +un I-TREATMENT +fraccionamiento I-TREATMENT +de I-TREATMENT +150 I-TREATMENT +cGy I-TREATMENT +/día I-TREATMENT +en I-TREATMENT +10 I-TREATMENT +fracciones I-TREATMENT +y I-TREATMENT +en I-TREATMENT +2 I-TREATMENT +semanas. I-TREATMENT +Una I-TREATMENT +semana I-TREATMENT +previa I-TREATMENT +al I-TREATMENT +inicio I-TREATMENT +del I-TREATMENT +tratamiento, I-TREATMENT +durante I-TREATMENT +y I-TREATMENT +una I-TREATMENT +semana I-TREATMENT +después I-TREATMENT +de I-TREATMENT +haber I-TREATMENT +finalizado I-TREATMENT +la I-TREATMENT +radioterapia I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +fue I-TREATMENT +medicado I-TREATMENT +con I-TREATMENT +fluconazol I-TREATMENT +50 I-TREATMENT +mg. I-TREATMENT +V.O./24h. I-TREATMENT + I-TREATMENT +A B-EVOLUTION +las I-EVOLUTION +dos I-EVOLUTION +semanas I-EVOLUTION +de I-EVOLUTION +haber I-EVOLUTION +finalizado I-EVOLUTION +el I-EVOLUTION +tratamiento I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +se I-EVOLUTION +había I-EVOLUTION +recuperado I-EVOLUTION +de I-EVOLUTION +su I-EVOLUTION +disfonía I-EVOLUTION +sin I-EVOLUTION +haber I-EVOLUTION +presentado I-EVOLUTION +toxicidad I-EVOLUTION +mucosa I-EVOLUTION +aguda I-EVOLUTION +y I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +actualidad I-EVOLUTION +tras I-EVOLUTION +un I-EVOLUTION +seguimiento I-EVOLUTION +de I-EVOLUTION +36 I-EVOLUTION +meses, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +se I-EVOLUTION +haya I-EVOLUTION +en I-EVOLUTION +remisión I-EVOLUTION +completa I-EVOLUTION +de I-EVOLUTION +su I-EVOLUTION +sarcoma I-EVOLUTION +de I-EVOLUTION +Kaposi I-EVOLUTION +laringeo, I-EVOLUTION +con I-EVOLUTION +controles I-EVOLUTION +periódicos. I-EVOLUTION +No I-EVOLUTION +obstante, I-EVOLUTION +en I-EVOLUTION +Febrero I-EVOLUTION +de I-EVOLUTION +2002 I-EVOLUTION +fue I-EVOLUTION +diagnosticado I-EVOLUTION +de I-EVOLUTION +una I-EVOLUTION +Giardiasis I-EVOLUTION +intestinal, I-EVOLUTION +que B-TREATMENT +se I-TREATMENT +resolvió I-TREATMENT +con I-TREATMENT +tratamiento I-TREATMENT +médico I-TREATMENT +y I-TREATMENT +de I-TREATMENT +un I-TREATMENT +Ameboma I-TREATMENT +rectal I-TREATMENT +que I-TREATMENT +requirió I-TREATMENT +intervención I-TREATMENT +quirúrgica I-TREATMENT +que B-EVOLUTION +ha I-EVOLUTION +dejado I-EVOLUTION +como I-EVOLUTION +secuelas I-EVOLUTION +una I-EVOLUTION +incontinencia I-EVOLUTION +anorrectal I-EVOLUTION +grado I-EVOLUTION +IV I-EVOLUTION +de I-EVOLUTION +caracter I-EVOLUTION +irreversible. I-EVOLUTION +También I-EVOLUTION +ha I-EVOLUTION +sido I-EVOLUTION +diagnosticado I-EVOLUTION +en I-EVOLUTION +Abril I-EVOLUTION +2002 I-EVOLUTION +de I-EVOLUTION +Condilomas I-EVOLUTION +acuminados I-EVOLUTION +perianales, I-EVOLUTION +habiendo B-TREATMENT +sido I-TREATMENT +intervenido I-TREATMENT +en I-TREATMENT +dos I-TREATMENT +ocasiones, I-TREATMENT +en I-TREATMENT +Junio I-TREATMENT +2002 I-TREATMENT +y I-TREATMENT +Abril I-TREATMENT +2004. I-TREATMENT +Así B-EVOLUTION +mismo I-EVOLUTION +en I-EVOLUTION +Enero I-EVOLUTION +2003 I-EVOLUTION +ha I-EVOLUTION +sido I-EVOLUTION +diagnosticado I-EVOLUTION +de I-EVOLUTION +una I-EVOLUTION +Hepatopatía I-EVOLUTION +crónica I-EVOLUTION +por I-EVOLUTION +virus I-EVOLUTION +C I-EVOLUTION +(informe I-EVOLUTION +AP: I-EVOLUTION +hepatitis I-EVOLUTION +crónica I-EVOLUTION +C I-EVOLUTION +de I-EVOLUTION +actividad I-EVOLUTION +leve, I-EVOLUTION +estadio I-EVOLUTION +1 I-EVOLUTION +(fibrosis I-EVOLUTION +portal); I-EVOLUTION +siderosis I-EVOLUTION +focal I-EVOLUTION +a I-EVOLUTION +nivel I-EVOLUTION +de I-EVOLUTION +células I-EVOLUTION +de I-EVOLUTION +Kupffer); I-EVOLUTION +carga I-EVOLUTION +viral I-EVOLUTION +VHC I-EVOLUTION +(virus I-EVOLUTION +hepatitis I-EVOLUTION +C) I-EVOLUTION +2.443.750 I-EVOLUTION +UI/ml I-EVOLUTION +genotipo I-EVOLUTION +1, I-EVOLUTION +subtipo I-EVOLUTION +B. I-EVOLUTION +El B-EXPLORATION +último I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +subpoblaciones I-EXPLORATION +linfoides I-EXPLORATION +en I-EXPLORATION +sangre I-EXPLORATION +periférica I-EXPLORATION +en I-EXPLORATION +Enero I-EXPLORATION +2005 I-EXPLORATION +muestra I-EXPLORATION +los I-EXPLORATION +siguientes I-EXPLORATION +resultados I-EXPLORATION +CD4: I-EXPLORATION +10, I-EXPLORATION +3% I-EXPLORATION +(504,7), I-EXPLORATION +CD8: I-EXPLORATION +60, I-EXPLORATION +7% I-EXPLORATION +(2.974,3), I-EXPLORATION +CD3: I-EXPLORATION +76, I-EXPLORATION +3, I-EXPLORATION +CD4/CD8: I-EXPLORATION +0, I-EXPLORATION +17 I-EXPLORATION +y I-EXPLORATION +carga I-EXPLORATION +viral I-EXPLORATION +HIV: I-EXPLORATION +304 I-EXPLORATION +copias I-EXPLORATION +RNA/ml. I-EXPLORATION + I-EXPLORATION + +Paciente B-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +64 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +es I-PRESENT_ILLNESS +estudiado I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +hipocondrio I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +unas I-PRESENT_ILLNESS +semanas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +otra I-PRESENT_ILLNESS +sintomatología I-PRESENT_ILLNESS +acompañante. I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +analítica I-EXPLORATION +solo I-EXPLORATION +destacaba I-EXPLORATION +una I-EXPLORATION +GGT I-EXPLORATION +discretamente I-EXPLORATION +elevada I-EXPLORATION +(70 I-EXPLORATION +U/l) I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +CA I-EXPLORATION +19.9 I-EXPLORATION +de I-EXPLORATION +170 I-EXPLORATION +U/ml. I-EXPLORATION +El I-EXPLORATION +resto I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +parámetros I-EXPLORATION +analíticos I-EXPLORATION +eran I-EXPLORATION +normales. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION +ya I-EXPLORATION +se I-EXPLORATION +apreciaba I-EXPLORATION +dilatación I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +vía I-EXPLORATION +biliar I-EXPLORATION +izquierda, I-EXPLORATION +mientras I-EXPLORATION +que I-EXPLORATION +las I-EXPLORATION +vías I-EXPLORATION +biliares I-EXPLORATION +principal I-EXPLORATION +y I-EXPLORATION +derechas I-EXPLORATION +presentaban I-EXPLORATION +características I-EXPLORATION +normales. I-EXPLORATION +Se I-EXPLORATION +le I-EXPLORATION +practica I-EXPLORATION +una I-EXPLORATION +colangio-RMN I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +puede I-EXPLORATION +apreciar I-EXPLORATION +una I-EXPLORATION +dilatación I-EXPLORATION +del I-EXPLORATION +árbol I-EXPLORATION +biliar I-EXPLORATION +izquierdo I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +polipoidea I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +origen I-EXPLORATION +del I-EXPLORATION +conducto I-EXPLORATION +hepático I-EXPLORATION +izquierdo, I-EXPLORATION +sin I-EXPLORATION +otros I-EXPLORATION +hallazgos. I-EXPLORATION +Previo I-EXPLORATION +a I-EXPLORATION +plantear I-EXPLORATION +un I-EXPLORATION +tratamiento I-EXPLORATION +se I-EXPLORATION +practica I-EXPLORATION +CPRE, I-EXPLORATION +que I-EXPLORATION +demuestra I-EXPLORATION +la I-EXPLORATION +dilatación I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +vía I-EXPLORATION +biliar I-EXPLORATION +izquierda I-EXPLORATION +por I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +polipoidea I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +origen I-EXPLORATION +del I-EXPLORATION +conducto I-EXPLORATION +hepático I-EXPLORATION +izquierdo, I-EXPLORATION +que I-EXPLORATION +es I-EXPLORATION +biopsiado. I-EXPLORATION +Además, B-TREATMENT +se I-TREATMENT +coloca I-TREATMENT +una I-TREATMENT +prótesis I-TREATMENT +plástica. I-TREATMENT +La B-EXPLORATION +biopsia I-EXPLORATION +confirma I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +neoplasia I-EXPLORATION +papilar I-EXPLORATION +con I-EXPLORATION +displasia I-EXPLORATION +de I-EXPLORATION +alto I-EXPLORATION +grado. I-EXPLORATION +Se B-TREATMENT +plantea I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +quirúrgico I-TREATMENT +y I-TREATMENT +se I-TREATMENT +practican I-TREATMENT +colecistectomía, I-TREATMENT +hepatectomía I-TREATMENT +izquierda I-TREATMENT +anatómica I-TREATMENT +con I-TREATMENT +resección I-TREATMENT +del I-TREATMENT +segmento I-TREATMENT +I I-TREATMENT +y I-TREATMENT +exéresis I-TREATMENT +del I-TREATMENT +árbol I-TREATMENT +biliar I-TREATMENT +izquierdo I-TREATMENT +hasta I-TREATMENT +la I-TREATMENT +confluencia I-TREATMENT +con I-TREATMENT +el I-TREATMENT +derecho. I-TREATMENT +El B-EXPLORATION +estudio I-EXPLORATION +intraoperatorio I-EXPLORATION +del I-EXPLORATION +borde I-EXPLORATION +de I-EXPLORATION +sección I-EXPLORATION +biliar I-EXPLORATION +no I-EXPLORATION +demuestra I-EXPLORATION +afectación. I-EXPLORATION +El B-EVOLUTION +postoperatorio I-EVOLUTION +transcurre I-EVOLUTION +sin I-EVOLUTION +incidencias I-EVOLUTION +reseñables. I-EVOLUTION +El B-EXPLORATION +estudio I-EXPLORATION +anatomopatológico I-EXPLORATION +confirma I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +neoplasia I-EXPLORATION +papilar I-EXPLORATION +biliar I-EXPLORATION +intraductal I-EXPLORATION +con I-EXPLORATION +foco I-EXPLORATION +de I-EXPLORATION +colangiocarcinoma I-EXPLORATION +papilar I-EXPLORATION +e I-EXPLORATION +invasivo, I-EXPLORATION +sin I-EXPLORATION +afectación I-EXPLORATION +linfática. I-EXPLORATION +Los I-EXPLORATION +bordes I-EXPLORATION +de I-EXPLORATION +resección I-EXPLORATION +estaban I-EXPLORATION +libres. I-EXPLORATION +No B-TREATMENT +se I-TREATMENT +realiza I-TREATMENT +tratamiento I-TREATMENT +complementario I-TREATMENT +y B-EVOLUTION +tras I-EVOLUTION +cinco I-EVOLUTION +años I-EVOLUTION +de I-EVOLUTION +seguimiento I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +está I-EVOLUTION +libre I-EVOLUTION +de I-EVOLUTION +enfermedad. I-EVOLUTION + I-EVOLUTION + +Hombre B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +37 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +antecedentes B-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +importancia I-PAST_MEDICAL_HISTORY +quien B-PRESENT_ILLNESS +desarrolló I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +masa I-PRESENT_ILLNESS +conjuntival I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +ojo I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS +(OD) I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +8 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +Clínicamente B-EXPLORATION +se I-EXPLORATION +encontró I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +pigmentada I-EXPLORATION +sobre I-EXPLORATION +la I-EXPLORATION +conjuntiva I-EXPLORATION +nasal I-EXPLORATION +que I-EXPLORATION +invadía I-EXPLORATION +parte I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +córnea I-EXPLORATION +pero I-EXPLORATION +no I-EXPLORATION +afectaba I-EXPLORATION +el I-EXPLORATION +eje I-EXPLORATION +visual. I-EXPLORATION +A I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +oftalmológica I-EXPLORATION +inicial, I-EXPLORATION +tenía I-EXPLORATION +una I-EXPLORATION +agudeza I-EXPLORATION +visual I-EXPLORATION +de I-EXPLORATION +20/20 I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +presión I-EXPLORATION +intraocular I-EXPLORATION +de I-EXPLORATION +12 I-EXPLORATION +mmHg I-EXPLORATION +en I-EXPLORATION +ambos I-EXPLORATION +ojos. I-EXPLORATION +Tanto I-EXPLORATION +la I-EXPLORATION +biomicroscopía I-EXPLORATION +como I-EXPLORATION +la I-EXPLORATION +oftalmoscopía I-EXPLORATION +indirecta I-EXPLORATION +del I-EXPLORATION +ojo I-EXPLORATION +izquierdo I-EXPLORATION +(OI) I-EXPLORATION +fueron I-EXPLORATION +normales. I-EXPLORATION +La I-EXPLORATION +biomicroscopía I-EXPLORATION +del I-EXPLORATION +OD I-EXPLORATION +reveló I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +densamente I-EXPLORATION +pigmentada, I-EXPLORATION +elevada, I-EXPLORATION +de I-EXPLORATION +9 I-EXPLORATION +x I-EXPLORATION +4 I-EXPLORATION +mm., I-EXPLORATION +de I-EXPLORATION +bordes I-EXPLORATION +bien I-EXPLORATION +delimitados, I-EXPLORATION +localizada I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +sector I-EXPLORATION +nasal I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +conjuntiva I-EXPLORATION +bulbar I-EXPLORATION +y I-EXPLORATION +que I-EXPLORATION +invadía I-EXPLORATION +parte I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +córnea. I-EXPLORATION +La I-EXPLORATION +masa I-EXPLORATION +se I-EXPLORATION +encontraba I-EXPLORATION +rodeada I-EXPLORATION +por I-EXPLORATION +algunos I-EXPLORATION +vasos I-EXPLORATION +nutricios I-EXPLORATION +prominentes. I-EXPLORATION +No I-EXPLORATION +hubo I-EXPLORATION +evidencia I-EXPLORATION +de I-EXPLORATION +melanosis I-EXPLORATION +adquirida I-EXPLORATION +primaria I-EXPLORATION +adyacente I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +lesión. I-EXPLORATION +El I-EXPLORATION +resto I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +oftalmológica, I-EXPLORATION +incluyendo I-EXPLORATION +la I-EXPLORATION +fundoscopía, I-EXPLORATION +resultó I-EXPLORATION +normal. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +escisión I-EXPLORATION +completa I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +lesión I-EXPLORATION +con I-EXPLORATION +márgenes I-EXPLORATION +quirúrgicos I-EXPLORATION +amplios. I-EXPLORATION +El I-EXPLORATION +examen I-EXPLORATION +macroscópico I-EXPLORATION +reveló I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +con I-EXPLORATION +dimensiones I-EXPLORATION +de I-EXPLORATION +8 I-EXPLORATION +x I-EXPLORATION +4 I-EXPLORATION +x I-EXPLORATION +3 I-EXPLORATION +mm, I-EXPLORATION +de I-EXPLORATION +forma I-EXPLORATION +nodular, I-EXPLORATION +superficie I-EXPLORATION +externa I-EXPLORATION +lisa, I-EXPLORATION +multilobulada, I-EXPLORATION +de I-EXPLORATION +color I-EXPLORATION +café I-EXPLORATION +negruzco I-EXPLORATION +y I-EXPLORATION +aspecto I-EXPLORATION +mucoso. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +examen I-EXPLORATION +histopatológico I-EXPLORATION +demostró I-EXPLORATION +epitelio I-EXPLORATION +de I-EXPLORATION +revestimiento I-EXPLORATION +conjuntival I-EXPLORATION +con I-EXPLORATION +cambios I-EXPLORATION +de I-EXPLORATION +papilomatosis I-EXPLORATION +y I-EXPLORATION +acantosis I-EXPLORATION +irregular, I-EXPLORATION +esta I-EXPLORATION +última I-EXPLORATION +a I-EXPLORATION +expensas I-EXPLORATION +de I-EXPLORATION +proliferación I-EXPLORATION +de I-EXPLORATION +células I-EXPLORATION +basaloides, I-EXPLORATION +mismas I-EXPLORATION +que I-EXPLORATION +estaban I-EXPLORATION +mezcladas I-EXPLORATION +con I-EXPLORATION +pequeños I-EXPLORATION +grupos I-EXPLORATION +de I-EXPLORATION +células I-EXPLORATION +escamosas I-EXPLORATION +y I-EXPLORATION +algunos I-EXPLORATION +melanocitos I-EXPLORATION +dendríticos. I-EXPLORATION +La I-EXPLORATION +sustancia I-EXPLORATION +propia I-EXPLORATION +presentaba I-EXPLORATION +además, I-EXPLORATION +áreas I-EXPLORATION +con I-EXPLORATION +degeneración I-EXPLORATION +elastótica, I-EXPLORATION +vasos I-EXPLORATION +sanguíneos I-EXPLORATION +de I-EXPLORATION +pequeño I-EXPLORATION +calibre I-EXPLORATION +dilatados I-EXPLORATION +y I-EXPLORATION +cúmulos I-EXPLORATION +variables I-EXPLORATION +de I-EXPLORATION +infiltrado I-EXPLORATION +inflamatorio I-EXPLORATION +formados I-EXPLORATION +por I-EXPLORATION +linfocitos I-EXPLORATION +maduros, I-EXPLORATION +células I-EXPLORATION +plasmáticas I-EXPLORATION +y I-EXPLORATION +algunos I-EXPLORATION +melanófagos. I-EXPLORATION + I-EXPLORATION +Con I-EXPLORATION +estos I-EXPLORATION +hallazgos I-EXPLORATION +se I-EXPLORATION +estableció I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +queratosis I-EXPLORATION +seborreica I-EXPLORATION +(QS) I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +conjuntiva. I-EXPLORATION + I-EXPLORATION + +Paciente B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +masculino I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +14 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +mórbidos, I-PAST_MEDICAL_HISTORY +quien I-PAST_MEDICAL_HISTORY +consultó I-PAST_MEDICAL_HISTORY +luego I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +sufrir I-PAST_MEDICAL_HISTORY +trauma I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +baja I-PAST_MEDICAL_HISTORY +intensidad I-PAST_MEDICAL_HISTORY +(pelotazo) I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +zona I-PAST_MEDICAL_HISTORY +genital. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Al B-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +presentaba I-EXPLORATION +dolor I-EXPLORATION +que I-EXPLORATION +dificultaba I-EXPLORATION +la I-EXPLORATION +palpación, I-EXPLORATION +evidenciándose I-EXPLORATION +un I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION +volumen I-EXPLORATION +asimétrico I-EXPLORATION +testicular I-EXPLORATION +izquierdo, I-EXPLORATION +sin I-EXPLORATION +otras I-EXPLORATION +lesiones I-EXPLORATION +asociadas. I-EXPLORATION +Se I-EXPLORATION +solicitó I-EXPLORATION +ecotomografía I-EXPLORATION +testicular I-EXPLORATION +presentándose I-EXPLORATION +a I-EXPLORATION +control I-EXPLORATION +luego I-EXPLORATION +de I-EXPLORATION +transcurridos I-EXPLORATION +5 I-EXPLORATION +meses, I-EXPLORATION +constatándose I-EXPLORATION +clínicamente I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +indurada I-EXPLORATION +en I-EXPLORATION +testículo I-EXPLORATION +izquierdo I-EXPLORATION +de I-EXPLORATION +aproximadamente I-EXPLORATION +2 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +diámetro I-EXPLORATION +mayor, I-EXPLORATION +no I-EXPLORATION +dolorosa I-EXPLORATION +y I-EXPLORATION +sin I-EXPLORATION +compromiso I-EXPLORATION +escrotal; I-EXPLORATION +testículo I-EXPLORATION +derecho I-EXPLORATION +y I-EXPLORATION +pene I-EXPLORATION +sin I-EXPLORATION +alteraciones. I-EXPLORATION +La I-EXPLORATION +ultrasonografía I-EXPLORATION +demostró I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +espesor I-EXPLORATION +del I-EXPLORATION +testículo I-EXPLORATION +izquierdo I-EXPLORATION +un I-EXPLORATION +nódulo I-EXPLORATION +de I-EXPLORATION +18 I-EXPLORATION +x I-EXPLORATION +19 I-EXPLORATION +x I-EXPLORATION +15 I-EXPLORATION +mm, I-EXPLORATION +bien I-EXPLORATION +delimitado, I-EXPLORATION +de I-EXPLORATION +paredes I-EXPLORATION +hiperecogénicas I-EXPLORATION +con I-EXPLORATION +sombra I-EXPLORATION +acústica I-EXPLORATION +posterior. I-EXPLORATION +El I-EXPLORATION +testículo I-EXPLORATION +derecho, I-EXPLORATION +epidídimos I-EXPLORATION +y I-EXPLORATION +cordones I-EXPLORATION +espermáticos I-EXPLORATION +no I-EXPLORATION +presentan I-EXPLORATION +alteraciones I-EXPLORATION +de I-EXPLORATION +su I-EXPLORATION +ecoestructura. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +serológico I-EXPLORATION +para I-EXPLORATION +marcadores I-EXPLORATION +tumorales I-EXPLORATION +(α-feto I-EXPLORATION +proteína I-EXPLORATION +y I-EXPLORATION +hormona I-EXPLORATION +gonadotropina I-EXPLORATION +coriónica I-EXPLORATION +sub-unidad I-EXPLORATION +β) I-EXPLORATION +fueron I-EXPLORATION +normales. I-EXPLORATION +Se I-EXPLORATION +complementó I-EXPLORATION +estudio I-EXPLORATION +con I-EXPLORATION +tomografía I-EXPLORATION +computada I-EXPLORATION +(TC) I-EXPLORATION +de I-EXPLORATION +pelvis, I-EXPLORATION +abdomen I-EXPLORATION +y I-EXPLORATION +tórax I-EXPLORATION +las I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +demostraron I-EXPLORATION +lesiones I-EXPLORATION +secundarias. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +efectuó I-TREATMENT +enucleación I-TREATMENT +del I-TREATMENT +tumor I-TREATMENT +y I-TREATMENT +biopsia I-TREATMENT +intra-operatoria. I-TREATMENT +Se B-EXPLORATION +examinó I-EXPLORATION +un I-EXPLORATION +fragmento I-EXPLORATION +de I-EXPLORATION +tejido I-EXPLORATION +testicular I-EXPLORATION +de I-EXPLORATION +5 I-EXPLORATION +g I-EXPLORATION +de I-EXPLORATION +35 I-EXPLORATION +x I-EXPLORATION +17 I-EXPLORATION +x I-EXPLORATION +15 I-EXPLORATION +mm I-EXPLORATION +presentando I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +superficie I-EXPLORATION +de I-EXPLORATION +corte I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +subcapsular I-EXPLORATION +redondeada, I-EXPLORATION +bien I-EXPLORATION +delimitada, I-EXPLORATION +amarillenta, I-EXPLORATION +de I-EXPLORATION +consistencia I-EXPLORATION +firme I-EXPLORATION +de I-EXPLORATION +22 I-EXPLORATION +mm I-EXPLORATION +de I-EXPLORATION +diámetro I-EXPLORATION +mayor, I-EXPLORATION +con I-EXPLORATION +áreas I-EXPLORATION +grumosas I-EXPLORATION +de I-EXPLORATION +aspecto I-EXPLORATION +arenoso. I-EXPLORATION +El I-EXPLORATION +corte I-EXPLORATION +histológico I-EXPLORATION +por I-EXPLORATION +congelación I-EXPLORATION +y I-EXPLORATION +diferido I-EXPLORATION +demostró I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +que I-EXPLORATION +presentaba I-EXPLORATION +nidos I-EXPLORATION +y I-EXPLORATION +cordones I-EXPLORATION +conformados I-EXPLORATION +por I-EXPLORATION +células I-EXPLORATION +ovales I-EXPLORATION +a I-EXPLORATION +poligonales I-EXPLORATION +de I-EXPLORATION +núcleos I-EXPLORATION +grandes, I-EXPLORATION +excéntricos I-EXPLORATION +y I-EXPLORATION +con I-EXPLORATION +nucléolo I-EXPLORATION +prominente, I-EXPLORATION +el I-EXPLORATION +citoplasma I-EXPLORATION +es I-EXPLORATION +eosinófilo I-EXPLORATION +y I-EXPLORATION +abundante, I-EXPLORATION +apreciándose I-EXPLORATION +infiltrado I-EXPLORATION +inflamatorio I-EXPLORATION +polimorfonuclear I-EXPLORATION +neutrófilo I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +región I-EXPLORATION +central I-EXPLORATION +del I-EXPLORATION +tumor I-EXPLORATION +y I-EXPLORATION +linfocitos I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +periferia I-EXPLORATION +en I-EXPLORATION +partes I-EXPLORATION +formando I-EXPLORATION +agregados I-EXPLORATION +linfoides. I-EXPLORATION +El I-EXPLORATION +estroma I-EXPLORATION +es I-EXPLORATION +en I-EXPLORATION +partes I-EXPLORATION +hialino I-EXPLORATION +con I-EXPLORATION +áreas I-EXPLORATION +de I-EXPLORATION +degeneración I-EXPLORATION +mixoide I-EXPLORATION +y I-EXPLORATION +abundantes I-EXPLORATION +calcificaciones I-EXPLORATION +dispuestas I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +intersticial I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +lumen I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +nidos I-EXPLORATION +tumorales, I-EXPLORATION +concluyéndose I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +biopsia I-EXPLORATION +contemporánea I-EXPLORATION +un I-EXPLORATION +tumor I-EXPLORATION +de I-EXPLORATION +células I-EXPLORATION +de I-EXPLORATION +Sertoli I-EXPLORATION +calcificado. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +extensión I-EXPLORATION +tumoral I-EXPLORATION +intratubular, I-EXPLORATION +figuras I-EXPLORATION +mitóticas, I-EXPLORATION +necrosis, I-EXPLORATION +acentuada I-EXPLORATION +atipía I-EXPLORATION +citológica I-EXPLORATION +ni I-EXPLORATION +extensión I-EXPLORATION +tumoral I-EXPLORATION +extra-testicular. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +inmunohistoquímico I-EXPLORATION +demostró I-EXPLORATION +intensa I-EXPLORATION +positividad I-EXPLORATION +para I-EXPLORATION +α-inhibina, I-EXPLORATION +S-100 I-EXPLORATION +y I-EXPLORATION +vimentina; I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +índice I-EXPLORATION +de I-EXPLORATION +proliferación I-EXPLORATION +(Ki-67) I-EXPLORATION +bajo I-EXPLORATION +(< I-EXPLORATION +1%). I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +completó I-TREATMENT +la I-TREATMENT +cirugía I-TREATMENT +realizándose I-TREATMENT +orquiectomía I-TREATMENT +radical. I-TREATMENT +No B-EVOLUTION +se I-EVOLUTION +registraron I-EVOLUTION +complicaciones I-EVOLUTION +post-operatorias. I-EVOLUTION +A I-EVOLUTION +los I-EVOLUTION +8 I-EVOLUTION +meses I-EVOLUTION +post-cirugía, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +se I-EVOLUTION +encuentra I-EVOLUTION +sano, I-EVOLUTION +sin I-EVOLUTION +evidencia I-EVOLUTION +de I-EVOLUTION +enfermedad I-EVOLUTION +en I-EVOLUTION +TC I-EVOLUTION +de I-EVOLUTION +tórax-abdomen I-EVOLUTION +y I-EVOLUTION +pelvis; I-EVOLUTION +descartándose I-EVOLUTION +en I-EVOLUTION +este I-EVOLUTION +paciente I-EVOLUTION +la I-EVOLUTION +asociación I-EVOLUTION +con I-EVOLUTION +complejo I-EVOLUTION +de I-EVOLUTION +Carney I-EVOLUTION +y I-EVOLUTION +síndrome I-EVOLUTION +de I-EVOLUTION +Peutz-Jeghers. I-EVOLUTION + I-EVOLUTION + +Niño B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +12 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +pediatra I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +revisión I-PRESENT_ILLNESS +rutinaria. I-PRESENT_ILLNESS +El B-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +es I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +niño I-PAST_MEDICAL_HISTORY +sano I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +ningún I-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +personal I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Durante B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física, I-EXPLORATION +el I-EXPLORATION +pediatra I-EXPLORATION +detecta I-EXPLORATION +un I-EXPLORATION +soplo I-EXPLORATION +cardiaco I-EXPLORATION +sistólico I-EXPLORATION +vibratorio I-EXPLORATION +2/6 I-EXPLORATION +en I-EXPLORATION +borde I-EXPLORATION +esternal I-EXPLORATION +izquierdo I-EXPLORATION +bajo, I-EXPLORATION +no I-EXPLORATION +irradiado I-EXPLORATION +y I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +modifica I-EXPLORATION +con I-EXPLORATION +la I-EXPLORATION +postura, I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +segundo I-EXPLORATION +tono I-EXPLORATION +normal I-EXPLORATION +y I-EXPLORATION +tonos I-EXPLORATION +arrítmicos I-EXPLORATION +sin I-EXPLORATION +relación I-EXPLORATION +con I-EXPLORATION +la I-EXPLORATION +fase I-EXPLORATION +respiratoria. I-EXPLORATION +Los I-EXPLORATION +pulsos I-EXPLORATION +periféricos I-EXPLORATION +son I-EXPLORATION +palpables I-EXPLORATION +y I-EXPLORATION +simétricos. I-EXPLORATION +El I-EXPLORATION +resto I-EXPLORATION +del I-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +es I-EXPLORATION +normal. I-EXPLORATION +La I-EXPLORATION +tensión I-EXPLORATION +arterial I-EXPLORATION +se I-EXPLORATION +encuentra I-EXPLORATION +dentro I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +percentiles I-EXPLORATION +para I-EXPLORATION +su I-EXPLORATION +edad I-EXPLORATION +y I-EXPLORATION +talla. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +paciente I-EXPLORATION +está I-EXPLORATION +asintomático; I-EXPLORATION +no I-EXPLORATION +refiere I-EXPLORATION +haber I-EXPLORATION +presentado I-EXPLORATION +palpitaciones, I-EXPLORATION +precordalgia I-EXPLORATION +ni I-EXPLORATION +síncopes I-EXPLORATION +y I-EXPLORATION +tiene I-EXPLORATION +una I-EXPLORATION +buena I-EXPLORATION +tolerancia I-EXPLORATION +al I-EXPLORATION +ejercicio I-EXPLORATION +físico. I-EXPLORATION + I-EXPLORATION +En B-FAMILY_HISTORY +la I-FAMILY_HISTORY +familia I-FAMILY_HISTORY +no I-FAMILY_HISTORY +refieren I-FAMILY_HISTORY +enfermedades I-FAMILY_HISTORY +cardiovasculares I-FAMILY_HISTORY +ni I-FAMILY_HISTORY +hay I-FAMILY_HISTORY +antecedente I-FAMILY_HISTORY +de I-FAMILY_HISTORY +muerte I-FAMILY_HISTORY +súbita. I-FAMILY_HISTORY + I-FAMILY_HISTORY +Ante B-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +tonos I-EXPLORATION +arrítmicos I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +auscultación, I-EXPLORATION +el I-EXPLORATION +pediatra I-EXPLORATION +realiza I-EXPLORATION +un I-EXPLORATION +electrocardiograma I-EXPLORATION +(ECG) I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +consulta I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +muestra I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +Fig. I-EXPLORATION +1. I-EXPLORATION + I-EXPLORATION +¿Cuál I-EXPLORATION +es I-EXPLORATION +la I-EXPLORATION +lectura I-EXPLORATION +e I-EXPLORATION +interpretación I-EXPLORATION +del I-EXPLORATION +electrocardiograma? I-EXPLORATION +1 I-EXPLORATION + I-EXPLORATION +Aunque I-EXPLORATION +lo I-EXPLORATION +primero I-EXPLORATION +que I-EXPLORATION +nos I-EXPLORATION +llama I-EXPLORATION +la I-EXPLORATION +atención I-EXPLORATION +es I-EXPLORATION +la I-EXPLORATION +irregularidad I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +ritmo, I-EXPLORATION +empezamos I-EXPLORATION +nuestra I-EXPLORATION +lectura I-EXPLORATION +sistemática I-EXPLORATION +comprobando I-EXPLORATION +que I-EXPLORATION +es I-EXPLORATION +un I-EXPLORATION +ritmo I-EXPLORATION +sinusal I-EXPLORATION +(onda I-EXPLORATION +P I-EXPLORATION +positiva I-EXPLORATION +en I-EXPLORATION +I I-EXPLORATION +y I-EXPLORATION +aVF) I-EXPLORATION +a I-EXPLORATION +una I-EXPLORATION +frecuencia I-EXPLORATION +de I-EXPLORATION +55 I-EXPLORATION +lpm. I-EXPLORATION + I-EXPLORATION +Seguidamente I-EXPLORATION +analizamos I-EXPLORATION +el I-EXPLORATION +eje I-EXPLORATION +del I-EXPLORATION +QRS I-EXPLORATION +siguiendo I-EXPLORATION +tres I-EXPLORATION +pasos: I-EXPLORATION +1) I-EXPLORATION +localizar I-EXPLORATION +el I-EXPLORATION +cuadrante I-EXPLORATION +utilizando I-EXPLORATION +las I-EXPLORATION +derivaciones I-EXPLORATION +I I-EXPLORATION +y I-EXPLORATION +aVF; I-EXPLORATION +2) I-EXPLORATION +encontrar I-EXPLORATION +la I-EXPLORATION +derivación I-EXPLORATION +con I-EXPLORATION +complejo I-EXPLORATION +QRS I-EXPLORATION +equifásico I-EXPLORATION +(altura I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +onda I-EXPLORATION +R I-EXPLORATION +similar I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +onda I-EXPLORATION +S) I-EXPLORATION +entre I-EXPLORATION +las I-EXPLORATION +derivaciones I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +miembros I-EXPLORATION +(I, I-EXPLORATION +II, I-EXPLORATION +III, I-EXPLORATION +aVR, I-EXPLORATION +aVL, I-EXPLORATION +aVF), I-EXPLORATION +y I-EXPLORATION +3) I-EXPLORATION +el I-EXPLORATION +eje I-EXPLORATION +QRS I-EXPLORATION +será I-EXPLORATION +perpendicular I-EXPLORATION +a I-EXPLORATION +esta I-EXPLORATION +derivación I-EXPLORATION +dentro I-EXPLORATION +del I-EXPLORATION +cuadrante I-EXPLORATION +localizado I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +paso I-EXPLORATION +1. I-EXPLORATION +En I-EXPLORATION +nuestro I-EXPLORATION +caso: I-EXPLORATION +1) I-EXPLORATION +el I-EXPLORATION +QRS I-EXPLORATION +es I-EXPLORATION +positivo I-EXPLORATION +en I-EXPLORATION +ambas I-EXPLORATION +derivaciones I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +el I-EXPLORATION +eje I-EXPLORATION +se I-EXPLORATION +encontrará I-EXPLORATION +entre I-EXPLORATION +0 I-EXPLORATION +y I-EXPLORATION +90o; I-EXPLORATION +2) I-EXPLORATION +la I-EXPLORATION +derivación I-EXPLORATION +con I-EXPLORATION +complejo I-EXPLORATION +más I-EXPLORATION +equifásico I-EXPLORATION +sería I-EXPLORATION +la I-EXPLORATION +derivación I-EXPLORATION +I, I-EXPLORATION +cuya I-EXPLORATION +perpendicular I-EXPLORATION +es I-EXPLORATION +90o, I-EXPLORATION +por I-EXPLORATION +tanto I-EXPLORATION +el I-EXPLORATION +eje I-EXPLORATION +QRS I-EXPLORATION +está I-EXPLORATION +a I-EXPLORATION +90o. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +eje I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +onda I-EXPLORATION +T I-EXPLORATION +es I-EXPLORATION +normal I-EXPLORATION +también I-EXPLORATION +pues I-EXPLORATION +está I-EXPLORATION +entre I-EXPLORATION +0 I-EXPLORATION +y I-EXPLORATION +90o. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +duración I-EXPLORATION +del I-EXPLORATION +complejo I-EXPLORATION +QRS I-EXPLORATION +es I-EXPLORATION +normal I-EXPLORATION +(0, I-EXPLORATION +04 I-EXPLORATION +seg). I-EXPLORATION +No I-EXPLORATION +observamos I-EXPLORATION +morfología I-EXPLORATION +de I-EXPLORATION +QRS I-EXPLORATION +que I-EXPLORATION +sugiera I-EXPLORATION +alteración I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +conducción I-EXPLORATION +intraventricular I-EXPLORATION +(por I-EXPLORATION +ejemplo, I-EXPLORATION +ausencia I-EXPLORATION +de I-EXPLORATION +rR´ I-EXPLORATION +en I-EXPLORATION +V1) I-EXPLORATION +ni I-EXPLORATION +hallazgos I-EXPLORATION +sugestivos I-EXPLORATION +de I-EXPLORATION +hipertrofia I-EXPLORATION +ventricular. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +onda I-EXPLORATION +T I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +segmento I-EXPLORATION +ST I-EXPLORATION +son I-EXPLORATION +normales; I-EXPLORATION +no I-EXPLORATION +hay I-EXPLORATION +alteraciones I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +repolarización. I-EXPLORATION + I-EXPLORATION +A I-EXPLORATION +continuación I-EXPLORATION +analizamos I-EXPLORATION +los I-EXPLORATION +intervalos I-EXPLORATION +PR2: I-EXPLORATION +llama I-EXPLORATION +la I-EXPLORATION +atención I-EXPLORATION +que I-EXPLORATION +el I-EXPLORATION +intervalo I-EXPLORATION +PR I-EXPLORATION +(desde I-EXPLORATION +el I-EXPLORATION +inicio I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +onda I-EXPLORATION +P I-EXPLORATION +hasta I-EXPLORATION +el I-EXPLORATION +inicio I-EXPLORATION +del I-EXPLORATION +QRS) I-EXPLORATION +va I-EXPLORATION +variando I-EXPLORATION +a I-EXPLORATION +lo I-EXPLORATION +largo I-EXPLORATION +del I-EXPLORATION +registro, I-EXPLORATION +no I-EXPLORATION +es I-EXPLORATION +constante. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +Fig. I-EXPLORATION +2 I-EXPLORATION +se I-EXPLORATION +muestra I-EXPLORATION +el I-EXPLORATION +trazado I-EXPLORATION +en I-EXPLORATION +DII I-EXPLORATION +a I-EXPLORATION +partir I-EXPLORATION +del I-EXPLORATION +quinto I-EXPLORATION +latido I-EXPLORATION +del I-EXPLORATION +ECG I-EXPLORATION +basal: I-EXPLORATION +el I-EXPLORATION +intervalo I-EXPLORATION +PR I-EXPLORATION +del I-EXPLORATION +primer I-EXPLORATION +latido I-EXPLORATION +mide I-EXPLORATION +4, I-EXPLORATION +5 I-EXPLORATION +cuadritos I-EXPLORATION +o I-EXPLORATION +milímetros I-EXPLORATION +(0, I-EXPLORATION +04 I-EXPLORATION +x I-EXPLORATION +4, I-EXPLORATION +5=0, I-EXPLORATION +18 I-EXPLORATION +seg), I-EXPLORATION +que I-EXPLORATION +está I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +límite I-EXPLORATION +superior I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +normalidad I-EXPLORATION +para I-EXPLORATION +la I-EXPLORATION +edad, I-EXPLORATION +el I-EXPLORATION +segundo I-EXPLORATION +latido I-EXPLORATION +tiene I-EXPLORATION +un I-EXPLORATION +intervalo I-EXPLORATION +PR I-EXPLORATION +de I-EXPLORATION +5, I-EXPLORATION +5 I-EXPLORATION +mm I-EXPLORATION +(0, I-EXPLORATION +22 I-EXPLORATION +seg), I-EXPLORATION +el I-EXPLORATION +tercero I-EXPLORATION +de I-EXPLORATION +6 I-EXPLORATION +mm I-EXPLORATION +(0, I-EXPLORATION +24 I-EXPLORATION +seg), I-EXPLORATION +el I-EXPLORATION +cuarto I-EXPLORATION +de I-EXPLORATION +8 I-EXPLORATION +mm I-EXPLORATION +(0, I-EXPLORATION +32 I-EXPLORATION +seg), I-EXPLORATION +todos I-EXPLORATION +ellos I-EXPLORATION +por I-EXPLORATION +encima I-EXPLORATION +del I-EXPLORATION +límite I-EXPLORATION +superior I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +normalidad. I-EXPLORATION +Vemos I-EXPLORATION +también I-EXPLORATION +que I-EXPLORATION +después I-EXPLORATION +del I-EXPLORATION +cuarto I-EXPLORATION +latido I-EXPLORATION +hay I-EXPLORATION +una I-EXPLORATION +onda I-EXPLORATION +P I-EXPLORATION +(marcada I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +flecha) I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +va I-EXPLORATION +seguida I-EXPLORATION +de I-EXPLORATION +complejo I-EXPLORATION +QRS. I-EXPLORATION +Este I-EXPLORATION +registro I-EXPLORATION +electrocardiográfico I-EXPLORATION +(intervalo I-EXPLORATION +PR I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +alarga I-EXPLORATION +progresivamente I-EXPLORATION +hasta I-EXPLORATION +que I-EXPLORATION +una I-EXPLORATION +onda I-EXPLORATION +P I-EXPLORATION +no I-EXPLORATION +conduce) I-EXPLORATION +refleja I-EXPLORATION +un I-EXPLORATION +bloqueo I-EXPLORATION +auriculoventricular I-EXPLORATION +(BAV) I-EXPLORATION +de I-EXPLORATION +segundo I-EXPLORATION +grado I-EXPLORATION +tipo I-EXPLORATION +Mobitz I-EXPLORATION +I. I-EXPLORATION +El I-EXPLORATION +intervalo I-EXPLORATION +QTc I-EXPLORATION +es I-EXPLORATION +normal I-EXPLORATION +(0, I-EXPLORATION +38 I-EXPLORATION +seg). I-EXPLORATION + I-EXPLORATION +Ante B-DERIVED_FROM/TO +los I-DERIVED_FROM/TO +hallazgos I-DERIVED_FROM/TO +electrocardiográficos, I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +pediatra I-DERIVED_FROM/TO +decide I-DERIVED_FROM/TO +remitir I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +paciente I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +hospital, I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +consulta I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Cardiología I-DERIVED_FROM/TO +Pediátrica, I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +valoración I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +esta I-DERIVED_FROM/TO +arritmia. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +En B-EXPLORATION +la I-EXPLORATION +consulta I-EXPLORATION +de I-EXPLORATION +Cardiología I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +un I-EXPLORATION +ecocardiograma I-EXPLORATION +que I-EXPLORATION +fue I-EXPLORATION +normal, I-EXPLORATION +descartando I-EXPLORATION +patología I-EXPLORATION +estructural. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +nuevo I-EXPLORATION +electrocardiograma I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +ritmo I-EXPLORATION +sinusal I-EXPLORATION +a I-EXPLORATION +60 I-EXPLORATION +lpm I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +PR I-EXPLORATION +alargado I-EXPLORATION +(BAV I-EXPLORATION +de I-EXPLORATION +primer I-EXPLORATION +grado), I-EXPLORATION +siendo I-EXPLORATION +el I-EXPLORATION +resto I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +lectura I-EXPLORATION +sistemática I-EXPLORATION +normal. I-EXPLORATION +Tras I-EXPLORATION +realizar I-EXPLORATION +ejercicio I-EXPLORATION +leve, I-EXPLORATION +con I-EXPLORATION +la I-EXPLORATION +finalidad I-EXPLORATION +de I-EXPLORATION +aumentar I-EXPLORATION +la I-EXPLORATION +frecuencia I-EXPLORATION +cardiaca, I-EXPLORATION +se I-EXPLORATION +repitió I-EXPLORATION +el I-EXPLORATION +ECG, I-EXPLORATION +con I-EXPLORATION +normalización I-EXPLORATION +(acortamiento) I-EXPLORATION +del I-EXPLORATION +intervalo I-EXPLORATION +PR. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +resumen, I-EXPLORATION +estamos I-EXPLORATION +ante I-EXPLORATION +un I-EXPLORATION +paciente I-EXPLORATION +asintomático I-EXPLORATION +desde I-EXPLORATION +el I-EXPLORATION +punto I-EXPLORATION +de I-EXPLORATION +vista I-EXPLORATION +cardiovascular, I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +soplo I-EXPLORATION +cardiaco I-EXPLORATION +de I-EXPLORATION +características I-EXPLORATION +funcionales, I-EXPLORATION +una I-EXPLORATION +ecocardiografía I-EXPLORATION +normal I-EXPLORATION +y I-EXPLORATION +un I-EXPLORATION +hallazgo I-EXPLORATION +casual I-EXPLORATION +de I-EXPLORATION +BAV I-EXPLORATION +de I-EXPLORATION +primer I-EXPLORATION +grado I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +segundo I-EXPLORATION +grado I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +ECG. I-EXPLORATION + I-EXPLORATION +Para I-EXPLORATION +ampliar I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +se I-EXPLORATION +solicitó I-EXPLORATION +un I-EXPLORATION +Holter-ECG I-EXPLORATION +de I-EXPLORATION +24 I-EXPLORATION +horas I-EXPLORATION +que I-EXPLORATION +constató I-EXPLORATION +un I-EXPLORATION +BAV I-EXPLORATION +de I-EXPLORATION +primer I-EXPLORATION +grado I-EXPLORATION +con I-EXPLORATION +dos I-EXPLORATION +episodios I-EXPLORATION +de I-EXPLORATION +BAV I-EXPLORATION +de I-EXPLORATION +segundo I-EXPLORATION +grado I-EXPLORATION +tipo I-EXPLORATION +Mobitz I-EXPLORATION +I I-EXPLORATION +durante I-EXPLORATION +el I-EXPLORATION +descanso I-EXPLORATION +nocturno. I-EXPLORATION + I-EXPLORATION + +Paciente B-PRESENT_ILLNESS +masculino I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +52 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +chofer, B-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento. I-PAST_MEDICAL_HISTORY +Consulta B-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +mes I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +caracterizado I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +pantorrilla I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +fosa I-PRESENT_ILLNESS +poplítea I-PRESENT_ILLNESS +izquierda, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +50 I-PRESENT_ILLNESS +metros I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +marcha. I-PRESENT_ILLNESS +Sin B-PAST_MEDICAL_HISTORY +historia I-PAST_MEDICAL_HISTORY +previa I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +claudicación I-PAST_MEDICAL_HISTORY +intermitente. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +destaca I-EXPLORATION +disminución I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +temperatura I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +piel I-EXPLORATION +de I-EXPLORATION +pierna I-EXPLORATION +y I-EXPLORATION +pie I-EXPLORATION +izquierdo, I-EXPLORATION +con I-EXPLORATION +ausencia I-EXPLORATION +de I-EXPLORATION +pulso I-EXPLORATION +poplíteo I-EXPLORATION +y I-EXPLORATION +distal I-EXPLORATION +en I-EXPLORATION +esa I-EXPLORATION +extremidad. I-EXPLORATION +En I-EXPLORATION +extremidad I-EXPLORATION +inferior I-EXPLORATION +derecha I-EXPLORATION +pulsos I-EXPLORATION +normales. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +laboratorio I-EXPLORATION +vascular I-EXPLORATION +no I-EXPLORATION +invasivo I-EXPLORATION +confirma I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +clínico I-EXPLORATION +de I-EXPLORATION +obliteración I-EXPLORATION +femoro-poplítea I-EXPLORATION +izquierda, I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +hospitaliza I-EXPLORATION +para I-EXPLORATION +angiografía. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +realiza I-EXPLORATION +estudio I-EXPLORATION +angiográfico I-EXPLORATION +; I-EXPLORATION +observándose I-EXPLORATION +en I-EXPLORATION +arteria I-EXPLORATION +poplítea I-EXPLORATION +izquierda I-EXPLORATION +en I-EXPLORATION +un I-EXPLORATION +segmento I-EXPLORATION +de I-EXPLORATION +45 I-EXPLORATION +mm I-EXPLORATION +de I-EXPLORATION +largo, I-EXPLORATION +una I-EXPLORATION +estenosis I-EXPLORATION +de I-EXPLORATION +hasta I-EXPLORATION +93%, I-EXPLORATION +de I-EXPLORATION +superficie I-EXPLORATION +lisa, I-EXPLORATION +que I-EXPLORATION +sugiere I-EXPLORATION +compresión I-EXPLORATION +extrínseca. I-EXPLORATION +Resto I-EXPLORATION +del I-EXPLORATION +árbol I-EXPLORATION +arterial I-EXPLORATION +sano, I-EXPLORATION +sin I-EXPLORATION +imágenes I-EXPLORATION +endoluminales. I-EXPLORATION + I-EXPLORATION +Llama B-EVOLUTION +la I-EVOLUTION +atención I-EVOLUTION +aparición I-EVOLUTION +de I-EVOLUTION +pulso I-EVOLUTION +poplíteo I-EVOLUTION +y I-EVOLUTION +distal I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +extremidad I-EVOLUTION +afectada I-EVOLUTION +al I-EVOLUTION +día I-EVOLUTION +siguiente I-EVOLUTION +del I-EVOLUTION +estudio. I-EVOLUTION + I-EVOLUTION +Al I-EVOLUTION +segundo I-EVOLUTION +día I-EVOLUTION +post I-EVOLUTION +angiografía I-EVOLUTION +se I-EVOLUTION +indica I-EVOLUTION +marcha I-EVOLUTION +al I-EVOLUTION +paciente, I-EVOLUTION +reproduciendo I-EVOLUTION +el I-EVOLUTION +dolor I-EVOLUTION +en I-EVOLUTION +pantorrilla I-EVOLUTION +izquierda. I-EVOLUTION +Examinado B-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +momento I-EXPLORATION +se I-EXPLORATION +pesquisa I-EXPLORATION +nuevamente I-EXPLORATION +ausencia I-EXPLORATION +de I-EXPLORATION +pulso I-EXPLORATION +poplíteo I-EXPLORATION +y I-EXPLORATION +distal. I-EXPLORATION +Estudio I-EXPLORATION +no I-EXPLORATION +invasivo I-EXPLORATION +PVR I-EXPLORATION +(registro I-EXPLORATION +volumen I-EXPLORATION +de I-EXPLORATION +pulsos) I-EXPLORATION +y I-EXPLORATION +PPG I-EXPLORATION +muestra I-EXPLORATION +alteración I-EXPLORATION +en I-EXPLORATION +morfología I-EXPLORATION +de I-EXPLORATION +curvas I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +poplítea I-EXPLORATION +a I-EXPLORATION +distal I-EXPLORATION +con I-EXPLORATION +PPG I-EXPLORATION +plano I-EXPLORATION +en I-EXPLORATION +ortejos.. I-EXPLORATION + I-EXPLORATION +Con I-EXPLORATION +hipótesis I-EXPLORATION +de I-EXPLORATION +síndrome I-EXPLORATION +de I-EXPLORATION +atrapamiento I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +arteria I-EXPLORATION +poplítea I-EXPLORATION +se I-EXPLORATION +realiza I-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION +(RM) I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +muestra I-EXPLORATION +compresión I-EXPLORATION +extrínseca I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +vasos I-EXPLORATION +por I-EXPLORATION +estructura I-EXPLORATION +alguna, I-EXPLORATION +destacando I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +pared I-EXPLORATION +una I-EXPLORATION +imagen I-EXPLORATION +hiperintensa I-EXPLORATION +en I-EXPLORATION +secuencia I-EXPLORATION +T1que I-EXPLORATION +determina I-EXPLORATION +estenosis I-EXPLORATION +y I-EXPLORATION +sugerente I-EXPLORATION +de I-EXPLORATION +hematoma. I-EXPLORATION +Estudio I-EXPLORATION +con I-EXPLORATION +angiografía I-EXPLORATION +por I-EXPLORATION +tomografía I-EXPLORATION +computada I-EXPLORATION +de I-EXPLORATION +extremidades I-EXPLORATION +inferiores I-EXPLORATION +(AngioTC I-EXPLORATION +de I-EXPLORATION +EEII) I-EXPLORATION +muestra I-EXPLORATION +en I-EXPLORATION +arteria I-EXPLORATION +poplítea I-EXPLORATION +izquierda, I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +estenosis, I-EXPLORATION +una I-EXPLORATION +imagen I-EXPLORATION +de I-EXPLORATION +baja I-EXPLORATION +densidad I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +pared, I-EXPLORATION +sin I-EXPLORATION +realce I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +contraste I-EXPLORATION +endovenoso, I-EXPLORATION +que I-EXPLORATION +hace I-EXPLORATION +plantear I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +degeneración I-EXPLORATION +quística I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +arteria I-EXPLORATION +poplítea. I-EXPLORATION + I-EXPLORATION +Intervenido B-TREATMENT +quirúrgicamente I-TREATMENT +mediante I-TREATMENT +abordaje I-TREATMENT +posterior, I-TREATMENT +se I-TREATMENT +realiza I-TREATMENT +puente I-TREATMENT +poplíteo I-TREATMENT +con I-TREATMENT +vena I-TREATMENT +safena I-TREATMENT +invertida, I-TREATMENT +resecando I-TREATMENT +la I-TREATMENT +arteria I-TREATMENT +poplítea I-TREATMENT +en I-TREATMENT +su I-TREATMENT +tercio I-TREATMENT +medio, I-TREATMENT +la I-TREATMENT +que I-TREATMENT +se I-TREATMENT +aprecia I-TREATMENT +de I-TREATMENT +coloración I-TREATMENT +violácea I-TREATMENT +y I-TREATMENT +contorno I-TREATMENT +irregular. I-TREATMENT +El B-EXPLORATION +informe I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +pieza I-EXPLORATION +enviada I-EXPLORATION +a I-EXPLORATION +biopsia I-EXPLORATION +concluye I-EXPLORATION +“degeneración I-EXPLORATION +quística I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +media”. I-EXPLORATION + I-EXPLORATION +El B-EVOLUTION +paciente I-EVOLUTION +evoluciona I-EVOLUTION +en I-EVOLUTION +buenas I-EVOLUTION +condiciones I-EVOLUTION +generales, I-EVOLUTION +con I-EVOLUTION +pulsos I-EVOLUTION +conservados I-EVOLUTION +y I-EVOLUTION +simétricos I-EVOLUTION +en I-EVOLUTION +ambas I-EVOLUTION +EEII, I-EVOLUTION +sin I-EVOLUTION +claudicación I-EVOLUTION +intermitente I-EVOLUTION +y I-EVOLUTION +pudiendo I-EVOLUTION +reintegrarse I-EVOLUTION +rápidamente I-EVOLUTION +a I-EVOLUTION +sus I-EVOLUTION +labores I-EVOLUTION +habituales. I-EVOLUTION + I-EVOLUTION +En I-EVOLUTION +controles I-EVOLUTION +posteriores I-EVOLUTION +se I-EVOLUTION +encuentra I-EVOLUTION +asintomático, I-EVOLUTION +con I-EVOLUTION +examen I-EVOLUTION +físico I-EVOLUTION +y I-EVOLUTION +estudio I-EVOLUTION +vascular I-EVOLUTION +no I-EVOLUTION +invasivo I-EVOLUTION +normal I-EVOLUTION +a I-EVOLUTION +un I-EVOLUTION +año I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +cirugía. I-EVOLUTION + I-EVOLUTION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +23 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +intervenido B-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +ocasiones I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +infancia I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +hipospadias I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +correcta I-PAST_MEDICAL_HISTORY +evolución I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +micción I-PAST_MEDICAL_HISTORY +confortable. I-PAST_MEDICAL_HISTORY +Acude B-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +urólogo I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +sordo I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +ingle I-PRESENT_ILLNESS +izquierda I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +aumento I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tamaño I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +testículo I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +varias I-PRESENT_ILLNESS +semanas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +A B-EXPLORATION +la I-EXPLORATION +exploración, I-EXPLORATION +se I-EXPLORATION +objetiva I-EXPLORATION +un I-EXPLORATION +testículo I-EXPLORATION +izquierdo I-EXPLORATION +muy I-EXPLORATION +aumentado I-EXPLORATION +de I-EXPLORATION +tamaño I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +totalidad, I-EXPLORATION +irregular I-EXPLORATION +e I-EXPLORATION +indurado I-EXPLORATION +sugestivo I-EXPLORATION +de I-EXPLORATION +tumor I-EXPLORATION +testicular I-EXPLORATION +con I-EXPLORATION +resto I-EXPLORATION +de I-EXPLORATION +exploración I-EXPLORATION +normal. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +realiza I-EXPLORATION +una I-EXPLORATION +ecografía I-EXPLORATION +testicular I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +describe I-EXPLORATION +como I-EXPLORATION +un I-EXPLORATION +nódulo I-EXPLORATION +quístico I-EXPLORATION +con I-EXPLORATION +tabiques I-EXPLORATION +finos I-EXPLORATION +y I-EXPLORATION +un I-EXPLORATION +granuloma I-EXPLORATION +con I-EXPLORATION +calcificaciones I-EXPLORATION +intratesticular I-EXPLORATION +y I-EXPLORATION +fuera I-EXPLORATION +del I-EXPLORATION +testículo I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +de I-EXPLORATION +polo I-EXPLORATION +inferior I-EXPLORATION +otro I-EXPLORATION +quiste I-EXPLORATION +con I-EXPLORATION +múltiples I-EXPLORATION +ecos I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +interior I-EXPLORATION +a I-EXPLORATION +descartar I-EXPLORATION +quiste I-EXPLORATION +epidermoide I-EXPLORATION +o I-EXPLORATION +hidatídico. I-EXPLORATION +Los I-EXPLORATION +marcadores I-EXPLORATION +tumorales I-EXPLORATION +alfa I-EXPLORATION +fetoproteína I-EXPLORATION +y I-EXPLORATION +BHCG I-EXPLORATION +se I-EXPLORATION +encontraban I-EXPLORATION +dentro I-EXPLORATION +de I-EXPLORATION +parámetros I-EXPLORATION +normales. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +TAC I-EXPLORATION +solicitado I-EXPLORATION +durante I-EXPLORATION +el I-EXPLORATION +ingreso I-EXPLORATION +del I-EXPLORATION +paciente I-EXPLORATION +se I-EXPLORATION +evidenciaba I-EXPLORATION +una I-EXPLORATION +tumoración I-EXPLORATION +sólida I-EXPLORATION +retroperitoneal I-EXPLORATION +izquierda I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +del I-EXPLORATION +hilio I-EXPLORATION +renal I-EXPLORATION +lateroaórtica I-EXPLORATION +y I-EXPLORATION +prerrenal I-EXPLORATION +de I-EXPLORATION +54x51x90 I-EXPLORATION +mm I-EXPLORATION +de I-EXPLORATION +diámetro. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +llevó I-TREATMENT +a I-TREATMENT +cabo I-TREATMENT +una I-TREATMENT +orquiectomía I-TREATMENT +inguinal I-TREATMENT +izquierda I-TREATMENT +con I-TREATMENT +resultado I-TREATMENT +anatomo-patológico I-TREATMENT +de I-TREATMENT +teratoma I-TREATMENT +maduro I-TREATMENT +puro I-TREATMENT +poco I-TREATMENT +diferenciado I-TREATMENT +limitado I-TREATMENT +a I-TREATMENT +testículo I-TREATMENT +sin I-TREATMENT +invasión I-TREATMENT +vascular I-TREATMENT +que I-TREATMENT +afectaba I-TREATMENT +a I-TREATMENT +túnica I-TREATMENT +albugínea I-TREATMENT +pero I-TREATMENT +no I-TREATMENT +a I-TREATMENT +vaginal, I-TREATMENT +sin I-TREATMENT +afectación I-TREATMENT +de I-TREATMENT +rete I-TREATMENT +testis I-TREATMENT +de I-TREATMENT +5x3x3 I-TREATMENT +mm. I-TREATMENT +de I-TREATMENT +tamaño. I-TREATMENT +El B-DERIVED_FROM/TO +paciente I-DERIVED_FROM/TO +es I-DERIVED_FROM/TO +remitido I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +nuestro I-DERIVED_FROM/TO +hospital I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +valoración I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +tratamiento I-DERIVED_FROM/TO +adyuvante. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +Nos B-EXPLORATION +encontramos I-EXPLORATION +ante I-EXPLORATION +un I-EXPLORATION +tumor I-EXPLORATION +testicular I-EXPLORATION +no I-EXPLORATION +seminomatoso I-EXPLORATION +estadio I-EXPLORATION +pT2 I-EXPLORATION +N3, I-EXPLORATION +M0 I-EXPLORATION +según I-EXPLORATION +la I-EXPLORATION +clasificación I-EXPLORATION +TNM I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION +estadio I-EXPLORATION +II I-EXPLORATION +c I-EXPLORATION +sin I-EXPLORATION +factores I-EXPLORATION +de I-EXPLORATION +mal I-EXPLORATION +pronóstico. I-EXPLORATION +En B-TREATMENT +esta I-TREATMENT +situación I-TREATMENT +se I-TREATMENT +plantean I-TREATMENT +dos I-TREATMENT +opciones, I-TREATMENT +comenzar I-TREATMENT +con I-TREATMENT +quimioterapia I-TREATMENT +y I-TREATMENT +plantear I-TREATMENT +resección I-TREATMENT +si I-TREATMENT +persistía I-TREATMENT +masa I-TREATMENT +residual I-TREATMENT +o I-TREATMENT +realizar I-TREATMENT +una I-TREATMENT +linfadenectomia I-TREATMENT +retroperitoneal. I-TREATMENT + I-TREATMENT +Dada I-TREATMENT +la I-TREATMENT +negatividad I-TREATMENT +de I-TREATMENT +los I-TREATMENT +marcadores I-TREATMENT +tumorales I-TREATMENT +y I-TREATMENT +la I-TREATMENT +anatomía I-TREATMENT +patológica I-TREATMENT +de I-TREATMENT +la I-TREATMENT +pieza I-TREATMENT +testicular I-TREATMENT +y I-TREATMENT +la I-TREATMENT +conocida I-TREATMENT +quimioresistencia I-TREATMENT +del I-TREATMENT +teratoma I-TREATMENT +maduro I-TREATMENT +puro I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +la I-TREATMENT +realización I-TREATMENT +de I-TREATMENT +linfadenectomía I-TREATMENT +retroperitoneal I-TREATMENT +por I-TREATMENT +las I-TREATMENT +posibilidades I-TREATMENT +de I-TREATMENT +ser I-TREATMENT +curativa I-TREATMENT +si I-TREATMENT +la I-TREATMENT +histología I-TREATMENT +era I-TREATMENT +coincidente I-TREATMENT +con I-TREATMENT +el I-TREATMENT +primario I-TREATMENT +sin I-TREATMENT +existir I-TREATMENT +otros I-TREATMENT +componentes I-TREATMENT +tumorales I-TREATMENT +no I-TREATMENT +seminomatosos. I-TREATMENT + I-TREATMENT +Se I-TREATMENT +realizó I-TREATMENT +linfadenectomía I-TREATMENT +retroperitoneal I-TREATMENT +hasta I-TREATMENT +vasos I-TREATMENT +iliacos I-TREATMENT +obteniendo I-TREATMENT +la I-TREATMENT +pieza I-TREATMENT +observada I-TREATMENT +en I-TREATMENT +Figura I-TREATMENT +2. I-TREATMENT +El B-EXPLORATION +resultado I-EXPLORATION +anatomo-patológico I-EXPLORATION +fue I-EXPLORATION +de I-EXPLORATION +teratoma I-EXPLORATION +maduro I-EXPLORATION +puro I-EXPLORATION +con I-EXPLORATION +los I-EXPLORATION +componentes I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +tres I-EXPLORATION +capas I-EXPLORATION +embrionarias I-EXPLORATION +sin I-EXPLORATION +invasión I-EXPLORATION +linfovascular. I-EXPLORATION +EL B-EVOLUTION +paciente I-EVOLUTION +sigue I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +actualidad I-EVOLUTION +vigilancia I-EVOLUTION +en I-EVOLUTION +consulta I-EVOLUTION +mediante I-EVOLUTION +marcadores, I-EVOLUTION +TAC I-EVOLUTION +abdominal I-EVOLUTION +y I-EVOLUTION +radiografía I-EVOLUTION +de I-EVOLUTION +tórax I-EVOLUTION +periódicas. I-EVOLUTION + I-EVOLUTION + +Hombre B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +19 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +refiere B-PAST_MEDICAL_HISTORY +haber I-PAST_MEDICAL_HISTORY +acudido I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +dentista I-PAST_MEDICAL_HISTORY +particular I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +tres I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +medio I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +presentar I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +nódulo I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +dorso I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +lengua, I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +mismo I-PAST_MEDICAL_HISTORY +color I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +mucosa I-PAST_MEDICAL_HISTORY +adyacente, I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +consistencia I-PAST_MEDICAL_HISTORY +firme, I-PAST_MEDICAL_HISTORY +asintomático, I-PAST_MEDICAL_HISTORY +aproximadamente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +cm. I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +diámetro, I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +le I-PAST_MEDICAL_HISTORY +realiza I-PAST_MEDICAL_HISTORY +biopsia I-PAST_MEDICAL_HISTORY +excisional I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +diagnóstico I-PAST_MEDICAL_HISTORY +histopatológico I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +adenoma I-PAST_MEDICAL_HISTORY +monomorfo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +canalicular; I-PAST_MEDICAL_HISTORY +tres B-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +después, I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +nuevamente I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +dentista I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +recidiva I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +lesión, I-PRESENT_ILLNESS +a B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +intraoral I-EXPLORATION +muestra I-EXPLORATION +un I-EXPLORATION +nódulo I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +dorso I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +lengua I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +misma I-EXPLORATION +localización I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +primera I-EXPLORATION +lesión, I-EXPLORATION +con I-EXPLORATION +dolor I-EXPLORATION +leve I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +presión, I-EXPLORATION +sin I-EXPLORATION +evidencia I-EXPLORATION +de I-EXPLORATION +linfadenopatía I-EXPLORATION +cervical, I-EXPLORATION +se I-EXPLORATION +solicita I-EXPLORATION +estudios I-EXPLORATION +de I-EXPLORATION +laboratorio, I-EXPLORATION +biometría I-EXPLORATION +hemática I-EXPLORATION +y I-EXPLORATION +química I-EXPLORATION +sanguínea, I-EXPLORATION +con I-EXPLORATION +resultados I-EXPLORATION +normales, I-EXPLORATION +decidiendo I-EXPLORATION +realizar I-EXPLORATION +segunda I-EXPLORATION +biopsia I-EXPLORATION +excisional. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +pieza I-EXPLORATION +macroscópica I-EXPLORATION +presenta I-EXPLORATION +consistencia I-EXPLORATION +firme, I-EXPLORATION +forma I-EXPLORATION +y I-EXPLORATION +superficie I-EXPLORATION +irregular, I-EXPLORATION +color I-EXPLORATION +marrón I-EXPLORATION +de I-EXPLORATION +10 I-EXPLORATION +x I-EXPLORATION +6 I-EXPLORATION +x I-EXPLORATION +5 I-EXPLORATION +mm.. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +histopatológico I-EXPLORATION +se I-EXPLORATION +podía I-EXPLORATION +observar I-EXPLORATION +múltiples I-EXPLORATION +cavidades I-EXPLORATION +pseudoquísticas I-EXPLORATION +de I-EXPLORATION +tamaño I-EXPLORATION +variable I-EXPLORATION +compuestos I-EXPLORATION +por I-EXPLORATION +células I-EXPLORATION +cúbicas I-EXPLORATION +de I-EXPLORATION +citoplasma I-EXPLORATION +escaso, I-EXPLORATION +núcleos I-EXPLORATION +ovales I-EXPLORATION +con I-EXPLORATION +contenido I-EXPLORATION +eosinófilo, I-EXPLORATION +rodeado I-EXPLORATION +por I-EXPLORATION +una I-EXPLORATION +banda I-EXPLORATION +de I-EXPLORATION +tejido I-EXPLORATION +conjuntivo I-EXPLORATION +fibroso I-EXPLORATION +denso, I-EXPLORATION +bien I-EXPLORATION +vascularizado, I-EXPLORATION +e I-EXPLORATION +infiltrado I-EXPLORATION +inflamatorio I-EXPLORATION +crónico I-EXPLORATION +moderado I-EXPLORATION +y I-EXPLORATION +difuso, I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +tejido I-EXPLORATION +fibroso I-EXPLORATION +que I-EXPLORATION +rodea I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +lesión I-EXPLORATION +principal I-EXPLORATION +se I-EXPLORATION +encuentran I-EXPLORATION +cordones I-EXPLORATION +alineados I-EXPLORATION +de I-EXPLORATION +células I-EXPLORATION +cúbicas I-EXPLORATION +con I-EXPLORATION +núcleos I-EXPLORATION +hipercromáticos, I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +periferia I-EXPLORATION +presenta I-EXPLORATION +infiltración I-EXPLORATION +perineural I-EXPLORATION +con I-EXPLORATION +tejido I-EXPLORATION +muscular I-EXPLORATION +estriado.. I-EXPLORATION + I-EXPLORATION +Con I-EXPLORATION +estas I-EXPLORATION +características I-EXPLORATION +se I-EXPLORATION +da I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +carcinoma I-EXPLORATION +adenoideo I-EXPLORATION +quístico I-EXPLORATION +siendo I-EXPLORATION +diferente I-EXPLORATION +al I-EXPLORATION +diagnóstico I-EXPLORATION +previo I-EXPLORATION +de I-EXPLORATION +adenoma I-EXPLORATION +canalicular, I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +decide I-EXPLORATION +solicitar I-EXPLORATION +el I-EXPLORATION +corte I-EXPLORATION +histológico I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +primera I-EXPLORATION +biopsia, I-EXPLORATION +observándose I-EXPLORATION +las I-EXPLORATION +características I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +CAQ I-EXPLORATION +con I-EXPLORATION +bordes I-EXPLORATION +tomados. I-EXPLORATION +Se I-EXPLORATION +decide I-EXPLORATION +realizar I-EXPLORATION +panel I-EXPLORATION +de I-EXPLORATION +inmunohistoquímica I-EXPLORATION +recomendado, I-EXPLORATION +el I-EXPLORATION +cual I-EXPLORATION +es I-EXPLORATION +el I-EXPLORATION +siguiente: I-EXPLORATION +proteína I-EXPLORATION +S-100, I-EXPLORATION +Actina I-EXPLORATION +para I-EXPLORATION +músculo I-EXPLORATION +liso I-EXPLORATION +específica, I-EXPLORATION +CALPONINA, I-EXPLORATION +CEA, I-EXPLORATION +Antígeno I-EXPLORATION +Epitelial I-EXPLORATION +de I-EXPLORATION +Membrana, I-EXPLORATION +PAGF, I-EXPLORATION +Ki67. I-EXPLORATION +(7-8) I-EXPLORATION + I-EXPLORATION +Los I-EXPLORATION +resultados I-EXPLORATION +de I-EXPLORATION +estos I-EXPLORATION +marcadores I-EXPLORATION +fueron: I-EXPLORATION +CEA I-EXPLORATION +positiva I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +citoplasma I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +membrana I-EXPLORATION +de I-EXPLORATION +células I-EXPLORATION +luminares I-EXPLORATION +(normalmente I-EXPLORATION +encontrado I-EXPLORATION +en I-EXPLORATION +conductos I-EXPLORATION +estriados I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +glándulas I-EXPLORATION +salivales I-EXPLORATION +menores), I-EXPLORATION +EMA I-EXPLORATION +positiva I-EXPLORATION +en I-EXPLORATION +citoplasma I-EXPLORATION +de I-EXPLORATION +conductos I-EXPLORATION +intercalados I-EXPLORATION +y I-EXPLORATION +estriados I-EXPLORATION +(abundante I-EXPLORATION +en I-EXPLORATION +células I-EXPLORATION +mioepiteliales I-EXPLORATION +alrededor I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +acinos), I-EXPLORATION +S-100 I-EXPLORATION +positiva I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +células I-EXPLORATION +mioepiteliales, I-EXPLORATION +conductos I-EXPLORATION +intercalados I-EXPLORATION +y I-EXPLORATION +estriados. I-EXPLORATION +La I-EXPLORATION +CALP I-EXPLORATION +fue I-EXPLORATION +positiva I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +confirma I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +células I-EXPLORATION +mioepiteliales, I-EXPLORATION +también I-EXPLORATION +la I-EXPLORATION +tinción I-EXPLORATION +con I-EXPLORATION +Ki-67 I-EXPLORATION +demostró I-EXPLORATION +áreas I-EXPLORATION +focales I-EXPLORATION +escasas I-EXPLORATION +con I-EXPLORATION +aproximadamente I-EXPLORATION +el I-EXPLORATION +15 I-EXPLORATION +al I-EXPLORATION +20% I-EXPLORATION +de I-EXPLORATION +tinción I-EXPLORATION +nuclear, I-EXPLORATION +que I-EXPLORATION +al I-EXPLORATION +correlacionar I-EXPLORATION +con I-EXPLORATION +la I-EXPLORATION +clínica I-EXPLORATION +nos I-EXPLORATION +indica I-EXPLORATION +que I-EXPLORATION +el I-EXPLORATION +tumor I-EXPLORATION +es I-EXPLORATION +de I-EXPLORATION +bajo I-EXPLORATION +grado, I-EXPLORATION +corroborado B-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +diagnostico I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +envía I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +paciente I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +centro I-DERIVED_FROM/TO +oncológico I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +su I-DERIVED_FROM/TO +tratamiento I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +seguimiento I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +largo I-DERIVED_FROM/TO +plazo, I-DERIVED_FROM/TO +después B-EVOLUTION +de I-EVOLUTION +2 I-EVOLUTION +años I-EVOLUTION +presenta I-EVOLUTION +recurrencia I-EVOLUTION +por I-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +le I-EVOLUTION +realiza I-EVOLUTION +glosectomia I-EVOLUTION +parcial, I-EVOLUTION +con I-EVOLUTION +seguimiento I-EVOLUTION +a I-EVOLUTION +largo I-EVOLUTION +plazo. I-EVOLUTION + I-EVOLUTION + +Niño B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +previamente B-PAST_MEDICAL_HISTORY +sano. I-PAST_MEDICAL_HISTORY +Comenzó B-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +dermato I-PRESENT_ILLNESS +sis I-PRESENT_ILLNESS +generalizada I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +máximo I-PRESENT_ILLNESS +lesional I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +región I-PRESENT_ILLNESS +umbilical, I-PRESENT_ILLNESS +miembros I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +genitales, I-PRESENT_ILLNESS +caracterizada I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +ampollas, I-PRESENT_ILLNESS +algunas I-PRESENT_ILLNESS +denudadas I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +sangrado I-PRESENT_ILLNESS +fácil, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +compromiso I-PRESENT_ILLNESS +mucoso I-PRESENT_ILLNESS +ni I-PRESENT_ILLNESS +fiebre. I-PRESENT_ILLNESS +Se B-TREATMENT +diagnosticó I-TREATMENT +impétigo I-TREATMENT +bulloso I-TREATMENT +y I-TREATMENT +se I-TREATMENT +indicó I-TREATMENT +antibioticoterapia I-TREATMENT +tópica I-TREATMENT +y I-TREATMENT +sistémica I-TREATMENT +sin I-TREATMENT +mejoría I-TREATMENT +clínica. I-TREATMENT +Evolucionó B-EVOLUTION +con I-EVOLUTION +extensión I-EVOLUTION +lesional, I-EVOLUTION +con I-EVOLUTION +compromiso I-EVOLUTION +de I-EVOLUTION +mucosas I-EVOLUTION +oral I-EVOLUTION +y I-EVOLUTION +anal. I-EVOLUTION +El B-EXPLORATION +estudio I-EXPLORATION +histológico I-EXPLORATION +e I-EXPLORATION +inmunohistoquí- I-EXPLORATION +mico I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +lesiones I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +piel I-EXPLORATION +perilesional I-EXPLORATION +confirmó I-EXPLORATION +pénfigo I-EXPLORATION +vulgar. I-EXPLORATION +Se B-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +corticoideo I-TREATMENT +e I-TREATMENT +inmunomodulador I-TREATMENT +con I-TREATMENT +buena I-TREATMENT +respuesta. I-TREATMENT + I-TREATMENT + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +61 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +proptosis I-PRESENT_ILLNESS +progresiva I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +ojo I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS +(OI) I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +infiltración I-PRESENT_ILLNESS +palpebral I-PRESENT_ILLNESS +dolorosa, I-PRESENT_ILLNESS +caliente I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +consistencia I-PRESENT_ILLNESS +dura, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +limitación I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +mirada I-PRESENT_ILLNESS +vertical I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +últimos I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +meses. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Como B-PAST_MEDICAL_HISTORY +antecedentes, I-PAST_MEDICAL_HISTORY +refería I-PAST_MEDICAL_HISTORY +carcinoma I-PAST_MEDICAL_HISTORY +mixto I-PAST_MEDICAL_HISTORY +ductal I-PAST_MEDICAL_HISTORY +lobulillar I-PAST_MEDICAL_HISTORY +infiltrante I-PAST_MEDICAL_HISTORY +multifocal I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +multicéntrico I-PAST_MEDICAL_HISTORY +(carcinoma I-PAST_MEDICAL_HISTORY +escirro, I-PAST_MEDICAL_HISTORY +T4 I-PAST_MEDICAL_HISTORY +N3 I-PAST_MEDICAL_HISTORY +M0) I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +mama I-PAST_MEDICAL_HISTORY +izquierda I-PAST_MEDICAL_HISTORY +siete I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +antes, I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +lo I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +sometida I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +mastectomía I-PAST_MEDICAL_HISTORY +radical I-PAST_MEDICAL_HISTORY +modificada I-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +Madden, I-PAST_MEDICAL_HISTORY +disección I-PAST_MEDICAL_HISTORY +axilar, I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +cuatro I-PAST_MEDICAL_HISTORY +ciclos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +quimioterapia I-PAST_MEDICAL_HISTORY +(Epirrubicina I-PAST_MEDICAL_HISTORY +75 I-PAST_MEDICAL_HISTORY +mg/m2), I-PAST_MEDICAL_HISTORY +tras I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +cuales I-PAST_MEDICAL_HISTORY +remitió I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +enfermedad I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +encontrándose I-PAST_MEDICAL_HISTORY +restos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +misma I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +estudios I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +extensión. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +La B-EXPLORATION +agudeza I-EXPLORATION +visual I-EXPLORATION +era I-EXPLORATION +7/10 I-EXPLORATION +con I-EXPLORATION +ambos I-EXPLORATION +ojos, I-EXPLORATION +cataratas I-EXPLORATION +nucleares I-EXPLORATION ++, I-EXPLORATION +presión I-EXPLORATION +intraocular I-EXPLORATION +OI I-EXPLORATION +de I-EXPLORATION +24 I-EXPLORATION +mmHg I-EXPLORATION +y I-EXPLORATION +ojo I-EXPLORATION +derecho I-EXPLORATION +14 I-EXPLORATION +mmHg. I-EXPLORATION +Fondo I-EXPLORATION +de I-EXPLORATION +ojo I-EXPLORATION +normal I-EXPLORATION +en I-EXPLORATION +ambos I-EXPLORATION +ojos. I-EXPLORATION +Presentaba I-EXPLORATION +un I-EXPLORATION +exoftalmos I-EXPLORATION +unilateral I-EXPLORATION +de I-EXPLORATION +5 I-EXPLORATION +mm I-EXPLORATION +en I-EXPLORATION +OI. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +tomografía I-EXPLORATION +axial I-EXPLORATION +computerizada I-EXPLORATION +mostró I-EXPLORATION +un I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION +densidad I-EXPLORATION +difusa I-EXPLORATION +de I-EXPLORATION +partes I-EXPLORATION +blandas, I-EXPLORATION +afectación I-EXPLORATION +de I-EXPLORATION +pared I-EXPLORATION +ósea, I-EXPLORATION +que I-EXPLORATION +desplazaba I-EXPLORATION +el I-EXPLORATION +nervio I-EXPLORATION +óptico I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +globo I-EXPLORATION +ocular. I-EXPLORATION +La I-EXPLORATION +lesión I-EXPLORATION +se I-EXPLORATION +realzaba I-EXPLORATION +tras I-EXPLORATION +la I-EXPLORATION +administración I-EXPLORATION +de I-EXPLORATION +contraste. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +gammagrafía I-EXPLORATION +ósea I-EXPLORATION +con I-EXPLORATION +Tecnecio I-EXPLORATION +99 I-EXPLORATION +se I-EXPLORATION +observaron I-EXPLORATION +múltiples I-EXPLORATION +metástasis I-EXPLORATION +por I-EXPLORATION +acúmulo I-EXPLORATION +de I-EXPLORATION +radiotrazador I-EXPLORATION +en I-EXPLORATION +calota, I-EXPLORATION +raquis, I-EXPLORATION +parrilla I-EXPLORATION +costal, I-EXPLORATION +húmeros I-EXPLORATION +y I-EXPLORATION +pelvis. I-EXPLORATION +Ante I-EXPLORATION +el I-EXPLORATION +mal I-EXPLORATION +estado I-EXPLORATION +general I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +paciente I-EXPLORATION +rehusó I-EXPLORATION +la I-EXPLORATION +realización I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +biopsia I-EXPLORATION +diagnóstica. I-EXPLORATION + I-EXPLORATION +La B-TREATMENT +paciente I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +quimioterapia, I-TREATMENT +tres I-TREATMENT +ciclos I-TREATMENT +de I-TREATMENT +Taxotere I-TREATMENT +100 I-TREATMENT +mg/m2, I-TREATMENT +un I-TREATMENT +ciclo I-TREATMENT +de I-TREATMENT +Mitoxantrone I-TREATMENT +12 I-TREATMENT +mg/m2 I-TREATMENT +y I-TREATMENT +dos I-TREATMENT +ciclos I-TREATMENT +de I-TREATMENT +Vinorelbina I-TREATMENT +25 I-TREATMENT +mg/m2, I-TREATMENT +y I-TREATMENT +esteroides I-TREATMENT +(6-metil-prednisolona) I-TREATMENT +(1 I-TREATMENT +mg/m2) I-TREATMENT +con I-TREATMENT +el I-TREATMENT +fin I-TREATMENT +de I-TREATMENT +reducir I-TREATMENT +el I-TREATMENT +edema I-TREATMENT +y I-TREATMENT +la I-TREATMENT +congestión I-TREATMENT +orbitaria. I-TREATMENT +Pese B-EVOLUTION +al I-EVOLUTION +tratamiento, I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +falleció I-EVOLUTION +dos I-EVOLUTION +meses I-EVOLUTION +más I-EVOLUTION +tarde. I-EVOLUTION + I-EVOLUTION + +Comunicamos B-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +22 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +procedente B-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Iquitos, I-PAST_MEDICAL_HISTORY +selva I-PAST_MEDICAL_HISTORY +peruana, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +importancia. I-PAST_MEDICAL_HISTORY +Tenía B-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +historia I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cuatro I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +sensación I-PRESENT_ILLNESS +febril, I-PRESENT_ILLNESS +calofríos, I-PRESENT_ILLNESS +cefalea, I-PRESENT_ILLNESS +epigastralgia I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +gingivorragia. I-PRESENT_ILLNESS +Al B-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +presentaba I-EXPLORATION +una I-EXPLORATION +temperatura I-EXPLORATION +de I-EXPLORATION +37, I-EXPLORATION +5°C, I-EXPLORATION +presión I-EXPLORATION +arterial I-EXPLORATION +de I-EXPLORATION +110/80 I-EXPLORATION +mm I-EXPLORATION +Hg I-EXPLORATION +y I-EXPLORATION +frecuencia I-EXPLORATION +respiratoria I-EXPLORATION +de I-EXPLORATION +22 I-EXPLORATION +respiraciones I-EXPLORATION +por I-EXPLORATION +min. I-EXPLORATION +El I-EXPLORATION +resto I-EXPLORATION +del I-EXPLORATION +examen I-EXPLORATION +no I-EXPLORATION +tenía I-EXPLORATION +alteraciones. I-EXPLORATION +Al B-EVOLUTION +día I-EVOLUTION +siguiente, I-EVOLUTION +se I-EVOLUTION +agregó I-EVOLUTION +distensión I-EVOLUTION +abdominal, I-EVOLUTION +disnea I-EVOLUTION +a I-EVOLUTION +mediano I-EVOLUTION +esfuerzo I-EVOLUTION +y I-EVOLUTION +deposiciones I-EVOLUTION +con I-EVOLUTION +contenido I-EVOLUTION +rojizo I-EVOLUTION +oscuro, I-EVOLUTION +cuyo I-EVOLUTION +cultivo I-EVOLUTION +fue I-EVOLUTION +negativo; I-EVOLUTION +al B-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +pulmonar I-EXPLORATION +presentaba I-EXPLORATION +un I-EXPLORATION +murmullo I-EXPLORATION +vesicular I-EXPLORATION +disminuido I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +tercio I-EXPLORATION +inferior, I-EXPLORATION +sin I-EXPLORATION +ruidos I-EXPLORATION +agregados. I-EXPLORATION +Dentro I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +parámetros I-EXPLORATION +de I-EXPLORATION +laboratorio I-EXPLORATION +se I-EXPLORATION +encontró I-EXPLORATION +un I-EXPLORATION +hematocrito I-EXPLORATION +de I-EXPLORATION +48% I-EXPLORATION +y I-EXPLORATION +plaquetas I-EXPLORATION +en I-EXPLORATION +51.000/mm3. I-EXPLORATION +Se I-EXPLORATION +le I-EXPLORATION +realizó I-EXPLORATION +serología I-EXPLORATION +para I-EXPLORATION +dengue I-EXPLORATION +y I-EXPLORATION +leptospira, I-EXPLORATION +resultando I-EXPLORATION +la I-EXPLORATION +IgM I-EXPLORATION +para I-EXPLORATION +dengue I-EXPLORATION +positiva. I-EXPLORATION +Se I-EXPLORATION +confirmó I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +dengue I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +segunda I-EXPLORATION +muestra I-EXPLORATION +de I-EXPLORATION +IgM. I-EXPLORATION +Por I-EXPLORATION +la I-EXPLORATION +aparición I-EXPLORATION +de I-EXPLORATION +disnea I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +ecocardiografía I-EXPLORATION +y I-EXPLORATION +troponina I-EXPLORATION +que I-EXPLORATION +resultó I-EXPLORATION +positiva I-EXPLORATION +y I-EXPLORATION +que I-EXPLORATION +configuró I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +miocarditis. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +tórax I-EXPLORATION +se I-EXPLORATION +encontró I-EXPLORATION +una I-EXPLORATION +cardiomegalia I-EXPLORATION +con I-EXPLORATION +derrame I-EXPLORATION +pleural. I-EXPLORATION +Se B-EVOLUTION +ingresó I-EVOLUTION +a I-EVOLUTION +Unidad I-EVOLUTION +de I-EVOLUTION +Cuidados I-EVOLUTION +Intensivos I-EVOLUTION +por I-EVOLUTION +mala I-EVOLUTION +evolución I-EVOLUTION +y I-EVOLUTION +persistencia I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +fiebre. I-EVOLUTION +Por B-TREATMENT +insuficiencia I-TREATMENT +respiratoria I-TREATMENT +y I-TREATMENT +compromiso I-TREATMENT +de I-TREATMENT +conciencia I-TREATMENT +(Glasgow I-TREATMENT +10) I-TREATMENT +se I-TREATMENT +conectó I-TREATMENT +a I-TREATMENT +ventilación I-TREATMENT +mecánica I-TREATMENT +invasora. I-TREATMENT +Dentro B-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +exámenes I-EXPLORATION +auxiliares I-EXPLORATION +destacaban I-EXPLORATION +gases I-EXPLORATION +arteriales: I-EXPLORATION +pH I-EXPLORATION +7, I-EXPLORATION +52; I-EXPLORATION +pCO2 I-EXPLORATION +58 I-EXPLORATION +mmHg I-EXPLORATION +y I-EXPLORATION +PO2 I-EXPLORATION +(A-a) I-EXPLORATION +368 I-EXPLORATION +mmHg, I-EXPLORATION +recuento I-EXPLORATION +de I-EXPLORATION +plaquetas I-EXPLORATION +157.000/mm3, I-EXPLORATION +hematocrito I-EXPLORATION +43%, I-EXPLORATION +glucosa I-EXPLORATION +167 I-EXPLORATION +mg/dl I-EXPLORATION +y I-EXPLORATION +creatinina I-EXPLORATION +1, I-EXPLORATION +08 I-EXPLORATION +mg/dl. I-EXPLORATION +Se B-EVOLUTION +diagnosticó I-EVOLUTION +dengue I-EVOLUTION +grave I-EVOLUTION +con I-EVOLUTION +injuria I-EVOLUTION +renal I-EVOLUTION +aguda, I-EVOLUTION +insuficiencia I-EVOLUTION +cardíaca, I-EVOLUTION +respiratoria I-EVOLUTION +y I-EVOLUTION +sepsis I-EVOLUTION +grave. I-EVOLUTION +Se B-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +ciprofloxacina, I-TREATMENT +ceftazidima I-TREATMENT +en I-TREATMENT +forma I-TREATMENT +empírica, I-TREATMENT +vitamina I-TREATMENT +K I-TREATMENT +y I-TREATMENT +furosemida I-TREATMENT +i.v. I-TREATMENT +A B-EVOLUTION +los I-EVOLUTION +dos I-EVOLUTION +días, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +evolucionó I-EVOLUTION +hacia I-EVOLUTION +la I-EVOLUTION +mejoría, I-EVOLUTION +con I-EVOLUTION +ventilación I-EVOLUTION +espontánea I-EVOLUTION +y I-EVOLUTION +disminución I-EVOLUTION +del I-EVOLUTION +edema. I-EVOLUTION +Dentro B-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +exámenes I-EXPLORATION +el I-EXPLORATION +control I-EXPLORATION +de I-EXPLORATION +troponina I-EXPLORATION +fue I-EXPLORATION +negativo I-EXPLORATION +y I-EXPLORATION +creatinina I-EXPLORATION +dentro I-EXPLORATION +de I-EXPLORATION +rangos I-EXPLORATION +normales. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +ecocardiografia I-EXPLORATION +de I-EXPLORATION +control I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +semana I-EXPLORATION +de I-EXPLORATION +evolución I-EXPLORATION +que I-EXPLORATION +resultó I-EXPLORATION +normal. I-EXPLORATION + I-EXPLORATION + +Se B-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +embarazo I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +controlado, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +madre I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +41 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +(G4A0V3), I-PRESENT_ILLNESS +inmune I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +rubeola I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +toxoplasma. I-PRESENT_ILLNESS +Exudado I-PRESENT_ILLNESS +rectovaginal I-PRESENT_ILLNESS +estreptocócico I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +recogido. I-PRESENT_ILLNESS +La I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +gestacional I-PRESENT_ILLNESS +estimada I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +biometría I-PRESENT_ILLNESS +es I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +33-34 I-PRESENT_ILLNESS +semanas. I-PRESENT_ILLNESS +Recibe B-TREATMENT +un I-TREATMENT +ciclo I-TREATMENT +de I-TREATMENT +corticoides I-TREATMENT +completo I-TREATMENT +y I-TREATMENT +precisa I-TREATMENT +tratamiento I-TREATMENT +por I-TREATMENT +preeclampsia I-TREATMENT +y I-TREATMENT +edema I-TREATMENT +agudo I-TREATMENT +de I-TREATMENT +pulmón. I-TREATMENT +Se I-TREATMENT +realiza I-TREATMENT +una I-TREATMENT +cesárea I-TREATMENT +urgente I-TREATMENT +por I-TREATMENT +causa I-TREATMENT +materna, I-TREATMENT +con I-TREATMENT +bolsa I-TREATMENT +rota I-TREATMENT +intraoperatoria I-TREATMENT +y I-TREATMENT +líquido I-TREATMENT +amniótico I-TREATMENT +claro. I-TREATMENT +Test B-EVOLUTION +de I-EVOLUTION +Apgar I-EVOLUTION +7/9, I-EVOLUTION +REA I-EVOLUTION +III. I-EVOLUTION +Peso I-EVOLUTION +del I-EVOLUTION +recién I-EVOLUTION +nacido I-EVOLUTION +(RN) I-EVOLUTION +de I-EVOLUTION +1600 I-EVOLUTION +g. I-EVOLUTION +No I-EVOLUTION +fue I-EVOLUTION +tallado I-EVOLUTION +por I-EVOLUTION +inestabilidad I-EVOLUTION +clínica. I-EVOLUTION +Precisa B-DERIVED_FROM/TO +traslado I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +una I-DERIVED_FROM/TO +Unidad I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Cuidados I-DERIVED_FROM/TO +Intensivos I-DERIVED_FROM/TO +Neonatales I-DERIVED_FROM/TO +(UCIN) I-DERIVED_FROM/TO +tipo I-DERIVED_FROM/TO +IIIC I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +las I-DERIVED_FROM/TO +12 I-DERIVED_FROM/TO +horas I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +vida I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +un I-DERIVED_FROM/TO +cuadro I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +enfermedad I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +membrana I-DERIVED_FROM/TO +hialina, I-DERIVED_FROM/TO +hipertensión I-DERIVED_FROM/TO +pulmonar I-DERIVED_FROM/TO +grave I-DERIVED_FROM/TO +e I-DERIVED_FROM/TO +inestabilidad I-DERIVED_FROM/TO +hemodinámica. I-DERIVED_FROM/TO +En B-TREATMENT +este I-TREATMENT +centro I-TREATMENT +precisa I-TREATMENT +varios I-TREATMENT +ciclos I-TREATMENT +de I-TREATMENT +antibioterapia I-TREATMENT +por I-TREATMENT +sepsis I-TREATMENT +nosocomial I-TREATMENT +y I-TREATMENT +por I-TREATMENT +sospecha I-TREATMENT +de I-TREATMENT +enterocolitis I-TREATMENT +necrotizante I-TREATMENT +no I-TREATMENT +confirmada, I-TREATMENT +y I-TREATMENT +recibe I-TREATMENT +una I-TREATMENT +transfusión I-TREATMENT +de I-TREATMENT +concentrado I-TREATMENT +de I-TREATMENT +hematíes. I-TREATMENT +Se B-EVOLUTION +realiza I-EVOLUTION +seguimiento I-EVOLUTION +con I-EVOLUTION +ecografías I-EVOLUTION +cerebrales I-EVOLUTION +seriadas, I-EVOLUTION +sin I-EVOLUTION +hallazgos I-EVOLUTION +significativos. I-EVOLUTION +Electroencefalografía I-EVOLUTION +normal. I-EVOLUTION + I-EVOLUTION +A B-DERIVED_FROM/TO +los I-DERIVED_FROM/TO +26 I-DERIVED_FROM/TO +días I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +vida, I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +una I-DERIVED_FROM/TO +edad I-DERIVED_FROM/TO +gestacional I-DERIVED_FROM/TO +corregida I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +36+4 I-DERIVED_FROM/TO +semanas, I-DERIVED_FROM/TO +es I-DERIVED_FROM/TO +trasladado I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +vuelta I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +nuestro I-DERIVED_FROM/TO +centro. I-DERIVED_FROM/TO +A B-EVOLUTION +los I-EVOLUTION +38 I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +vida, I-EVOLUTION +se I-EVOLUTION +objetiva I-EVOLUTION +ausencia I-EVOLUTION +de I-EVOLUTION +movimiento I-EVOLUTION +espontáneo I-EVOLUTION +del I-EVOLUTION +brazo I-EVOLUTION +derecho, I-EVOLUTION +con I-EVOLUTION +un I-EVOLUTION +reflejo I-EVOLUTION +de I-EVOLUTION +Moro I-EVOLUTION +asimétrico I-EVOLUTION +y I-EVOLUTION +escasa I-EVOLUTION +prensión I-EVOLUTION +palmar, I-EVOLUTION +junto I-EVOLUTION +con I-EVOLUTION +tumefacción I-EVOLUTION +y I-EVOLUTION +mínimo I-EVOLUTION +eritema I-EVOLUTION +del I-EVOLUTION +hombro I-EVOLUTION +derecho, I-EVOLUTION +que I-EVOLUTION +resulta I-EVOLUTION +doloroso, I-EVOLUTION +con I-EVOLUTION +llanto I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +palpación I-EVOLUTION +y I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +movilización. I-EVOLUTION +En B-EXPLORATION +la I-EXPLORATION +ecografía I-EXPLORATION +articular I-EXPLORATION +se I-EXPLORATION +evidencia I-EXPLORATION +derrame I-EXPLORATION +articular I-EXPLORATION +leve-moderado, I-EXPLORATION +hiperecogénico I-EXPLORATION +y I-EXPLORATION +sugerente I-EXPLORATION +de I-EXPLORATION +derrame I-EXPLORATION +complicado. I-EXPLORATION +Se B-TREATMENT +realiza I-TREATMENT +punción I-TREATMENT +y I-TREATMENT +drenaje I-TREATMENT +con I-TREATMENT +aguja I-TREATMENT +fina I-TREATMENT +sin I-TREATMENT +incidencias, I-TREATMENT +obteniendo I-TREATMENT +2 I-TREATMENT +ml I-TREATMENT +de I-TREATMENT +líquido I-TREATMENT +hemopurulento I-TREATMENT +y I-TREATMENT +se I-TREATMENT +inicia I-TREATMENT +tratamiento I-TREATMENT +empírico I-TREATMENT +con I-TREATMENT +cefotaxima I-TREATMENT +y I-TREATMENT +cloxacilina I-TREATMENT +intravenosa. I-TREATMENT +Tras B-EVOLUTION +el I-EVOLUTION +drenaje I-EVOLUTION +se I-EVOLUTION +reduce I-EVOLUTION +la I-EVOLUTION +tumefacción I-EVOLUTION +si I-EVOLUTION +bien I-EVOLUTION +persiste I-EVOLUTION +una I-EVOLUTION +asimetría I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +tamaño I-EVOLUTION +del I-EVOLUTION +hombro I-EVOLUTION +derecho I-EVOLUTION +respecto I-EVOLUTION +al I-EVOLUTION +izquierdo. I-EVOLUTION +A I-EVOLUTION +las I-EVOLUTION +48 I-EVOLUTION +horas I-EVOLUTION +se I-EVOLUTION +confirma I-EVOLUTION +que I-EVOLUTION +crece I-EVOLUTION +E. I-EVOLUTION +coli I-EVOLUTION +sin I-EVOLUTION +resistencias I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +antibiograma, I-EVOLUTION +por I-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +suspende I-EVOLUTION +la I-EVOLUTION +cloxacilina, I-EVOLUTION +manteniendo I-EVOLUTION +la I-EVOLUTION +cefotaxima I-EVOLUTION +en I-EVOLUTION +monoterapia. I-EVOLUTION +A B-EXPLORATION +los I-EXPLORATION +cinco I-EXPLORATION +días I-EXPLORATION +de I-EXPLORATION +tratamiento I-EXPLORATION +intravenoso, I-EXPLORATION +se I-EXPLORATION +obtiene I-EXPLORATION +una I-EXPLORATION +nueva I-EXPLORATION +muestra I-EXPLORATION +de I-EXPLORATION +proteína I-EXPLORATION +C I-EXPLORATION +reactiva I-EXPLORATION +(PCR) I-EXPLORATION +que I-EXPLORATION +es I-EXPLORATION +de I-EXPLORATION +14, I-EXPLORATION +6 I-EXPLORATION +mg/dl, I-EXPLORATION +a I-EXPLORATION +pesar I-EXPLORATION +de I-EXPLORATION +no I-EXPLORATION +presentar I-EXPLORATION +empeoramiento I-EXPLORATION +clínico I-EXPLORATION +del I-EXPLORATION +hombro. I-EXPLORATION +Se I-EXPLORATION +repite I-EXPLORATION +de I-EXPLORATION +nuevo I-EXPLORATION +la I-EXPLORATION +ecografía, I-EXPLORATION +que I-EXPLORATION +evidencia I-EXPLORATION +un I-EXPLORATION +mínimo I-EXPLORATION +derrame I-EXPLORATION +articular I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +colección I-EXPLORATION +abscesificada I-EXPLORATION +incipiente I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +cara I-EXPLORATION +anterior I-EXPLORATION +capsular. I-EXPLORATION +Se B-TREATMENT +realiza I-TREATMENT +un I-TREATMENT +nuevo I-TREATMENT +drenaje I-TREATMENT +guiado I-TREATMENT +por I-TREATMENT +ecografía. I-TREATMENT +Se I-TREATMENT +obtienen I-TREATMENT +0, I-TREATMENT +3 I-TREATMENT +ml I-TREATMENT +de I-TREATMENT +muestra, I-TREATMENT +en I-TREATMENT +cuyo I-TREATMENT +cultivo I-TREATMENT +crece I-TREATMENT +el I-TREATMENT +mismo I-TREATMENT +E. I-TREATMENT +coli I-TREATMENT +multisensible. I-TREATMENT +A I-TREATMENT +los I-TREATMENT +siete I-TREATMENT +días I-TREATMENT +de I-TREATMENT +tratamiento, I-TREATMENT +se I-TREATMENT +decide I-TREATMENT +asociar I-TREATMENT +amikacina I-TREATMENT +intravenosa I-TREATMENT +para I-TREATMENT +potenciar I-TREATMENT +el I-TREATMENT +efecto I-TREATMENT +antibiótico I-TREATMENT +por I-TREATMENT +aumento I-TREATMENT +leve I-TREATMENT +de I-TREATMENT +la I-TREATMENT +PCR. I-TREATMENT +Tras B-EVOLUTION +esto, I-EVOLUTION +a I-EVOLUTION +las I-EVOLUTION +72 I-EVOLUTION +horas I-EVOLUTION +presenta I-EVOLUTION +una I-EVOLUTION +marcada I-EVOLUTION +mejoría I-EVOLUTION +clínica I-EVOLUTION +y I-EVOLUTION +analítica. I-EVOLUTION +Ante B-TREATMENT +la I-TREATMENT +buena I-TREATMENT +evolución I-TREATMENT +clínica I-TREATMENT +y I-TREATMENT +analítica, I-TREATMENT +se I-TREATMENT +decide I-TREATMENT +pasar I-TREATMENT +a I-TREATMENT +cefuroxima-axetilo I-TREATMENT +para I-TREATMENT +completar I-TREATMENT +tres I-TREATMENT +semanas I-TREATMENT +de I-TREATMENT +antibiótico I-TREATMENT +oral. I-TREATMENT + I-TREATMENT + +Paciente B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +femenino I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +4 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +(39 I-PRESENT_ILLNESS +ºC) I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +seis I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal. I-PRESENT_ILLNESS +Antecedentes B-PAST_MEDICAL_HISTORY +personales: I-PAST_MEDICAL_HISTORY +recién I-PAST_MEDICAL_HISTORY +nacido I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +gesta I-PAST_MEDICAL_HISTORY +1, I-PAST_MEDICAL_HISTORY +embarazo I-PAST_MEDICAL_HISTORY +controlado, I-PAST_MEDICAL_HISTORY +parto I-PAST_MEDICAL_HISTORY +normal, I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +término I-PAST_MEDICAL_HISTORY +(40 I-PAST_MEDICAL_HISTORY +semanas), I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +peso I-PAST_MEDICAL_HISTORY +adecuado I-PAST_MEDICAL_HISTORY +(3360 I-PAST_MEDICAL_HISTORY +kg). I-PAST_MEDICAL_HISTORY +A I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +2 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +le I-PAST_MEDICAL_HISTORY +diagnosticaron I-PAST_MEDICAL_HISTORY +miopía, I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +lo I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +encuentra I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +seguimiento I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +oftalmología. I-PAST_MEDICAL_HISTORY +A I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +3 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +5 I-PAST_MEDICAL_HISTORY +meses I-PAST_MEDICAL_HISTORY +presentó I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +infección I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +tracto I-PAST_MEDICAL_HISTORY +urinario I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +Escherichia I-PAST_MEDICAL_HISTORY +coli, I-PAST_MEDICAL_HISTORY +recibió I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +ambulatorio, I-PAST_MEDICAL_HISTORY +pero I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +realizaron I-PAST_MEDICAL_HISTORY +controles I-PAST_MEDICAL_HISTORY +posteriores I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +esta I-PAST_MEDICAL_HISTORY +patología. I-PAST_MEDICAL_HISTORY +Refiere I-PAST_MEDICAL_HISTORY +poliuria I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +polidipsia I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +temprana I-PAST_MEDICAL_HISTORY +edad. I-PAST_MEDICAL_HISTORY +Antecedentes B-FAMILY_HISTORY +familiares: I-FAMILY_HISTORY +abuela I-FAMILY_HISTORY +paterna I-FAMILY_HISTORY +hipoacúsica, I-FAMILY_HISTORY +primo I-FAMILY_HISTORY +paterno I-FAMILY_HISTORY +con I-FAMILY_HISTORY +litiasis I-FAMILY_HISTORY +renal, I-FAMILY_HISTORY +padre I-FAMILY_HISTORY +con I-FAMILY_HISTORY +microhematuria. I-FAMILY_HISTORY +Al B-EXPLORATION +ingreso, I-EXPLORATION +la I-EXPLORATION +paciente I-EXPLORATION +se I-EXPLORATION +encontraba I-EXPLORATION +eutrófica I-EXPLORATION +(peso: I-EXPLORATION +17.400 I-EXPLORATION +kg, I-EXPLORATION +talla: I-EXPLORATION +104 I-EXPLORATION +cm), I-EXPLORATION +en I-EXPLORATION +buen I-EXPLORATION +estado I-EXPLORATION +general, I-EXPLORATION +febril, I-EXPLORATION +normotensa. I-EXPLORATION +Por I-EXPLORATION +presentar I-EXPLORATION +orina I-EXPLORATION +patológica I-EXPLORATION +se I-EXPLORATION +solicitan: I-EXPLORATION +urocultivo, I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +informa I-EXPLORATION +positivo I-EXPLORATION +para I-EXPLORATION +Escherichia I-EXPLORATION +coli, I-EXPLORATION +y I-EXPLORATION +ecografía I-EXPLORATION +renal I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +evidencian I-EXPLORATION +imágenes I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION +nefrocalcinosis. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +abdomen I-EXPLORATION +se I-EXPLORATION +observan I-EXPLORATION +calcificaciones I-EXPLORATION +renales. I-EXPLORATION + I-EXPLORATION +Los I-EXPLORATION +exámenes I-EXPLORATION +de I-EXPLORATION +laboratorio I-EXPLORATION +manifestaron I-EXPLORATION +insuficiencia I-EXPLORATION +renal I-EXPLORATION +(depuración I-EXPLORATION +de I-EXPLORATION +creatinina I-EXPLORATION +50 I-EXPLORATION +ml/min/1, I-EXPLORATION +73, I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +calculó I-EXPLORATION +por I-EXPLORATION +fórmula), I-EXPLORATION +hipercalciuria I-EXPLORATION +(13 I-EXPLORATION +mg/kg/d), I-EXPLORATION +hipomagnesemia, I-EXPLORATION +hipermagnesuria, I-EXPLORATION +anemia I-EXPLORATION +y I-EXPLORATION +acidosis. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +evaluación I-EXPLORATION +cardiológica I-EXPLORATION +y I-EXPLORATION +otorrinolaringológica I-EXPLORATION +fue I-EXPLORATION +normal. I-EXPLORATION +En I-EXPLORATION +oftalmología I-EXPLORATION +se I-EXPLORATION +diagnosticó I-EXPLORATION +"coriorretinitis I-EXPLORATION +cicatrizal I-EXPLORATION +macular, I-EXPLORATION +coriopatía I-EXPLORATION +miópica". I-EXPLORATION +Se I-EXPLORATION +arriba I-EXPLORATION +al I-EXPLORATION +diagnóstico I-EXPLORATION +por I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +hipercalciuria, I-EXPLORATION +nefrocalcinosis, I-EXPLORATION +hipomagnesemia, I-EXPLORATION +hipermagnesuria I-EXPLORATION +e I-EXPLORATION +insuficiencia I-EXPLORATION +renal, I-EXPLORATION +asociadas I-EXPLORATION +a I-EXPLORATION +patología I-EXPLORATION +ocular I-EXPLORATION +y I-EXPLORATION +antecedentes I-EXPLORATION +personales I-EXPLORATION +y I-EXPLORATION +familiares I-EXPLORATION +compatibles. I-EXPLORATION +Cumplió B-TREATMENT +tratamiento I-TREATMENT +para I-TREATMENT +infección I-TREATMENT +urinaria. I-TREATMENT +Se I-TREATMENT +indicó I-TREATMENT +citrato I-TREATMENT +de I-TREATMENT +potasio, I-TREATMENT +amiloride-hidroclorotiazida I-TREATMENT +25 I-TREATMENT +mg/día, I-TREATMENT +pidolato I-TREATMENT +de I-TREATMENT +magnesio I-TREATMENT +1, I-TREATMENT +5 I-TREATMENT +g/ I-TREATMENT +día, I-TREATMENT +ácido I-TREATMENT +fólico I-TREATMENT +5 I-TREATMENT +mg/día, I-TREATMENT +sulfato I-TREATMENT +ferroso I-TREATMENT +3 I-TREATMENT +mg/ I-TREATMENT +kg/día, I-TREATMENT +dieta I-TREATMENT +hiposódica I-TREATMENT +controlada I-TREATMENT +en I-TREATMENT +proteínas I-TREATMENT +y I-TREATMENT +líquidos I-TREATMENT +a I-TREATMENT +demanda. I-TREATMENT +Durante B-EVOLUTION +su I-EVOLUTION +evolución I-EVOLUTION +presentó I-EVOLUTION +nueva I-EVOLUTION +infección I-EVOLUTION +urinaria I-EVOLUTION +a I-EVOLUTION +E. I-EVOLUTION +coli, I-EVOLUTION +se B-EXPLORATION +realizó I-EXPLORATION +cistouretrografía I-EXPLORATION +miccional, I-EXPLORATION +que I-EXPLORATION +fue I-EXPLORATION +normal, I-EXPLORATION +y B-TREATMENT +se I-TREATMENT +inició I-TREATMENT +profilaxis I-TREATMENT +antibiótica I-TREATMENT +con I-TREATMENT +nitrofurantoína. I-TREATMENT +Se I-TREATMENT +suspendió I-TREATMENT +la I-TREATMENT +hidroclorotiazida I-TREATMENT +a I-TREATMENT +los I-TREATMENT +dos I-TREATMENT +meses I-TREATMENT +de I-TREATMENT +tratamiento I-TREATMENT +por I-TREATMENT +brusco I-TREATMENT +aumento I-TREATMENT +de I-TREATMENT +urea I-TREATMENT +y I-TREATMENT +creatinina, I-TREATMENT +con I-TREATMENT +mejoría I-TREATMENT +posterior I-TREATMENT +y I-TREATMENT +mantenimiento I-TREATMENT +de I-TREATMENT +valores I-TREATMENT +de I-TREATMENT +calciuria I-TREATMENT +dentro I-TREATMENT +de I-TREATMENT +la I-TREATMENT +normalidad. I-TREATMENT +Se B-EVOLUTION +mantiene I-EVOLUTION +hasta I-EVOLUTION +la I-EVOLUTION +actualidad I-EVOLUTION +el I-EVOLUTION +resto I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +medicación. I-EVOLUTION + I-EVOLUTION + +Lactante B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +año I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +7 I-PRESENT_ILLNESS +meses, I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +femenino, I-PRESENT_ILLNESS +previamente I-PRESENT_ILLNESS +sana, I-PRESENT_ILLNESS +buen I-PRESENT_ILLNESS +incremento I-PRESENT_ILLNESS +pondoestatural I-PRESENT_ILLNESS +(P/T I-PRESENT_ILLNESS +–0, I-PRESENT_ILLNESS +4 I-PRESENT_ILLNESS +DS I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +T/E I-PRESENT_ILLNESS +0, I-PRESENT_ILLNESS +5 I-PRESENT_ILLNESS +DS), I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +curso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +febril I-PRESENT_ILLNESS +prolongado I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +inapetencia I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +vómitos I-PRESENT_ILLNESS +se B-EXPLORATION +solicitaron I-EXPLORATION +exámenes I-EXPLORATION +que I-EXPLORATION +mostraron I-EXPLORATION +elevación I-EXPLORATION +severa I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +actividad I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +FA I-EXPLORATION +(5.553 I-EXPLORATION +UI/l), I-EXPLORATION +la I-EXPLORATION +medición I-EXPLORATION +de I-EXPLORATION +isoenzimas I-EXPLORATION +evidenció I-EXPLORATION +predominio I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +fracción I-EXPLORATION +ósea I-EXPLORATION +—75%— I-EXPLORATION +sobre I-EXPLORATION +la I-EXPLORATION +hepática I-EXPLORATION +—24%—. I-EXPLORATION +El I-EXPLORATION +resto I-EXPLORATION +del I-EXPLORATION +estudio I-EXPLORATION +no I-EXPLORATION +mostró I-EXPLORATION +alteración I-EXPLORATION +hepática, I-EXPLORATION +ni I-EXPLORATION +ósea, I-EXPLORATION +con I-EXPLORATION +hemograma, I-EXPLORATION +VHS, I-EXPLORATION +transaminasas, I-EXPLORATION +calcio, I-EXPLORATION +fósforo, I-EXPLORATION +hormona I-EXPLORATION +paratiroidea I-EXPLORATION +(PTH), I-EXPLORATION +niveles I-EXPLORATION +de I-EXPLORATION +25-OH I-EXPLORATION +vit. I-EXPLORATION +D3 I-EXPLORATION +y I-EXPLORATION +cintigrafía I-EXPLORATION +ósea I-EXPLORATION +normales. I-EXPLORATION +El B-EVOLUTION +seguimiento I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +niveles I-EVOLUTION +de I-EVOLUTION +FA I-EVOLUTION +al I-EVOLUTION +mes I-EVOLUTION +mostraron I-EVOLUTION +un I-EVOLUTION +leve I-EVOLUTION +ascenso I-EVOLUTION +con I-EVOLUTION +respecto I-EVOLUTION +al I-EVOLUTION +valor I-EVOLUTION +previo I-EVOLUTION +(5.857 I-EVOLUTION +UI/l), I-EVOLUTION +con I-EVOLUTION +buena I-EVOLUTION +recuperación I-EVOLUTION +clínica I-EVOLUTION +de I-EVOLUTION +cuadro I-EVOLUTION +febril I-EVOLUTION +intercurrente; I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +3 I-EVOLUTION +meses I-EVOLUTION +los I-EVOLUTION +valores I-EVOLUTION +disminuyeron I-EVOLUTION +a I-EVOLUTION +631 I-EVOLUTION +UI/l, I-EVOLUTION +normalizándose I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +6 I-EVOLUTION +meses I-EVOLUTION +con I-EVOLUTION +un I-EVOLUTION +valor I-EVOLUTION +de I-EVOLUTION +297 I-EVOLUTION +U/l. I-EVOLUTION + I-EVOLUTION + +Hombre B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +27 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +mórbidos. I-PAST_MEDICAL_HISTORY +Luego B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +estar I-PRESENT_ILLNESS +consumiendo I-PRESENT_ILLNESS +drogas I-PRESENT_ILLNESS +(clorhidrato I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +pasta I-PRESENT_ILLNESS +base) I-PRESENT_ILLNESS +notó I-PRESENT_ILLNESS +disminución I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +AV I-PRESENT_ILLNESS +bilateral I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +ojos I-PRESENT_ILLNESS +rojos. I-PRESENT_ILLNESS +El I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +acompañó I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cefalea I-PRESENT_ILLNESS +frontal I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +fotopsias I-PRESENT_ILLNESS +bilaterales. I-PRESENT_ILLNESS +Consultó I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +semana I-PRESENT_ILLNESS +después. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Al B-EXPLORATION +examen I-EXPLORATION +oftalmológico I-EXPLORATION +destacaba: I-EXPLORATION +AVMC I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +OD I-EXPLORATION +igual I-EXPLORATION +a I-EXPLORATION +0, I-EXPLORATION +05 I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +Oí I-EXPLORATION +igual I-EXPLORATION +a I-EXPLORATION +0, I-EXPLORATION +1. I-EXPLORATION +Visión I-EXPLORATION +de I-EXPLORATION +colores I-EXPLORATION +alterada I-EXPLORATION +en I-EXPLORATION +ambos I-EXPLORATION +ojos. I-EXPLORATION +Reflejos I-EXPLORATION +pupilares I-EXPLORATION +lentos I-EXPLORATION +bilaterales I-EXPLORATION +y I-EXPLORATION +sin I-EXPLORATION +DPAR. I-EXPLORATION +PIÓ I-EXPLORATION +igual I-EXPLORATION +a I-EXPLORATION +24 I-EXPLORATION +mm I-EXPLORATION +Hg I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +OD I-EXPLORATION +y I-EXPLORATION +23 I-EXPLORATION +mm I-EXPLORATION +Hg I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +Oí. I-EXPLORATION +Al I-EXPLORATION +examen I-EXPLORATION +al I-EXPLORATION +biomicroscopio I-EXPLORATION +destacaba I-EXPLORATION +Tyndall I-EXPLORATION ++++ I-EXPLORATION +en I-EXPLORATION +ambos I-EXPLORATION +ojos. I-EXPLORATION +Presentaba I-EXPLORATION +al I-EXPLORATION +fondo I-EXPLORATION +de I-EXPLORATION +ojo I-EXPLORATION +vitreítis I-EXPLORATION +++ I-EXPLORATION +bilateral. I-EXPLORATION +Ambas I-EXPLORATION +papilas I-EXPLORATION +estaban I-EXPLORATION +levemente I-EXPLORATION +pálidas. I-EXPLORATION +El I-EXPLORATION +campo I-EXPLORATION +visual I-EXPLORATION +de I-EXPLORATION +Goldmann I-EXPLORATION +mostró I-EXPLORATION +escotomas I-EXPLORATION +centro I-EXPLORATION +centrales I-EXPLORATION +bilaterales. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +TAC I-EXPLORATION +de I-EXPLORATION +cerebro I-EXPLORATION +no I-EXPLORATION +mostró I-EXPLORATION +hallazgos I-EXPLORATION +patológicos. I-EXPLORATION +Se I-EXPLORATION +planteó I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +neuritis I-EXPLORATION +óptica I-EXPLORATION +bilateral I-EXPLORATION +y I-EXPLORATION +panuveitis. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +etiológico I-EXPLORATION +mostró I-EXPLORATION +VDRL I-EXPLORATION +en I-EXPLORATION +sangre I-EXPLORATION +(+), I-EXPLORATION +título: I-EXPLORATION +1/128, I-EXPLORATION +FTA-ABS I-EXPLORATION +(+) I-EXPLORATION +y I-EXPLORATION +VDRL I-EXPLORATION +en I-EXPLORATION +LCR I-EXPLORATION +(-). I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +citoquímico I-EXPLORATION +del I-EXPLORATION +LCR I-EXPLORATION +resultó I-EXPLORATION +normal. I-EXPLORATION +Se B-TREATMENT +realizó I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +penicilina I-TREATMENT +según I-TREATMENT +pautas. I-TREATMENT +Diez B-EVOLUTION +días I-EVOLUTION +después I-EVOLUTION +de I-EVOLUTION +iniciada I-EVOLUTION +la I-EVOLUTION +terapia I-EVOLUTION +los I-EVOLUTION +campos I-EVOLUTION +visuales I-EVOLUTION +mostraron I-EVOLUTION +una I-EVOLUTION +importante I-EVOLUTION +mejoría I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +agudeza I-EVOLUTION +visual I-EVOLUTION +mejoró I-EVOLUTION +a I-EVOLUTION +0, I-EVOLUTION +67 I-EVOLUTION +en I-EVOLUTION +ambos I-EVOLUTION +ojos. I-EVOLUTION + I-EVOLUTION + +Paciente B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +36 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés I-PAST_MEDICAL_HISTORY +salvo I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +cesáreas, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +fue I-PRESENT_ILLNESS +remitida I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +nuestro I-PRESENT_ILLNESS +servicio I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +fosa I-PRESENT_ILLNESS +renal I-PRESENT_ILLNESS +derecha. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +radiografía I-EXPLORATION +simple I-EXPLORATION +de I-EXPLORATION +abdomen I-EXPLORATION +se I-EXPLORATION +evidencia I-EXPLORATION +una I-EXPLORATION +litiasis I-EXPLORATION +renal I-EXPLORATION +derecha I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +urografía I-EXPLORATION +intravenosa I-EXPLORATION +una I-EXPLORATION +acodadura I-EXPLORATION +del I-EXPLORATION +uréter I-EXPLORATION +derecho I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +tercio I-EXPLORATION +superior I-EXPLORATION +sin I-EXPLORATION +otros I-EXPLORATION +hallazgos I-EXPLORATION +significativos. I-EXPLORATION +Asintomática, B-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +fue I-EVOLUTION +dada I-EVOLUTION +de I-EVOLUTION +alta. I-EVOLUTION +A B-EXPLORATION +los I-EXPLORATION +dos I-EXPLORATION +meses, I-EXPLORATION +nuevo I-EXPLORATION +ingreso I-EXPLORATION +por I-EXPLORATION +la I-EXPLORATION +misma I-EXPLORATION +clínica I-EXPLORATION +y I-EXPLORATION +nueva I-EXPLORATION +batería I-EXPLORATION +de I-EXPLORATION +pruebas: I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +radiografía I-EXPLORATION +simple I-EXPLORATION +de I-EXPLORATION +abdomen I-EXPLORATION +se I-EXPLORATION +comprueba I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +litiasis I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +de I-EXPLORATION +uréter I-EXPLORATION +distal I-EXPLORATION +derecho I-EXPLORATION +y I-EXPLORATION +pequeñas I-EXPLORATION +calcificaciones I-EXPLORATION +en I-EXPLORATION +riñón I-EXPLORATION +derecho; I-EXPLORATION +la I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION +confirma I-EXPLORATION +lo I-EXPLORATION +hallado I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +radiografía I-EXPLORATION +y I-EXPLORATION +además I-EXPLORATION +descarta I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION +de I-EXPLORATION +uropatía I-EXPLORATION +obstructiva. I-EXPLORATION +En I-EXPLORATION +todo I-EXPLORATION +momento I-EXPLORATION +las I-EXPLORATION +pruebas I-EXPLORATION +de I-EXPLORATION +laboratorio I-EXPLORATION +se I-EXPLORATION +encuentran I-EXPLORATION +dentro I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +normalidad. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +trata I-TREATMENT +la I-TREATMENT +litiasis I-TREATMENT +ureteral I-TREATMENT +mediante I-TREATMENT +ureteroscopia I-TREATMENT +y I-TREATMENT +lasertricia I-TREATMENT +persistiendo I-TREATMENT +la I-TREATMENT +clínica I-TREATMENT +a I-TREATMENT +pesar I-TREATMENT +de I-TREATMENT +la I-TREATMENT +eficacia I-TREATMENT +del I-TREATMENT +tratamiento I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +motiva I-TREATMENT +nuevo I-TREATMENT +ingreso I-TREATMENT +unos I-TREATMENT +meses I-TREATMENT +más I-TREATMENT +tarde. I-TREATMENT +Se B-EXPLORATION +realiza I-EXPLORATION +UIV I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +una I-EXPLORATION +ectasia I-EXPLORATION +ureteropielocalicial I-EXPLORATION +derecha I-EXPLORATION +hasta I-EXPLORATION +cresta I-EXPLORATION +iliaca. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +TC I-EXPLORATION +los I-EXPLORATION +riñones I-EXPLORATION +son I-EXPLORATION +normales I-EXPLORATION +pero I-EXPLORATION +el I-EXPLORATION +uréter I-EXPLORATION +derecho I-EXPLORATION +está I-EXPLORATION +discretamente I-EXPLORATION +dilatado I-EXPLORATION +hasta I-EXPLORATION +el I-EXPLORATION +tercio I-EXPLORATION +distal I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +identifica I-EXPLORATION +un I-EXPLORATION +quiste I-EXPLORATION +ovárico I-EXPLORATION +de I-EXPLORATION +1, I-EXPLORATION +5 I-EXPLORATION +cm, I-EXPLORATION +que I-EXPLORATION +pudiera I-EXPLORATION +estar I-EXPLORATION +comprimiendo I-EXPLORATION +parcialmente I-EXPLORATION +el I-EXPLORATION +tercio I-EXPLORATION +distal I-EXPLORATION +del I-EXPLORATION +uréter I-EXPLORATION +(vista I-EXPLORATION +por I-EXPLORATION +el I-EXPLORATION +servicio I-EXPLORATION +de I-EXPLORATION +ginecología I-EXPLORATION +no I-EXPLORATION +precisa I-EXPLORATION +tratamiento I-EXPLORATION +alguno, I-EXPLORATION +solamente I-EXPLORATION +revisiones I-EXPLORATION +periódicas). I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +pielografía I-EXPLORATION +ascendente I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +realiza I-EXPLORATION +se I-EXPLORATION +ve I-EXPLORATION +la I-EXPLORATION +ectasia I-EXPLORATION +ureteropielocalicial I-EXPLORATION +sin I-EXPLORATION +observar I-EXPLORATION +claramente I-EXPLORATION +una I-EXPLORATION +estenosis I-EXPLORATION +ureteral; I-EXPLORATION +se B-TREATMENT +coloca I-TREATMENT +un I-TREATMENT +catéter I-TREATMENT +doble I-TREATMENT +J I-TREATMENT +que I-TREATMENT +es I-TREATMENT +retirado I-TREATMENT +a I-TREATMENT +las I-TREATMENT +8 I-TREATMENT +semanas I-TREATMENT +sin I-TREATMENT +apreciar I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +mejoría I-TREATMENT +clínica. I-TREATMENT +Se B-EXPLORATION +decide I-EXPLORATION +hacer I-EXPLORATION +una I-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION +nuclear I-EXPLORATION +(RMN) I-EXPLORATION +que I-EXPLORATION +nos I-EXPLORATION +pueda I-EXPLORATION +aportar I-EXPLORATION +algún I-EXPLORATION +dato I-EXPLORATION +nuevo I-EXPLORATION +que I-EXPLORATION +justifique I-EXPLORATION +los I-EXPLORATION +síntomas; I-EXPLORATION +dicha I-EXPLORATION +RMN I-EXPLORATION +nos I-EXPLORATION +informa I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +ectasia I-EXPLORATION +ureteral I-EXPLORATION +derecha I-EXPLORATION +por I-EXPLORATION +un I-EXPLORATION +posible I-EXPLORATION +síndrome I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +vena I-EXPLORATION +ovárica. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +programa I-TREATMENT +para I-TREATMENT +intervención I-TREATMENT +quirúrgica: I-TREATMENT +ligadura I-TREATMENT +de I-TREATMENT +vena I-TREATMENT +ovárica I-TREATMENT +más I-TREATMENT +ureterolisis I-TREATMENT +derecha I-TREATMENT +por I-TREATMENT +vía I-TREATMENT +laparoscópica I-TREATMENT +transabdominal. I-TREATMENT +La I-TREATMENT +paciente I-TREATMENT +es I-TREATMENT +colocada I-TREATMENT +en I-TREATMENT +ligero I-TREATMENT +decúbito I-TREATMENT +lateral I-TREATMENT +izquierdo. I-TREATMENT +Insuflación I-TREATMENT +abdominal I-TREATMENT +con I-TREATMENT +CO2 I-TREATMENT +a I-TREATMENT +través I-TREATMENT +de I-TREATMENT +una I-TREATMENT +aguja I-TREATMENT +de I-TREATMENT +Veress I-TREATMENT +y I-TREATMENT +colocación I-TREATMENT +de I-TREATMENT +cuatro I-TREATMENT +trócares, I-TREATMENT +2 I-TREATMENT +de I-TREATMENT +5 I-TREATMENT +mm I-TREATMENT +- I-TREATMENT +(uno I-TREATMENT +subesternal I-TREATMENT +y I-TREATMENT +otro I-TREATMENT +en I-TREATMENT +la I-TREATMENT +zona I-TREATMENT +lumbar I-TREATMENT +entre I-TREATMENT +la I-TREATMENT +cresta I-TREATMENT +iliaca I-TREATMENT +y I-TREATMENT +la I-TREATMENT +12ª I-TREATMENT +costilla) I-TREATMENT +- I-TREATMENT +y I-TREATMENT +2 I-TREATMENT +de I-TREATMENT +10 I-TREATMENT +mm I-TREATMENT +- I-TREATMENT +(uno I-TREATMENT +en I-TREATMENT +el I-TREATMENT +ombligo, I-TREATMENT +donde I-TREATMENT +se I-TREATMENT +coloca I-TREATMENT +la I-TREATMENT +óptica, I-TREATMENT +y I-TREATMENT +el I-TREATMENT +otro I-TREATMENT +suprapúbico) I-TREATMENT +-. I-TREATMENT +Tras I-TREATMENT +la I-TREATMENT +incisión I-TREATMENT +de I-TREATMENT +la I-TREATMENT +línea I-TREATMENT +de I-TREATMENT +Toldt I-TREATMENT +y I-TREATMENT +decolación I-TREATMENT +se I-TREATMENT +procede I-TREATMENT +a I-TREATMENT +la I-TREATMENT +identificación I-TREATMENT +del I-TREATMENT +uréter I-TREATMENT +lumbar I-TREATMENT +y I-TREATMENT +seguimiento I-TREATMENT +del I-TREATMENT +mismo I-TREATMENT +hasta I-TREATMENT +observar I-TREATMENT +su I-TREATMENT +paso I-TREATMENT +entre I-TREATMENT +la I-TREATMENT +arteria I-TREATMENT +iliaca I-TREATMENT +y I-TREATMENT +la I-TREATMENT +vena I-TREATMENT +ovárica, I-TREATMENT +ésta I-TREATMENT +última I-TREATMENT +cruza I-TREATMENT +por I-TREATMENT +encima I-TREATMENT +del I-TREATMENT +uréter I-TREATMENT +y I-TREATMENT +se I-TREATMENT +bifurca I-TREATMENT +en I-TREATMENT +2 I-TREATMENT +ramas I-TREATMENT +que I-TREATMENT +actúan I-TREATMENT +a I-TREATMENT +modo I-TREATMENT +de I-TREATMENT +pinza I-TREATMENT +comprimiendo I-TREATMENT +el I-TREATMENT +uréter. I-TREATMENT +Se I-TREATMENT +libera I-TREATMENT +la I-TREATMENT +vena I-TREATMENT +ovárica I-TREATMENT +y I-TREATMENT +posteriormente I-TREATMENT +se I-TREATMENT +procede I-TREATMENT +a I-TREATMENT +la I-TREATMENT +ligadura I-TREATMENT +y I-TREATMENT +sección I-TREATMENT +de I-TREATMENT +la I-TREATMENT +misma. I-TREATMENT +Para I-TREATMENT +finalizar, I-TREATMENT +colocamos I-TREATMENT +un I-TREATMENT +drenaje I-TREATMENT +tipo I-TREATMENT +Redon I-TREATMENT +sin I-TREATMENT +aspiración I-TREATMENT +a I-TREATMENT +través I-TREATMENT +del I-TREATMENT +trócar I-TREATMENT +lateral, I-TREATMENT +se I-TREATMENT +confirma I-TREATMENT +la I-TREATMENT +hemostasia, I-TREATMENT +se I-TREATMENT +evacúa I-TREATMENT +el I-TREATMENT +CO2 I-TREATMENT +y I-TREATMENT +se I-TREATMENT +suturan I-TREATMENT +los I-TREATMENT +puertos I-TREATMENT +de I-TREATMENT +entrada. I-TREATMENT +El B-EVOLUTION +postoperatorio I-EVOLUTION +cursa I-EVOLUTION +sin I-EVOLUTION +incidencias I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +es I-EVOLUTION +dada I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +al I-EVOLUTION +segundo I-EVOLUTION +día I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +intervención. I-EVOLUTION + I-EVOLUTION +En I-EVOLUTION +revisiones I-EVOLUTION +posteriores, I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +3 I-EVOLUTION +y I-EVOLUTION +6 I-EVOLUTION +meses I-EVOLUTION +después I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +cirugía, I-EVOLUTION +se I-EVOLUTION +encuentra I-EVOLUTION +totalmente I-EVOLUTION +asintomática I-EVOLUTION +y I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +UIV I-EVOLUTION +de I-EVOLUTION +control I-EVOLUTION +ha I-EVOLUTION +desaparecido I-EVOLUTION +la I-EVOLUTION +ectasia I-EVOLUTION +y I-EVOLUTION +acodadura I-EVOLUTION +del I-EVOLUTION +uréter I-EVOLUTION +derecho. I-EVOLUTION + I-EVOLUTION + +Una B-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +21 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +previamente B-PAST_MEDICAL_HISTORY +sana I-PAST_MEDICAL_HISTORY +ingresó B-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +mes I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +fiebre, I-PRESENT_ILLNESS +compromiso I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +estado I-PRESENT_ILLNESS +general I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +alteración I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +pruebas I-PRESENT_ILLNESS +hepáticas. I-PRESENT_ILLNESS +Al B-EXPLORATION +ingreso I-EXPLORATION +se I-EXPLORATION +encontró I-EXPLORATION +decaída I-EXPLORATION +y I-EXPLORATION +sin I-EXPLORATION +alteraciones I-EXPLORATION +al I-EXPLORATION +examen I-EXPLORATION +físico. I-EXPLORATION +Se I-EXPLORATION +realizaron I-EXPLORATION +exámenes I-EXPLORATION +de I-EXPLORATION +laboratorio I-EXPLORATION +que I-EXPLORATION +mostraron I-EXPLORATION +pancitopenia I-EXPLORATION +(hemoglobina I-EXPLORATION +10 I-EXPLORATION +gr%, I-EXPLORATION +leucocitos I-EXPLORATION +1.900/uL, I-EXPLORATION +plaquetas I-EXPLORATION +43.000/mL) I-EXPLORATION +y I-EXPLORATION +alteración I-EXPLORATION +de I-EXPLORATION +pruebas I-EXPLORATION +hepáticas I-EXPLORATION +(GOT I-EXPLORATION +1.800 I-EXPLORATION +U/L, I-EXPLORATION +GPT I-EXPLORATION +1.300 I-EXPLORATION +U/L). I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +enfermedades I-EXPLORATION +infecciosas I-EXPLORATION +el I-EXPLORATION +cual I-EXPLORATION +fue I-EXPLORATION +negativo I-EXPLORATION +(hemocultivo, I-EXPLORATION +urocultivo, I-EXPLORATION +virus I-EXPLORATION +hepatotropos, I-EXPLORATION +mycoplasma, I-EXPLORATION +toxoplasma, I-EXPLORATION +leptospira, I-EXPLORATION +bartonella, I-EXPLORATION +brucella, I-EXPLORATION +rubéola, I-EXPLORATION +sarampión, I-EXPLORATION +VIH, I-EXPLORATION +parvovirus I-EXPLORATION +B19, I-EXPLORATION +citomegalovirus I-EXPLORATION +y I-EXPLORATION +Epstein I-EXPLORATION +Barr). I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +estudio I-EXPLORATION +reumatológico I-EXPLORATION +donde I-EXPLORATION +resultó I-EXPLORATION +ANA I-EXPLORATION +1: I-EXPLORATION +40 I-EXPLORATION +patrón I-EXPLORATION +moteado I-EXPLORATION +y I-EXPLORATION +anti I-EXPLORATION +DNA I-EXPLORATION +por I-EXPLORATION +FARR, I-EXPLORATION +factor I-EXPLORATION +reumatoide I-EXPLORATION +y I-EXPLORATION +perfil I-EXPLORATION +ENA I-EXPLORATION +negativos I-EXPLORATION +con I-EXPLORATION +complemento I-EXPLORATION +normal. I-EXPLORATION +La I-EXPLORATION +paciente I-EXPLORATION +continuó I-EXPLORATION +con I-EXPLORATION +fiebre I-EXPLORATION +y I-EXPLORATION +pruebas I-EXPLORATION +hepáticas I-EXPLORATION +en I-EXPLORATION +deterioro. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +TAC I-EXPLORATION +de I-EXPLORATION +tórax, I-EXPLORATION +abdomen I-EXPLORATION +y I-EXPLORATION +pelvis I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +linfonodos I-EXPLORATION +pequeños I-EXPLORATION +difusos, I-EXPLORATION +derrame I-EXPLORATION +pleural I-EXPLORATION +laminar I-EXPLORATION +bilateral I-EXPLORATION +y I-EXPLORATION +hepatoesplenomegalia. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +biopsia I-EXPLORATION +de I-EXPLORATION +linfonodos I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +adenitis I-EXPLORATION +no I-EXPLORATION +específica. I-EXPLORATION +Los I-EXPLORATION +niveles I-EXPLORATION +de I-EXPLORATION +ferritina I-EXPLORATION +resultaron I-EXPLORATION +en I-EXPLORATION +23.460 I-EXPLORATION +U/L. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +estudio I-EXPLORATION +medular I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +hiperplasia I-EXPLORATION +linfoide I-EXPLORATION +y I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +abundantes I-EXPLORATION +hemofagocitos. I-EXPLORATION +La B-TREATMENT +paciente I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +protocolo I-TREATMENT +HLH I-TREATMENT +04 I-TREATMENT +con I-TREATMENT +buena I-TREATMENT +respuesta I-TREATMENT +clínica, I-TREATMENT +con I-TREATMENT +normalización I-TREATMENT +de I-TREATMENT +pruebas I-TREATMENT +hepáticas I-TREATMENT +y I-TREATMENT +descenso I-TREATMENT +de I-TREATMENT +la I-TREATMENT +ferritina I-TREATMENT +hasta I-TREATMENT +valores I-TREATMENT +normales. I-TREATMENT +Al B-EVOLUTION +momento I-EVOLUTION +de I-EVOLUTION +redactar I-EVOLUTION +este I-EVOLUTION +reporte I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +lleva I-EVOLUTION +24 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +tratamiento I-EVOLUTION +sin I-EVOLUTION +complicaciones I-EVOLUTION +y I-EVOLUTION +con I-EVOLUTION +buena I-EVOLUTION +calidad I-EVOLUTION +de I-EVOLUTION +vida. I-EVOLUTION +La I-EVOLUTION +paciente I-EVOLUTION +no I-EVOLUTION +dispone I-EVOLUTION +de I-EVOLUTION +hermanos I-EVOLUTION +HLA I-EVOLUTION +compatibles. I-EVOLUTION + I-EVOLUTION + +Familia B-PRESENT_ILLNESS +afectada I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +madre. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Estudio I-PRESENT_ILLNESS +molecular I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +hormonal. I-PRESENT_ILLNESS +El B-FAMILY_HISTORY +estudio I-FAMILY_HISTORY +hormonal I-FAMILY_HISTORY +de I-FAMILY_HISTORY +la I-FAMILY_HISTORY +tía I-FAMILY_HISTORY +y I-FAMILY_HISTORY +de I-FAMILY_HISTORY +la I-FAMILY_HISTORY +madre I-FAMILY_HISTORY +del I-FAMILY_HISTORY +probando I-FAMILY_HISTORY +(sujetos I-FAMILY_HISTORY +II. I-FAMILY_HISTORY +2 I-FAMILY_HISTORY +y I-FAMILY_HISTORY +II. I-FAMILY_HISTORY +3) I-FAMILY_HISTORY +incluyó I-FAMILY_HISTORY +una I-FAMILY_HISTORY +prueba I-FAMILY_HISTORY +de I-FAMILY_HISTORY +ACTH, I-FAMILY_HISTORY +cuyos I-FAMILY_HISTORY +valores I-FAMILY_HISTORY +de I-FAMILY_HISTORY +170H I-FAMILY_HISTORY +Progesterona I-FAMILY_HISTORY +basal I-FAMILY_HISTORY +y I-FAMILY_HISTORY +estimulado I-FAMILY_HISTORY +fueron I-FAMILY_HISTORY +normales, I-FAMILY_HISTORY +no I-FAMILY_HISTORY +permitiendo I-FAMILY_HISTORY +aclarar I-FAMILY_HISTORY +si I-FAMILY_HISTORY +estos I-FAMILY_HISTORY +sujetos I-FAMILY_HISTORY +eran I-FAMILY_HISTORY +heterocigotos I-FAMILY_HISTORY +de I-FAMILY_HISTORY +una I-FAMILY_HISTORY +mutación I-FAMILY_HISTORY +del I-FAMILY_HISTORY +CYP21A2. I-FAMILY_HISTORY + I-FAMILY_HISTORY +El B-EXPLORATION +estudio I-EXPLORATION +molecular I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +en I-EXPLORATION +ADN I-EXPLORATION +genómi-co I-EXPLORATION +extraído I-EXPLORATION +de I-EXPLORATION +leucocitos I-EXPLORATION +y I-EXPLORATION +las I-EXPLORATION +siete I-EXPLORATION +mutaciones I-EXPLORATION +más I-EXPLORATION +frecuentes I-EXPLORATION +del I-EXPLORATION +gen I-EXPLORATION +CYP21A2 I-EXPLORATION +fueron I-EXPLORATION +estudiadas I-EXPLORATION +con I-EXPLORATION +PCR I-EXPLORATION +alelo I-EXPLORATION +específica I-EXPLORATION +(Fardella, I-EXPLORATION +1998). I-EXPLORATION +Este B-FAMILY_HISTORY +estudio I-FAMILY_HISTORY +demostró I-FAMILY_HISTORY +en I-FAMILY_HISTORY +la I-FAMILY_HISTORY +familia I-FAMILY_HISTORY +paterna I-FAMILY_HISTORY +(sujetos I-FAMILY_HISTORY +II.2, I-FAMILY_HISTORY +II.4, I-FAMILY_HISTORY +II.6) I-FAMILY_HISTORY +la I-FAMILY_HISTORY +mutación I-FAMILY_HISTORY +Q318X I-FAMILY_HISTORY +en I-FAMILY_HISTORY +el I-FAMILY_HISTORY +exón I-FAMILY_HISTORY +8, I-FAMILY_HISTORY +que I-FAMILY_HISTORY +consiste I-FAMILY_HISTORY +en I-FAMILY_HISTORY +el I-FAMILY_HISTORY +cambio I-FAMILY_HISTORY +de I-FAMILY_HISTORY +una I-FAMILY_HISTORY +glutamina I-FAMILY_HISTORY +por I-FAMILY_HISTORY +un I-FAMILY_HISTORY +codón I-FAMILY_HISTORY +de I-FAMILY_HISTORY +stop. I-FAMILY_HISTORY +Este I-FAMILY_HISTORY +resultado I-FAMILY_HISTORY +no I-FAMILY_HISTORY +permitió I-FAMILY_HISTORY +clasificar I-FAMILY_HISTORY +a I-FAMILY_HISTORY +la I-FAMILY_HISTORY +familia I-FAMILY_HISTORY +materna I-FAMILY_HISTORY +y I-FAMILY_HISTORY +por I-FAMILY_HISTORY +ende I-FAMILY_HISTORY +decidir I-FAMILY_HISTORY +sobre I-FAMILY_HISTORY +la I-FAMILY_HISTORY +necesidad I-FAMILY_HISTORY +del I-FAMILY_HISTORY +tratamiento I-FAMILY_HISTORY +prenatal I-FAMILY_HISTORY +en I-FAMILY_HISTORY +estas I-FAMILY_HISTORY +parejas. I-FAMILY_HISTORY + I-FAMILY_HISTORY +Posteriormente, B-EXPLORATION +el I-EXPLORATION +gen I-EXPLORATION +CYP21A2fue I-EXPLORATION +secuenciado I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +Universidad I-EXPLORATION +de I-EXPLORATION +Sao I-EXPLORATION +Paulo I-EXPLORATION +según I-EXPLORATION +las I-EXPLORATION +técnicas I-EXPLORATION +clásicas I-EXPLORATION +(Wedell, I-EXPLORATION +1993). I-EXPLORATION +Usando B-FAMILY_HISTORY +esta I-FAMILY_HISTORY +metodología, I-FAMILY_HISTORY +se I-FAMILY_HISTORY +encontró I-FAMILY_HISTORY +en I-FAMILY_HISTORY +uno I-FAMILY_HISTORY +de I-FAMILY_HISTORY +los I-FAMILY_HISTORY +alelos I-FAMILY_HISTORY +de I-FAMILY_HISTORY +la I-FAMILY_HISTORY +familia I-FAMILY_HISTORY +paterna I-FAMILY_HISTORY +(sujetos I-FAMILY_HISTORY +II.2, I-FAMILY_HISTORY +II.4, I-FAMILY_HISTORY +II.6) I-FAMILY_HISTORY +la I-FAMILY_HISTORY +mutación I-FAMILY_HISTORY +Q318X I-FAMILY_HISTORY +junto I-FAMILY_HISTORY +a I-FAMILY_HISTORY +la I-FAMILY_HISTORY +mutación I-FAMILY_HISTORY +R483W, I-FAMILY_HISTORY +la I-FAMILY_HISTORY +que I-FAMILY_HISTORY +consiste I-FAMILY_HISTORY +en I-FAMILY_HISTORY +la I-FAMILY_HISTORY +sustitución I-FAMILY_HISTORY +de I-FAMILY_HISTORY +una I-FAMILY_HISTORY +arginina I-FAMILY_HISTORY +por I-FAMILY_HISTORY +triptofano I-FAMILY_HISTORY +(CGG>TGG). I-FAMILY_HISTORY +En I-FAMILY_HISTORY +la I-FAMILY_HISTORY +familia I-FAMILY_HISTORY +materna I-FAMILY_HISTORY +(sujetos I-FAMILY_HISTORY +II. I-FAMILY_HISTORY +1, I-FAMILY_HISTORY +II.3, I-FAMILY_HISTORY +II.5) I-FAMILY_HISTORY +se I-FAMILY_HISTORY +encontró I-FAMILY_HISTORY +un I-FAMILY_HISTORY +alelo I-FAMILY_HISTORY +con I-FAMILY_HISTORY +la I-FAMILY_HISTORY +mutación I-FAMILY_HISTORY +R483->frameshift, I-FAMILY_HISTORY +también I-FAMILY_HISTORY +conocida I-FAMILY_HISTORY +como I-FAMILY_HISTORY +R483delGGinsC, I-FAMILY_HISTORY +la I-FAMILY_HISTORY +cuál I-FAMILY_HISTORY +consiste I-FAMILY_HISTORY +en I-FAMILY_HISTORY +el I-FAMILY_HISTORY +cambio I-FAMILY_HISTORY +de I-FAMILY_HISTORY +los I-FAMILY_HISTORY +nucleótidos I-FAMILY_HISTORY +GG I-FAMILY_HISTORY +por I-FAMILY_HISTORY +C, I-FAMILY_HISTORY +alterando I-FAMILY_HISTORY +la I-FAMILY_HISTORY +lectura I-FAMILY_HISTORY +del I-FAMILY_HISTORY +codón. I-FAMILY_HISTORY +De I-FAMILY_HISTORY +este I-FAMILY_HISTORY +modo I-FAMILY_HISTORY +se I-FAMILY_HISTORY +certificó I-FAMILY_HISTORY +que I-FAMILY_HISTORY +los I-FAMILY_HISTORY +seis I-FAMILY_HISTORY +cónyuges I-FAMILY_HISTORY +poseen I-FAMILY_HISTORY +mutaciones I-FAMILY_HISTORY +para I-FAMILY_HISTORY +HSC I-FAMILY_HISTORY +perdedora I-FAMILY_HISTORY +de I-FAMILY_HISTORY +sal, I-FAMILY_HISTORY +y I-FAMILY_HISTORY +por I-FAMILY_HISTORY +lo I-FAMILY_HISTORY +tanto, I-FAMILY_HISTORY +se I-FAMILY_HISTORY +encuentran I-FAMILY_HISTORY +en I-FAMILY_HISTORY +riesgo I-FAMILY_HISTORY +de I-FAMILY_HISTORY +tener I-FAMILY_HISTORY +hijas I-FAMILY_HISTORY +con I-FAMILY_HISTORY +ambigüedad I-FAMILY_HISTORY +genital. I-FAMILY_HISTORY + I-FAMILY_HISTORY +Consejo B-TREATMENT +genético I-TREATMENT +y I-TREATMENT +manejo I-TREATMENT +de I-TREATMENT +los I-TREATMENT +embarazos. I-TREATMENT +Se I-TREATMENT +procede I-TREATMENT +a I-TREATMENT +dar I-TREATMENT +consejo I-TREATMENT +genético I-TREATMENT +a I-TREATMENT +los I-TREATMENT +tres I-TREATMENT +matrimonios I-TREATMENT +afectados. I-TREATMENT +La B-EVOLUTION +tía I-EVOLUTION +paterna I-EVOLUTION +(sujeto I-EVOLUTION +II.2), I-EVOLUTION +mujer I-EVOLUTION +sana I-EVOLUTION +de I-EVOLUTION +34 I-EVOLUTION +años, I-EVOLUTION +suspende I-EVOLUTION +el I-EVOLUTION +método I-EVOLUTION +anticonceptivo I-EVOLUTION +por I-EVOLUTION +deseos I-EVOLUTION +de I-EVOLUTION +fertilidad I-EVOLUTION +y I-EVOLUTION +logra I-EVOLUTION +concepción I-EVOLUTION +espontánea I-EVOLUTION +en I-EVOLUTION +marzo I-EVOLUTION +2005. I-EVOLUTION +Se B-TREATMENT +explican I-TREATMENT +los I-TREATMENT +beneficios I-TREATMENT +y I-TREATMENT +riesgos I-TREATMENT +del I-TREATMENT +tratamiento I-TREATMENT +prenatal I-TREATMENT +con I-TREATMENT +corti-coides, I-TREATMENT +los I-TREATMENT +que I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +entiende I-TREATMENT +y I-TREATMENT +acepta, I-TREATMENT +firmando I-TREATMENT +un I-TREATMENT +consentimiento I-TREATMENT +en I-TREATMENT +que I-TREATMENT +opta I-TREATMENT +por I-TREATMENT +realizar I-TREATMENT +esta I-TREATMENT +terapia. I-TREATMENT +El I-TREATMENT +tratamiento I-TREATMENT +comenzó I-TREATMENT +a I-TREATMENT +las I-TREATMENT +6 I-TREATMENT +semanas I-TREATMENT +de I-TREATMENT +edad I-TREATMENT +gestacional I-TREATMENT +(EG) I-TREATMENT +con I-TREATMENT +dexametasona I-TREATMENT +en I-TREATMENT +dosis I-TREATMENT +de I-TREATMENT +20 I-TREATMENT +µg/kg/día. I-TREATMENT + I-TREATMENT +A B-EXPLORATION +las I-EXPLORATION +13 I-EXPLORATION +semanas I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +sexo I-EXPLORATION +fetal I-EXPLORATION +masculino I-EXPLORATION +por I-EXPLORATION +ultrasonografía I-EXPLORATION +de I-EXPLORATION +alta I-EXPLORATION +resolución I-EXPLORATION +(Voluson I-EXPLORATION +730, I-EXPLORATION +General I-EXPLORATION +Electric, I-EXPLORATION +Austria, I-EXPLORATION +transductor I-EXPLORATION +transabdominal I-EXPLORATION +de I-EXPLORATION +3, I-EXPLORATION +5-5 I-EXPLORATION +MHz), I-EXPLORATION +la I-EXPLORATION +cual I-EXPLORATION +es I-EXPLORATION +capaz I-EXPLORATION +de I-EXPLORATION +predecir I-EXPLORATION +conectamente I-EXPLORATION +el I-EXPLORATION +sexo I-EXPLORATION +fetal I-EXPLORATION +con I-EXPLORATION +99% I-EXPLORATION +de I-EXPLORATION +certeza I-EXPLORATION +después I-EXPLORATION +de I-EXPLORATION +12+6 I-EXPLORATION +semanas I-EXPLORATION +EG I-EXPLORATION +(Efrat, I-EXPLORATION +2006); I-EXPLORATION +la I-EXPLORATION +familia I-EXPLORATION +no I-EXPLORATION +aceptó I-EXPLORATION +técnicas I-EXPLORATION +invasivas I-EXPLORATION +de I-EXPLORATION +diagnóstico I-EXPLORATION +prenatal. I-EXPLORATION +Se B-TREATMENT +disminuyó I-TREATMENT +progresivamente I-TREATMENT +las I-TREATMENT +dosis I-TREATMENT +de I-TREATMENT +esteroides, I-TREATMENT +suspendiéndolo I-TREATMENT +en I-TREATMENT +forma I-TREATMENT +completa I-TREATMENT +a I-TREATMENT +las I-TREATMENT +22 I-TREATMENT +semanas. I-TREATMENT +Durante B-EVOLUTION +el I-EVOLUTION +período I-EVOLUTION +de I-EVOLUTION +tratamiento I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +presentó I-EVOLUTION +edema I-EVOLUTION +e I-EVOLUTION +hipertensión I-EVOLUTION +arterial I-EVOLUTION +que B-TREATMENT +requirió I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +ametildo-pa. I-TREATMENT +Los B-EVOLUTION +síntomas I-EVOLUTION +revirtieron I-EVOLUTION +parcialmente I-EVOLUTION +con I-EVOLUTION +la I-EVOLUTION +suspensión I-EVOLUTION +de I-EVOLUTION +terapia I-EVOLUTION +corticoidal, I-EVOLUTION +y I-EVOLUTION +totalmente I-EVOLUTION +posparto. I-EVOLUTION +A I-EVOLUTION +las I-EVOLUTION +39 I-EVOLUTION +semanas I-EVOLUTION +se I-EVOLUTION +realizó I-EVOLUTION +cesárea I-EVOLUTION +y I-EVOLUTION +se I-EVOLUTION +obtuvo I-EVOLUTION +recién I-EVOLUTION +nacido I-EVOLUTION +de I-EVOLUTION +sexo I-EVOLUTION +masculino, I-EVOLUTION +con I-EVOLUTION +peso I-EVOLUTION +adecuado I-EVOLUTION +y I-EVOLUTION +examen I-EVOLUTION +físico I-EVOLUTION +normal. I-EVOLUTION +Los I-EVOLUTION +niveles I-EVOLUTION +de I-EVOLUTION +170HP I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +5 I-EVOLUTION +días I-EVOLUTION +se I-EVOLUTION +muestran I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +Figura I-EVOLUTION +IB. I-EVOLUTION + I-EVOLUTION +La I-EVOLUTION +tía I-EVOLUTION +materna I-EVOLUTION +(sujeto I-EVOLUTION +II.5) I-EVOLUTION +de I-EVOLUTION +37 I-EVOLUTION +años I-EVOLUTION +consultó I-EVOLUTION +por I-EVOLUTION +embarazo I-EVOLUTION +inicial I-EVOLUTION +de I-EVOLUTION +5 I-EVOLUTION +semanas I-EVOLUTION +de I-EVOLUTION +EG. I-EVOLUTION +Se B-TREATMENT +ofrece I-TREATMENT +nuevamente I-TREATMENT +tratamiento I-TREATMENT +prenatal I-TREATMENT +de I-TREATMENT +HSC, I-TREATMENT +y I-TREATMENT +también I-TREATMENT +se I-TREATMENT +solicitó I-TREATMENT +firma I-TREATMENT +de I-TREATMENT +consentimiento I-TREATMENT +informado. I-TREATMENT +La I-TREATMENT +familia I-TREATMENT +optó I-TREATMENT +nuevamente I-TREATMENT +por I-TREATMENT +seguir I-TREATMENT +este I-TREATMENT +tratamiento. I-TREATMENT +A I-TREATMENT +las I-TREATMENT +6 I-TREATMENT +semanas I-TREATMENT +de I-TREATMENT +EG I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +dexametasona I-TREATMENT +en I-TREATMENT +dosis I-TREATMENT +de I-TREATMENT +20 I-TREATMENT +Lig/kg/día. I-TREATMENT +La B-EXPLORATION +madre I-EXPLORATION +no I-EXPLORATION +aceptó I-EXPLORATION +las I-EXPLORATION +técnicas I-EXPLORATION +invasivas I-EXPLORATION +de I-EXPLORATION +diagnóstico I-EXPLORATION +prenatal I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +decidió I-EXPLORATION +realizar I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +sexo I-EXPLORATION +fetal I-EXPLORATION +mediante I-EXPLORATION +ecografía I-EXPLORATION +precoz. I-EXPLORATION +En B-TREATMENT +caso I-TREATMENT +de I-TREATMENT +que I-TREATMENT +se I-TREATMENT +tratara I-TREATMENT +de I-TREATMENT +un I-TREATMENT +feto I-TREATMENT +femenino I-TREATMENT +continuarían I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +hasta I-TREATMENT +el I-TREATMENT +término I-TREATMENT +del I-TREATMENT +embarazo. I-TREATMENT +A I-TREATMENT +las I-TREATMENT +12 I-TREATMENT +semanas I-TREATMENT +se I-TREATMENT +diagnosticó I-TREATMENT +sexo I-TREATMENT +fetal I-TREATMENT +masculino I-TREATMENT +y I-TREATMENT +se I-TREATMENT +programó I-TREATMENT +suspensión I-TREATMENT +de I-TREATMENT +esteroides. I-TREATMENT +La B-EVOLUTION +paciente I-EVOLUTION +no I-EVOLUTION +presentó I-EVOLUTION +efectos I-EVOLUTION +adversos I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +dexametasona. I-EVOLUTION +A I-EVOLUTION +las I-EVOLUTION +40 I-EVOLUTION +semanas I-EVOLUTION +nació I-EVOLUTION +niño I-EVOLUTION +sano, I-EVOLUTION +no I-EVOLUTION +afectado. I-EVOLUTION + I-EVOLUTION + +Paciente B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +26 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +IMC B-PAST_MEDICAL_HISTORY +21, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +legrado I-PAST_MEDICAL_HISTORY +uterino I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +aborto I-PAST_MEDICAL_HISTORY +provocado I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +primer I-PAST_MEDICAL_HISTORY +trimestre, I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +17 I-PAST_MEDICAL_HISTORY +años. I-PAST_MEDICAL_HISTORY +Consultó B-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +marzo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2007 I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +historia I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +siete I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dismenorrea I-PRESENT_ILLNESS +invalidante, I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +pesar I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +uso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +anticonceptivos I-PRESENT_ILLNESS +orales, I-PRESENT_ILLNESS +polimenorrea I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +hipermenorrea I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +últimos I-PRESENT_ILLNESS +ciclos I-PRESENT_ILLNESS +menstruales, I-PRESENT_ILLNESS +refriendo I-PRESENT_ILLNESS +además I-PRESENT_ILLNESS +dispareunia. I-PRESENT_ILLNESS +Examen B-EXPLORATION +físico I-EXPLORATION +general I-EXPLORATION +y I-EXPLORATION +ginecológico I-EXPLORATION +normal I-EXPLORATION +en I-EXPLORATION +primera I-EXPLORATION +consulta. I-EXPLORATION +Se I-EXPLORATION +solicitó I-EXPLORATION +ecotomografía I-EXPLORATION +transvaginal I-EXPLORATION +que I-EXPLORATION +mostraba I-EXPLORATION +toda I-EXPLORATION +la I-EXPLORATION +cavidad I-EXPLORATION +endometrial I-EXPLORATION +ocupada I-EXPLORATION +por I-EXPLORATION +imagen I-EXPLORATION +hiperecogénica I-EXPLORATION +lineal I-EXPLORATION +con I-EXPLORATION +sombra I-EXPLORATION +acústica I-EXPLORATION +posterior, I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +extensa I-EXPLORATION +metaplasia I-EXPLORATION +ósea. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +histeroscopía I-EXPLORATION +mostró I-EXPLORATION +cavidad I-EXPLORATION +uterina I-EXPLORATION +de I-EXPLORATION +7, I-EXPLORATION +5 I-EXPLORATION +cm, I-EXPLORATION +poco I-EXPLORATION +distensible, I-EXPLORATION +revestida I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +totalidad I-EXPLORATION +por I-EXPLORATION +múltiples I-EXPLORATION +fragmentos I-EXPLORATION +espiculados I-EXPLORATION +de I-EXPLORATION +aspecto I-EXPLORATION +y I-EXPLORATION +consistencia I-EXPLORATION +ósea. I-EXPLORATION +Se B-TREATMENT +realizó I-TREATMENT +extracción I-TREATMENT +de I-TREATMENT +éstos I-TREATMENT +con I-TREATMENT +asa I-TREATMENT +de I-TREATMENT +resectoscopio I-TREATMENT +asistido I-TREATMENT +con I-TREATMENT +cucharilla I-TREATMENT +N° I-TREATMENT +2 I-TREATMENT +y I-TREATMENT +pinza I-TREATMENT +Randall, I-TREATMENT +sin I-TREATMENT +incidentes. I-TREATMENT +Posteriormente B-EVOLUTION +se I-EVOLUTION +observó I-EVOLUTION +cavidad I-EVOLUTION +endometrial I-EVOLUTION +sana I-EVOLUTION +y I-EVOLUTION +ostium I-EVOLUTION +tubarios I-EVOLUTION +permeables. I-EVOLUTION + I-EVOLUTION +Su B-EXPLORATION +laparoscopía I-EXPLORATION +exploradora I-EXPLORATION +mostró I-EXPLORATION +pelvis I-EXPLORATION +sana, I-EXPLORATION +útero I-EXPLORATION +y I-EXPLORATION +anexos I-EXPLORATION +normales, I-EXPLORATION +con I-EXPLORATION +buena I-EXPLORATION +relación I-EXPLORATION +tubo I-EXPLORATION +ovárica. I-EXPLORATION +Trompas I-EXPLORATION +permeables I-EXPLORATION +con I-EXPLORATION +índigo I-EXPLORATION +carmín. I-EXPLORATION + I-EXPLORATION +Biopsia I-EXPLORATION +operatoria I-EXPLORATION +estuvo I-EXPLORATION +constituida I-EXPLORATION +por I-EXPLORATION +fragmentos I-EXPLORATION +de I-EXPLORATION +tejido I-EXPLORATION +óseo I-EXPLORATION +maduro, I-EXPLORATION +reconociéndose I-EXPLORATION +además I-EXPLORATION +colonias I-EXPLORATION +de I-EXPLORATION +tipo I-EXPLORATION +Actinomyces. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +observaban I-EXPLORATION +evidencias I-EXPLORATION +de I-EXPLORATION +neoplasia. I-EXPLORATION +Los I-EXPLORATION +hallazgos I-EXPLORATION +fueron I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION +metaplasia I-EXPLORATION +ósea I-EXPLORATION +del I-EXPLORATION +endometrio. I-EXPLORATION +Se B-TREATMENT +indicaron I-TREATMENT +anticonceptivos I-TREATMENT +orales I-TREATMENT +hasta I-TREATMENT +deseo I-TREATMENT +de I-TREATMENT +embarazo. I-TREATMENT + I-TREATMENT +Una B-EXPLORATION +histerosonografía I-EXPLORATION +tres I-EXPLORATION +meses I-EXPLORATION +post I-EXPLORATION +cirugía I-EXPLORATION +mostraba I-EXPLORATION +cavidad I-EXPLORATION +uterina I-EXPLORATION +normal. I-EXPLORATION + I-EXPLORATION +En B-TREATMENT +agosto I-TREATMENT +de I-TREATMENT +2008 I-TREATMENT +consultó I-TREATMENT +cursando I-TREATMENT +embarazo I-TREATMENT +espontáneo I-TREATMENT +único I-TREATMENT +de I-TREATMENT +6 I-TREATMENT +semanas I-TREATMENT +de I-TREATMENT +gestación I-TREATMENT +confirmado I-TREATMENT +ecográficamente. I-TREATMENT +A I-TREATMENT +las I-TREATMENT +39 I-TREATMENT +semanas I-TREATMENT +de I-TREATMENT +gestación, I-TREATMENT +se I-TREATMENT +obtuvo I-TREATMENT +un I-TREATMENT +recién I-TREATMENT +nacido I-TREATMENT +sano I-TREATMENT +de I-TREATMENT +3.380 I-TREATMENT +g I-TREATMENT +mediante I-TREATMENT +operación I-TREATMENT +cesárea I-TREATMENT +por I-TREATMENT +prueba I-TREATMENT +de I-TREATMENT +trabajo I-TREATMENT +de I-TREATMENT +parto I-TREATMENT +fracasada. I-TREATMENT +Durante I-TREATMENT +la I-TREATMENT +misma, I-TREATMENT +se I-TREATMENT +produjo I-TREATMENT +inercia I-TREATMENT +uterina I-TREATMENT +que I-TREATMENT +logró I-TREATMENT +ser I-TREATMENT +revertida I-TREATMENT +con I-TREATMENT +uso I-TREATMENT +de I-TREATMENT +retractores I-TREATMENT +en I-TREATMENT +altas I-TREATMENT +dosis. I-TREATMENT + I-TREATMENT + +Hombre B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +27 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +secuelas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +trauma I-PRESENT_ILLNESS +contundente I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +hemicara I-PRESENT_ILLNESS +izquierda, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +fractura I-PRESENT_ILLNESS +blow-out I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +tratada. I-PRESENT_ILLNESS +Como B-EXPLORATION +consecuencia I-EXPLORATION +presentó I-EXPLORATION +enoftalmos, I-EXPLORATION +distopia I-EXPLORATION +y I-EXPLORATION +diplopia I-EXPLORATION +izquierdas I-EXPLORATION +; I-EXPLORATION +18 B-TREATMENT +meses I-TREATMENT +posterior I-TREATMENT +al I-TREATMENT +trauma I-TREATMENT +se I-TREATMENT +realiza I-TREATMENT +la I-TREATMENT +corrección I-TREATMENT +de I-TREATMENT +dichas I-TREATMENT +secuelas I-TREATMENT +mediante I-TREATMENT +la I-TREATMENT +colocación I-TREATMENT +de I-TREATMENT +injerto I-TREATMENT +escalonado I-TREATMENT +de I-TREATMENT +calota I-TREATMENT +en I-TREATMENT +suelo I-TREATMENT +de I-TREATMENT +órbita, I-TREATMENT +previo I-TREATMENT +abordaje I-TREATMENT +transconjuntival I-TREATMENT +izquierdo. I-TREATMENT +Observándose B-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +evaluación I-EVOLUTION +postoperatoria I-EVOLUTION +mejoría I-EVOLUTION +estética I-EVOLUTION +y I-EVOLUTION +funcional I-EVOLUTION +importante I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +condiciones I-EVOLUTION +ya I-EVOLUTION +descritas. I-EVOLUTION + I-EVOLUTION + +Paciente B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +68 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +médicos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +ingresa I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +nuestro I-PRESENT_ILLNESS +servicio I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +litiasis I-PRESENT_ILLNESS +piélica I-PRESENT_ILLNESS +izquierda. I-PRESENT_ILLNESS +El I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +refiere I-PRESENT_ILLNESS +nicturia I-PRESENT_ILLNESS +3-4, I-PRESENT_ILLNESS +polaquiuria, I-PRESENT_ILLNESS +escozor I-PRESENT_ILLNESS +miccional I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +episodios I-PRESENT_ILLNESS +aislados I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +hematuria. I-PRESENT_ILLNESS +La B-EXPLORATION +exploración I-EXPLORATION +física, I-EXPLORATION +el I-EXPLORATION +sistemático I-EXPLORATION +de I-EXPLORATION +sangre I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +bioquímica I-EXPLORATION +están I-EXPLORATION +dentro I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +normalidad. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +radiografía I-EXPLORATION +simple I-EXPLORATION +de I-EXPLORATION +aparato I-EXPLORATION +urinario, I-EXPLORATION +se I-EXPLORATION +visualiza I-EXPLORATION +una I-EXPLORATION +imagen I-EXPLORATION +radiopaca I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +de I-EXPLORATION +riñón I-EXPLORATION +izquierdo. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION +se I-EXPLORATION +aprecia I-EXPLORATION +una I-EXPLORATION +imagen I-EXPLORATION +anecóica I-EXPLORATION +que I-EXPLORATION +afecta I-EXPLORATION +a I-EXPLORATION +todo I-EXPLORATION +el I-EXPLORATION +riñón I-EXPLORATION +derecho, I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +hidronefrosis I-EXPLORATION +e I-EXPLORATION +importante I-EXPLORATION +atrofia I-EXPLORATION +cortical. I-EXPLORATION +En I-EXPLORATION +riñón I-EXPLORATION +izquierdo I-EXPLORATION +se I-EXPLORATION +visualiza I-EXPLORATION +hidronefrosis I-EXPLORATION +izquierda, I-EXPLORATION +con I-EXPLORATION +imágenes I-EXPLORATION +ecogénicas I-EXPLORATION +en I-EXPLORATION +pelvis, I-EXPLORATION +cálices I-EXPLORATION +medios I-EXPLORATION +e I-EXPLORATION +inferiores I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION +cálculos. I-EXPLORATION +Ante I-EXPLORATION +estos I-EXPLORATION +hallazgos I-EXPLORATION +se I-EXPLORATION +realiza I-EXPLORATION +una I-EXPLORATION +urografía I-EXPLORATION +intravenosa, I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +distinguen I-EXPLORATION +un I-EXPLORATION +riñón I-EXPLORATION +derecho I-EXPLORATION +no I-EXPLORATION +funcionante I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +bifidez I-EXPLORATION +pieloureteral, I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +litiasis I-EXPLORATION +coraliforme I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +pielón I-EXPLORATION +inferior I-EXPLORATION +izquierdo. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +TAC I-EXPLORATION +abdomino-pélvico, I-EXPLORATION +el I-EXPLORATION +riñón I-EXPLORATION +derecho I-EXPLORATION +aparece I-EXPLORATION +como I-EXPLORATION +una I-EXPLORATION +gran I-EXPLORATION +cavidad I-EXPLORATION +quística, I-EXPLORATION +sin I-EXPLORATION +evidencia I-EXPLORATION +de I-EXPLORATION +cortical I-EXPLORATION +funcionante. I-EXPLORATION +El I-EXPLORATION +riñón I-EXPLORATION +izquierdo I-EXPLORATION +presenta I-EXPLORATION +hipertrofia I-EXPLORATION +compensadora, I-EXPLORATION +con I-EXPLORATION +varias I-EXPLORATION +lesiones I-EXPLORATION +quísticas I-EXPLORATION +corticales I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +polo I-EXPLORATION +superior I-EXPLORATION +y I-EXPLORATION +cálculos I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +polo I-EXPLORATION +inferior. I-EXPLORATION +Se I-EXPLORATION +decide I-EXPLORATION +practicar I-EXPLORATION +punción I-EXPLORATION +percutánea I-EXPLORATION +bilateral, I-EXPLORATION +observando I-EXPLORATION +gran I-EXPLORATION +dilatación I-EXPLORATION +de I-EXPLORATION +riñón I-EXPLORATION +derecho, I-EXPLORATION +sin I-EXPLORATION +paso I-EXPLORATION +de I-EXPLORATION +contraste I-EXPLORATION +al I-EXPLORATION +uréter I-EXPLORATION +y I-EXPLORATION +bifidez I-EXPLORATION +pieloureteral I-EXPLORATION +del I-EXPLORATION +riñón I-EXPLORATION +izquierdo, I-EXPLORATION +con I-EXPLORATION +litiasis I-EXPLORATION +coraliforme I-EXPLORATION +en I-EXPLORATION +pielón I-EXPLORATION +inferior. I-EXPLORATION +Se B-TREATMENT +deja I-TREATMENT +colocada I-TREATMENT +una I-TREATMENT +sonda I-TREATMENT +de I-TREATMENT +nefrostomía I-TREATMENT +en I-TREATMENT +el I-TREATMENT +lado I-TREATMENT +izquierdo I-TREATMENT +y I-TREATMENT +se I-TREATMENT +instaura I-TREATMENT +tratamiento I-TREATMENT +antibiótico, I-TREATMENT +al I-TREATMENT +extraer I-TREATMENT +orina I-TREATMENT +purulenta I-TREATMENT +en I-TREATMENT +la I-TREATMENT +descarga I-TREATMENT +del I-TREATMENT +pielón I-TREATMENT +inferior. I-TREATMENT +La B-EXPLORATION +gammagrafía I-EXPLORATION +renal I-EXPLORATION +confirma I-EXPLORATION +la I-EXPLORATION +escasa I-EXPLORATION +función I-EXPLORATION +riñón I-EXPLORATION +derecho I-EXPLORATION +(11%). I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +cistoscopia I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +objetivan I-EXPLORATION +neorformaciones I-EXPLORATION +vesicales. I-EXPLORATION + I-EXPLORATION +Tras B-TREATMENT +estudios I-TREATMENT +preoperatorios I-TREATMENT +dentro I-TREATMENT +de I-TREATMENT +la I-TREATMENT +normalidad I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +es I-TREATMENT +intervenido I-TREATMENT +quirúrgicamente I-TREATMENT +realizándose I-TREATMENT +nefrolitotomía I-TREATMENT +percutánea I-TREATMENT +izquierda, I-TREATMENT +con I-TREATMENT +fragmentación I-TREATMENT +de I-TREATMENT +litiasis I-TREATMENT +con I-TREATMENT +lithoclast I-TREATMENT +y I-TREATMENT +extracción I-TREATMENT +de I-TREATMENT +fragmentos. I-TREATMENT +A I-TREATMENT +los I-TREATMENT +quince I-TREATMENT +días I-TREATMENT +se I-TREATMENT +lleva I-TREATMENT +a I-TREATMENT +cabo I-TREATMENT +una I-TREATMENT +nueva I-TREATMENT +nefrolitotomía I-TREATMENT +con I-TREATMENT +el I-TREATMENT +fin I-TREATMENT +de I-TREATMENT +eliminar I-TREATMENT +todos I-TREATMENT +los I-TREATMENT +restos I-TREATMENT +litiásicos. I-TREATMENT + I-TREATMENT +El B-EVOLUTION +paciente I-EVOLUTION +continúa I-EVOLUTION +eliminando I-EVOLUTION +orina I-EVOLUTION +purulenta I-EVOLUTION +por I-EVOLUTION +sonda I-EVOLUTION +de I-EVOLUTION +nefrostomía I-EVOLUTION +percutánea. I-EVOLUTION +La B-EXPLORATION +angiografía I-EXPLORATION +por I-EXPLORATION +sustracción I-EXPLORATION +digital' I-EXPLORATION +(DIVAS) I-EXPLORATION +demuestra I-EXPLORATION +una I-EXPLORATION +escasa I-EXPLORATION +vascularización I-EXPLORATION +del I-EXPLORATION +polo I-EXPLORATION +inferior I-EXPLORATION +de I-EXPLORATION +riñón I-EXPLORATION +izquierdo. I-EXPLORATION +El B-TREATMENT +paciente I-TREATMENT +es I-TREATMENT +sometido I-TREATMENT +a I-TREATMENT +una I-TREATMENT +heminefrectomía I-TREATMENT +polar I-TREATMENT +inferior I-TREATMENT +izquierda. I-TREATMENT +En I-TREATMENT +el I-TREATMENT +postoperatorio I-TREATMENT +inmediato I-TREATMENT +se I-TREATMENT +produce I-TREATMENT +un I-TREATMENT +empeoramiento I-TREATMENT +de I-TREATMENT +la I-TREATMENT +función I-TREATMENT +renal, I-TREATMENT +con I-TREATMENT +fiebre I-TREATMENT +y I-TREATMENT +leucocitosis, I-TREATMENT +proceso I-TREATMENT +compatible I-TREATMENT +con I-TREATMENT +sepsis I-TREATMENT +de I-TREATMENT +origen I-TREATMENT +urinario I-TREATMENT +que I-TREATMENT +mejora I-TREATMENT +con I-TREATMENT +sueroterapia I-TREATMENT +y I-TREATMENT +antibioterapia I-TREATMENT +parenteral. I-TREATMENT + I-TREATMENT +La B-EXPLORATION +pieza I-EXPLORATION +extirpada I-EXPLORATION +corresponde I-EXPLORATION +a I-EXPLORATION +un I-EXPLORATION +riñón I-EXPLORATION +izquierdo I-EXPLORATION +de I-EXPLORATION +452 I-EXPLORATION +gramos I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +acompaña I-EXPLORATION +de I-EXPLORATION +abundante I-EXPLORATION +grasa I-EXPLORATION +intimamente I-EXPLORATION +pegada I-EXPLORATION +al I-EXPLORATION +parenquima I-EXPLORATION +renal. I-EXPLORATION +Al I-EXPLORATION +corte I-EXPLORATION +el I-EXPLORATION +parenquima I-EXPLORATION +está I-EXPLORATION +sustituido I-EXPLORATION +por I-EXPLORATION +grandes I-EXPLORATION +cavidades I-EXPLORATION +quísticas I-EXPLORATION +ocupadas I-EXPLORATION +por I-EXPLORATION +un I-EXPLORATION +material I-EXPLORATION +blanquecino I-EXPLORATION +y I-EXPLORATION +blando. I-EXPLORATION +Histológicamente I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +una I-EXPLORATION +tumoración I-EXPLORATION +constituida I-EXPLORATION +por I-EXPLORATION +grandes I-EXPLORATION +masas I-EXPLORATION +sólidas, I-EXPLORATION +nidos I-EXPLORATION +y I-EXPLORATION +regueros I-EXPLORATION +infiltrantes I-EXPLORATION +de I-EXPLORATION +células I-EXPLORATION +de I-EXPLORATION +hábito I-EXPLORATION +escamoso I-EXPLORATION +que I-EXPLORATION +presentan I-EXPLORATION +grandes I-EXPLORATION +núcleos I-EXPLORATION +vesiculosos I-EXPLORATION +e I-EXPLORATION +irregulares I-EXPLORATION +con I-EXPLORATION +nucleolo I-EXPLORATION +prominente, I-EXPLORATION +citoplasma I-EXPLORATION +amplio, I-EXPLORATION +bien I-EXPLORATION +definido, I-EXPLORATION +eosinófilo I-EXPLORATION +claro, I-EXPLORATION +con I-EXPLORATION +abundantes I-EXPLORATION +imágenes I-EXPLORATION +de I-EXPLORATION +queratinización I-EXPLORATION +individual I-EXPLORATION +y I-EXPLORATION +formación I-EXPLORATION +de I-EXPLORATION +perlas I-EXPLORATION +corneas. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +urografía I-EXPLORATION +de I-EXPLORATION +control I-EXPLORATION +posterior I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +cirugía I-EXPLORATION +se I-EXPLORATION +aprecia I-EXPLORATION +una I-EXPLORATION +función I-EXPLORATION +normal I-EXPLORATION +del I-EXPLORATION +hemirriñón I-EXPLORATION +superior I-EXPLORATION +izquierdo, I-EXPLORATION +sin I-EXPLORATION +uropatía I-EXPLORATION +obstructiva. I-EXPLORATION + I-EXPLORATION +Un B-EVOLUTION +año I-EVOLUTION +y I-EVOLUTION +seis I-EVOLUTION +meses I-EVOLUTION +más I-EVOLUTION +tarde I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +ingresa I-EVOLUTION +desde I-EVOLUTION +urgencias I-EVOLUTION +por I-EVOLUTION +hematuria I-EVOLUTION +macroscópica. I-EVOLUTION +En B-EXPLORATION +la I-EXPLORATION +urografía I-EXPLORATION +se I-EXPLORATION +aprecia I-EXPLORATION +un I-EXPLORATION +defecto I-EXPLORATION +de I-EXPLORATION +replección I-EXPLORATION +en I-EXPLORATION +cara I-EXPLORATION +lateral I-EXPLORATION +derecha, I-EXPLORATION +que I-EXPLORATION +es I-EXPLORATION +corroborado I-EXPLORATION +mediante I-EXPLORATION +cistoscopia. I-EXPLORATION +Se B-TREATMENT +realiza I-TREATMENT +resección I-TREATMENT +transuretral I-TREATMENT +de I-TREATMENT +tumoración I-TREATMENT +sólida I-TREATMENT +en I-TREATMENT +cara I-TREATMENT +lateral I-TREATMENT +derecha I-TREATMENT +de I-TREATMENT +vejiga, I-TREATMENT +con I-TREATMENT +diagnóstico I-TREATMENT +anatomo-patológico I-TREATMENT +de I-TREATMENT +carcinoma I-TREATMENT +vesical I-TREATMENT +con I-TREATMENT +áreas I-TREATMENT +de I-TREATMENT +diferenciación I-TREATMENT +escamosa I-TREATMENT +que I-TREATMENT +infiltra I-TREATMENT +la I-TREATMENT +muscular, I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +es I-TREATMENT +sometido I-TREATMENT +a I-TREATMENT +cistoprostatectomía I-TREATMENT +radical I-TREATMENT +con I-TREATMENT +derivación I-TREATMENT +urinaria I-TREATMENT +de I-TREATMENT +uréter I-TREATMENT +izquierdo I-TREATMENT +a I-TREATMENT +sigma I-TREATMENT +(Mainz I-TREATMENT +II). I-TREATMENT +En I-TREATMENT +el I-TREATMENT +mismo I-TREATMENT +acto I-TREATMENT +quirúrgico I-TREATMENT +se I-TREATMENT +practica I-TREATMENT +una I-TREATMENT +nefroureterectomía I-TREATMENT +derecha, I-TREATMENT +donde I-TREATMENT +se I-TREATMENT +observa I-TREATMENT +un I-TREATMENT +riñón I-TREATMENT +hidronefrótico, I-TREATMENT +con I-TREATMENT +un I-TREATMENT +síndrome I-TREATMENT +de I-TREATMENT +la I-TREATMENT +unión I-TREATMENT +pieloureteral I-TREATMENT +por I-TREATMENT +un I-TREATMENT +vaso I-TREATMENT +polar. I-TREATMENT +El B-EXPLORATION +estudio I-EXPLORATION +histológico I-EXPLORATION +reveló I-EXPLORATION +un I-EXPLORATION +carcinoma I-EXPLORATION +de I-EXPLORATION +células I-EXPLORATION +escamosas, I-EXPLORATION +estadio I-EXPLORATION +pT3a, I-EXPLORATION +pNx, I-EXPLORATION +pMx. I-EXPLORATION + I-EXPLORATION +El B-EVOLUTION +paciente I-EVOLUTION +fallece I-EVOLUTION +cuatro I-EVOLUTION +meses I-EVOLUTION +más I-EVOLUTION +tarde, I-EVOLUTION +con I-EVOLUTION +metástasis I-EVOLUTION +pulmonares I-EVOLUTION +y I-EVOLUTION +hepáticas. I-EVOLUTION + I-EVOLUTION + +Los B-PRESENT_ILLNESS +casos I-PRESENT_ILLNESS +fueron I-PRESENT_ILLNESS +recolectados I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +forma I-PRESENT_ILLNESS +retrospectiva I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +presentan I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +Tabla1; I-PRESENT_ILLNESS +sólo I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +detalla I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +último. I-PRESENT_ILLNESS +Eran I-PRESENT_ILLNESS +hombres I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +media, I-PRESENT_ILLNESS +4/5 I-PRESENT_ILLNESS +heterosexuales, I-PRESENT_ILLNESS +todos I-PRESENT_ILLNESS +VIH I-PRESENT_ILLNESS +negativos. I-PRESENT_ILLNESS +Presentaron I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +síndrome I-PRESENT_ILLNESS +frontal I-PRESENT_ILLNESS +subagudo; I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +3 I-PRESENT_ILLNESS +casos I-PRESENT_ILLNESS +destacó I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +apatía, I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +otros I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +ánimo I-PRESENT_ILLNESS +subido. I-PRESENT_ILLNESS +Todos I-PRESENT_ILLNESS +tenían I-PRESENT_ILLNESS +amnesias I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +síndrome I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Korsakoff. I-PRESENT_ILLNESS +En I-PRESENT_ILLNESS +3 I-PRESENT_ILLNESS +existían I-PRESENT_ILLNESS +signos I-PRESENT_ILLNESS +piramidales I-PRESENT_ILLNESS +discretos; I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS +retención I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +orina, I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +uno I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +ellos I-PRESENT_ILLNESS +asociado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +ataxia. I-PRESENT_ILLNESS +Cuando I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +aplicaron I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +pruebas I-PRESENT_ILLNESS +Minimental I-PRESENT_ILLNESS +test I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Folstein I-PRESENT_ILLNESS +(MM), I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +mide I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +eficiencia I-PRESENT_ILLNESS +cognitiva I-PRESENT_ILLNESS +global, I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +Frontal I-PRESENT_ILLNESS +Assessment I-PRESENT_ILLNESS +Battery I-PRESENT_ILLNESS +(FAB), I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +evalúa I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +funciones I-PRESENT_ILLNESS +frontales, I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +mayor I-PRESENT_ILLNESS +compromiso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +esta I-PRESENT_ILLNESS +confirmó I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +síndrome I-PRESENT_ILLNESS +disejecutivo. I-PRESENT_ILLNESS +En I-PRESENT_ILLNESS +3 I-PRESENT_ILLNESS +existía I-PRESENT_ILLNESS +laconismo I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +o I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +afasia. I-PRESENT_ILLNESS +Dos I-PRESENT_ILLNESS +casos I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +episodios I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +isquemia I-PRESENT_ILLNESS +cerebral I-PRESENT_ILLNESS +tenían I-PRESENT_ILLNESS +factores I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +riesgo I-PRESENT_ILLNESS +vascular. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +El B-EXPLORATION +líquido I-EXPLORATION +cefaloraquídeo I-EXPLORATION +(LCR) I-EXPLORATION +fue I-EXPLORATION +siempre I-EXPLORATION +inflamatorio I-EXPLORATION +y I-EXPLORATION +con I-EXPLORATION +VDRL I-EXPLORATION +reactivo; I-EXPLORATION +en I-EXPLORATION +uno I-EXPLORATION +la I-EXPLORATION +serología I-EXPLORATION +en I-EXPLORATION +sangre I-EXPLORATION +fue I-EXPLORATION +negativa. I-EXPLORATION +El I-EXPLORATION +electroencefalograma I-EXPLORATION +(EEG) I-EXPLORATION +estuvo I-EXPLORATION +alterado I-EXPLORATION +en I-EXPLORATION +3/3 I-EXPLORATION +casos; I-EXPLORATION +en I-EXPLORATION +cambio I-EXPLORATION +las I-EXPLORATION +imágenes I-EXPLORATION +estructurales I-EXPLORATION +no I-EXPLORATION +siempre I-EXPLORATION +fueron I-EXPLORATION +anormales. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +caso I-EXPLORATION +T I-EXPLORATION +una I-EXPLORATION +angiografía I-EXPLORATION +(indicada I-EXPLORATION +por I-EXPLORATION +un I-EXPLORATION +infarto I-EXPLORATION +cerebral I-EXPLORATION +en I-EXPLORATION +un I-EXPLORATION +hombre I-EXPLORATION +joven I-EXPLORATION +con I-EXPLORATION +VDRL I-EXPLORATION +no I-EXPLORATION +reactivo I-EXPLORATION +en I-EXPLORATION +sangre I-EXPLORATION +y I-EXPLORATION +antes I-EXPLORATION +del I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +LCR) I-EXPLORATION +fue I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +vasculitis. I-EXPLORATION +Todos B-TREATMENT +recibieron I-TREATMENT +altas I-TREATMENT +dosis I-TREATMENT +de I-TREATMENT +penicilina I-TREATMENT +sódica I-TREATMENT +ev, I-TREATMENT +pero B-EVOLUTION +la I-EVOLUTION +mejoría I-EVOLUTION +fue I-EVOLUTION +parcial I-EVOLUTION +y I-EVOLUTION +quedaron I-EVOLUTION +con I-EVOLUTION +secuelas I-EVOLUTION +cognitivas. I-EVOLUTION + I-EVOLUTION +W B-PRESENT_ILLNESS +tenía I-PRESENT_ILLNESS +35 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +era B-PAST_MEDICAL_HISTORY +supervisor I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +ventas, I-PAST_MEDICAL_HISTORY +soltero; I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +importancia I-PAST_MEDICAL_HISTORY +salvo I-PAST_MEDICAL_HISTORY +ser I-PAST_MEDICAL_HISTORY +promiscuo; I-PAST_MEDICAL_HISTORY +fumaba I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +bebía I-PAST_MEDICAL_HISTORY +poco, I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +consumía I-PAST_MEDICAL_HISTORY +drogas. I-PAST_MEDICAL_HISTORY +En B-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +2° I-PRESENT_ILLNESS +semestre I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2008 I-PRESENT_ILLNESS +aparecieron I-PRESENT_ILLNESS +tendencia I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +aislarse, I-PRESENT_ILLNESS +olvidos, I-PRESENT_ILLNESS +insomnio, I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +libido, I-PRESENT_ILLNESS +disartria, I-PRESENT_ILLNESS +cefaleas. I-PRESENT_ILLNESS +Existía I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +mezcla I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +labilidad I-PRESENT_ILLNESS +emocional I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +apatía. I-PRESENT_ILLNESS +Perdió I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +trabajo I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +abril I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2009. I-PRESENT_ILLNESS +En B-DERIVED_FROM/TO +mayo I-DERIVED_FROM/TO +un I-DERIVED_FROM/TO +psiquiatra I-DERIVED_FROM/TO +lo I-DERIVED_FROM/TO +derivó I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +neurólogo, I-DERIVED_FROM/TO +quien I-DERIVED_FROM/TO +pidió I-DERIVED_FROM/TO +una I-DERIVED_FROM/TO +batería I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +exámenes, I-DERIVED_FROM/TO +entre I-DERIVED_FROM/TO +ellos I-DERIVED_FROM/TO +VDRL I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +sangre I-DERIVED_FROM/TO +que I-DERIVED_FROM/TO +fue I-DERIVED_FROM/TO +reactivo. I-DERIVED_FROM/TO +El B-EXPLORATION +examen I-EXPLORATION +general I-EXPLORATION +era I-EXPLORATION +normal. I-EXPLORATION +Se I-EXPLORATION +mostraba I-EXPLORATION +alerta I-EXPLORATION +y I-EXPLORATION +colaboraba I-EXPLORATION +al I-EXPLORATION +examen; I-EXPLORATION +destacaban I-EXPLORATION +un I-EXPLORATION +síndrome I-EXPLORATION +frontal I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +afasia I-EXPLORATION +no I-EXPLORATION +fluente I-EXPLORATION +mixta. I-EXPLORATION +Existían I-EXPLORATION +nistagmo I-EXPLORATION +en I-EXPLORATION +miradas I-EXPLORATION +extremas, I-EXPLORATION +paramimesis, I-EXPLORATION +enganche I-EXPLORATION +digital, I-EXPLORATION +tics I-EXPLORATION +de I-EXPLORATION +elevación I-EXPLORATION +de I-EXPLORATION +hombros. I-EXPLORATION +Una I-EXPLORATION +discreta I-EXPLORATION +ataxia I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +marcha, I-EXPLORATION +arreflexia I-EXPLORATION +tendinosa I-EXPLORATION +de I-EXPLORATION +miembros I-EXPLORATION +inferiores I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +retención I-EXPLORATION +de I-EXPLORATION +orina I-EXPLORATION +configuraban I-EXPLORATION +una I-EXPLORATION +tabes I-EXPLORATION +dorsal. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +síndrome I-EXPLORATION +frontal I-EXPLORATION +se I-EXPLORATION +expresaba I-EXPLORATION +en I-EXPLORATION +apatía, I-EXPLORATION +abulia I-EXPLORATION +y I-EXPLORATION +conducta I-EXPLORATION +de I-EXPLORATION +imitación. I-EXPLORATION +Fue I-EXPLORATION +incapaz I-EXPLORATION +de I-EXPLORATION +comprender I-EXPLORATION +escenas I-EXPLORATION +complejas I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +interpretar I-EXPLORATION +proverbios; I-EXPLORATION +perseveraba I-EXPLORATION +con I-EXPLORATION +frecuencia. I-EXPLORATION +Tenía I-EXPLORATION +defectos I-EXPLORATION +atencionales I-EXPLORATION +(cálculo, I-EXPLORATION +retención I-EXPLORATION +de I-EXPLORATION +cifras, I-EXPLORATION +inversión I-EXPLORATION +de I-EXPLORATION +series I-EXPLORATION +automáticas) I-EXPLORATION +y I-EXPLORATION +existía I-EXPLORATION +una I-EXPLORATION +afasia I-EXPLORATION +no I-EXPLORATION +fluente I-EXPLORATION +mixta. I-EXPLORATION +En I-EXPLORATION +MM I-EXPLORATION +obtuvo I-EXPLORATION +9/30 I-EXPLORATION +puntos, I-EXPLORATION +en I-EXPLORATION +FAB I-EXPLORATION +3/18 I-EXPLORATION +puntos; I-EXPLORATION +fue I-EXPLORATION +incapaz I-EXPLORATION +de I-EXPLORATION +abstraer. I-EXPLORATION +Rindió I-EXPLORATION +mejor I-EXPLORATION +en I-EXPLORATION +Matrices I-EXPLORATION +Progresivas I-EXPLORATION +Coloreadas I-EXPLORATION +(MPC, I-EXPLORATION +25/36 I-EXPLORATION +puntos) I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +prueba I-EXPLORATION +de I-EXPLORATION +asociación I-EXPLORATION +semántica I-EXPLORATION +del I-EXPLORATION +4° I-EXPLORATION +excluido I-EXPLORATION +(acertó I-EXPLORATION +en I-EXPLORATION +7/8 I-EXPLORATION +ensayos). I-EXPLORATION +No I-EXPLORATION +existían I-EXPLORATION +agnosias I-EXPLORATION +visuales I-EXPLORATION +ni I-EXPLORATION +espaciales, I-EXPLORATION +apraxia I-EXPLORATION +constructiva, I-EXPLORATION +ideatoria, I-EXPLORATION +ideomotora I-EXPLORATION +ni I-EXPLORATION +del I-EXPLORATION +vestir. I-EXPLORATION +Tampoco I-EXPLORATION +tenía I-EXPLORATION +agnosia I-EXPLORATION +digital I-EXPLORATION +ni I-EXPLORATION +desorientación I-EXPLORATION +derecha-izquierda. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +LCR I-EXPLORATION +mostró I-EXPLORATION +pleocitosis I-EXPLORATION +(130 I-EXPLORATION +mononuclea-res, I-EXPLORATION +88% I-EXPLORATION +de I-EXPLORATION +linfocitos, I-EXPLORATION +10% I-EXPLORATION +de I-EXPLORATION +polinucleares I-EXPLORATION +y I-EXPLORATION +2% I-EXPLORATION +de I-EXPLORATION +monocitos), I-EXPLORATION +glucosa I-EXPLORATION +21 I-EXPLORATION +mg/dL I-EXPLORATION +y I-EXPLORATION +proteínas I-EXPLORATION +180 I-EXPLORATION +mg/dL. I-EXPLORATION +El I-EXPLORATION +VRDL I-EXPLORATION +fue I-EXPLORATION +reactivo I-EXPLORATION +1/128. I-EXPLORATION +La I-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION +(RM) I-EXPLORATION +cerebral I-EXPLORATION +mostró I-EXPLORATION +atrofia I-EXPLORATION +de I-EXPLORATION +predominio I-EXPLORATION +frontotemporal I-EXPLORATION +izquierdo, I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +EEG I-EXPLORATION +actividad I-EXPLORATION +irritativa I-EXPLORATION +y I-EXPLORATION +lenta I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +misma I-EXPLORATION +zona. I-EXPLORATION +La I-EXPLORATION +serología I-EXPLORATION +para I-EXPLORATION +VIH I-EXPLORATION +fue I-EXPLORATION +negativa, I-EXPLORATION +y I-EXPLORATION +otros I-EXPLORATION +exámenes I-EXPLORATION +humorales I-EXPLORATION +fueron I-EXPLORATION +normales I-EXPLORATION +(función I-EXPLORATION +hepática, I-EXPLORATION +coagulación, I-EXPLORATION +hemograma I-EXPLORATION +y I-EXPLORATION +VHS, I-EXPLORATION +nivel I-EXPLORATION +de I-EXPLORATION +vitamina I-EXPLORATION +B12, I-EXPLORATION +Na, I-EXPLORATION +K I-EXPLORATION +y I-EXPLORATION +Cl, I-EXPLORATION +perfil I-EXPLORATION +bioquímico, I-EXPLORATION +proteína I-EXPLORATION +C I-EXPLORATION +reactiva, I-EXPLORATION +PCR I-EXPLORATION +para I-EXPLORATION +virus I-EXPLORATION +herpes I-EXPLORATION +simple I-EXPLORATION +en I-EXPLORATION +LCR). I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +trató I-TREATMENT +con I-TREATMENT +penicilina I-TREATMENT +sódica I-TREATMENT +4.000.000 I-TREATMENT +ui I-TREATMENT +ev I-TREATMENT +c/4 I-TREATMENT +horas I-TREATMENT +durante I-TREATMENT +15 I-TREATMENT +días, I-TREATMENT +betametasona I-TREATMENT +4 I-TREATMENT +mg I-TREATMENT +ev I-TREATMENT +c/8 I-TREATMENT +horas I-TREATMENT +por I-TREATMENT +3 I-TREATMENT +días I-TREATMENT +y I-TREATMENT +fenitoina I-TREATMENT +100 I-TREATMENT +mg I-TREATMENT +c/8 I-TREATMENT +horas. I-TREATMENT +El B-EVOLUTION +tratamiento I-EVOLUTION +fue I-EVOLUTION +bien I-EVOLUTION +tolerado I-EVOLUTION +y I-EVOLUTION +parcialmente I-EVOLUTION +eficaz. I-EVOLUTION +A B-EXPLORATION +comienzos I-EXPLORATION +de I-EXPLORATION +2010 I-EXPLORATION +el I-EXPLORATION +examen I-EXPLORATION +neurológico I-EXPLORATION +básico I-EXPLORATION +era I-EXPLORATION +normal, I-EXPLORATION +en I-EXPLORATION +MM I-EXPLORATION +obtuvo I-EXPLORATION +28/30 I-EXPLORATION +puntos, I-EXPLORATION +en I-EXPLORATION +MPC I-EXPLORATION +31/36, I-EXPLORATION +en I-EXPLORATION +FAB I-EXPLORATION +13/18. I-EXPLORATION +Persistía I-EXPLORATION +un I-EXPLORATION +síndrome I-EXPLORATION +frontal, I-EXPLORATION +con I-EXPLORATION +actitud I-EXPLORATION +pueril, I-EXPLORATION +fallas I-EXPLORATION +de I-EXPLORATION +juicio I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +coherencia I-EXPLORATION +del I-EXPLORATION +discurso. I-EXPLORATION +El I-EXPLORATION +LCR I-EXPLORATION +era I-EXPLORATION +normal, I-EXPLORATION +con I-EXPLORATION +serología I-EXPLORATION +reactiva I-EXPLORATION +a I-EXPLORATION +1/32, I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +unido I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +aparición I-EXPLORATION +de I-EXPLORATION +crisis I-EXPLORATION +convulsivas I-EXPLORATION +llevó B-TREATMENT +a I-TREATMENT +un I-TREATMENT +segundo I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +penicilina, I-TREATMENT +de I-TREATMENT +21 I-TREATMENT +días, I-TREATMENT +y I-TREATMENT +a I-TREATMENT +indicar I-TREATMENT +ácido I-TREATMENT +valproico I-TREATMENT +en I-TREATMENT +vez I-TREATMENT +de I-TREATMENT +fenitoína. I-TREATMENT +Fue B-EVOLUTION +jubilado I-EVOLUTION +por I-EVOLUTION +invalidez I-EVOLUTION +y I-EVOLUTION +vive I-EVOLUTION +con I-EVOLUTION +sus I-EVOLUTION +padres. I-EVOLUTION + I-EVOLUTION + +Paciente B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +masculino I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +60 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +haber I-PAST_MEDICAL_HISTORY +residido I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +forma I-PAST_MEDICAL_HISTORY +transitoria I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +Ovalle, I-PAST_MEDICAL_HISTORY +Región I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Coquimbo, I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +motivos I-PAST_MEDICAL_HISTORY +laborales I-PAST_MEDICAL_HISTORY +hacía I-PAST_MEDICAL_HISTORY +aproximadamente I-PAST_MEDICAL_HISTORY +20 I-PAST_MEDICAL_HISTORY +años, I-PAST_MEDICAL_HISTORY +además I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +parálisis I-PAST_MEDICAL_HISTORY +facial I-PAST_MEDICAL_HISTORY +periférica I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +antes. I-PAST_MEDICAL_HISTORY +Consultó B-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +peso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +8 I-PRESENT_ILLNESS +kg I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +meses, I-PRESENT_ILLNESS +vómitos I-PRESENT_ILLNESS +repetidos I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +posterior I-PRESENT_ILLNESS +trastorno I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +equilibrio I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +vértigo. I-PRESENT_ILLNESS +Al B-EXPLORATION +ingreso, I-EXPLORATION +se I-EXPLORATION +encontraba I-EXPLORATION +enflaquecido, I-EXPLORATION +consciente I-EXPLORATION +y I-EXPLORATION +orientado, I-EXPLORATION +sin I-EXPLORATION +otros I-EXPLORATION +hallazgos I-EXPLORATION +al I-EXPLORATION +examen I-EXPLORATION +general. I-EXPLORATION +El I-EXPLORATION +examen I-EXPLORATION +neurológico I-EXPLORATION +se I-EXPLORATION +constató I-EXPLORATION +sin I-EXPLORATION +afasia, I-EXPLORATION +con I-EXPLORATION +prueba I-EXPLORATION +positiva I-EXPLORATION +de I-EXPLORATION +mínima I-EXPLORATION +paresia, I-EXPLORATION +dismetría I-EXPLORATION +y I-EXPLORATION +disdiadococinesia I-EXPLORATION +izquierdas. I-EXPLORATION +Entre I-EXPLORATION +los I-EXPLORATION +exámenes I-EXPLORATION +de I-EXPLORATION +laboratorio I-EXPLORATION +tenía I-EXPLORATION +un I-EXPLORATION +hemograma, I-EXPLORATION +proteína I-EXPLORATION +C I-EXPLORATION +reactiva, I-EXPLORATION +función I-EXPLORATION +renal, I-EXPLORATION +perfil I-EXPLORATION +hepático, I-EXPLORATION +coagulación I-EXPLORATION +y I-EXPLORATION +orina I-EXPLORATION +completa I-EXPLORATION +normales, I-EXPLORATION +salvo I-EXPLORATION +una I-EXPLORATION +albuminemia I-EXPLORATION +de I-EXPLORATION +3, I-EXPLORATION +4 I-EXPLORATION +g/dl. I-EXPLORATION +La I-EXPLORATION +tomografía I-EXPLORATION +computarizada I-EXPLORATION +(TC) I-EXPLORATION +cerebral I-EXPLORATION +reveló I-EXPLORATION +un I-EXPLORATION +edema I-EXPLORATION +vasogénico I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +tipo I-EXPLORATION +masa I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +lóbulo I-EXPLORATION +frontal I-EXPLORATION +derecho; I-EXPLORATION +y I-EXPLORATION +otra I-EXPLORATION +imagen I-EXPLORATION +parietal I-EXPLORATION +con I-EXPLORATION +impregnación I-EXPLORATION +de I-EXPLORATION +contomos I-EXPLORATION +irregulares I-EXPLORATION +al I-EXPLORATION +contraste. I-EXPLORATION +La I-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION +(RM) I-EXPLORATION +cerebral I-EXPLORATION +confirmó I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +al I-EXPLORATION +menos I-EXPLORATION +tres I-EXPLORATION +lesiones I-EXPLORATION +hipointensas I-EXPLORATION +con I-EXPLORATION +impregnación I-EXPLORATION +marginal I-EXPLORATION +con I-EXPLORATION +medio I-EXPLORATION +de I-EXPLORATION +contraste I-EXPLORATION +y I-EXPLORATION +significativo I-EXPLORATION +edema I-EXPLORATION +perilesional I-EXPLORATION +de I-EXPLORATION +ubicación I-EXPLORATION +frontal, I-EXPLORATION +con I-EXPLORATION +características I-EXPLORATION +de I-EXPLORATION +granulomas, I-EXPLORATION +y I-EXPLORATION +otras I-EXPLORATION +similares I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +frontoparietal I-EXPLORATION +derecho I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION +fosa I-EXPLORATION +posterior I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +cerebelar I-EXPLORATION +izquierdo, I-EXPLORATION +menores I-EXPLORATION +a I-EXPLORATION +2, I-EXPLORATION +6 I-EXPLORATION +cm, I-EXPLORATION +sugerentes I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +probable I-EXPLORATION +toxoplasmosis I-EXPLORATION +cerebral. I-EXPLORATION +El I-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +segmentario I-EXPLORATION +reveló I-EXPLORATION +una I-EXPLORATION +candidiasis I-EXPLORATION +orofaríngea I-EXPLORATION +y I-EXPLORATION +leucoplaquia I-EXPLORATION +vellosa I-EXPLORATION +y B-TREATMENT +por I-TREATMENT +la I-TREATMENT +sospecha I-TREATMENT +de I-TREATMENT +una I-TREATMENT +toxoplasmosis I-TREATMENT +cerebral I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +terapia I-TREATMENT +con I-TREATMENT +cotrimoxazol I-TREATMENT +en I-TREATMENT +dosis I-TREATMENT +8-10 I-TREATMENT +mg/kg/día I-TREATMENT +(en I-TREATMENT +base I-TREATMENT +a I-TREATMENT +trimetoprim), I-TREATMENT +corticoesteroides I-TREATMENT +sistémicos I-TREATMENT +(dexametasona I-TREATMENT +12-16 I-TREATMENT +mg/día) I-TREATMENT +y I-TREATMENT +fluconazol I-TREATMENT +oral I-TREATMENT +(150 I-TREATMENT +mg/día I-TREATMENT +v.o. I-TREATMENT +por I-TREATMENT +10 I-TREATMENT +días). I-TREATMENT +Las B-EXPLORATION +serologías I-EXPLORATION +por I-EXPLORATION +quimioluminiscencia I-EXPLORATION +de I-EXPLORATION +VIH I-EXPLORATION +y I-EXPLORATION +ELISA I-EXPLORATION +de I-EXPLORATION +T. I-EXPLORATION +cruzi I-EXPLORATION +resultaron I-EXPLORATION +reactivas, I-EXPLORATION +siendo I-EXPLORATION +ambas I-EXPLORATION +confirmadas I-EXPLORATION +posteriormente I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +laboratorio I-EXPLORATION +de I-EXPLORATION +referencia I-EXPLORATION +nacional I-EXPLORATION +(ELISA I-EXPLORATION +e I-EXPLORATION +IFI I-EXPLORATION +positivas I-EXPLORATION +para I-EXPLORATION +Chagas) I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +confirmó I-EXPLORATION +además I-EXPLORATION +serología I-EXPLORATION +positiva I-EXPLORATION +IgG I-EXPLORATION +para I-EXPLORATION +Toxoplasma I-EXPLORATION +gondii. I-EXPLORATION +Las I-EXPLORATION +serologías I-EXPLORATION +para I-EXPLORATION +sífilis, I-EXPLORATION +hepatitis I-EXPLORATION +B I-EXPLORATION +y I-EXPLORATION +C I-EXPLORATION +fueron I-EXPLORATION +negativas, I-EXPLORATION +sin I-EXPLORATION +detectar I-EXPLORATION +anomalías I-EXPLORATION +al I-EXPLORATION +fondo I-EXPLORATION +de I-EXPLORATION +ojo. I-EXPLORATION +El I-EXPLORATION +análisis I-EXPLORATION +de I-EXPLORATION +LCR I-EXPLORATION +no I-EXPLORATION +demostró I-EXPLORATION +alteraciones I-EXPLORATION +en I-EXPLORATION +sus I-EXPLORATION +valores I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +para I-EXPLORATION +sífilis, I-EXPLORATION +bacterias, I-EXPLORATION +hongos I-EXPLORATION +y I-EXPLORATION +tuberculosis I-EXPLORATION +fue I-EXPLORATION +negativo. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +hizo I-EXPLORATION +estudio I-EXPLORATION +molecular I-EXPLORATION +en I-EXPLORATION +esta I-EXPLORATION +primera I-EXPLORATION +punción I-EXPLORATION +lumbar. I-EXPLORATION +Posteriormente, I-EXPLORATION +se I-EXPLORATION +obtuvo I-EXPLORATION +recuento I-EXPLORATION +de I-EXPLORATION +linfocitos I-EXPLORATION +CD4 I-EXPLORATION +de I-EXPLORATION +73 I-EXPLORATION +cél/mm3 I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +carga I-EXPLORATION +viral I-EXPLORATION +VIH I-EXPLORATION +de I-EXPLORATION +54.438 I-EXPLORATION +copias/ml I-EXPLORATION +(log I-EXPLORATION +4, I-EXPLORATION +74). I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +por I-EXPLORATION +TC I-EXPLORATION +de I-EXPLORATION +tórax, I-EXPLORATION +abdomen I-EXPLORATION +y I-EXPLORATION +pelvis I-EXPLORATION +no I-EXPLORATION +mostró I-EXPLORATION +adenopatías, I-EXPLORATION +visceromegalias I-EXPLORATION +ni I-EXPLORATION +lesiones I-EXPLORATION +residuales I-EXPLORATION +de I-EXPLORATION +tuberculosis. I-EXPLORATION + I-EXPLORATION +El B-EVOLUTION +paciente I-EVOLUTION +evolucionó I-EVOLUTION +con I-EVOLUTION +rechazo I-EVOLUTION +alimentario, I-EVOLUTION +ánimo I-EVOLUTION +bajo I-EVOLUTION +y I-EVOLUTION +labilidad I-EVOLUTION +emocional. I-EVOLUTION +Se I-EVOLUTION +diagnosticó I-EVOLUTION +un I-EVOLUTION +trastorno I-EVOLUTION +depresivo/adaptativo I-EVOLUTION +grave, I-EVOLUTION +que B-TREATMENT +se I-TREATMENT +trató I-TREATMENT +con I-TREATMENT +mirtazapina I-TREATMENT +y I-TREATMENT +olanzapina. I-TREATMENT +A I-TREATMENT +los I-TREATMENT +10 I-TREATMENT +días I-TREATMENT +de I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +cotrimoxazol I-TREATMENT +y I-TREATMENT +26 I-TREATMENT +de I-TREATMENT +hospitalización I-TREATMENT +se I-TREATMENT +inicio I-TREATMENT +terapia I-TREATMENT +antiretroviral I-TREATMENT +(TARV) I-TREATMENT +con I-TREATMENT +abacavir, I-TREATMENT +lamivudina I-TREATMENT +y I-TREATMENT +raltegravir, I-TREATMENT +que I-TREATMENT +toleró I-TREATMENT +en I-TREATMENT +forma I-TREATMENT +adecuada I-TREATMENT +y I-TREATMENT +con I-TREATMENT +estudio I-TREATMENT +previo I-TREATMENT +genotípico I-TREATMENT +para I-TREATMENT +HLA*B5701 I-TREATMENT +negativo. I-TREATMENT +Se I-TREATMENT +desestimó I-TREATMENT +el I-TREATMENT +uso I-TREATMENT +de I-TREATMENT +inhibidores I-TREATMENT +de I-TREATMENT +proteasa I-TREATMENT +por I-TREATMENT +eventuales I-TREATMENT +interacciones I-TREATMENT +con I-TREATMENT +psicofármacos I-TREATMENT +y I-TREATMENT +de I-TREATMENT +efavirenz I-TREATMENT +por I-TREATMENT +la I-TREATMENT +depresión I-TREATMENT +concurrente. I-TREATMENT +Durante B-EVOLUTION +los I-EVOLUTION +primeros I-EVOLUTION +días I-EVOLUTION +del I-EVOLUTION +inicio I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +TARV I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +presentó I-EVOLUTION +diplopía, I-EVOLUTION +nistagmus I-EVOLUTION +y I-EVOLUTION +estrabismo I-EVOLUTION +convergente I-EVOLUTION +del I-EVOLUTION +ojo I-EVOLUTION +derecho, I-EVOLUTION +asociado I-EVOLUTION +a I-EVOLUTION +una I-EVOLUTION +marcada I-EVOLUTION +agresividad. I-EVOLUTION +Se B-EXPLORATION +controló I-EXPLORATION +una I-EXPLORATION +nueva I-EXPLORATION +RM I-EXPLORATION +cerebral I-EXPLORATION +a I-EXPLORATION +los I-EXPLORATION +15 I-EXPLORATION +días I-EXPLORATION +de I-EXPLORATION +terapia I-EXPLORATION +con I-EXPLORATION +cotrimoxazol I-EXPLORATION +(+31 I-EXPLORATION +días I-EXPLORATION +de I-EXPLORATION +hospitalización), I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +disminución I-EXPLORATION +significativa I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +lesiones I-EXPLORATION +frontales I-EXPLORATION +y I-EXPLORATION +del I-EXPLORATION +edema I-EXPLORATION +pero I-EXPLORATION +con I-EXPLORATION +lesiones I-EXPLORATION +cerebelares I-EXPLORATION +estacionarias I-EXPLORATION +con I-EXPLORATION +mayor I-EXPLORATION +edema I-EXPLORATION +perilesional. I-EXPLORATION +Se I-EXPLORATION +planteó I-EXPLORATION +la I-EXPLORATION +realización I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +estudio I-EXPLORATION +histológico I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +lesiones, I-EXPLORATION +para I-EXPLORATION +descartar I-EXPLORATION +un I-EXPLORATION +linfoma I-EXPLORATION +primario I-EXPLORATION +de I-EXPLORATION +SNC I-EXPLORATION +y I-EXPLORATION +otros I-EXPLORATION +diagnósticos I-EXPLORATION +diferenciales. I-EXPLORATION +No I-EXPLORATION +obstante, I-EXPLORATION +debido I-EXPLORATION +a I-EXPLORATION +que I-EXPLORATION +dichas I-EXPLORATION +lesiones I-EXPLORATION +radiológicamente I-EXPLORATION +no I-EXPLORATION +empeoraron, I-EXPLORATION +el I-EXPLORATION +equipo I-EXPLORATION +de I-EXPLORATION +Neurocirugía I-EXPLORATION +desestimó I-EXPLORATION +realizar I-EXPLORATION +una I-EXPLORATION +biopsia I-EXPLORATION +abierta. I-EXPLORATION + I-EXPLORATION +Durante B-EVOLUTION +la I-EVOLUTION +cuarta I-EVOLUTION +semana I-EVOLUTION +de I-EVOLUTION +terapia I-EVOLUTION +con I-EVOLUTION +cotrimoxazol I-EVOLUTION +y I-EVOLUTION +tercera I-EVOLUTION +de I-EVOLUTION +TARV, I-EVOLUTION +inició I-EVOLUTION +fiebre I-EVOLUTION +hasta I-EVOLUTION +38°C, I-EVOLUTION +somnolencia I-EVOLUTION +hasta I-EVOLUTION +el I-EVOLUTION +sopor I-EVOLUTION +profundo, I-EVOLUTION +paresia I-EVOLUTION +de I-EVOLUTION +hemicuerpo I-EVOLUTION +izquierdo, I-EVOLUTION +del I-EVOLUTION +velo I-EVOLUTION +palatino I-EVOLUTION +izquierdo I-EVOLUTION +y I-EVOLUTION +disartria I-EVOLUTION +intensa, I-EVOLUTION +objetivándose I-EVOLUTION +una I-EVOLUTION +infección I-EVOLUTION +del I-EVOLUTION +tracto I-EVOLUTION +urinario I-EVOLUTION +por I-EVOLUTION +Klebsiella I-EVOLUTION +pneumoniae I-EVOLUTION +multiresistente. I-EVOLUTION +Un B-EXPLORATION +nuevo I-EXPLORATION +control I-EXPLORATION +de I-EXPLORATION +RM I-EXPLORATION +cerebral, I-EXPLORATION +al I-EXPLORATION +mes I-EXPLORATION +de I-EXPLORATION +tratamiento I-EXPLORATION +con I-EXPLORATION +cotrimoxazol, I-EXPLORATION +confirmó I-EXPLORATION +la I-EXPLORATION +progresión I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +lesiones I-EXPLORATION +cerebrales, I-EXPLORATION +especialmente I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +fosa I-EXPLORATION +posterior I-EXPLORATION +izquierda I-EXPLORATION +con I-EXPLORATION +mayor I-EXPLORATION +edema I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +lesión I-EXPLORATION +frontal I-EXPLORATION +derecha I-EXPLORATION +y I-EXPLORATION +aparición I-EXPLORATION +de I-EXPLORATION +nuevas I-EXPLORATION +lesiones I-EXPLORATION +supra I-EXPLORATION +e I-EXPLORATION +infratentoriales, I-EXPLORATION +efecto I-EXPLORATION +de I-EXPLORATION +masa I-EXPLORATION +y I-EXPLORATION +herniación I-EXPLORATION +subfalcina I-EXPLORATION +a I-EXPLORATION +izquierda. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +planteó I-TREATMENT +un I-TREATMENT +probable I-TREATMENT +compromiso I-TREATMENT +de I-TREATMENT +SNC I-TREATMENT +por I-TREATMENT +enfermedad I-TREATMENT +de I-TREATMENT +Chagas I-TREATMENT +o I-TREATMENT +un I-TREATMENT +síndrome I-TREATMENT +inflamatorio I-TREATMENT +de I-TREATMENT +reconstitución I-TREATMENT +inmune I-TREATMENT +(SIRI), I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +trasladar I-TREATMENT +a I-TREATMENT +UCI I-TREATMENT +ese I-TREATMENT +mismo I-TREATMENT +día I-TREATMENT +para I-TREATMENT +protección I-TREATMENT +de I-TREATMENT +la I-TREATMENT +vía I-TREATMENT +aérea I-TREATMENT +(escala I-TREATMENT +Glasgow I-TREATMENT +de I-TREATMENT +coma I-TREATMENT +5-6 I-TREATMENT +puntos) I-TREATMENT +con I-TREATMENT +ventilación I-TREATMENT +mecánica I-TREATMENT +invasora I-TREATMENT +y I-TREATMENT +monitorización, I-TREATMENT +manteniéndose I-TREATMENT +la I-TREATMENT +TARV, I-TREATMENT +cotrimoxazol I-TREATMENT +y I-TREATMENT +corticoesteroides. I-TREATMENT +Se I-TREATMENT +inició I-TREATMENT +empíricamente I-TREATMENT +nifurtimox I-TREATMENT +8 I-TREATMENT +mg/kg/día I-TREATMENT +(120 I-TREATMENT +mg I-TREATMENT +fraccionado I-TREATMENT +cada I-TREATMENT +6 I-TREATMENT +horas I-TREATMENT +por I-TREATMENT +SNG), I-TREATMENT +asociado I-TREATMENT +a I-TREATMENT +meropenem I-TREATMENT +i.v. I-TREATMENT +para I-TREATMENT +el I-TREATMENT +manejo I-TREATMENT +de I-TREATMENT +la I-TREATMENT +infección I-TREATMENT +urinaria. I-TREATMENT +Se B-EXPLORATION +amplió I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +etiológico I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +carga I-EXPLORATION +viral I-EXPLORATION +para I-EXPLORATION +citomegalovirus I-EXPLORATION +en I-EXPLORATION +sangre I-EXPLORATION +que I-EXPLORATION +fue I-EXPLORATION +indetectable I-EXPLORATION +y I-EXPLORATION +hemocultivos I-EXPLORATION +para I-EXPLORATION +micobacterias I-EXPLORATION +que I-EXPLORATION +resultó I-EXPLORATION +negativo. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +segunda I-EXPLORATION +punción I-EXPLORATION +lumbar, I-EXPLORATION +con I-EXPLORATION +cultivo I-EXPLORATION +corriente, I-EXPLORATION +de I-EXPLORATION +hongos I-EXPLORATION +y I-EXPLORATION +tinta I-EXPLORATION +china I-EXPLORATION +en I-EXPLORATION +LCR I-EXPLORATION +nuevamente I-EXPLORATION +negativos, I-EXPLORATION +pero I-EXPLORATION +apareció I-EXPLORATION +una I-EXPLORATION +proteinorraquia I-EXPLORATION +de I-EXPLORATION +55 I-EXPLORATION +mg/dL. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +complementario I-EXPLORATION +del I-EXPLORATION +LCR I-EXPLORATION +con I-EXPLORATION +tinción I-EXPLORATION +de I-EXPLORATION +tripomastigotes, I-EXPLORATION +RPC I-EXPLORATION +con I-EXPLORATION +Xpert I-EXPLORATION +MTB/RIF I-EXPLORATION +para I-EXPLORATION +Mycobacterium I-EXPLORATION +tuberculosis I-EXPLORATION +y I-EXPLORATION +RPC I-EXPLORATION +de I-EXPLORATION +virus I-EXPLORATION +herpes I-EXPLORATION +simplex-1 I-EXPLORATION +y I-EXPLORATION +2, I-EXPLORATION +varicela I-EXPLORATION +zoster, I-EXPLORATION +Epstein-Barr I-EXPLORATION +y I-EXPLORATION +JC I-EXPLORATION +también I-EXPLORATION +fueron I-EXPLORATION +negativos. I-EXPLORATION +Además, I-EXPLORATION +la I-EXPLORATION +RPC I-EXPLORATION +para I-EXPLORATION +T. I-EXPLORATION +gondii I-EXPLORATION +en I-EXPLORATION +sangre I-EXPLORATION +periférica I-EXPLORATION +y I-EXPLORATION +LCR I-EXPLORATION +también I-EXPLORATION +fue I-EXPLORATION +negativa I-EXPLORATION +teniendo I-EXPLORATION +como I-EXPLORATION +target I-EXPLORATION +el I-EXPLORATION +gen I-EXPLORATION +multicopia I-EXPLORATION +B1 I-EXPLORATION +9. I-EXPLORATION +Sin I-EXPLORATION +embargo, I-EXPLORATION +la I-EXPLORATION +RPC I-EXPLORATION +para I-EXPLORATION +T. I-EXPLORATION +cruzi I-EXPLORATION +en I-EXPLORATION +sangre I-EXPLORATION +reveló I-EXPLORATION +1.400 I-EXPLORATION +copias/mL, I-EXPLORATION +y I-EXPLORATION +35.000 I-EXPLORATION +copias/mL I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +LCR, I-EXPLORATION +confirmándose I-EXPLORATION +una I-EXPLORATION +encefalitis I-EXPLORATION +chagásica. I-EXPLORATION +Los I-EXPLORATION +targets I-EXPLORATION +utilizados I-EXPLORATION +para I-EXPLORATION +la I-EXPLORATION +detección I-EXPLORATION +de I-EXPLORATION +T. I-EXPLORATION +cruzi I-EXPLORATION +fueron I-EXPLORATION +para I-EXPLORATION +el I-EXPLORATION +minicírculo I-EXPLORATION +contenido I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +ADN I-EXPLORATION +de I-EXPLORATION +kinetoplasto I-EXPLORATION +(ADNk) I-EXPLORATION +10 I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +región I-EXPLORATION +repetitiva I-EXPLORATION +de I-EXPLORATION +195 I-EXPLORATION +pb I-EXPLORATION +contenida I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +núcleo, I-EXPLORATION +denominado I-EXPLORATION +ADN I-EXPLORATION +satélite I-EXPLORATION +(ADNsat). I-EXPLORATION +11 I-EXPLORATION +En B-EVOLUTION +su I-EVOLUTION +quinta I-EVOLUTION +semana I-EVOLUTION +de I-EVOLUTION +TARV I-EVOLUTION +se I-EVOLUTION +realizó I-EVOLUTION +control I-EVOLUTION +de I-EVOLUTION +carga I-EVOLUTION +viral I-EVOLUTION +de I-EVOLUTION +VIH I-EVOLUTION +que I-EVOLUTION +fue I-EVOLUTION +indetectable I-EVOLUTION +(con I-EVOLUTION +reducción I-EVOLUTION +> I-EVOLUTION +1 I-EVOLUTION +log I-EVOLUTION +respecto I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +basal), I-EVOLUTION +sin I-EVOLUTION +aumento I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +recuento I-EVOLUTION +CD4 I-EVOLUTION +(30 I-EVOLUTION +céls/μL), I-EVOLUTION +aunque I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +estaba I-EVOLUTION +recibiendo I-EVOLUTION +altas I-EVOLUTION +dosis I-EVOLUTION +de I-EVOLUTION +corticoesteroides. I-EVOLUTION + I-EVOLUTION +El I-EVOLUTION +paciente I-EVOLUTION +evolucionó I-EVOLUTION +con I-EVOLUTION +extrema I-EVOLUTION +gravedad, I-EVOLUTION +necesidad I-EVOLUTION +continua I-EVOLUTION +de I-EVOLUTION +VM I-EVOLUTION +y I-EVOLUTION +aminas I-EVOLUTION +vasoactivas, I-EVOLUTION +sin I-EVOLUTION +mayor I-EVOLUTION +respuesta I-EVOLUTION +neurológica I-EVOLUTION +a I-EVOLUTION +terapias I-EVOLUTION +instauradas. I-EVOLUTION +Luego I-EVOLUTION +de I-EVOLUTION +dos I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +hospitalización I-EVOLUTION +falleció I-EVOLUTION +por I-EVOLUTION +un I-EVOLUTION +síndrome I-EVOLUTION +de I-EVOLUTION +hipertensión I-EVOLUTION +intracraneal I-EVOLUTION +y I-EVOLUTION +falla I-EVOLUTION +multiorgánica. I-EVOLUTION + I-EVOLUTION + +Paciente B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +masculino I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +78 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +alcoholismo I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +hacía I-PAST_MEDICAL_HISTORY +10 I-PAST_MEDICAL_HISTORY +años. I-PAST_MEDICAL_HISTORY +Ingresó B-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +Unidad I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Emergencia I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +Complejo I-PRESENT_ILLNESS +Asistencial I-PRESENT_ILLNESS +Barros I-PRESENT_ILLNESS +Luco I-PRESENT_ILLNESS +(CABL) I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +historia I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +semana I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +caracterizada I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +muslo I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +cadera I-PRESENT_ILLNESS +derecha, I-PRESENT_ILLNESS +progresivo I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +intensidad. I-PRESENT_ILLNESS +El I-PRESENT_ILLNESS +día I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +ingreso I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +hospital I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +asoció I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +cuadrante I-PRESENT_ILLNESS +inferior I-PRESENT_ILLNESS +ipsilateral I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +episodio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +lipotimia. I-PRESENT_ILLNESS +No B-PAST_MEDICAL_HISTORY +presentaba I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +trauma I-PAST_MEDICAL_HISTORY +abdominal I-PAST_MEDICAL_HISTORY +ni I-PAST_MEDICAL_HISTORY +otras I-PAST_MEDICAL_HISTORY +enfermedades I-PAST_MEDICAL_HISTORY +asociadas. I-PAST_MEDICAL_HISTORY +En B-EXPLORATION +el I-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +de I-EXPLORATION +ingreso I-EXPLORATION +destacaba I-EXPLORATION +una I-EXPLORATION +presión I-EXPLORATION +arterial I-EXPLORATION +de I-EXPLORATION +80/54 I-EXPLORATION +mmHg, I-EXPLORATION +pulso I-EXPLORATION +78 I-EXPLORATION +x', I-EXPLORATION +coloración I-EXPLORATION +lívida I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +zona I-EXPLORATION +infraumbilical I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +pared I-EXPLORATION +abdominal I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +extremidades I-EXPLORATION +inferiores. I-EXPLORATION +Se I-EXPLORATION +aportaron I-EXPLORATION +entonces I-EXPLORATION +1.000 I-EXPLORATION +ce I-EXPLORATION +de I-EXPLORATION +solución I-EXPLORATION +cristaloide I-EXPLORATION +intravenosa I-EXPLORATION +que I-EXPLORATION +permitieron I-EXPLORATION +normalizar I-EXPLORATION +la I-EXPLORATION +presión I-EXPLORATION +arterial. I-EXPLORATION +El I-EXPLORATION +abdomen I-EXPLORATION +aparecía I-EXPLORATION +distendido, I-EXPLORATION +con I-EXPLORATION +dolor I-EXPLORATION +intenso I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación I-EXPLORATION +superficial I-EXPLORATION +y I-EXPLORATION +profunda I-EXPLORATION +en I-EXPLORATION +hipocondrio, I-EXPLORATION +flanco I-EXPLORATION +y I-EXPLORATION +fosa I-EXPLORATION +ilíaca I-EXPLORATION +derecha. I-EXPLORATION +Presentaba, I-EXPLORATION +además, I-EXPLORATION +dolor I-EXPLORATION +de I-EXPLORATION +rebote I-EXPLORATION +difuso, I-EXPLORATION +resistencia I-EXPLORATION +muscular I-EXPLORATION +difusa I-EXPLORATION +y I-EXPLORATION +puño I-EXPLORATION +percusión I-EXPLORATION +derecha I-EXPLORATION +positiva. I-EXPLORATION +En I-EXPLORATION +los I-EXPLORATION +exámenes I-EXPLORATION +de I-EXPLORATION +laboratorio I-EXPLORATION +de I-EXPLORATION +ingreso I-EXPLORATION +se I-EXPLORATION +obtuvo: I-EXPLORATION +glicemla I-EXPLORATION +de I-EXPLORATION +250 I-EXPLORATION +mg/dl, I-EXPLORATION +nitrógeno I-EXPLORATION +ureico I-EXPLORATION +de I-EXPLORATION +17 I-EXPLORATION +mg/dl, I-EXPLORATION +creatininemia I-EXPLORATION +de I-EXPLORATION +1, I-EXPLORATION +17 I-EXPLORATION +mg/dl, I-EXPLORATION +amilasa I-EXPLORATION +86 I-EXPLORATION +U/1, I-EXPLORATION +lipasa I-EXPLORATION +40 I-EXPLORATION +U/1, I-EXPLORATION +proteína I-EXPLORATION +C I-EXPLORATION +reactiva I-EXPLORATION +2 I-EXPLORATION +mg/1, I-EXPLORATION +protrombine-mia I-EXPLORATION +83, I-EXPLORATION +5%; I-EXPLORATION +tiempo I-EXPLORATION +de I-EXPLORATION +tromboplastina I-EXPLORATION +parcial I-EXPLORATION +activado: I-EXPLORATION +28, I-EXPLORATION +1 I-EXPLORATION +s, I-EXPLORATION +recuento I-EXPLORATION +de I-EXPLORATION +leucocitos I-EXPLORATION +de I-EXPLORATION +18.200/fxl, I-EXPLORATION +hemoglobinemia I-EXPLORATION +de I-EXPLORATION +12, I-EXPLORATION +7 I-EXPLORATION +mg/dl I-EXPLORATION +y I-EXPLORATION +un I-EXPLORATION +hematocrito I-EXPLORATION +de I-EXPLORATION +39%. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +tomografía I-EXPLORATION +computada I-EXPLORATION +(TC) I-EXPLORATION +de I-EXPLORATION +abdomen I-EXPLORATION +y I-EXPLORATION +pelvis, I-EXPLORATION +con I-EXPLORATION +contraste, I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +espontáneamente I-EXPLORATION +hiperdensa I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +del I-EXPLORATION +hipocondrio I-EXPLORATION +y I-EXPLORATION +flanco I-EXPLORATION +derecho I-EXPLORATION +de I-EXPLORATION +16 I-EXPLORATION +por I-EXPLORATION +12 I-EXPLORATION +por I-EXPLORATION +9 I-EXPLORATION +cm I-EXPLORATION +y I-EXPLORATION +que I-EXPLORATION +desplazaba I-EXPLORATION +el I-EXPLORATION +colon I-EXPLORATION +derecho I-EXPLORATION +hacia I-EXPLORATION +la I-EXPLORATION +periferia, I-EXPLORATION +manteniendo I-EXPLORATION +un I-EXPLORATION +plano I-EXPLORATION +de I-EXPLORATION +clivaje I-EXPLORATION +con I-EXPLORATION +él. I-EXPLORATION +Se I-EXPLORATION +sugería I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +extenso I-EXPLORATION +hematoma I-EXPLORATION +mesentérico, I-EXPLORATION +sin I-EXPLORATION +poder I-EXPLORATION +descartar I-EXPLORATION +también I-EXPLORATION +neoplasia I-EXPLORATION +subyacente. I-EXPLORATION +Al B-EVOLUTION +segundo I-EVOLUTION +día I-EVOLUTION +de I-EVOLUTION +hospitalización I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +estaba I-EVOLUTION +hemodinámicamente I-EVOLUTION +estable, I-EVOLUTION +afebril I-EVOLUTION +y I-EVOLUTION +con I-EVOLUTION +menos I-EVOLUTION +dolor I-EVOLUTION +abdominal I-EVOLUTION +espontáneo, I-EVOLUTION +sin I-EVOLUTION +embargo, I-EVOLUTION +el I-EVOLUTION +hematocrito I-EVOLUTION +de I-EVOLUTION +control I-EVOLUTION +descendió I-EVOLUTION +a I-EVOLUTION +21%, I-EVOLUTION +decidiéndose B-TREATMENT +entonces I-TREATMENT +transfundir I-TREATMENT +2 I-TREATMENT +U I-TREATMENT +de I-TREATMENT +glóbulos I-TREATMENT +rojos I-TREATMENT +e I-TREATMENT +intervenir I-TREATMENT +quirúrgicamente I-TREATMENT +al I-TREATMENT +paciente. I-TREATMENT + I-TREATMENT +Se I-TREATMENT +efectuó I-TREATMENT +laparotomía I-TREATMENT +exploradora, I-TREATMENT +encontrándose I-TREATMENT +un I-TREATMENT +gran I-TREATMENT +hematoma I-TREATMENT +encapsulado I-TREATMENT +retrope-ritoneal I-TREATMENT +derecho, I-TREATMENT +que I-TREATMENT +se I-TREATMENT +extendía I-TREATMENT +desde I-TREATMENT +el I-TREATMENT +mesocolon I-TREATMENT +transverso I-TREATMENT +hasta I-TREATMENT +la I-TREATMENT +pelvis, I-TREATMENT +sin I-TREATMENT +observar I-TREATMENT +lesión I-TREATMENT +con I-TREATMENT +sangrado I-TREATMENT +activo. I-TREATMENT +Se I-TREATMENT +realizó I-TREATMENT +vaciamiento, I-TREATMENT +aseo, I-TREATMENT +instalación I-TREATMENT +de I-TREATMENT +drenajes I-TREATMENT +en I-TREATMENT +el I-TREATMENT +retroperito-neo I-TREATMENT +y I-TREATMENT +toma I-TREATMENT +de I-TREATMENT +muestras I-TREATMENT +para I-TREATMENT +biopsia, I-TREATMENT +la I-TREATMENT +que, I-TREATMENT +posteriormente, I-TREATMENT +se I-TREATMENT +informó I-TREATMENT +como I-TREATMENT +hematoma I-TREATMENT +de I-TREATMENT +mesenterio I-TREATMENT +sin I-TREATMENT +evidencias I-TREATMENT +de I-TREATMENT +neoplasia. I-TREATMENT + I-TREATMENT +El B-EVOLUTION +paciente I-EVOLUTION +evolucionó I-EVOLUTION +satisfactoriamente I-EVOLUTION +hasta I-EVOLUTION +el I-EVOLUTION +sexto I-EVOLUTION +día I-EVOLUTION +del I-EVOLUTION +posoperatorio, I-EVOLUTION +cuando I-EVOLUTION +se I-EVOLUTION +observó I-EVOLUTION +salida I-EVOLUTION +de I-EVOLUTION +líquido I-EVOLUTION +fecal I-EVOLUTION +por I-EVOLUTION +los I-EVOLUTION +drenajes, I-EVOLUTION +realizándose I-EVOLUTION +el I-EVOLUTION +diagnóstico I-EVOLUTION +de I-EVOLUTION +fístula I-EVOLUTION +estercorácea. I-EVOLUTION +Se B-TREATMENT +decidió, I-TREATMENT +entonces, I-TREATMENT +conectar I-TREATMENT +los I-TREATMENT +tubulares I-TREATMENT +a I-TREATMENT +aspiración I-TREATMENT +e I-TREATMENT +iniciar I-TREATMENT +tratamiento I-TREATMENT +antibiótico I-TREATMENT +con I-TREATMENT +metronidazol I-TREATMENT +más I-TREATMENT +ciprofloxacina, I-TREATMENT +con I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +consiguió I-TREATMENT +buen I-TREATMENT +control I-TREATMENT +de I-TREATMENT +la I-TREATMENT +fístula, I-TREATMENT +la I-TREATMENT +cual I-TREATMENT +evolucionó I-TREATMENT +al I-TREATMENT +cierre I-TREATMENT +definitivo I-TREATMENT +al I-TREATMENT +vigésimo I-TREATMENT +día I-TREATMENT +desde I-TREATMENT +la I-TREATMENT +operación, I-TREATMENT +dándose I-TREATMENT +de I-TREATMENT +alta I-TREATMENT +en I-TREATMENT +óptimas I-TREATMENT +condiciones I-TREATMENT +generales I-TREATMENT +y I-TREATMENT +de I-TREATMENT +la I-TREATMENT +herida. I-TREATMENT +El B-EVOLUTION +paciente I-EVOLUTION +se I-EVOLUTION +ha I-EVOLUTION +mantenido I-EVOLUTION +en I-EVOLUTION +control I-EVOLUTION +ambulatorio I-EVOLUTION +en I-EVOLUTION +policlínico I-EVOLUTION +de I-EVOLUTION +cirugía, I-EVOLUTION +permaneciendo I-EVOLUTION +asintomático I-EVOLUTION +a I-EVOLUTION +6 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +su I-EVOLUTION +egreso. I-EVOLUTION + I-EVOLUTION + +Se B-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +94 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +insuficiencia I-PAST_MEDICAL_HISTORY +cardiaca I-PAST_MEDICAL_HISTORY +clase I-PAST_MEDICAL_HISTORY +funcional I-PAST_MEDICAL_HISTORY +III, I-PAST_MEDICAL_HISTORY +fibrilación I-PAST_MEDICAL_HISTORY +auricular I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +litiasis I-PAST_MEDICAL_HISTORY +vesicular I-PAST_MEDICAL_HISTORY +conocida I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +requirió I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +esfinterotomía I-PAST_MEDICAL_HISTORY +mediante I-PAST_MEDICAL_HISTORY +endoscopia I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +coledocolitiasis I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +88 I-PAST_MEDICAL_HISTORY +años. I-PAST_MEDICAL_HISTORY +Se I-PAST_MEDICAL_HISTORY +desestimó I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +colecistectomía I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +comorbilidad I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +paciente. I-PAST_MEDICAL_HISTORY +La B-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +acudió I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +nuestro I-PRESENT_ILLNESS +centro I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +mes I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +había I-PRESENT_ILLNESS +intensificado I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +últimos I-PRESENT_ILLNESS +7 I-PRESENT_ILLNESS +días. I-PRESENT_ILLNESS +Refería I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +aparición I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +masa I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +cuadrante I-PRESENT_ILLNESS +superior I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +crecimiento I-PRESENT_ILLNESS +progresivo I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +hacía I-PRESENT_ILLNESS +48 I-PRESENT_ILLNESS +horas. I-PRESENT_ILLNESS +Negó I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +aparición I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +fiebre. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Una B-EXPLORATION +punción I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +masa, I-EXPLORATION +de I-EXPLORATION +7 I-EXPLORATION +x I-EXPLORATION +11, I-EXPLORATION +5 I-EXPLORATION +cm I-EXPLORATION +objetivó I-EXPLORATION +la I-EXPLORATION +salida I-EXPLORATION +de I-EXPLORATION +material I-EXPLORATION +purulento. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +analítica, I-EXPLORATION +presentaba I-EXPLORATION +únicamente I-EXPLORATION +leucocitosis I-EXPLORATION +(17,6.103/μl) I-EXPLORATION +con I-EXPLORATION +neutrofilia I-EXPLORATION +del I-EXPLORATION +88, I-EXPLORATION +9%. I-EXPLORATION +La I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +tórax I-EXPLORATION +fue I-EXPLORATION +normal. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +tomografía I-EXPLORATION +computerizada I-EXPLORATION +(TC) I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +litiasis I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +vesícula, I-EXPLORATION +la I-EXPLORATION +cual I-EXPLORATION +contactaba I-EXPLORATION +directamente I-EXPLORATION +con I-EXPLORATION +la I-EXPLORATION +pared I-EXPLORATION +abdominal I-EXPLORATION +adyacente, I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +observaba I-EXPLORATION +una I-EXPLORATION +colección I-EXPLORATION +de I-EXPLORATION +unos I-EXPLORATION +10 I-EXPLORATION +x I-EXPLORATION +6 I-EXPLORATION +x I-EXPLORATION +8, I-EXPLORATION +6 I-EXPLORATION +cm I-EXPLORATION +con I-EXPLORATION +aire I-EXPLORATION +y I-EXPLORATION +calcificaciones I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +interior I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +mismas I-EXPLORATION +características I-EXPLORATION +a I-EXPLORATION +las I-EXPLORATION +del I-EXPLORATION +interior I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +vesícula I-EXPLORATION +correspondiendo I-EXPLORATION +a I-EXPLORATION +un I-EXPLORATION +Empiema I-EXPLORATION +necessitatis I-EXPLORATION +por I-EXPLORATION +colecistitis. I-EXPLORATION + I-EXPLORATION +Dada B-TREATMENT +la I-TREATMENT +comorbilidad I-TREATMENT +de I-TREATMENT +la I-TREATMENT +paciente, I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +realizar I-TREATMENT +únicamente I-TREATMENT +desbridamiento I-TREATMENT +y I-TREATMENT +colocación I-TREATMENT +de I-TREATMENT +un I-TREATMENT +drenaje I-TREATMENT +en I-TREATMENT +la I-TREATMENT +zona I-TREATMENT +del I-TREATMENT +empiema I-TREATMENT +bajo I-TREATMENT +sedación. I-TREATMENT +La B-EVOLUTION +paciente I-EVOLUTION +presentó I-EVOLUTION +una I-EVOLUTION +evolución I-EVOLUTION +clínica I-EVOLUTION +correcta. I-EVOLUTION +Fue I-EVOLUTION +dada I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +al I-EVOLUTION +noveno I-EVOLUTION +día I-EVOLUTION +postoperatorio. I-EVOLUTION + I-EVOLUTION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +47 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +tabaquismo I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +alcoholismo I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +ingresa I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +agudo I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +diagnóstico I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +pseudoquiste I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +cabeza I-PRESENT_ILLNESS +pancreática I-PRESENT_ILLNESS +sobre I-PRESENT_ILLNESS +pancreatitis I-PRESENT_ILLNESS +crónica I-PRESENT_ILLNESS +alcohólica. I-PRESENT_ILLNESS +Amilasemia B-EXPLORATION +normal. I-EXPLORATION +Tras B-TREATMENT +tratamiento I-TREATMENT +sintomático, I-TREATMENT +el B-EVOLUTION +paciente I-EVOLUTION +presenta I-EVOLUTION +disnea I-EVOLUTION +progresiva I-EVOLUTION +y I-EVOLUTION +derrame I-EVOLUTION +pleural I-EVOLUTION +derecho I-EVOLUTION +que B-TREATMENT +mejora I-TREATMENT +tras I-TREATMENT +drenaje I-TREATMENT +pleural. I-TREATMENT +Una B-EXPLORATION +colangio-RM I-EXPLORATION +verifica I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +y I-EXPLORATION +revela I-EXPLORATION +un I-EXPLORATION +aumento I-EXPLORATION +del I-EXPLORATION +volumen I-EXPLORATION +del I-EXPLORATION +pseudoquiste I-EXPLORATION +con I-EXPLORATION +probable I-EXPLORATION +punto I-EXPLORATION +de I-EXPLORATION +comunicación I-EXPLORATION +entre I-EXPLORATION +ducto I-EXPLORATION +pancreático I-EXPLORATION +y I-EXPLORATION +pseudoquiste. I-EXPLORATION +Posteriormente, B-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +presenta I-EVOLUTION +aumento I-EVOLUTION +del I-EVOLUTION +dolor I-EVOLUTION +abdominal I-EVOLUTION +y I-EVOLUTION +empeoramiento I-EVOLUTION +de I-EVOLUTION +su I-EVOLUTION +disnea, I-EVOLUTION +consecuencia I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +rotura I-EVOLUTION +del I-EVOLUTION +pseudoquiste I-EVOLUTION +y I-EVOLUTION +difusión I-EVOLUTION +a I-EVOLUTION +cavidad I-EVOLUTION +pleural I-EVOLUTION +izquierda I-EVOLUTION +a I-EVOLUTION +través I-EVOLUTION +de I-EVOLUTION +hiato I-EVOLUTION +esofágico. I-EVOLUTION +Se B-TREATMENT +realizó I-TREATMENT +drenaje I-TREATMENT +pleural, I-TREATMENT +evidenciándose I-TREATMENT +líquido I-TREATMENT +pleural I-TREATMENT +de I-TREATMENT +características I-TREATMENT +hemorrágicas, I-TREATMENT +compatible I-TREATMENT +con I-TREATMENT +comunicación I-TREATMENT +pancreático-pleural. I-TREATMENT +Tras B-EVOLUTION +una I-EVOLUTION +mejoría I-EVOLUTION +inicial, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +presenta I-EVOLUTION +una I-EVOLUTION +progresión I-EVOLUTION +de I-EVOLUTION +su I-EVOLUTION +disnea I-EVOLUTION +y I-EVOLUTION +recurrencia I-EVOLUTION +del I-EVOLUTION +derrame, I-EVOLUTION +realizándose B-TREATMENT +un I-TREATMENT +tercer I-TREATMENT +drenaje I-TREATMENT +pleural I-TREATMENT +y I-TREATMENT +pleurodesis. I-TREATMENT +Tras B-EVOLUTION +la I-EVOLUTION +mejoría I-EVOLUTION +del I-EVOLUTION +cuadro I-EVOLUTION +se B-TREATMENT +decide I-TREATMENT +tratamiento I-TREATMENT +quirúgico I-TREATMENT +definitivo I-TREATMENT +del I-TREATMENT +pseudoquiste. I-TREATMENT + I-TREATMENT +A I-TREATMENT +los I-TREATMENT +25 I-TREATMENT +días I-TREATMENT +de I-TREATMENT +su I-TREATMENT +ingreso I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +es I-TREATMENT +intervenido, I-TREATMENT +realizándosele I-TREATMENT +una I-TREATMENT +cistogastrostomía I-TREATMENT +a I-TREATMENT +cara I-TREATMENT +posterior I-TREATMENT +gástrica I-TREATMENT +con B-EVOLUTION +mejoría I-EVOLUTION +definitiva I-EVOLUTION +y I-EVOLUTION +reducción I-EVOLUTION +del I-EVOLUTION +pseudoquiste. I-EVOLUTION + I-EVOLUTION + +Se B-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +73 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial I-PAST_MEDICAL_HISTORY +sistémica I-PAST_MEDICAL_HISTORY +actualmente I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +control I-PAST_MEDICAL_HISTORY +médico, I-PAST_MEDICAL_HISTORY +quien B-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +valoración I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +aumento I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +volumen I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +cara I-PRESENT_ILLNESS +ventral I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +borde I-PRESENT_ILLNESS +lateral I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +lengua, I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +6 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +exofítico, B-EXPLORATION +de I-EXPLORATION +aspecto I-EXPLORATION +granulomatoso, I-EXPLORATION +fácilmente I-EXPLORATION +sangrante, I-EXPLORATION +que I-EXPLORATION +dificulta I-EXPLORATION +considerablemente I-EXPLORATION +la I-EXPLORATION +deglución I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +habla, I-EXPLORATION +de I-EXPLORATION +crecimiento I-EXPLORATION +aparentemente I-EXPLORATION +rápido, I-EXPLORATION +con I-EXPLORATION +medidas I-EXPLORATION +de I-EXPLORATION +5 I-EXPLORATION +× I-EXPLORATION +3 I-EXPLORATION +cm, I-EXPLORATION +de I-EXPLORATION +coloración I-EXPLORATION +violácea, I-EXPLORATION +con I-EXPLORATION +zonas I-EXPLORATION +eritematosas, I-EXPLORATION +de I-EXPLORATION +color I-EXPLORATION +rojo I-EXPLORATION +intenso I-EXPLORATION +brillante, I-EXPLORATION +adherido I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +superficie I-EXPLORATION +lingual I-EXPLORATION +por I-EXPLORATION +un I-EXPLORATION +pedículo I-EXPLORATION +de I-EXPLORATION +1 I-EXPLORATION +cm, I-EXPLORATION +refiriendo I-EXPLORATION +sangrados I-EXPLORATION +espontáneos I-EXPLORATION +y I-EXPLORATION +controlables I-EXPLORATION +con I-EXPLORATION +presión I-EXPLORATION +simple, I-EXPLORATION +sin I-EXPLORATION +linfadenopatía I-EXPLORATION +regional I-EXPLORATION +palpable I-EXPLORATION +y I-EXPLORATION +con I-EXPLORATION +edentulismo I-EXPLORATION +total I-EXPLORATION +adquirido. I-EXPLORATION +Se I-EXPLORATION +obtienen I-EXPLORATION +exámenes I-EXPLORATION +de I-EXPLORATION +laboratorio I-EXPLORATION +de I-EXPLORATION +rutina, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +una I-EXPLORATION +tomografía I-EXPLORATION +axial I-EXPLORATION +computarizada I-EXPLORATION +de I-EXPLORATION +tórax I-EXPLORATION +y I-EXPLORATION +abdomen I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +descartan I-EXPLORATION +lesiones I-EXPLORATION +y I-EXPLORATION +metástasis I-EXPLORATION +a I-EXPLORATION +distancia. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +realiza I-EXPLORATION +biopsia I-EXPLORATION +incisional I-EXPLORATION +bajo I-EXPLORATION +anestesia I-EXPLORATION +local I-EXPLORATION +cuyo I-EXPLORATION +estudio I-EXPLORATION +reporta I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +leiomiosarcoma. I-EXPLORATION +En B-TREATMENT +un I-TREATMENT +segundo I-TREATMENT +tiempo I-TREATMENT +quirúrgico, I-TREATMENT +se I-TREATMENT +realiza I-TREATMENT +resección I-TREATMENT +de I-TREATMENT +la I-TREATMENT +lesión I-TREATMENT +con I-TREATMENT +márgenes I-TREATMENT +de I-TREATMENT +seguridad I-TREATMENT +amplios I-TREATMENT +y I-TREATMENT +se I-TREATMENT +realiza I-TREATMENT +plastia I-TREATMENT +lingual I-TREATMENT +y I-TREATMENT +cierre I-TREATMENT +primario I-TREATMENT +del I-TREATMENT +defecto. I-TREATMENT +La B-EXPLORATION +pieza I-EXPLORATION +quirúrgica I-EXPLORATION +es I-EXPLORATION +enviada I-EXPLORATION +para I-EXPLORATION +valoración I-EXPLORATION +histológica I-EXPLORATION +e I-EXPLORATION +inmunohistoquímica I-EXPLORATION +siendo I-EXPLORATION +confirmado I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +leiomiosarcoma I-EXPLORATION +de I-EXPLORATION +bajo I-EXPLORATION +grado I-EXPLORATION +con I-EXPLORATION +márgenes I-EXPLORATION +libres I-EXPLORATION +de I-EXPLORATION +neoplasia. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +histopatológico I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +alta I-EXPLORATION +cantidad I-EXPLORATION +de I-EXPLORATION +células I-EXPLORATION +espinosas I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +músculo I-EXPLORATION +liso, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +inmunorreactividad I-EXPLORATION +para I-EXPLORATION +vicentina I-EXPLORATION +y I-EXPLORATION +actina I-EXPLORATION +alfa I-EXPLORATION +músculo I-EXPLORATION +liso, I-EXPLORATION +negativo I-EXPLORATION +para I-EXPLORATION +panqueratina, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +para I-EXPLORATION +desmina I-EXPLORATION +y I-EXPLORATION +CD34. I-EXPLORATION + I-EXPLORATION +La B-EVOLUTION +paciente I-EVOLUTION +cursó I-EVOLUTION +un I-EVOLUTION +postoperatorio I-EVOLUTION +inmediato I-EVOLUTION +favorable I-EVOLUTION +siendo I-EVOLUTION +dada I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +hospitalaria I-EVOLUTION +al I-EVOLUTION +5.° I-EVOLUTION +día I-EVOLUTION +de I-EVOLUTION +internamiento I-EVOLUTION +para I-EVOLUTION +continuar I-EVOLUTION +con I-EVOLUTION +manejo I-EVOLUTION +ambulatorio. I-EVOLUTION +A I-EVOLUTION +un I-EVOLUTION +año I-EVOLUTION +de I-EVOLUTION +postoperada I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +continúa I-EVOLUTION +con I-EVOLUTION +una I-EVOLUTION +adecuada I-EVOLUTION +evolución, I-EVOLUTION +alimentándose I-EVOLUTION +de I-EVOLUTION +manera I-EVOLUTION +adecuada, I-EVOLUTION +sin I-EVOLUTION +problemas I-EVOLUTION +de I-EVOLUTION +fonación I-EVOLUTION +después I-EVOLUTION +de I-EVOLUTION +una I-EVOLUTION +intensiva I-EVOLUTION +terapia I-EVOLUTION +de I-EVOLUTION +lenguaje; I-EVOLUTION +no I-EVOLUTION +hay I-EVOLUTION +datos I-EVOLUTION +de I-EVOLUTION +metástasis I-EVOLUTION +corroborados I-EVOLUTION +con I-EVOLUTION +TAC I-EVOLUTION +de I-EVOLUTION +control. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +45 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cuatro I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +duración I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +prurito I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +zonas I-PRESENT_ILLNESS +paravertebrales I-PRESENT_ILLNESS +diferenciadas, I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +zona I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +D2 I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +D7, I-PRESENT_ILLNESS +paravertebrales I-PRESENT_ILLNESS +ambas. I-PRESENT_ILLNESS +Aumentaba I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +prurito I-PRESENT_ILLNESS +solo I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +época I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +mayor I-PRESENT_ILLNESS +calor. I-PRESENT_ILLNESS +La B-EXPLORATION +exploración I-EXPLORATION +fue I-EXPLORATION +normal, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +la I-EXPLORATION +RMN I-EXPLORATION +de I-EXPLORATION +columna I-EXPLORATION +practicada. I-EXPLORATION +Se B-TREATMENT +intentó I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +capsaicina I-TREATMENT +tópica, I-TREATMENT +pero I-TREATMENT +como I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +no I-TREATMENT +lo I-TREATMENT +toleraba I-TREATMENT +y I-TREATMENT +en I-TREATMENT +cambio I-TREATMENT +sí I-TREATMENT +el I-TREATMENT +prurito, I-TREATMENT +prefirió I-TREATMENT +no I-TREATMENT +probar I-TREATMENT +otros I-TREATMENT +tratamientos I-TREATMENT +farmacológicos. I-TREATMENT + I-TREATMENT + +Paciente B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +69 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +procedente B-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Guinea I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +llevaba I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +mes I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +España. I-PAST_MEDICAL_HISTORY +Acudió B-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +médico I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +atención I-PRESENT_ILLNESS +primaria I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +hace I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +tiempo I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tos I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +expectoración, I-PRESENT_ILLNESS +malestar I-PRESENT_ILLNESS +general, I-PRESENT_ILLNESS +mialgias, I-PRESENT_ILLNESS +prurito I-PRESENT_ILLNESS +intenso I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +(que I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +objetiva I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +consulta). I-PRESENT_ILLNESS +La B-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +es I-EXPLORATION +normal. I-EXPLORATION +Se I-EXPLORATION +remiten I-EXPLORATION +muestras I-EXPLORATION +al I-EXPLORATION +laboratorio I-EXPLORATION +para I-EXPLORATION +bioquímica I-EXPLORATION +básica I-EXPLORATION +y I-EXPLORATION +hemograma. I-EXPLORATION +Sólo I-EXPLORATION +son I-EXPLORATION +destacables I-EXPLORATION +una I-EXPLORATION +ligera I-EXPLORATION +anemia I-EXPLORATION +11, I-EXPLORATION +3 I-EXPLORATION +g/dL I-EXPLORATION +de I-EXPLORATION +hemoglobina I-EXPLORATION +y I-EXPLORATION +eosinofilia I-EXPLORATION +2, I-EXPLORATION +6*1.000/ml. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +revisión I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +extensión I-EXPLORATION +de I-EXPLORATION +sangre I-EXPLORATION +teñida I-EXPLORATION +con I-EXPLORATION +Giemsa I-EXPLORATION +se I-EXPLORATION +observaron I-EXPLORATION +microfilarias I-EXPLORATION +envainadas. I-EXPLORATION + B-EVOLUTION +Dadas I-EVOLUTION +las I-EVOLUTION +diferencias I-EVOLUTION +de I-EVOLUTION +periodicidad I-EVOLUTION +de I-EVOLUTION +aparición I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +microfilarias I-EVOLUTION +en I-EVOLUTION +sangre I-EVOLUTION +periférica I-EVOLUTION +(diurna I-EVOLUTION +y I-EVOLUTION +nocturna), I-EVOLUTION +se I-EVOLUTION +decidió I-EVOLUTION +ingresar I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +para I-EVOLUTION +tomar I-EVOLUTION +una I-EVOLUTION +segunda I-EVOLUTION +muestra I-EVOLUTION +de I-EVOLUTION +sangre I-EVOLUTION +que I-EVOLUTION +confirmase I-EVOLUTION +el I-EVOLUTION +diagnóstico I-EVOLUTION +de I-EVOLUTION +filariasis. I-EVOLUTION +En B-EXPLORATION +la I-EXPLORATION +segunda I-EXPLORATION +muestra I-EXPLORATION +de I-EXPLORATION +sangre I-EXPLORATION +periférica, I-EXPLORATION +tras I-EXPLORATION +concentración I-EXPLORATION +de I-EXPLORATION +Knott I-EXPLORATION +y I-EXPLORATION +tinción I-EXPLORATION +con I-EXPLORATION +Giemsa, I-EXPLORATION +se I-EXPLORATION +observaron I-EXPLORATION +microfilarias I-EXPLORATION +envainadas I-EXPLORATION +y I-EXPLORATION +sin I-EXPLORATION +envainar. I-EXPLORATION + I-EXPLORATION +Se B-DERIVED_FROM/TO +remitió I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +muestra I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +Centro I-DERIVED_FROM/TO +Nacional I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Microbiología, I-DERIVED_FROM/TO +donde I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +identificaron I-DERIVED_FROM/TO +como I-DERIVED_FROM/TO +Loa I-DERIVED_FROM/TO +loa I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +Mansonella I-DERIVED_FROM/TO +perstans. I-DERIVED_FROM/TO +Se B-TREATMENT +inició I-TREATMENT +un I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +dietilcarbamicina I-TREATMENT +6 I-TREATMENT +mg I-TREATMENT +en I-TREATMENT +dosis I-TREATMENT +única I-TREATMENT +y I-TREATMENT +100 I-TREATMENT +mg I-TREATMENT +de I-TREATMENT +mebendazol I-TREATMENT +cada I-TREATMENT +12 I-TREATMENT +horas I-TREATMENT +durante I-TREATMENT +30 I-TREATMENT +días I-TREATMENT +bajo I-TREATMENT +supervisión I-TREATMENT +médica I-TREATMENT +los I-TREATMENT +primeros I-TREATMENT +días I-TREATMENT +en I-TREATMENT +previsión I-TREATMENT +de I-TREATMENT +una I-TREATMENT +posible I-TREATMENT +reacción I-TREATMENT +de I-TREATMENT +Herxheimer. I-TREATMENT +La B-EVOLUTION +evolución I-EVOLUTION +fue I-EVOLUTION +buena, I-EVOLUTION +con I-EVOLUTION +disminución I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +cifra I-EVOLUTION +de I-EVOLUTION +eosinófilos, I-EVOLUTION +mejoría I-EVOLUTION +del I-EVOLUTION +prurito I-EVOLUTION +y I-EVOLUTION +desaparición I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +microfilarias I-EVOLUTION +en I-EVOLUTION +sangre I-EVOLUTION +periférica. I-EVOLUTION + I-EVOLUTION + +Presentamos B-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +47 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +acudió I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Urgencias I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +nuestro I-PRESENT_ILLNESS +hospital I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +lumbar I-PRESENT_ILLNESS +intenso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +aparición I-PRESENT_ILLNESS +brusca I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +dificultad I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +marcha, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +progresó I-PRESENT_ILLNESS +rápidamente I-PRESENT_ILLNESS +hacia I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +paraplejia I-PRESENT_ILLNESS +completa. I-PRESENT_ILLNESS +Entre B-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +destacaban I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +alergia I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +penicilina I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial I-PAST_MEDICAL_HISTORY +clasificada I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +idiopática, I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +diagnosticada I-PAST_MEDICAL_HISTORY +siete I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +atrás I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +tratada I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +enalapril-hidroclorotiazida I-PAST_MEDICAL_HISTORY +(20-12.5mg/24h). I-PAST_MEDICAL_HISTORY +En B-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +anamnesis I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +refirió I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +inicio I-PRESENT_ILLNESS +súbito, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +le I-PRESENT_ILLNESS +llegó I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +despertar I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +noche. I-PRESENT_ILLNESS +El I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +irradiaba I-PRESENT_ILLNESS +hacia I-PRESENT_ILLNESS +ambas I-PRESENT_ILLNESS +extremidades I-PRESENT_ILLNESS +inferiores I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +dificultaba I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +marcha. I-PRESENT_ILLNESS +La I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +negaba I-PRESENT_ILLNESS +antecedente I-PRESENT_ILLNESS +traumático I-PRESENT_ILLNESS +alguno. I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +inicial I-EXPLORATION +se I-EXPLORATION +objetivó I-EXPLORATION +un I-EXPLORATION +balance I-EXPLORATION +motor I-EXPLORATION +de I-EXPLORATION +3/5 I-EXPLORATION +en I-EXPLORATION +psoas I-EXPLORATION +y I-EXPLORATION +cuádriceps I-EXPLORATION +con I-EXPLORATION +0/5 I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +flexo-extensión I-EXPLORATION +plantar. I-EXPLORATION +Igualmente I-EXPLORATION +se I-EXPLORATION +detectó I-EXPLORATION +una I-EXPLORATION +anestesia I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +extremidad I-EXPLORATION +inferior I-EXPLORATION +derecha I-EXPLORATION +con I-EXPLORATION +hipoestesia I-EXPLORATION +termoalgésica I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +extremidad I-EXPLORATION +inferior I-EXPLORATION +izquierda I-EXPLORATION +junto I-EXPLORATION +con I-EXPLORATION +anestesia I-EXPLORATION +perineal, I-EXPLORATION +globo I-EXPLORATION +vesical I-EXPLORATION +e I-EXPLORATION +incontinencia I-EXPLORATION +fecal. I-EXPLORATION +El I-EXPLORATION +balance I-EXPLORATION +motor I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +extremidades I-EXPLORATION +superiores I-EXPLORATION +fue I-EXPLORATION +de I-EXPLORATION +5/5. I-EXPLORATION +La I-EXPLORATION +paciente I-EXPLORATION +no I-EXPLORATION +presentaba I-EXPLORATION +fiebre I-EXPLORATION +o I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +irritación I-EXPLORATION +meníngea. I-EXPLORATION +Se I-EXPLORATION +solicitó I-EXPLORATION +una I-EXPLORATION +tomografía I-EXPLORATION +axial I-EXPLORATION +computarizada I-EXPLORATION +(TAC) I-EXPLORATION +urgente I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +región I-EXPLORATION +lumbar, I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +mostró I-EXPLORATION +alteración I-EXPLORATION +alguna. I-EXPLORATION +Ante I-EXPLORATION +estos I-EXPLORATION +hallazgos I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION +(RMN) I-EXPLORATION +de I-EXPLORATION +columna I-EXPLORATION +lumbar I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +intradural I-EXPLORATION +que I-EXPLORATION +ocupaba I-EXPLORATION +la I-EXPLORATION +totalidad I-EXPLORATION +del I-EXPLORATION +saco I-EXPLORATION +dural I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +niveles I-EXPLORATION +L2-L3-L4 I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +satélite I-EXPLORATION +asociada I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +sacro. I-EXPLORATION + I-EXPLORATION +Con B-TREATMENT +la I-TREATMENT +sospecha I-TREATMENT +clínica I-TREATMENT +y I-TREATMENT +radiológica I-TREATMENT +inicial I-TREATMENT +de I-TREATMENT +ependimoma I-TREATMENT +se I-TREATMENT +intervino I-TREATMENT +de I-TREATMENT +urgencia I-TREATMENT +practicando I-TREATMENT +una I-TREATMENT +laminectomía I-TREATMENT +y I-TREATMENT +fijación I-TREATMENT +pedicular I-TREATMENT +L2-L3-L4. I-TREATMENT +Al I-TREATMENT +proceder I-TREATMENT +a I-TREATMENT +la I-TREATMENT +apertura I-TREATMENT +dural I-TREATMENT +observamos I-TREATMENT +una I-TREATMENT +tumoración I-TREATMENT +de I-TREATMENT +color I-TREATMENT +rojo I-TREATMENT +violáceo, I-TREATMENT +encapsulada, I-TREATMENT +que I-TREATMENT +desplazaba I-TREATMENT +las I-TREATMENT +raíces I-TREATMENT +nerviosas I-TREATMENT +lateralmente. I-TREATMENT +Mediante I-TREATMENT +microcirugía I-TREATMENT +se I-TREATMENT +disecó I-TREATMENT +con I-TREATMENT +facilidad I-TREATMENT +el I-TREATMENT +tumor I-TREATMENT +de I-TREATMENT +las I-TREATMENT +raíces I-TREATMENT +adyacentes I-TREATMENT +y I-TREATMENT +se I-TREATMENT +extirpó I-TREATMENT +en I-TREATMENT +su I-TREATMENT +totalidad I-TREATMENT +en I-TREATMENT +una I-TREATMENT +única I-TREATMENT +pieza. I-TREATMENT +La I-TREATMENT +lesión I-TREATMENT +se I-TREATMENT +encontraba I-TREATMENT +adherida I-TREATMENT +únicamente I-TREATMENT +al I-TREATMENT +filum I-TREATMENT +terminal. I-TREATMENT +El B-EVOLUTION +postoperatorio I-EVOLUTION +transcurrió I-EVOLUTION +sin I-EVOLUTION +complicaciones, I-EVOLUTION +experimentando I-EVOLUTION +una I-EVOLUTION +progresiva I-EVOLUTION +recuperación I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +función I-EVOLUTION +motora I-EVOLUTION +e I-EVOLUTION +inicio I-EVOLUTION +de I-EVOLUTION +control I-EVOLUTION +de I-EVOLUTION +esfínteres. I-EVOLUTION +Ante I-EVOLUTION +el I-EVOLUTION +diagnóstico I-EVOLUTION +anatomopatológico I-EVOLUTION +de I-EVOLUTION +paraganglioma, I-EVOLUTION +se I-EVOLUTION +solicitaron I-EVOLUTION +niveles I-EVOLUTION +de I-EVOLUTION +catecolaminas I-EVOLUTION +en I-EVOLUTION +sangre I-EVOLUTION +y I-EVOLUTION +en I-EVOLUTION +orina, I-EVOLUTION +resultando I-EVOLUTION +todos I-EVOLUTION +ellos I-EVOLUTION +normales. I-EVOLUTION +La I-EVOLUTION +paciente I-EVOLUTION +fue I-EVOLUTION +dada I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +a I-EVOLUTION +un I-EVOLUTION +centro I-EVOLUTION +rehabilitador I-EVOLUTION +para I-EVOLUTION +completar I-EVOLUTION +su I-EVOLUTION +recuperación. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +81 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +medicos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +acudió I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +nuestro I-PRESENT_ILLNESS +centro I-PRESENT_ILLNESS +hospitalario I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +hematoquecia I-PRESENT_ILLNESS +grave I-PRESENT_ILLNESS +(Hb I-PRESENT_ILLNESS +7, I-PRESENT_ILLNESS +9 I-PRESENT_ILLNESS +g/dl). I-PRESENT_ILLNESS +No B-EXPLORATION +se I-EXPLORATION +evidenciaron I-EXPLORATION +lesiones I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +endoscopia I-EXPLORATION +digestiva I-EXPLORATION +alta. I-EXPLORATION +Sin I-EXPLORATION +embargo, I-EXPLORATION +tras I-EXPLORATION +la I-EXPLORATION +estabilización I-EXPLORATION +hemodinámica I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +colonoscopia I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +objetivó I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +ulcerada I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +colon I-EXPLORATION +descendente, I-EXPLORATION +de I-EXPLORATION +aspecto I-EXPLORATION +submucoso, I-EXPLORATION +de I-EXPLORATION +unos I-EXPLORATION +12 I-EXPLORATION +mm I-EXPLORATION +de I-EXPLORATION +diámetro, I-EXPLORATION +localizada I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +interior I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +formación I-EXPLORATION +diverticular I-EXPLORATION +de I-EXPLORATION +gran I-EXPLORATION +tamaño. I-EXPLORATION +El I-EXPLORATION +enema I-EXPLORATION +opaco I-EXPLORATION +demostró I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +duplicación I-EXPLORATION +colónica I-EXPLORATION +a I-EXPLORATION +dicho I-EXPLORATION +nivel, I-EXPLORATION +simulando I-EXPLORATION +un I-EXPLORATION +gran I-EXPLORATION +divertículo, I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +fija I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +borde I-EXPLORATION +superior. I-EXPLORATION +La I-EXPLORATION +TC I-EXPLORATION +abdominal I-EXPLORATION +no I-EXPLORATION +demostró I-EXPLORATION +otras I-EXPLORATION +lesiones. I-EXPLORATION +El I-EXPLORATION +diagnóstico I-EXPLORATION +histológico I-EXPLORATION +obtenido I-EXPLORATION +por I-EXPLORATION +biopsias I-EXPLORATION +endoscópicas I-EXPLORATION +fue I-EXPLORATION +el I-EXPLORATION +de I-EXPLORATION +GIST I-EXPLORATION +de I-EXPLORATION +colon. I-EXPLORATION + I-EXPLORATION +Tras B-TREATMENT +la I-TREATMENT +evaluación I-TREATMENT +quirúrgica I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +una I-TREATMENT +resección I-TREATMENT +colónica I-TREATMENT +segmentaria I-TREATMENT +por I-TREATMENT +vía I-TREATMENT +laparoscópica. I-TREATMENT +La B-EXPLORATION +pieza I-EXPLORATION +obtenida I-EXPLORATION +contenía I-EXPLORATION +una I-EXPLORATION +duplicación I-EXPLORATION +colónica I-EXPLORATION +de I-EXPLORATION +32 I-EXPLORATION +x I-EXPLORATION +30 I-EXPLORATION +mm, I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +nódulo I-EXPLORATION +grisáceo I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +interior, I-EXPLORATION +de I-EXPLORATION +consistencia I-EXPLORATION +dura, I-EXPLORATION +de I-EXPLORATION +12 I-EXPLORATION +x I-EXPLORATION +7 I-EXPLORATION +mm. I-EXPLORATION +Histológicamente I-EXPLORATION +este I-EXPLORATION +nódulo I-EXPLORATION +era I-EXPLORATION +un I-EXPLORATION +GIST I-EXPLORATION +de I-EXPLORATION +colon I-EXPLORATION +calcificado I-EXPLORATION +(c-kit I-EXPLORATION ++, I-EXPLORATION +CD34 I-EXPLORATION ++), I-EXPLORATION +de I-EXPLORATION +tipo I-EXPLORATION +fusocelular, I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +índice I-EXPLORATION +mitótico I-EXPLORATION +< I-EXPLORATION +5/50 I-EXPLORATION +campos I-EXPLORATION +de I-EXPLORATION +gran I-EXPLORATION +aumento. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +paciente I-EXPLORATION +permanece I-EXPLORATION +asintomática I-EXPLORATION +7 I-EXPLORATION +meses I-EXPLORATION +después I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +intervención. I-EXPLORATION + I-EXPLORATION + +Tercera B-PRESENT_ILLNESS +hija, I-PRESENT_ILLNESS +embarazo B-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +parto I-PAST_MEDICAL_HISTORY +normal, I-PAST_MEDICAL_HISTORY +sin B-FAMILY_HISTORY +antecedentes I-FAMILY_HISTORY +de I-FAMILY_HISTORY +epilepsia I-FAMILY_HISTORY +en I-FAMILY_HISTORY +familiares I-FAMILY_HISTORY +de I-FAMILY_HISTORY +primer I-FAMILY_HISTORY +grado. I-FAMILY_HISTORY +Inició B-PRESENT_ILLNESS +CF I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +6 I-PRESENT_ILLNESS +meses, I-PRESENT_ILLNESS +prolongadas, I-PRESENT_ILLNESS +focales, I-PRESENT_ILLNESS +clonías I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +hemicara I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +SE I-PRESENT_ILLNESS +febriles I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +mulitples I-PRESENT_ILLNESS +EEG I-PRESENT_ILLNESS +standard I-PRESENT_ILLNESS +normales. I-PRESENT_ILLNESS +A I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +10 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +le I-PRESENT_ILLNESS +agregan I-PRESENT_ILLNESS +crisis I-PRESENT_ILLNESS +afebriles I-PRESENT_ILLNESS +pero I-PRESENT_ILLNESS +gatilladas I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +cuadros I-PRESENT_ILLNESS +infecciosos. I-PRESENT_ILLNESS +Posterior I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +año I-PRESENT_ILLNESS +persistió I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +múltiples I-PRESENT_ILLNESS +crisis I-PRESENT_ILLNESS +afebriles I-PRESENT_ILLNESS +hemigeneralizadas, I-PRESENT_ILLNESS +mioclónicas, I-PRESENT_ILLNESS +ausencias I-PRESENT_ILLNESS +atípicas I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +tónicas I-PRESENT_ILLNESS +clónicas I-PRESENT_ILLNESS +generalizadas I-PRESENT_ILLNESS +precipitadas I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +foto I-PRESENT_ILLNESS +estimulación. I-PRESENT_ILLNESS +Entre I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +primer I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +segundo I-PRESENT_ILLNESS +año I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +7 I-PRESENT_ILLNESS +SE I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +requirieron I-PRESENT_ILLNESS +ingreso I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +Unidad I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cuidados I-PRESENT_ILLNESS +intensivos I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +10 I-PRESENT_ILLNESS +hospitalizaciones I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +crisis I-PRESENT_ILLNESS +prolongadas. I-PRESENT_ILLNESS +La B-TREATMENT +triasociación I-TREATMENT +de I-TREATMENT +fenobarbital, I-TREATMENT +ácido I-TREATMENT +valproico I-TREATMENT +y I-TREATMENT +levetiracetam I-TREATMENT +no I-TREATMENT +logró I-TREATMENT +control I-TREATMENT +de I-TREATMENT +crisis. I-TREATMENT +La B-EXPLORATION +RM I-EXPLORATION +cerebral I-EXPLORATION +y I-EXPLORATION +estudios I-EXPLORATION +metabólicos I-EXPLORATION +fueron I-EXPLORATION +normales. I-EXPLORATION + I-EXPLORATION +Evolucionó B-EVOLUTION +con I-EVOLUTION +retraso I-EVOLUTION +de I-EVOLUTION +lenguaje, I-EVOLUTION +compromiso I-EVOLUTION +motor I-EVOLUTION +de I-EVOLUTION +menor I-EVOLUTION +cuantía I-EVOLUTION +y I-EVOLUTION +microcefalia. I-EVOLUTION +A B-EXPLORATION +la I-EXPLORATION +edad I-EXPLORATION +de I-EXPLORATION +3 I-EXPLORATION +años I-EXPLORATION +se I-EXPLORATION +solicitó I-EXPLORATION +estudio I-EXPLORATION +molecular I-EXPLORATION +del I-EXPLORATION +gen I-EXPLORATION +SCN1A I-EXPLORATION +que I-EXPLORATION +confirmó I-EXPLORATION +la I-EXPLORATION +mutación I-EXPLORATION +c.3311C>A I-EXPLORATION +(p.Ser1104X) I-EXPLORATION +exón I-EXPLORATION +16 I-EXPLORATION +en I-EXPLORATION +estado I-EXPLORATION +heterocigoto I-EXPLORATION +para I-EXPLORATION +el I-EXPLORATION +gen. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +molecular I-EXPLORATION +de I-EXPLORATION +ambos I-EXPLORATION +padres I-EXPLORATION +fue I-EXPLORATION +normal. I-EXPLORATION +El B-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +topiramato, I-TREATMENT +clobazam I-TREATMENT +y I-TREATMENT +Levetiracetam I-TREATMENT +permitió I-TREATMENT +controlar I-TREATMENT +crisis I-TREATMENT +prolongadas. I-TREATMENT +Sin B-EVOLUTION +SE I-EVOLUTION +desde I-EVOLUTION +9 I-EVOLUTION +meses I-EVOLUTION +pero I-EVOLUTION +ha I-EVOLUTION +persistido I-EVOLUTION +con I-EVOLUTION +5-7 I-EVOLUTION +crisis I-EVOLUTION +semanales I-EVOLUTION +de I-EVOLUTION +corta I-EVOLUTION +duración I-EVOLUTION +que I-EVOLUTION +no I-EVOLUTION +requieren I-EVOLUTION +uso I-EVOLUTION +de I-EVOLUTION +benzodiacepinas. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +49 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +médicos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +importancia I-PAST_MEDICAL_HISTORY +ni I-PAST_MEDICAL_HISTORY +consumo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +medicamentos I-PAST_MEDICAL_HISTORY +recientes. I-PAST_MEDICAL_HISTORY +Consultó B-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +tos I-PRESENT_ILLNESS +seca I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +5 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +asociada I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +odinofagia I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +lesiones I-PRESENT_ILLNESS +pruriginosas I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +muslos. I-PRESENT_ILLNESS +Se B-TREATMENT +diagnosticó I-TREATMENT +una I-TREATMENT +faringoamigdalitis I-TREATMENT +aguda I-TREATMENT +con I-TREATMENT +una I-TREATMENT +escarlatina I-TREATMENT +y I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +lincomicina I-TREATMENT +oral, I-TREATMENT +sin I-TREATMENT +mejoría I-TREATMENT +de I-TREATMENT +la I-TREATMENT +sintomatología I-TREATMENT +ni I-TREATMENT +remisión I-TREATMENT +de I-TREATMENT +las I-TREATMENT +lesiones I-TREATMENT +cutáneas. I-TREATMENT +A B-EVOLUTION +las I-EVOLUTION +48 I-EVOLUTION +h, I-EVOLUTION +se I-EVOLUTION +agregó I-EVOLUTION +fiebre I-EVOLUTION +hasta I-EVOLUTION +38, I-EVOLUTION +5°C I-EVOLUTION +y I-EVOLUTION +las I-EVOLUTION +lesiones I-EVOLUTION +se I-EVOLUTION +diseminaron I-EVOLUTION +en I-EVOLUTION +forma I-EVOLUTION +centrípeta, I-EVOLUTION +por I-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +consultó I-EVOLUTION +nuevamente. I-EVOLUTION +La B-EXPLORATION +paciente I-EXPLORATION +estaba I-EXPLORATION +en I-EXPLORATION +regulares I-EXPLORATION +condiciones I-EXPLORATION +generales, I-EXPLORATION +hemodinámicamente I-EXPLORATION +estable. I-EXPLORATION +Al I-EXPLORATION +examen I-EXPLORATION +físico, I-EXPLORATION +presentaba I-EXPLORATION +un I-EXPLORATION +leve I-EXPLORATION +eritema I-EXPLORATION +faríngeo I-EXPLORATION +asociado I-EXPLORATION +a I-EXPLORATION +un I-EXPLORATION +examen I-EXPLORATION +pulmonar I-EXPLORATION +normal. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +pesquisaron I-EXPLORATION +adenopatías. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +examen I-EXPLORATION +cutáneo, I-EXPLORATION +destacaban I-EXPLORATION +máculas I-EXPLORATION +y I-EXPLORATION +pápulas I-EXPLORATION +eritematosas I-EXPLORATION +palmoplantares I-EXPLORATION +y I-EXPLORATION +pústulas I-EXPLORATION +no I-EXPLORATION +foliculares, I-EXPLORATION +de I-EXPLORATION +base I-EXPLORATION +eritematosa, I-EXPLORATION +confluentes I-EXPLORATION +en I-EXPLORATION +placas, I-EXPLORATION +localizadas I-EXPLORATION +en I-EXPLORATION +cuello, I-EXPLORATION +dorso, I-EXPLORATION +región I-EXPLORATION +lumbar I-EXPLORATION +y I-EXPLORATION +muslos. I-EXPLORATION +El I-EXPLORATION +signo I-EXPLORATION +de I-EXPLORATION +Nikolsky I-EXPLORATION +era I-EXPLORATION +negativo. I-EXPLORATION +No I-EXPLORATION +tenía I-EXPLORATION +compromiso I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +mucosa I-EXPLORATION +oral, I-EXPLORATION +ocular I-EXPLORATION +ni I-EXPLORATION +genital. I-EXPLORATION +Sin B-TREATMENT +embargo, I-TREATMENT +dado I-TREATMENT +el I-TREATMENT +compromiso I-TREATMENT +cutáneo I-TREATMENT +extenso, I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +su I-TREATMENT +internación. I-TREATMENT + I-TREATMENT +Los B-EXPLORATION +exámenes I-EXPLORATION +de I-EXPLORATION +laboratorio I-EXPLORATION +mostraron I-EXPLORATION +una I-EXPLORATION +leucocitosis I-EXPLORATION +(15.500 I-EXPLORATION +neutrófilos/mm3, I-EXPLORATION +sin I-EXPLORATION +eosinofilia), I-EXPLORATION +proteína I-EXPLORATION +C I-EXPLORATION +reactiva I-EXPLORATION +de I-EXPLORATION +14, I-EXPLORATION +7 I-EXPLORATION +mg/dL I-EXPLORATION +(valor I-EXPLORATION +normal I-EXPLORATION +< I-EXPLORATION +1 I-EXPLORATION +mg/dL) I-EXPLORATION +y I-EXPLORATION +pruebas I-EXPLORATION +hepáticas I-EXPLORATION +levemente I-EXPLORATION +alteradas: I-EXPLORATION +GOT: I-EXPLORATION +23 I-EXPLORATION +UI/L I-EXPLORATION +(VN I-EXPLORATION +9-25), I-EXPLORATION +GPT: I-EXPLORATION +48 I-EXPLORATION +UI/L I-EXPLORATION +(VN I-EXPLORATION +7-30), I-EXPLORATION +fosfatasas I-EXPLORATION +alcalinas: I-EXPLORATION +199 I-EXPLORATION +UI/L I-EXPLORATION +(VN I-EXPLORATION +30-100), I-EXPLORATION +GGT: I-EXPLORATION +110 I-EXPLORATION +UI/L I-EXPLORATION +(VN I-EXPLORATION +4-50). I-EXPLORATION +La I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +tórax I-EXPLORATION +mostró I-EXPLORATION +escaso I-EXPLORATION +infiltrado I-EXPLORATION +intersticial, I-EXPLORATION +sin I-EXPLORATION +focos I-EXPLORATION +de I-EXPLORATION +consolidación. I-EXPLORATION +El I-EXPLORATION +panel I-EXPLORATION +viral I-EXPLORATION +respiratorio I-EXPLORATION +molecular, I-EXPLORATION +por I-EXPLORATION +técnica I-EXPLORATION +de I-EXPLORATION +reacción I-EXPLORATION +de I-EXPLORATION +polimerasa I-EXPLORATION +en I-EXPLORATION +cadena I-EXPLORATION +(RPC), I-EXPLORATION +fue I-EXPLORATION +negativo. I-EXPLORATION +La I-EXPLORATION +IgM I-EXPLORATION +para I-EXPLORATION +M. I-EXPLORATION +pneumoniae I-EXPLORATION +(técnica I-EXPLORATION +cualitativa I-EXPLORATION +por I-EXPLORATION +ELISA) I-EXPLORATION +fue I-EXPLORATION +positiva I-EXPLORATION +al I-EXPLORATION +segundo I-EXPLORATION +día I-EXPLORATION +de I-EXPLORATION +hospitalización I-EXPLORATION +(correspondiente I-EXPLORATION +al I-EXPLORATION +noveno I-EXPLORATION +día I-EXPLORATION +de I-EXPLORATION +evolución). I-EXPLORATION +Las I-EXPLORATION +serologías I-EXPLORATION +para I-EXPLORATION +VIH, I-EXPLORATION +virus I-EXPLORATION +hepatitis I-EXPLORATION +B, I-EXPLORATION +C, I-EXPLORATION +y I-EXPLORATION +sífilis I-EXPLORATION +fueron I-EXPLORATION +negativas. I-EXPLORATION +La I-EXPLORATION +tinción I-EXPLORATION +de I-EXPLORATION +Gram I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +cultivo I-EXPLORATION +corriente I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +pústulas I-EXPLORATION +fueron I-EXPLORATION +negativos. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +biopsia I-EXPLORATION +de I-EXPLORATION +piel I-EXPLORATION +en I-EXPLORATION +que I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +histopatológico I-EXPLORATION +mostró I-EXPLORATION +acantosis, I-EXPLORATION +espongiosis, I-EXPLORATION +exocitosis I-EXPLORATION +de I-EXPLORATION +neutrófilos I-EXPLORATION +y I-EXPLORATION +pústulas I-EXPLORATION +intracórneas, I-EXPLORATION +intraepidérmicas I-EXPLORATION +e I-EXPLORATION +intrafoliculares. I-EXPLORATION +La I-EXPLORATION +dermis I-EXPLORATION +presentaba I-EXPLORATION +un I-EXPLORATION +infiltrado I-EXPLORATION +perivascular I-EXPLORATION +difuso I-EXPLORATION +con I-EXPLORATION +linfocitos I-EXPLORATION +y I-EXPLORATION +neutrófilos. I-EXPLORATION +La I-EXPLORATION +tinción I-EXPLORATION +de I-EXPLORATION +PAS I-EXPLORATION +fue I-EXPLORATION +negativa I-EXPLORATION +para I-EXPLORATION +microorganismos. I-EXPLORATION +Dado I-EXPLORATION +estos I-EXPLORATION +hallazgos I-EXPLORATION +clínicos I-EXPLORATION +e I-EXPLORATION +histopatológicos, I-EXPLORATION +se I-EXPLORATION +diagnosticó I-EXPLORATION +una I-EXPLORATION +PEGA, I-EXPLORATION +probablemente I-EXPLORATION +causada I-EXPLORATION +por I-EXPLORATION +M. I-EXPLORATION +pneumoniae. I-EXPLORATION +Se B-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +hidrocortisona I-TREATMENT +i.v., I-TREATMENT +a I-TREATMENT +dosis I-TREATMENT +de I-TREATMENT +50 I-TREATMENT +mg I-TREATMENT +fraccionada I-TREATMENT +cada I-TREATMENT +8 I-TREATMENT +h, I-TREATMENT +y I-TREATMENT +levofloxacina I-TREATMENT +oral I-TREATMENT +400 I-TREATMENT +mg I-TREATMENT +al I-TREATMENT +día, I-TREATMENT +con B-EVOLUTION +excelente I-EVOLUTION +evolución I-EVOLUTION +marcada I-EVOLUTION +por I-EVOLUTION +la I-EVOLUTION +desaparición I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +fiebre I-EVOLUTION +y I-EVOLUTION +disminución I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +lesiones I-EVOLUTION +cutáneas, I-EVOLUTION +dándose I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +a I-EVOLUTION +las I-EVOLUTION +48 I-EVOLUTION +h I-EVOLUTION +con B-TREATMENT +prednisona I-TREATMENT +en I-TREATMENT +dosis I-TREATMENT +decrecientes I-TREATMENT +y I-TREATMENT +el I-TREATMENT +mismo I-TREATMENT +antimicrobiano, I-TREATMENT +ambos I-TREATMENT +por I-TREATMENT +7 I-TREATMENT +días I-TREATMENT +más. I-TREATMENT +Al B-EVOLUTION +control I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +dos I-EVOLUTION +semanas, I-EVOLUTION +ya I-EVOLUTION +no I-EVOLUTION +presentaba I-EVOLUTION +lesiones I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +piel. I-EVOLUTION + I-EVOLUTION + +Paciente B-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +81 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial, I-PAST_MEDICAL_HISTORY +fibrilación I-PAST_MEDICAL_HISTORY +auricular I-PAST_MEDICAL_HISTORY +(por I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +encontraba I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +anticoagulante) I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +adenocarcinoma I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +próstata I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +sido I-PAST_MEDICAL_HISTORY +intervenido I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +encontraba I-PAST_MEDICAL_HISTORY +libre I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +enfermedad. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Acudió B-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Urgencias I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +episodio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +precordial I-PRESENT_ILLNESS +irradiado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +hipocondrio I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +varias I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +acompañado I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +disnea I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +mínimos I-PRESENT_ILLNESS +esfuerzos. I-PRESENT_ILLNESS +En B-EXPLORATION +el I-EXPLORATION +momento I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +valoración I-EXPLORATION +la I-EXPLORATION +sintomatología I-EXPLORATION +había I-EXPLORATION +disminuido. I-EXPLORATION +Inicialmente I-EXPLORATION +se I-EXPLORATION +diagnosticó I-EXPLORATION +como I-EXPLORATION +un I-EXPLORATION +posible I-EXPLORATION +síndrome I-EXPLORATION +coronario I-EXPLORATION +agudo I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +inició I-EXPLORATION +tratamiento I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +solicitó I-EXPLORATION +una I-EXPLORATION +analítica I-EXPLORATION +con I-EXPLORATION +enzimas I-EXPLORATION +de I-EXPLORATION +daño I-EXPLORATION +miocárdico I-EXPLORATION +y I-EXPLORATION +un I-EXPLORATION +electrocardiograma I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +presentaban I-EXPLORATION +anomalías. I-EXPLORATION +El I-EXPLORATION +paciente I-EXPLORATION +refería I-EXPLORATION +astenia I-EXPLORATION +y I-EXPLORATION +molestias I-EXPLORATION +en I-EXPLORATION +hipocondrio I-EXPLORATION +derecho I-EXPLORATION +de I-EXPLORATION +7 I-EXPLORATION +días I-EXPLORATION +de I-EXPLORATION +evolución, I-EXPLORATION +pero I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +momento I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +valoración I-EXPLORATION +no I-EXPLORATION +presentaba I-EXPLORATION +dolor I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +era I-EXPLORATION +anodina I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +tras I-EXPLORATION +ser I-EXPLORATION +valorado I-EXPLORATION +por I-EXPLORATION +el I-EXPLORATION +servicio I-EXPLORATION +de I-EXPLORATION +Cardiología I-EXPLORATION +se I-EXPLORATION +dio I-EXPLORATION +de I-EXPLORATION +alta. I-EXPLORATION + I-EXPLORATION +Seis B-EVOLUTION +días I-EVOLUTION +después I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +acudió I-EVOLUTION +al I-EVOLUTION +servicio I-EVOLUTION +de I-EVOLUTION +Urgencias I-EVOLUTION +por I-EVOLUTION +persistencia I-EVOLUTION +del I-EVOLUTION +dolor I-EVOLUTION +en I-EVOLUTION +hipocondrio I-EVOLUTION +derecho I-EVOLUTION +acompañado I-EVOLUTION +de I-EVOLUTION +naúseas I-EVOLUTION +e I-EVOLUTION +hiporexia. I-EVOLUTION +No B-EXPLORATION +presentaba I-EXPLORATION +fiebre I-EXPLORATION +ni I-EXPLORATION +otra I-EXPLORATION +clínica I-EXPLORATION +acompañante. I-EXPLORATION +A I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +destacaba I-EXPLORATION +un I-EXPLORATION +abdomen I-EXPLORATION +distendido, I-EXPLORATION +doloroso I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación I-EXPLORATION +en I-EXPLORATION +hipocondrio I-EXPLORATION +y I-EXPLORATION +flanco I-EXPLORATION +derecho I-EXPLORATION +con I-EXPLORATION +defensa I-EXPLORATION +pero I-EXPLORATION +con I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +Blumberg I-EXPLORATION +y I-EXPLORATION +Murphy I-EXPLORATION +negativos. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +analítica I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +observaba I-EXPLORATION +una I-EXPLORATION +hemoglobina I-EXPLORATION +de I-EXPLORATION +11 I-EXPLORATION +g/dl, I-EXPLORATION +hematocrito I-EXPLORATION +de I-EXPLORATION +32, I-EXPLORATION +6%, I-EXPLORATION +leucocitos I-EXPLORATION +14.000 I-EXPLORATION +con I-EXPLORATION +74% I-EXPLORATION +de I-EXPLORATION +neutrófilos, I-EXPLORATION +INR I-EXPLORATION +2, I-EXPLORATION +95 I-EXPLORATION +y I-EXPLORATION +fibrinógeno I-EXPLORATION +816 I-EXPLORATION +mg/dl. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +solicitó I-EXPLORATION +una I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +una I-EXPLORATION +vesícula I-EXPLORATION +con I-EXPLORATION +paredes I-EXPLORATION +mal I-EXPLORATION +definidas I-EXPLORATION +y I-EXPLORATION +colelitiasis, I-EXPLORATION +además I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +imagen I-EXPLORATION +hipoecoica I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +líquido I-EXPLORATION +libre I-EXPLORATION +perivesicular I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +interpretó I-EXPLORATION +como I-EXPLORATION +colecistitis I-EXPLORATION +aguda I-EXPLORATION +perforada I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +decidió I-EXPLORATION +completar I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +tomografía I-EXPLORATION +computarizada I-EXPLORATION +(TC). I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +TC I-EXPLORATION +se I-EXPLORATION +confirmó I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +vesícula I-EXPLORATION +con I-EXPLORATION +paredes I-EXPLORATION +mal I-EXPLORATION +definidas I-EXPLORATION +junto I-EXPLORATION +a I-EXPLORATION +una I-EXPLORATION +colección I-EXPLORATION +de I-EXPLORATION +líquido I-EXPLORATION +de I-EXPLORATION +alta I-EXPLORATION +densidad I-EXPLORATION +de I-EXPLORATION +7x3 I-EXPLORATION +cm I-EXPLORATION +que I-EXPLORATION +alteraba I-EXPLORATION +la I-EXPLORATION +grasa I-EXPLORATION +circundante I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +colecistitis I-EXPLORATION +aguda I-EXPLORATION +perforada. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +paciente I-EXPLORATION +se I-EXPLORATION +encontraba I-EXPLORATION +estable I-EXPLORATION +y I-EXPLORATION +no I-EXPLORATION +presentaba I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +irritación I-EXPLORATION +peritoneal I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +decidió I-EXPLORATION +el I-EXPLORATION +ingreso I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +planta I-EXPLORATION +de I-EXPLORATION +Cirugía I-EXPLORATION +para I-EXPLORATION +tratamiento I-EXPLORATION +conservador. I-EXPLORATION +Se B-TREATMENT +instauró I-TREATMENT +tratamiento I-TREATMENT +analgésico I-TREATMENT +y I-TREATMENT +antibiótico I-TREATMENT +(Piperacilina-Tazobactan). I-TREATMENT +A B-EVOLUTION +las I-EVOLUTION +48 I-EVOLUTION +horas I-EVOLUTION +del I-EVOLUTION +ingreso I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +continuaba I-EVOLUTION +con I-EVOLUTION +molestias I-EVOLUTION +en I-EVOLUTION +hipocondrio I-EVOLUTION +derecho I-EVOLUTION +y I-EVOLUTION +en I-EVOLUTION +los I-EVOLUTION +análisis I-EVOLUTION +de I-EVOLUTION +control I-EVOLUTION +persistía I-EVOLUTION +la I-EVOLUTION +leucocitosis I-EVOLUTION +por I-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +decidió I-EVOLUTION +realizar I-EVOLUTION +una I-EVOLUTION +TC I-EVOLUTION +de I-EVOLUTION +control. I-EVOLUTION +En I-EVOLUTION +la I-EVOLUTION +prueba I-EVOLUTION +de I-EVOLUTION +imagen I-EVOLUTION +se I-EVOLUTION +confirmó I-EVOLUTION +la I-EVOLUTION +mala I-EVOLUTION +evolución I-EVOLUTION +del I-EVOLUTION +proceso I-EVOLUTION +con I-EVOLUTION +aumento I-EVOLUTION +del I-EVOLUTION +líquido I-EVOLUTION +libre I-EVOLUTION +intraabdominal. I-EVOLUTION +Con B-TREATMENT +estos I-TREATMENT +hallazgos I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +una I-TREATMENT +intervención I-TREATMENT +quirúrgica I-TREATMENT +urgente. I-TREATMENT + I-TREATMENT +Fue I-TREATMENT +intervenido I-TREATMENT +mediante I-TREATMENT +una I-TREATMENT +incisión I-TREATMENT +subcostal I-TREATMENT +derecha I-TREATMENT +por I-TREATMENT +la I-TREATMENT +que I-TREATMENT +se I-TREATMENT +accedió I-TREATMENT +a I-TREATMENT +la I-TREATMENT +cavidad I-TREATMENT +peritoneal. I-TREATMENT +Se I-TREATMENT +localizó I-TREATMENT +un I-TREATMENT +plastrón I-TREATMENT +de I-TREATMENT +epiplón I-TREATMENT +que I-TREATMENT +cubría I-TREATMENT +la I-TREATMENT +vesícula, I-TREATMENT +de I-TREATMENT +aspecto I-TREATMENT +tumoral, I-TREATMENT +con I-TREATMENT +sufusión I-TREATMENT +hemorrágica I-TREATMENT +en I-TREATMENT +espacio I-TREATMENT +subfrénico I-TREATMENT +y I-TREATMENT +perirrenal, I-TREATMENT +así I-TREATMENT +como I-TREATMENT +un I-TREATMENT +hemoperitoneo I-TREATMENT +de I-TREATMENT +2, I-TREATMENT +7 I-TREATMENT +litros I-TREATMENT +sin I-TREATMENT +apreciarse I-TREATMENT +punto I-TREATMENT +de I-TREATMENT +hemorragia. I-TREATMENT +Se I-TREATMENT +realizó I-TREATMENT +una I-TREATMENT +colecistectomía I-TREATMENT +subtotal I-TREATMENT +por I-TREATMENT +invasión I-TREATMENT +tumoral I-TREATMENT +del I-TREATMENT +parénquima I-TREATMENT +hepático I-TREATMENT +y I-TREATMENT +se I-TREATMENT +extirpó I-TREATMENT +la I-TREATMENT +mayor I-TREATMENT +parte I-TREATMENT +del I-TREATMENT +epiplón I-TREATMENT +quedando I-TREATMENT +residuo I-TREATMENT +tumoral I-TREATMENT +macroscópico. I-TREATMENT + I-TREATMENT +La B-EVOLUTION +evolución I-EVOLUTION +postoperatoria I-EVOLUTION +fue I-EVOLUTION +favorable I-EVOLUTION +y I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +fue I-EVOLUTION +dado I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +al I-EVOLUTION +6o I-EVOLUTION +día I-EVOLUTION +postoperatorio. I-EVOLUTION + I-EVOLUTION +A I-EVOLUTION +la I-EVOLUTION +semana I-EVOLUTION +del I-EVOLUTION +alta, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +reingresó I-EVOLUTION +por I-EVOLUTION +dolor I-EVOLUTION +abdominal I-EVOLUTION +en I-EVOLUTION +hipocondrio I-EVOLUTION +derecho I-EVOLUTION +asociado I-EVOLUTION +a I-EVOLUTION +astenia I-EVOLUTION +y I-EVOLUTION +anorexia. I-EVOLUTION +En B-EXPLORATION +los I-EXPLORATION +análisis I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +una I-EXPLORATION +hemoglobina I-EXPLORATION +de I-EXPLORATION +7, I-EXPLORATION +5 I-EXPLORATION +g/dL, I-EXPLORATION +hematocrito I-EXPLORATION +de I-EXPLORATION +22, I-EXPLORATION +7% I-EXPLORATION +y I-EXPLORATION +32.500 I-EXPLORATION +leucocitos I-EXPLORATION +con I-EXPLORATION +desviación I-EXPLORATION +izquierda. I-EXPLORATION +El I-EXPLORATION +paciente I-EXPLORATION +presentaba I-EXPLORATION +mal I-EXPLORATION +estado I-EXPLORATION +general, I-EXPLORATION +con I-EXPLORATION +dolor I-EXPLORATION +en I-EXPLORATION +mesogastrio I-EXPLORATION +e I-EXPLORATION +hipocondrio I-EXPLORATION +derecho. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +apreció I-EXPLORATION +una I-EXPLORATION +colección I-EXPLORATION +de I-EXPLORATION +4x4 I-EXPLORATION +cm I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +lecho I-EXPLORATION +quirúrgico. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +estableció I-TREATMENT +tratamiento I-TREATMENT +sintomático I-TREATMENT +pero I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +presentó I-TREATMENT +un I-TREATMENT +deterioro I-TREATMENT +progresivo I-TREATMENT +durante I-TREATMENT +los I-TREATMENT +días I-TREATMENT +siguientes I-TREATMENT +marcado I-TREATMENT +por I-TREATMENT +disnea, I-TREATMENT +dolor I-TREATMENT +abdominal I-TREATMENT +en I-TREATMENT +aumento, I-TREATMENT +melenas I-TREATMENT +y I-TREATMENT +una I-TREATMENT +anemización I-TREATMENT +progresiva I-TREATMENT +asociada I-TREATMENT +a I-TREATMENT +hipotensión I-TREATMENT +a I-TREATMENT +pesar I-TREATMENT +de I-TREATMENT +transfusiones I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +finalmente I-TREATMENT +falleció I-TREATMENT +a I-TREATMENT +los I-TREATMENT +20 I-TREATMENT +días I-TREATMENT +de I-TREATMENT +ser I-TREATMENT +intervenido. I-TREATMENT + I-TREATMENT +Se B-EXPLORATION +realizó I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +muestras I-EXPLORATION +remitidas I-EXPLORATION +a I-EXPLORATION +anatomía I-EXPLORATION +patológica. I-EXPLORATION +En I-EXPLORATION +ellas I-EXPLORATION +se I-EXPLORATION +identificaron I-EXPLORATION +áreas I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +infiltrado I-EXPLORATION +en I-EXPLORATION +células I-EXPLORATION +entremezclado I-EXPLORATION +con I-EXPLORATION +focos I-EXPLORATION +hemorrágicos I-EXPLORATION +y I-EXPLORATION +zonas I-EXPLORATION +en I-EXPLORATION +donde I-EXPLORATION +las I-EXPLORATION +células I-EXPLORATION +se I-EXPLORATION +disponen I-EXPLORATION +formando I-EXPLORATION +canales I-EXPLORATION +vasculares. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +completó I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +análisis I-EXPLORATION +inmunohistoquímico I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +que I-EXPLORATION +destacaba I-EXPLORATION +la I-EXPLORATION +queratina I-EXPLORATION +7 I-EXPLORATION +positivo I-EXPLORATION +intenso, I-EXPLORATION +D2.40, I-EXPLORATION +CD-31 I-EXPLORATION +y I-EXPLORATION +vimentina I-EXPLORATION +intensamente I-EXPLORATION +positivo. I-EXPLORATION +Todo I-EXPLORATION +ello I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +angiosarcoma I-EXPLORATION +epitelioide I-EXPLORATION +primario I-EXPLORATION +de I-EXPLORATION +vesícula I-EXPLORATION +biliar. I-EXPLORATION + I-EXPLORATION + +Recien B-PRESENT_ILLNESS +nacido I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +día I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +vida I-PRESENT_ILLNESS +después I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +gestación I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +40 I-PRESENT_ILLNESS +semanas I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +parto I-PRESENT_ILLNESS +asistido I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +forceps. I-PRESENT_ILLNESS +Es B-DERIVED_FROM/TO +trasladado I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +nuestro I-DERIVED_FROM/TO +centro I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +cefalohematoma I-DERIVED_FROM/TO +parietal I-DERIVED_FROM/TO +izquierdo I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +fractura I-DERIVED_FROM/TO +deprimida I-DERIVED_FROM/TO +parietal I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +hematoma I-DERIVED_FROM/TO +epidural I-DERIVED_FROM/TO +subyacente. I-DERIVED_FROM/TO +La B-EXPLORATION +exploración I-EXPLORATION +neurológica I-EXPLORATION +fue I-EXPLORATION +normal. I-EXPLORATION +Fue B-TREATMENT +intervenido I-TREATMENT +evacuándose I-TREATMENT +el I-TREATMENT +hematoma I-TREATMENT +y I-TREATMENT +elevándose I-TREATMENT +la I-TREATMENT +fractura I-TREATMENT +deprimida, I-TREATMENT +dejando I-TREATMENT +un I-TREATMENT +drenaje I-TREATMENT +epidural I-TREATMENT +24 I-TREATMENT +horas. I-TREATMENT +Fue B-EVOLUTION +dado I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +4 I-EVOLUTION +días I-EVOLUTION +y I-EVOLUTION +tras I-EVOLUTION +2 I-EVOLUTION +años I-EVOLUTION +de I-EVOLUTION +seguimiento I-EVOLUTION +está I-EVOLUTION +asintomático. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +48 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +endometriosis, I-PAST_MEDICAL_HISTORY +mioma I-PAST_MEDICAL_HISTORY +uterino I-PAST_MEDICAL_HISTORY +tratado I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +embolización I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +miomectomía, I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +hábitos I-PAST_MEDICAL_HISTORY +tóxicos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +tabaquismo I-PAST_MEDICAL_HISTORY +o I-PAST_MEDICAL_HISTORY +alcoholismo. I-PAST_MEDICAL_HISTORY +Sin I-PAST_MEDICAL_HISTORY +hijos; I-PAST_MEDICAL_HISTORY +padres I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +hermanos I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés. I-PAST_MEDICAL_HISTORY +Acude B-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +hace I-PRESENT_ILLNESS +varios I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +aumento I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +perímetro I-PRESENT_ILLNESS +abdominal, I-PRESENT_ILLNESS +molestias I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +epigastrio I-PRESENT_ILLNESS +asociado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +pirosis, I-PRESENT_ILLNESS +pesadez I-PRESENT_ILLNESS +posprandial I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +difuso I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +continuo, I-PRESENT_ILLNESS +más I-PRESENT_ILLNESS +intenso I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +hipocondrio I-PRESENT_ILLNESS +derecho. I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +un I-EXPLORATION +abdomen I-EXPLORATION +distendido, I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +palpa I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +abdominal I-EXPLORATION +en I-EXPLORATION +hipocondrio I-EXPLORATION +derecho, I-EXPLORATION +epigastrio I-EXPLORATION +y I-EXPLORATION +mesogastrio, I-EXPLORATION +indurada I-EXPLORATION +y I-EXPLORATION +dolorosa. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +palpa I-EXPLORATION +esplenomegalia I-EXPLORATION +ni I-EXPLORATION +existe I-EXPLORATION +semiología I-EXPLORATION +de I-EXPLORATION +ascitis. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +analítica I-EXPLORATION +presenta I-EXPLORATION +una I-EXPLORATION +elevación I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +GGT, I-EXPLORATION +resto I-EXPLORATION +del I-EXPLORATION +estudio I-EXPLORATION +(hemograma, I-EXPLORATION +sistemático I-EXPLORATION +de I-EXPLORATION +orina, I-EXPLORATION +bioquímica I-EXPLORATION +general, I-EXPLORATION +proteinograma, I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +coagulación, I-EXPLORATION +marcadores I-EXPLORATION +de I-EXPLORATION +virus I-EXPLORATION +hepatotropos I-EXPLORATION +y I-EXPLORATION +tumorales), I-EXPLORATION +sin I-EXPLORATION +hallazgos I-EXPLORATION +significativos. I-EXPLORATION +La I-EXPLORATION +tomografía I-EXPLORATION +computarizada I-EXPLORATION +abdominal I-EXPLORATION +muestra I-EXPLORATION +una I-EXPLORATION +hepatomegalia I-EXPLORATION +con I-EXPLORATION +incontables I-EXPLORATION +lesiones I-EXPLORATION +quísticas; I-EXPLORATION +destaca I-EXPLORATION +en I-EXPLORATION +lóbulo I-EXPLORATION +hepático I-EXPLORATION +derecho I-EXPLORATION +(LHD) I-EXPLORATION +un I-EXPLORATION +quiste I-EXPLORATION +de I-EXPLORATION +18 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +tamaño, I-EXPLORATION +vía I-EXPLORATION +biliar, I-EXPLORATION +páncreas I-EXPLORATION +y I-EXPLORATION +bazo I-EXPLORATION +sin I-EXPLORATION +alteraciones. I-EXPLORATION +Riñón I-EXPLORATION +derecho I-EXPLORATION +pélvico I-EXPLORATION +por I-EXPLORATION +desplazamiento I-EXPLORATION +hepático. I-EXPLORATION +Sendos I-EXPLORATION +quistes I-EXPLORATION +renales I-EXPLORATION +bilaterales I-EXPLORATION +de I-EXPLORATION +pequeño I-EXPLORATION +tamaño. I-EXPLORATION +Miomas I-EXPLORATION +uterinos I-EXPLORATION +calcificados. I-EXPLORATION +La I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION +confirmó I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +enfermedad I-EXPLORATION +hepática I-EXPLORATION +poliquística, I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +quiste I-EXPLORATION +gigante I-EXPLORATION +en I-EXPLORATION +LHD. I-EXPLORATION +La I-EXPLORATION +ausencia I-EXPLORATION +de I-EXPLORATION +quistes I-EXPLORATION +renales I-EXPLORATION +significativos I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +criterios I-EXPLORATION +de I-EXPLORATION +enfermedad I-EXPLORATION +poliquística I-EXPLORATION +renal I-EXPLORATION +permite I-EXPLORATION +establecer I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +EHPA. I-EXPLORATION +Posteriormente B-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +ingresa I-TREATMENT +de I-TREATMENT +forma I-TREATMENT +programada I-TREATMENT +a I-TREATMENT +la I-TREATMENT +planta I-TREATMENT +del I-TREATMENT +Servicio I-TREATMENT +de I-TREATMENT +Digestivo, I-TREATMENT +y I-TREATMENT +se I-TREATMENT +realiza I-TREATMENT +un I-TREATMENT +drenaje I-TREATMENT +percutáneo I-TREATMENT +con I-TREATMENT +catéter I-TREATMENT +8F I-TREATMENT +pig-tail, I-TREATMENT +con I-TREATMENT +control I-TREATMENT +ecográfico I-TREATMENT +del I-TREATMENT +quiste I-TREATMENT +hepático I-TREATMENT +gigante, I-TREATMENT +evacuándose I-TREATMENT +un I-TREATMENT +líquido I-TREATMENT +transparente, I-TREATMENT +sin I-TREATMENT +complicaciones I-TREATMENT +inmediatas. I-TREATMENT +En I-TREATMENT +un I-TREATMENT +segundo I-TREATMENT +tiempo, I-TREATMENT +durante I-TREATMENT +el I-TREATMENT +mismo I-TREATMENT +día, I-TREATMENT +se I-TREATMENT +realiza I-TREATMENT +en I-TREATMENT +el I-TREATMENT +Servicio I-TREATMENT +de I-TREATMENT +Radiología I-TREATMENT +una I-TREATMENT +quistografía I-TREATMENT +transcatéter, I-TREATMENT +en I-TREATMENT +la I-TREATMENT +que I-TREATMENT +no I-TREATMENT +se I-TREATMENT +advierten I-TREATMENT +signos I-TREATMENT +de I-TREATMENT +fugas I-TREATMENT +de I-TREATMENT +contraste I-TREATMENT +y I-TREATMENT +se I-TREATMENT +procede I-TREATMENT +a I-TREATMENT +la I-TREATMENT +instilación I-TREATMENT +de I-TREATMENT +270 I-TREATMENT +ml I-TREATMENT +de I-TREATMENT +alcohol I-TREATMENT +puro I-TREATMENT +durante I-TREATMENT +treinta I-TREATMENT +minutos, I-TREATMENT +y I-TREATMENT +que I-TREATMENT +se I-TREATMENT +aspira I-TREATMENT +posteriormente. I-TREATMENT +Más B-EVOLUTION +tarde I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +fue I-EVOLUTION +dada I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +con I-EVOLUTION +mejoría I-EVOLUTION +clínica I-EVOLUTION +y I-EVOLUTION +analítica, I-EVOLUTION +sin I-EVOLUTION +complicaciones I-EVOLUTION +inmediatas. I-EVOLUTION +Continúa I-EVOLUTION +en I-EVOLUTION +seguimiento I-EVOLUTION +en I-EVOLUTION +las I-EVOLUTION +consultas, I-EVOLUTION +permaneciendo I-EVOLUTION +asintomática, I-EVOLUTION +sin I-EVOLUTION +requerir I-EVOLUTION +más I-EVOLUTION +sesiones I-EVOLUTION +de I-EVOLUTION +escleroterapia. I-EVOLUTION +Tras I-EVOLUTION +4 I-EVOLUTION +años I-EVOLUTION +del I-EVOLUTION +procedimiento, I-EVOLUTION +se I-EVOLUTION +le I-EVOLUTION +realizó I-EVOLUTION +un I-EVOLUTION +TAC I-EVOLUTION +abdominal, I-EVOLUTION +observándose I-EVOLUTION +una I-EVOLUTION +disminución I-EVOLUTION +del I-EVOLUTION +tamaño I-EVOLUTION +del I-EVOLUTION +quiste I-EVOLUTION +hepático I-EVOLUTION +tratado I-EVOLUTION +(8, I-EVOLUTION +4 I-EVOLUTION +cm). I-EVOLUTION + I-EVOLUTION + +Paciente B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +masculino I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +74 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +médicos I-PAST_MEDICAL_HISTORY +o B-FAMILY_HISTORY +familiares I-FAMILY_HISTORY +de I-FAMILY_HISTORY +importancia. I-FAMILY_HISTORY +Consultó B-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +urgencia I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +septiembre I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2007 I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +hipocondrio I-PRESENT_ILLNESS +derecho, I-PRESENT_ILLNESS +afebril, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +vómitos I-PRESENT_ILLNESS +ni I-PRESENT_ILLNESS +alteraciones I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +tránsito I-PRESENT_ILLNESS +intestinal. I-PRESENT_ILLNESS +El B-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +no I-EXPLORATION +fue I-EXPLORATION +concluyente I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +solicitaron I-EXPLORATION +exámenes I-EXPLORATION +de I-EXPLORATION +laboratorio I-EXPLORATION +e I-EXPLORATION +imágenes. I-EXPLORATION +En I-EXPLORATION +los I-EXPLORATION +análisis I-EXPLORATION +destacaba I-EXPLORATION +una I-EXPLORATION +proteína I-EXPLORATION +C I-EXPLORATION +reactiva I-EXPLORATION +de I-EXPLORATION +7, I-EXPLORATION +2 I-EXPLORATION +mg/dL, I-EXPLORATION +leucocitos I-EXPLORATION +8.080/mm3 I-EXPLORATION +con I-EXPLORATION +67, I-EXPLORATION +8% I-EXPLORATION +de I-EXPLORATION +neutrófilos I-EXPLORATION +y I-EXPLORATION +amilasemia I-EXPLORATION +normal. I-EXPLORATION +Una I-EXPLORATION +ecotomografía I-EXPLORATION +demostró I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +sólido-quística I-EXPLORATION +compleja I-EXPLORATION +de I-EXPLORATION +alrededor I-EXPLORATION +de I-EXPLORATION +5 I-EXPLORATION +cm I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +lóbulo I-EXPLORATION +izquierdo I-EXPLORATION +del I-EXPLORATION +hígado. I-EXPLORATION +La I-EXPLORATION +tomografía I-EXPLORATION +computada I-EXPLORATION +de I-EXPLORATION +abdomen I-EXPLORATION +reveló I-EXPLORATION +una I-EXPLORATION +probable I-EXPLORATION +colecistitis I-EXPLORATION +aguda I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +focal I-EXPLORATION +hepática I-EXPLORATION +sospechosa I-EXPLORATION +de I-EXPLORATION +absceso. I-EXPLORATION +Se B-TREATMENT +efectuó I-TREATMENT +colecistectomía I-TREATMENT +y I-TREATMENT +biopsia I-TREATMENT +de I-TREATMENT +la I-TREATMENT +lesión I-TREATMENT +hepática. I-TREATMENT +No I-TREATMENT +se I-TREATMENT +identifican I-TREATMENT +otras I-TREATMENT +lesiones I-TREATMENT +abdominales I-TREATMENT +durante I-TREATMENT +la I-TREATMENT +exploración I-TREATMENT +quirúrgica. I-TREATMENT +El B-EXPLORATION +estudio I-EXPLORATION +anatomopatológico I-EXPLORATION +demuestra I-EXPLORATION +una I-EXPLORATION +metástasis I-EXPLORATION +hepática I-EXPLORATION +de I-EXPLORATION +tumor I-EXPLORATION +neuroendocrino I-EXPLORATION +con I-EXPLORATION +inmunohistoquímica I-EXPLORATION +concordante. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +solicitó I-EXPLORATION +un I-EXPLORATION +PET/CT I-EXPLORATION +con I-EXPLORATION +18FDG I-EXPLORATION +de I-EXPLORATION +cuerpo I-EXPLORATION +entero I-EXPLORATION +el I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +sólo I-EXPLORATION +captación I-EXPLORATION +fisiológica I-EXPLORATION +en I-EXPLORATION +diversos I-EXPLORATION +órganos I-EXPLORATION +sin I-EXPLORATION +observarse I-EXPLORATION +un I-EXPLORATION +incremento I-EXPLORATION +significativo I-EXPLORATION +del I-EXPLORATION +metabolismo I-EXPLORATION +glucídico I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +metástasis I-EXPLORATION +del I-EXPLORATION +lóbulo I-EXPLORATION +izquierdo I-EXPLORATION +del I-EXPLORATION +hígado I-EXPLORATION +en I-EXPLORATION +comparación I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +resto I-EXPLORATION +del I-EXPLORATION +parénquima I-EXPLORATION +hepático. I-EXPLORATION +Una I-EXPLORATION +colonoscopia I-EXPLORATION +en I-EXPLORATION +búsqueda I-EXPLORATION +del I-EXPLORATION +tumor I-EXPLORATION +de I-EXPLORATION +origen I-EXPLORATION +fue I-EXPLORATION +catalogada I-EXPLORATION +como I-EXPLORATION +normal. I-EXPLORATION + I-EXPLORATION +Tres I-EXPLORATION +meses I-EXPLORATION +más I-EXPLORATION +tarde I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +un I-EXPLORATION +examen I-EXPLORATION +PET/CT I-EXPLORATION +utilizando I-EXPLORATION +el I-EXPLORATION +nuevo I-EXPLORATION +radiofármaco I-EXPLORATION +68Ga-DOTATATE I-EXPLORATION +(CGM I-EXPLORATION +Nuclear, I-EXPLORATION +Santiago-Chile) I-EXPLORATION +recientemente I-EXPLORATION +incorporado I-EXPLORATION +a I-EXPLORATION +nuestro I-EXPLORATION +centro. I-EXPLORATION +El I-EXPLORATION +control I-EXPLORATION +de I-EXPLORATION +calidad I-EXPLORATION +del I-EXPLORATION +producto I-EXPLORATION +reveló I-EXPLORATION +una I-EXPLORATION +pureza I-EXPLORATION +radioquímica I-EXPLORATION +superior I-EXPLORATION +al I-EXPLORATION +99%. I-EXPLORATION +Se I-EXPLORATION +inyectaron I-EXPLORATION +por I-EXPLORATION +vía I-EXPLORATION +e.v. I-EXPLORATION +111 I-EXPLORATION +MBq I-EXPLORATION +(3 I-EXPLORATION +mCi) I-EXPLORATION +del I-EXPLORATION +radiotrazador. I-EXPLORATION +Cincuenta I-EXPLORATION +minutos I-EXPLORATION +más I-EXPLORATION +tarde I-EXPLORATION +se I-EXPLORATION +registraron I-EXPLORATION +imágenes I-EXPLORATION +PET/ I-EXPLORATION +CT I-EXPLORATION +3D I-EXPLORATION +de I-EXPLORATION +cuerpo I-EXPLORATION +entero I-EXPLORATION +en I-EXPLORATION +un I-EXPLORATION +aparato I-EXPLORATION +Biograph I-EXPLORATION +6 I-EXPLORATION +HiRez I-EXPLORATION +P3D I-EXPLORATION +(Siemens I-EXPLORATION +Medical I-EXPLORATION +Systems, I-EXPLORATION +USA). I-EXPLORATION +El I-EXPLORATION +examen I-EXPLORATION +mostró, I-EXPLORATION +además I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +intensa I-EXPLORATION +captación I-EXPLORATION +del I-EXPLORATION +radiofármaco I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +metástasis I-EXPLORATION +del I-EXPLORATION +lóbulo I-EXPLORATION +hepático I-EXPLORATION +izquierdo I-EXPLORATION +y I-EXPLORATION +un I-EXPLORATION +segundo I-EXPLORATION +foco I-EXPLORATION +de I-EXPLORATION +sobreexpresión I-EXPLORATION +de I-EXPLORATION +receptores I-EXPLORATION +de I-EXPLORATION +SST I-EXPLORATION +situado I-EXPLORATION +en I-EXPLORATION +un I-EXPLORATION +asa I-EXPLORATION +de I-EXPLORATION +íleon I-EXPLORATION +distal I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +región I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +válvula I-EXPLORATION +ileocecal I-EXPLORATION +altamente I-EXPLORATION +sugerente I-EXPLORATION +de I-EXPLORATION +corresponder I-EXPLORATION +al I-EXPLORATION +tumor I-EXPLORATION +primario. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +encontraron I-EXPLORATION +otros I-EXPLORATION +focos I-EXPLORATION +patológicos. I-EXPLORATION + I-EXPLORATION +El B-TREATMENT +paciente I-TREATMENT +fue I-TREATMENT +sometido I-TREATMENT +a I-TREATMENT +una I-TREATMENT +nueva I-TREATMENT +cirugía I-TREATMENT +mediante I-TREATMENT +laparotomía I-TREATMENT +subcostal I-TREATMENT +identificándose I-TREATMENT +un I-TREATMENT +nodulo I-TREATMENT +de I-TREATMENT +16 I-TREATMENT +mm I-TREATMENT +en I-TREATMENT +el I-TREATMENT +íleon I-TREATMENT +terminal, I-TREATMENT +vecino I-TREATMENT +a I-TREATMENT +la I-TREATMENT +válvula I-TREATMENT +ileocecal, I-TREATMENT +sin I-TREATMENT +extensión I-TREATMENT +regional I-TREATMENT +macroscópica. I-TREATMENT +Se I-TREATMENT +efectúa I-TREATMENT +resección I-TREATMENT +del I-TREATMENT +íleon I-TREATMENT +terminal, I-TREATMENT +ciego I-TREATMENT +y I-TREATMENT +apéndice I-TREATMENT +cecal I-TREATMENT +mediante I-TREATMENT +laparotomía I-TREATMENT +subcostal I-TREATMENT +ampliada. I-TREATMENT +En I-TREATMENT +el I-TREATMENT +mismo I-TREATMENT +acto I-TREATMENT +se I-TREATMENT +extirpa I-TREATMENT +la I-TREATMENT +metástasis I-TREATMENT +hepática I-TREATMENT +mediante I-TREATMENT +hepatectomía I-TREATMENT +izquierda. I-TREATMENT +Como I-TREATMENT +hallazgos I-TREATMENT +intraoperatorio I-TREATMENT +se I-TREATMENT +identifica I-TREATMENT +una I-TREATMENT +segunda I-TREATMENT +metástasis I-TREATMENT +de I-TREATMENT +8 I-TREATMENT +mm I-TREATMENT +del I-TREATMENT +segmento I-TREATMENT +VII I-TREATMENT +del I-TREATMENT +hígado I-TREATMENT +la I-TREATMENT +que I-TREATMENT +se I-TREATMENT +reseca I-TREATMENT +en I-TREATMENT +cuña. I-TREATMENT +La B-EXPLORATION +anatomía I-EXPLORATION +patológica I-EXPLORATION +confirmó I-EXPLORATION +un I-EXPLORATION +carcinoma I-EXPLORATION +neuroendocrino I-EXPLORATION +de I-EXPLORATION +bajo I-EXPLORATION +grado I-EXPLORATION +del I-EXPLORATION +íleon I-EXPLORATION +terminal I-EXPLORATION +de I-EXPLORATION +16 I-EXPLORATION +mm I-EXPLORATION +que I-EXPLORATION +infiltraba I-EXPLORATION +el I-EXPLORATION +espesor I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +pared I-EXPLORATION +y I-EXPLORATION +con I-EXPLORATION +penetración I-EXPLORATION +linfovascular, I-EXPLORATION +6 I-EXPLORATION +linfonodos I-EXPLORATION +regionales I-EXPLORATION +sin I-EXPLORATION +tumor I-EXPLORATION +y I-EXPLORATION +2 I-EXPLORATION +metástasis I-EXPLORATION +hepáticas I-EXPLORATION +de I-EXPLORATION +carcinoma I-EXPLORATION +neuroendocrino I-EXPLORATION +de I-EXPLORATION +también I-EXPLORATION +de I-EXPLORATION +bajo I-EXPLORATION +grado, I-EXPLORATION +la I-EXPLORATION +ya I-EXPLORATION +conocida I-EXPLORATION +de I-EXPLORATION +4, I-EXPLORATION +1 I-EXPLORATION +cm I-EXPLORATION +y I-EXPLORATION +otra I-EXPLORATION +de I-EXPLORATION +0, I-EXPLORATION +8 I-EXPLORATION +cm. I-EXPLORATION + I-EXPLORATION + +Se B-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +50 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +sin B-FAMILY_HISTORY +antecedentes I-FAMILY_HISTORY +familiares I-FAMILY_HISTORY +de I-FAMILY_HISTORY +interés, I-FAMILY_HISTORY +diagnosticado B-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +hipotiroidismo I-PAST_MEDICAL_HISTORY +subclínico I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +esclerodermia I-PAST_MEDICAL_HISTORY +precoz I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +seguimiento I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +consultas I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Reumatología I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +Dermatología. I-PAST_MEDICAL_HISTORY +Un I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +antes I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +presentado I-PAST_MEDICAL_HISTORY +necrosis I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +pulpejos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +dedos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +manos I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +lo I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +inició I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +estudio. I-PAST_MEDICAL_HISTORY +La I-PAST_MEDICAL_HISTORY +capilaroscopia I-PAST_MEDICAL_HISTORY +era I-PAST_MEDICAL_HISTORY +compatible I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +ANA I-PAST_MEDICAL_HISTORY +positivos I-PAST_MEDICAL_HISTORY +(1/640), I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +anticuerpos I-PAST_MEDICAL_HISTORY +anticentrómero, I-PAST_MEDICAL_HISTORY +RNP I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +scl-70 I-PAST_MEDICAL_HISTORY +negativos. I-PAST_MEDICAL_HISTORY +Se I-PAST_MEDICAL_HISTORY +inició I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +entonces I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +bosentán I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +ácido I-PAST_MEDICAL_HISTORY +acetilsalicílico. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Acudió B-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +Urgencias I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +nuestro I-PRESENT_ILLNESS +hospital I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +melenas I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +epistaxis I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tres I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +Al B-EXPLORATION +ingreso I-EXPLORATION +presentó I-EXPLORATION +un I-EXPLORATION +valor I-EXPLORATION +de I-EXPLORATION +hemoglobina I-EXPLORATION +de I-EXPLORATION +8, I-EXPLORATION +5 I-EXPLORATION +mg/dl I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +cifra I-EXPLORATION +de I-EXPLORATION +plaquetas I-EXPLORATION +normales, I-EXPLORATION +una I-EXPLORATION +coagulación I-EXPLORATION +normal I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +VSG I-EXPLORATION +de I-EXPLORATION +48 I-EXPLORATION +mm/h. I-EXPLORATION +A I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +destacaban I-EXPLORATION +múltiples I-EXPLORATION +telangiectasias I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +pulpejos I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +dedos, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +en I-EXPLORATION +mucosa I-EXPLORATION +oral I-EXPLORATION +y I-EXPLORATION +región I-EXPLORATION +peribucal. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +gastroscopia I-EXPLORATION +que I-EXPLORATION +evidenció I-EXPLORATION +varias I-EXPLORATION +lesiones I-EXPLORATION +de I-EXPLORATION +pequeño I-EXPLORATION +tamaño I-EXPLORATION +(menor I-EXPLORATION +de I-EXPLORATION +5 I-EXPLORATION +mm) I-EXPLORATION +de I-EXPLORATION +aspecto I-EXPLORATION +vascular I-EXPLORATION +en I-EXPLORATION +mucosa I-EXPLORATION +esofágica, I-EXPLORATION +gástrica I-EXPLORATION +y I-EXPLORATION +duodenal, I-EXPLORATION +sin I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +sangrado I-EXPLORATION +reciente I-EXPLORATION +ni I-EXPLORATION +restos I-EXPLORATION +hemáticos. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +colonoscopia I-EXPLORATION +se I-EXPLORATION +visualizaron I-EXPLORATION +múltiples I-EXPLORATION +telangiectasias I-EXPLORATION +desde I-EXPLORATION +el I-EXPLORATION +ano I-EXPLORATION +hasta I-EXPLORATION +ciego. I-EXPLORATION +No B-EVOLUTION +presentó I-EVOLUTION +melenas I-EVOLUTION +durante I-EVOLUTION +el I-EVOLUTION +ingreso I-EVOLUTION +ni I-EVOLUTION +hubo I-EVOLUTION +un I-EVOLUTION +descenso I-EVOLUTION +del I-EVOLUTION +hematocrito I-EVOLUTION +por I-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +fue I-EVOLUTION +dado I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +con B-TREATMENT +suplementos I-TREATMENT +de I-TREATMENT +hierro I-TREATMENT +y I-TREATMENT +ácido I-TREATMENT +fólico I-TREATMENT +orales. I-TREATMENT + I-TREATMENT + +Hombre B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +34 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +hepatitis I-PAST_MEDICAL_HISTORY +B I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +VIH I-PAST_MEDICAL_HISTORY +positivo I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +consultó I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +decaimiento, I-PRESENT_ILLNESS +baja I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +peso, I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +torácico I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +conducta I-PRESENT_ILLNESS +frontalizada. I-PRESENT_ILLNESS +La B-EXPLORATION +punción I-EXPLORATION +lumbar I-EXPLORATION +resultó I-EXPLORATION +negativa I-EXPLORATION +para I-EXPLORATION +VDRL, I-EXPLORATION +toxoplasma I-EXPLORATION +y I-EXPLORATION +VEB I-EXPLORATION +(por I-EXPLORATION +técnica I-EXPLORATION +de I-EXPLORATION +PCR). I-EXPLORATION +Los I-EXPLORATION +estudios I-EXPLORATION +hematológicos I-EXPLORATION +mostraron I-EXPLORATION +una I-EXPLORATION +anemia I-EXPLORATION +leve I-EXPLORATION +con I-EXPLORATION +Hb I-EXPLORATION +de I-EXPLORATION +10, I-EXPLORATION +3 I-EXPLORATION +g/dL I-EXPLORATION +(ref. I-EXPLORATION +13, I-EXPLORATION +5-17, I-EXPLORATION +5 I-EXPLORATION +g/dL), I-EXPLORATION +Hto I-EXPLORATION +30% I-EXPLORATION +(ref. I-EXPLORATION +41-53%), I-EXPLORATION +leucopenia I-EXPLORATION +con I-EXPLORATION +3.100 I-EXPLORATION +leucocitos/mm3 I-EXPLORATION +(ref. I-EXPLORATION +4.500-11.000/mm3) I-EXPLORATION +y I-EXPLORATION +linfopenia I-EXPLORATION +con I-EXPLORATION +800/mm3 I-EXPLORATION +(ref. I-EXPLORATION +1.000-4.800/mm3). I-EXPLORATION +LDH I-EXPLORATION +y I-EXPLORATION +proteína I-EXPLORATION +C I-EXPLORATION +reactiva I-EXPLORATION +se I-EXPLORATION +encontraban I-EXPLORATION +dentro I-EXPLORATION +de I-EXPLORATION +límites I-EXPLORATION +normales I-EXPLORATION +(133 I-EXPLORATION +U/L I-EXPLORATION +[ref. I-EXPLORATION +135-225 I-EXPLORATION +U/L] I-EXPLORATION +y I-EXPLORATION +0, I-EXPLORATION +1 I-EXPLORATION +mg/dL I-EXPLORATION +[ref. I-EXPLORATION +0-1 I-EXPLORATION +mg/dL], I-EXPLORATION +respectivamente). I-EXPLORATION +El I-EXPLORATION +paciente I-EXPLORATION +presentaba I-EXPLORATION +además I-EXPLORATION +severo I-EXPLORATION +estado I-EXPLORATION +de I-EXPLORATION +inmunosupresión I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +recuento I-EXPLORATION +de I-EXPLORATION +linfocitos I-EXPLORATION +T I-EXPLORATION +CD4 I-EXPLORATION +de I-EXPLORATION +6, I-EXPLORATION +9/mm3. I-EXPLORATION + I-EXPLORATION +Los I-EXPLORATION +estudios I-EXPLORATION +de I-EXPLORATION +imágenes I-EXPLORATION +revelaron I-EXPLORATION +2 I-EXPLORATION +nódulos I-EXPLORATION +córtico-subcorticales I-EXPLORATION +en I-EXPLORATION +zonas I-EXPLORATION +frontal I-EXPLORATION +media I-EXPLORATION +y I-EXPLORATION +derecha I-EXPLORATION +de I-EXPLORATION +aspecto I-EXPLORATION +inflamatorio. I-EXPLORATION +No I-EXPLORATION +había I-EXPLORATION +compromiso I-EXPLORATION +pulmonar I-EXPLORATION +ni I-EXPLORATION +de I-EXPLORATION +otros I-EXPLORATION +sitios I-EXPLORATION +anatómicos. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +biopsia I-EXPLORATION +estereotáxica I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +tejido I-EXPLORATION +cerebral I-EXPLORATION +con I-EXPLORATION +gliosis I-EXPLORATION +reactiva I-EXPLORATION +y I-EXPLORATION +extenso I-EXPLORATION +infiltrado I-EXPLORATION +celular I-EXPLORATION +mixto, I-EXPLORATION +predominantemente I-EXPLORATION +perivascular I-EXPLORATION +y I-EXPLORATION +zonas I-EXPLORATION +con I-EXPLORATION +angiotropismo I-EXPLORATION +y I-EXPLORATION +angiodestruccción I-EXPLORATION +compuestas I-EXPLORATION +por I-EXPLORATION +linfocitos I-EXPLORATION +pequeños I-EXPLORATION +inmunorreactivos I-EXPLORATION +para I-EXPLORATION +CD3 I-EXPLORATION +(linfocitos I-EXPLORATION +T). I-EXPLORATION +Además I-EXPLORATION +se I-EXPLORATION +identificaron I-EXPLORATION +abundantes I-EXPLORATION +células I-EXPLORATION +linfoides I-EXPLORATION +atípicas I-EXPLORATION +medianas I-EXPLORATION +y I-EXPLORATION +grandes, I-EXPLORATION +de I-EXPLORATION +núcleos I-EXPLORATION +vesiculosos I-EXPLORATION +y I-EXPLORATION +pleomórficos I-EXPLORATION +inmunorreactivas I-EXPLORATION +para I-EXPLORATION +CD20 I-EXPLORATION +(linfocitos I-EXPLORATION +B). I-EXPLORATION +Los I-EXPLORATION +linfocitos I-EXPLORATION +mostraron I-EXPLORATION +reacción I-EXPLORATION +positiva I-EXPLORATION +para I-EXPLORATION +la I-EXPLORATION +secuencia I-EXPLORATION +pequeña I-EXPLORATION +de I-EXPLORATION +ARN I-EXPLORATION +asociado I-EXPLORATION +al I-EXPLORATION +VEB I-EXPLORATION +EBER-1 I-EXPLORATION +mediante I-EXPLORATION +hibridización I-EXPLORATION +in I-EXPLORATION +situ. I-EXPLORATION +Estas I-EXPLORATION +células I-EXPLORATION +mostraron I-EXPLORATION +reacción I-EXPLORATION +negativa I-EXPLORATION +para I-EXPLORATION +CD30, I-EXPLORATION +CD68 I-EXPLORATION +y I-EXPLORATION +proteína I-EXPLORATION +S-100. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +identificaron I-EXPLORATION +microorganismos I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +biopsia I-EXPLORATION +con I-EXPLORATION +tinciones I-EXPLORATION +de I-EXPLORATION +Gram, I-EXPLORATION +PAS, I-EXPLORATION +Ziehl-Neelsen I-EXPLORATION +y I-EXPLORATION +Warthin-Starry. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +citometría I-EXPLORATION +de I-EXPLORATION +flujo I-EXPLORATION +del I-EXPLORATION +tejido I-EXPLORATION +cerebral I-EXPLORATION +reveló I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +células I-EXPLORATION +atípicas I-EXPLORATION +medianas I-EXPLORATION +de I-EXPLORATION +estirpe I-EXPLORATION +B I-EXPLORATION +con I-EXPLORATION +restricción I-EXPLORATION +de I-EXPLORATION +cadena I-EXPLORATION +ligera I-EXPLORATION +Kappa, I-EXPLORATION +sugerentes I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +síndrome I-EXPLORATION +linfoproliferativo. I-EXPLORATION +El I-EXPLORATION +mielograma I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +biopsia I-EXPLORATION +de I-EXPLORATION +médula I-EXPLORATION +ósea I-EXPLORATION +resultaron I-EXPLORATION +negativos. I-EXPLORATION +En I-EXPLORATION +conjunto, I-EXPLORATION +los I-EXPLORATION +hallazgos I-EXPLORATION +fueron I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION +GL I-EXPLORATION +cerebral I-EXPLORATION +grado I-EXPLORATION +3 I-EXPLORATION +(linfoma I-EXPLORATION +B I-EXPLORATION +difuso I-EXPLORATION +de I-EXPLORATION +células I-EXPLORATION +grandes). I-EXPLORATION + I-EXPLORATION +El B-TREATMENT +caso I-TREATMENT +comunicado I-TREATMENT +en I-TREATMENT +el I-TREATMENT +presente I-TREATMENT +artículo I-TREATMENT +fue I-TREATMENT +confirmado I-TREATMENT +como I-TREATMENT +síndrome I-TREATMENT +de I-TREATMENT +inmunodeficiencia I-TREATMENT +por I-TREATMENT +virus I-TREATMENT +VIH I-TREATMENT +etapa I-TREATMENT +C3 I-TREATMENT +y I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +terapia I-TREATMENT +antirretroviral. I-TREATMENT +El B-DERIVED_FROM/TO +paciente I-DERIVED_FROM/TO +solicitó I-DERIVED_FROM/TO +posteriormente I-DERIVED_FROM/TO +su I-DERIVED_FROM/TO +traslado I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +otro I-DERIVED_FROM/TO +centro I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +continuar I-DERIVED_FROM/TO +manejo. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +50 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +historia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +poliartralgias I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +tabaquismo I-PAST_MEDICAL_HISTORY +crónico I-PAST_MEDICAL_HISTORY +activo. I-PAST_MEDICAL_HISTORY +Refiere B-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +caracterizado I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +persistente, I-PRESENT_ILLNESS +sudo-ración I-PRESENT_ILLNESS +nocturna, I-PRESENT_ILLNESS +baja I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +peso, I-PRESENT_ILLNESS +poliartralgias I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +extremidades I-PRESENT_ILLNESS +inferiores I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +aumento I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +volumen I-PRESENT_ILLNESS +cervical I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS +sensible. I-PRESENT_ILLNESS +Relata B-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +hermana I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +EKF I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +contacto I-PAST_MEDICAL_HISTORY +directo I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +gato. I-PAST_MEDICAL_HISTORY +Consultó B-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +Servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Urgencias, I-PRESENT_ILLNESS +donde I-PRESENT_ILLNESS +le I-PRESENT_ILLNESS +realizaron I-PRESENT_ILLNESS +ecografía I-PRESENT_ILLNESS +cervical I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +mostraba I-PRESENT_ILLNESS +múltiples I-PRESENT_ILLNESS +linfonodos I-PRESENT_ILLNESS +cervicales I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +derecha. I-PRESENT_ILLNESS +Le B-TREATMENT +indicaron I-TREATMENT +amoxicilina-ácido I-TREATMENT +clavulánico I-TREATMENT +durante I-TREATMENT +5 I-TREATMENT +días I-TREATMENT +sin I-TREATMENT +mejoría I-TREATMENT +clínica I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +hospitalizó. I-TREATMENT +En B-EXPLORATION +el I-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +destacaba I-EXPLORATION +una I-EXPLORATION +adenopatía I-EXPLORATION +cervical I-EXPLORATION +derecha I-EXPLORATION +de I-EXPLORATION +5 I-EXPLORATION +x I-EXPLORATION +6 I-EXPLORATION +cm, I-EXPLORATION +sensible I-EXPLORATION +y I-EXPLORATION +sin I-EXPLORATION +visceromegalia. I-EXPLORATION +El I-EXPLORATION +hemograma I-EXPLORATION +mostró I-EXPLORATION +VHS I-EXPLORATION +de I-EXPLORATION +56 I-EXPLORATION +mm/h I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +PCR I-EXPLORATION +y I-EXPLORATION +ferritina I-EXPLORATION +fueron I-EXPLORATION +de I-EXPLORATION +77 I-EXPLORATION +mg/L I-EXPLORATION +y I-EXPLORATION +1.789 I-EXPLORATION +ng/mL I-EXPLORATION +respectivamente. I-EXPLORATION +El I-EXPLORATION +TAC I-EXPLORATION +de I-EXPLORATION +cuello, I-EXPLORATION +tórax, I-EXPLORATION +abdomen I-EXPLORATION +y I-EXPLORATION +pelvis, I-EXPLORATION +además I-EXPLORATION +de I-EXPLORATION +constatar I-EXPLORATION +adenopatías I-EXPLORATION +cervicales I-EXPLORATION +y I-EXPLORATION +mediastínicas, I-EXPLORATION +reveló I-EXPLORATION +opacidades I-EXPLORATION +pulmonares I-EXPLORATION +en I-EXPLORATION +vidrio I-EXPLORATION +esmerilado. I-EXPLORATION +Paralelamente, I-EXPLORATION +se I-EXPLORATION +descartó I-EXPLORATION +infección I-EXPLORATION +por I-EXPLORATION +VIH, I-EXPLORATION +VEB, I-EXPLORATION +CMV, I-EXPLORATION +virus I-EXPLORATION +hepatitis I-EXPLORATION +B I-EXPLORATION +y I-EXPLORATION +C, I-EXPLORATION +sífilis I-EXPLORATION +y I-EXPLORATION +Toxoplasma I-EXPLORATION +gondii. I-EXPLORATION +La I-EXPLORATION +IgM I-EXPLORATION +para I-EXPLORATION +Bartonella I-EXPLORATION +hensenlae I-EXPLORATION +fue I-EXPLORATION +negativa, I-EXPLORATION +mientras I-EXPLORATION +que I-EXPLORATION +la I-EXPLORATION +IgG I-EXPLORATION +resultó I-EXPLORATION +positiva I-EXPLORATION +(1/64). I-EXPLORATION +Se I-EXPLORATION +indicó I-EXPLORATION +azitromicina I-EXPLORATION +lg I-EXPLORATION +al I-EXPLORATION +día I-EXPLORATION +durante I-EXPLORATION +6 I-EXPLORATION +días, I-EXPLORATION +sin I-EXPLORATION +respuesta. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +inmunológico I-EXPLORATION +fue I-EXPLORATION +prácticamente I-EXPLORATION +normal, I-EXPLORATION +solamente I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +ANA I-EXPLORATION +positivo I-EXPLORATION +a I-EXPLORATION +título I-EXPLORATION +bajo I-EXPLORATION +(1/40). I-EXPLORATION +Se I-EXPLORATION +decidió I-EXPLORATION +realizar I-EXPLORATION +biopsia I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +adenopatía I-EXPLORATION +cervical. I-EXPLORATION +Los I-EXPLORATION +estudios I-EXPLORATION +para I-EXPLORATION +hongos I-EXPLORATION +y I-EXPLORATION +bacterias I-EXPLORATION +resultaron I-EXPLORATION +negativos, I-EXPLORATION +mientras I-EXPLORATION +que I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +histológico I-EXPLORATION +reveló I-EXPLORATION +linfadenitis I-EXPLORATION +necrotizante I-EXPLORATION +histiocitaria. I-EXPLORATION +Se B-TREATMENT +inició I-TREATMENT +prednisona I-TREATMENT +30 I-TREATMENT +mg I-TREATMENT +al I-TREATMENT +día I-TREATMENT +durante I-TREATMENT +tres I-TREATMENT +semanas I-TREATMENT +con I-TREATMENT +disminución I-TREATMENT +progresiva I-TREATMENT +de I-TREATMENT +las I-TREATMENT +dosis I-TREATMENT +completando I-TREATMENT +45 I-TREATMENT +días I-TREATMENT +de I-TREATMENT +terapia. I-TREATMENT +Los B-EVOLUTION +síntomas I-EVOLUTION +desaparecen I-EVOLUTION +a I-EVOLUTION +las I-EVOLUTION +48 I-EVOLUTION +h I-EVOLUTION +de I-EVOLUTION +tratamiento. I-EVOLUTION +Dos B-EXPLORATION +meses I-EXPLORATION +después I-EXPLORATION +asiste I-EXPLORATION +a I-EXPLORATION +control I-EXPLORATION +con I-EXPLORATION +TAC I-EXPLORATION +de I-EXPLORATION +tórax I-EXPLORATION +que I-EXPLORATION +informó I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION +imágenes I-EXPLORATION +en I-EXPLORATION +vidrio I-EXPLORATION +esmerilado. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +biopsia I-EXPLORATION +pulmonar I-EXPLORATION +revelando I-EXPLORATION +hallazgos I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION +neumonía I-EXPLORATION +intersticial I-EXPLORATION +usual I-EXPLORATION +en I-EXPLORATION +fase I-EXPLORATION +tardía. I-EXPLORATION +A B-EVOLUTION +los I-EVOLUTION +6 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +seguimiento I-EVOLUTION +no I-EVOLUTION +ha I-EVOLUTION +presentado I-EVOLUTION +sintoma-tología I-EVOLUTION +respiratoria I-EVOLUTION +ni I-EVOLUTION +alteraciones I-EVOLUTION +significativas I-EVOLUTION +en I-EVOLUTION +las I-EVOLUTION +pruebas I-EVOLUTION +de I-EVOLUTION +función I-EVOLUTION +pulmonar. I-EVOLUTION + I-EVOLUTION + +Paciente B-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +68 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +con B-EXPLORATION +un I-EXPLORATION +índice I-EXPLORATION +de I-EXPLORATION +masa I-EXPLORATION +corporal I-EXPLORATION +(IMC) I-EXPLORATION +de I-EXPLORATION +31, I-EXPLORATION +2, I-EXPLORATION +que B-PRESENT_ILLNESS +fue I-PRESENT_ILLNESS +diagnosticado I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cáncer I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +próstata I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +estadio I-PRESENT_ILLNESS +T2a I-PRESENT_ILLNESS +durante I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +examen I-PRESENT_ILLNESS +(antígeno I-PRESENT_ILLNESS +prostático I-PRESENT_ILLNESS +específico I-PRESENT_ILLNESS +[PSA], I-PRESENT_ILLNESS +3, I-PRESENT_ILLNESS +18 I-PRESENT_ILLNESS +ng/ml). I-PRESENT_ILLNESS +Tenía B-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +historia I-PAST_MEDICAL_HISTORY +clínica I-PAST_MEDICAL_HISTORY +anterior I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +hipertensión, I-PAST_MEDICAL_HISTORY +diabetes, I-PAST_MEDICAL_HISTORY +hiperlipemia, I-PAST_MEDICAL_HISTORY +miocardiopatía I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +cirrosis. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Antes B-TREATMENT +de I-TREATMENT +la I-TREATMENT +cirugía, I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +tenía I-TREATMENT +vendaje I-TREATMENT +espiral I-TREATMENT +y I-TREATMENT +dispositivos I-TREATMENT +de I-TREATMENT +compresión I-TREATMENT +intermitente I-TREATMENT +en I-TREATMENT +ambas I-TREATMENT +extremidades I-TREATMENT +inferiores I-TREATMENT +para I-TREATMENT +prevenir I-TREATMENT +trombosis I-TREATMENT +venosa I-TREATMENT +profunda I-TREATMENT +(TVP). I-TREATMENT +Tras I-TREATMENT +administrar I-TREATMENT +anestesia I-TREATMENT +combinada I-TREATMENT +general-espinal, I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +fue I-TREATMENT +colocado I-TREATMENT +en I-TREATMENT +posición I-TREATMENT +de I-TREATMENT +Trendelenburg I-TREATMENT +y I-TREATMENT +fue I-TREATMENT +sometido I-TREATMENT +a I-TREATMENT +una I-TREATMENT +PRL I-TREATMENT +extraperitoneal, I-TREATMENT +con I-TREATMENT +preservación I-TREATMENT +nerviosa I-TREATMENT +bilateral. I-TREATMENT +Su I-TREATMENT +presión I-TREATMENT +sanguínea I-TREATMENT +en I-TREATMENT +el I-TREATMENT +momento I-TREATMENT +de I-TREATMENT +administrar I-TREATMENT +la I-TREATMENT +anestesia I-TREATMENT +era I-TREATMENT +de I-TREATMENT +150/80 I-TREATMENT +mmHg I-TREATMENT +y I-TREATMENT +permaneció I-TREATMENT +por I-TREATMENT +debajo I-TREATMENT +de I-TREATMENT +este I-TREATMENT +nivel I-TREATMENT +durante I-TREATMENT +todo I-TREATMENT +el I-TREATMENT +procedimiento. I-TREATMENT +La I-TREATMENT +operación I-TREATMENT +duró I-TREATMENT +360 I-TREATMENT +min I-TREATMENT +y I-TREATMENT +la I-TREATMENT +pérdida I-TREATMENT +de I-TREATMENT +sangre I-TREATMENT +fue I-TREATMENT +de I-TREATMENT +1.000 I-TREATMENT +ml. I-TREATMENT +El I-TREATMENT +sangrado I-TREATMENT +ocurrió I-TREATMENT +durante I-TREATMENT +el I-TREATMENT +control I-TREATMENT +de I-TREATMENT +pedículos I-TREATMENT +vasculares I-TREATMENT +y I-TREATMENT +la I-TREATMENT +disección I-TREATMENT +del I-TREATMENT +paquete I-TREATMENT +neurovascular. I-TREATMENT +La B-EXPLORATION +patología I-EXPLORATION +quirúrgica I-EXPLORATION +reveló I-EXPLORATION +una I-EXPLORATION +próstata I-EXPLORATION +de I-EXPLORATION +55 I-EXPLORATION +g, I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +adenocarcinoma I-EXPLORATION +en I-EXPLORATION +estadio I-EXPLORATION +T2a I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +puntuación I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +escala I-EXPLORATION +de I-EXPLORATION +Gleason I-EXPLORATION +6 I-EXPLORATION +con I-EXPLORATION +márgenes I-EXPLORATION +negativos. I-EXPLORATION + I-EXPLORATION +En B-EVOLUTION +el I-EVOLUTION +primer I-EVOLUTION +día I-EVOLUTION +posquirúrgico, I-EVOLUTION +comenzó I-EVOLUTION +a I-EVOLUTION +quejarse I-EVOLUTION +de I-EVOLUTION +entumecimiento I-EVOLUTION +y I-EVOLUTION +dolor I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +pierna I-EVOLUTION +derecha, I-EVOLUTION +que I-EVOLUTION +estaba I-EVOLUTION +inflamada I-EVOLUTION +y I-EVOLUTION +blanda I-EVOLUTION +al I-EVOLUTION +tacto. I-EVOLUTION +Los B-EXPLORATION +pulsos I-EXPLORATION +pedios I-EXPLORATION +estaban I-EXPLORATION +presentes I-EXPLORATION +de I-EXPLORATION +forma I-EXPLORATION +bilateral. I-EXPLORATION +Sospechamos I-EXPLORATION +una I-EXPLORATION +TVP I-EXPLORATION +y I-EXPLORATION +pedimos I-EXPLORATION +una I-EXPLORATION +prueba I-EXPLORATION +Doppler, I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +permeabilidad I-EXPLORATION +del I-EXPLORATION +sistema I-EXPLORATION +venoso I-EXPLORATION +profundo. I-EXPLORATION +Su I-EXPLORATION +creatinina I-EXPLORATION +sérica I-EXPLORATION +fue I-EXPLORATION +de I-EXPLORATION +3, I-EXPLORATION +2 I-EXPLORATION +mg/dl I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +creatina I-EXPLORATION +fosfocinasa I-EXPLORATION +llegó I-EXPLORATION +hasta I-EXPLORATION +23.000 I-EXPLORATION +U/l. I-EXPLORATION +Aunque B-TREATMENT +el I-TREATMENT +Doppler I-TREATMENT +fue I-TREATMENT +normal, I-TREATMENT +se I-TREATMENT +diagnosticó I-TREATMENT +una I-TREATMENT +TVP I-TREATMENT +con I-TREATMENT +rabdomiólisis I-TREATMENT +secundaria I-TREATMENT +y I-TREATMENT +fallo I-TREATMENT +renal I-TREATMENT +sobre I-TREATMENT +la I-TREATMENT +base I-TREATMENT +de I-TREATMENT +los I-TREATMENT +resultados I-TREATMENT +clínicos, I-TREATMENT +y I-TREATMENT +se I-TREATMENT +comenzó I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +heparina. I-TREATMENT + I-TREATMENT +En B-EVOLUTION +los I-EVOLUTION +días I-EVOLUTION +posquirúrgicos I-EVOLUTION +siguientes, I-EVOLUTION +aunque I-EVOLUTION +los I-EVOLUTION +pulsos I-EVOLUTION +pedios I-EVOLUTION +seguían I-EVOLUTION +siendo I-EVOLUTION +palpables I-EVOLUTION +y I-EVOLUTION +los I-EVOLUTION +valores I-EVOLUTION +de I-EVOLUTION +creatinina I-EVOLUTION +sérica I-EVOLUTION +y I-EVOLUTION +creatina I-EVOLUTION +fosfocinasa I-EVOLUTION +mejoraban, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +presentaba I-EVOLUTION +un I-EVOLUTION +empeoramiento I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +episodios I-EVOLUTION +de I-EVOLUTION +dolor I-EVOLUTION +intermitente. I-EVOLUTION +Se B-EXPLORATION +repitieron I-EXPLORATION +las I-EXPLORATION +pruebas I-EXPLORATION +Doppler, I-EXPLORATION +que I-EXPLORATION +excluyeron I-EXPLORATION +TVP I-EXPLORATION +y I-EXPLORATION +mostraron I-EXPLORATION +un I-EXPLORATION +patrón I-EXPLORATION +de I-EXPLORATION +alta I-EXPLORATION +resistencia I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +arterias I-EXPLORATION +tibiales I-EXPLORATION +derechas. I-EXPLORATION +El B-TREATMENT +paciente I-TREATMENT +fue I-TREATMENT +sometido I-TREATMENT +a I-TREATMENT +una I-TREATMENT +fasciotomía I-TREATMENT +de I-TREATMENT +cuatro I-TREATMENT +compartimentos I-TREATMENT +por I-TREATMENT +el I-TREATMENT +SC I-TREATMENT +de I-TREATMENT +la I-TREATMENT +pierna. I-TREATMENT +Los I-TREATMENT +músculos I-TREATMENT +sobresalían I-TREATMENT +fácilmente I-TREATMENT +a I-TREATMENT +medida I-TREATMENT +que I-TREATMENT +se I-TREATMENT +seccionaba I-TREATMENT +la I-TREATMENT +fascia I-TREATMENT +suprayacente. I-TREATMENT +Había I-TREATMENT +áreas I-TREATMENT +de I-TREATMENT +necrosis I-TREATMENT +focal I-TREATMENT +que I-TREATMENT +fueron I-TREATMENT +eliminadas. I-TREATMENT +En B-EVOLUTION +el I-EVOLUTION +postoperatorio, I-EVOLUTION +el I-EVOLUTION +dolor I-EVOLUTION +fue I-EVOLUTION +remitiendo I-EVOLUTION +y I-EVOLUTION +fue I-EVOLUTION +capaz I-EVOLUTION +de I-EVOLUTION +caminar I-EVOLUTION +con I-EVOLUTION +ayuda. I-EVOLUTION +Las I-EVOLUTION +heridas I-EVOLUTION +se I-EVOLUTION +cerraron I-EVOLUTION +en I-EVOLUTION +los I-EVOLUTION +14 I-EVOLUTION +días I-EVOLUTION +posteriores I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +fasciotomía. I-EVOLUTION + I-EVOLUTION +Seis I-EVOLUTION +meses I-EVOLUTION +después I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +PRL, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +se I-EVOLUTION +recuperó I-EVOLUTION +y I-EVOLUTION +fue I-EVOLUTION +capaz I-EVOLUTION +de I-EVOLUTION +caminar I-EVOLUTION +sin I-EVOLUTION +ayuda, I-EVOLUTION +pero I-EVOLUTION +aún I-EVOLUTION +presenta I-EVOLUTION +dolor I-EVOLUTION +neuropático I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +empeine I-EVOLUTION +del I-EVOLUTION +pie I-EVOLUTION +derecho. I-EVOLUTION +Su I-EVOLUTION +PSA I-EVOLUTION +estaba I-EVOLUTION +por I-EVOLUTION +debajo I-EVOLUTION +de I-EVOLUTION +0, I-EVOLUTION +04 I-EVOLUTION +ng/ml, I-EVOLUTION +usaba I-EVOLUTION +pañal I-EVOLUTION +diario I-EVOLUTION +por I-EVOLUTION +una I-EVOLUTION +leve I-EVOLUTION +incontinencia I-EVOLUTION +por I-EVOLUTION +esfuerzo I-EVOLUTION +y I-EVOLUTION +aún I-EVOLUTION +no I-EVOLUTION +había I-EVOLUTION +recuperado I-EVOLUTION +la I-EVOLUTION +función I-EVOLUTION +sexual. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +53 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +apendicectomía I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +neurinoma I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +región I-PAST_MEDICAL_HISTORY +cervical I-PAST_MEDICAL_HISTORY +izquierda I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +1986. I-PAST_MEDICAL_HISTORY +Ingresó B-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +astenia I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +prurito I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +reciente I-PRESENT_ILLNESS +comienzo, I-PRESENT_ILLNESS +sin B-EXPLORATION +dolor I-EXPLORATION +abdominal I-EXPLORATION +ni I-EXPLORATION +alteraciones I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +analítica I-EXPLORATION +destacaba I-EXPLORATION +FA I-EXPLORATION +1499 I-EXPLORATION +UI/l, I-EXPLORATION +GGT I-EXPLORATION +1163 I-EXPLORATION +UI/l, I-EXPLORATION +bilirrubina I-EXPLORATION +total I-EXPLORATION +1, I-EXPLORATION +62 I-EXPLORATION +mg/dl I-EXPLORATION +y I-EXPLORATION +CA-19.9 I-EXPLORATION +533 I-EXPLORATION +UI/ml I-EXPLORATION +(normal I-EXPLORATION +< I-EXPLORATION +37 I-EXPLORATION +UI/ml). I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +ecografía-doppler I-EXPLORATION +y I-EXPLORATION +TAC I-EXPLORATION +abdominal I-EXPLORATION +que I-EXPLORATION +mostraban I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +de I-EXPLORATION +6 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +diámetro, I-EXPLORATION +situada I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +cabeza I-EXPLORATION +del I-EXPLORATION +páncreas, I-EXPLORATION +con I-EXPLORATION +dilatación I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +vía I-EXPLORATION +biliar I-EXPLORATION +intra- I-EXPLORATION +y I-EXPLORATION +extrahepática. I-EXPLORATION +La I-EXPLORATION +lesión I-EXPLORATION +presentaba I-EXPLORATION +zonas I-EXPLORATION +quísticas, I-EXPLORATION +con I-EXPLORATION +septos I-EXPLORATION +y I-EXPLORATION +mamelones I-EXPLORATION +sólidos I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +interior, I-EXPLORATION +alguno I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +cuales I-EXPLORATION +captaba I-EXPLORATION +contraste I-EXPLORATION +intensamente I-EXPLORATION +; I-EXPLORATION +sin I-EXPLORATION +datos I-EXPLORATION +de I-EXPLORATION +invasión I-EXPLORATION +vascular I-EXPLORATION +ni I-EXPLORATION +adenopatías. I-EXPLORATION +Con B-TREATMENT +la I-TREATMENT +impresión I-TREATMENT +diagnóstica I-TREATMENT +de I-TREATMENT +neoplasia I-TREATMENT +quística I-TREATMENT +del I-TREATMENT +páncreas I-TREATMENT +sin I-TREATMENT +contraindicación I-TREATMENT +quirúrgica I-TREATMENT +y I-TREATMENT +resecable, I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +duodeno-pancreatectomía I-TREATMENT +cefálica. I-TREATMENT +En B-EXPLORATION +la I-EXPLORATION +pieza I-EXPLORATION +quirúrgica I-EXPLORATION +se I-EXPLORATION +apreciaba I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +sólida I-EXPLORATION +de I-EXPLORATION +coloración I-EXPLORATION +blanquecina I-EXPLORATION +y I-EXPLORATION +consistencia I-EXPLORATION +elástica, I-EXPLORATION +localizada I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +cabeza I-EXPLORATION +del I-EXPLORATION +páncreas, I-EXPLORATION +no I-EXPLORATION +encapsulada I-EXPLORATION +pero I-EXPLORATION +de I-EXPLORATION +contornos I-EXPLORATION +bien I-EXPLORATION +delimitados, I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +separaba I-EXPLORATION +con I-EXPLORATION +facilidad I-EXPLORATION +del I-EXPLORATION +páncreas I-EXPLORATION +adyacente. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +inmunohistoquímica I-EXPLORATION +mostró I-EXPLORATION +positividad I-EXPLORATION +para I-EXPLORATION +el I-EXPLORATION +marcador I-EXPLORATION +vimentina, I-EXPLORATION +y I-EXPLORATION +negatividad I-EXPLORATION +para I-EXPLORATION +citoqueratinas I-EXPLORATION +(AE1-AE3), I-EXPLORATION +S-100, I-EXPLORATION +cromogranina, I-EXPLORATION +CD I-EXPLORATION +34, I-EXPLORATION +C-KIT I-EXPLORATION +y I-EXPLORATION +actina, I-EXPLORATION +presentando I-EXPLORATION +además I-EXPLORATION +un I-EXPLORATION +índice I-EXPLORATION +de I-EXPLORATION +proliferación I-EXPLORATION +celular I-EXPLORATION +(MIB-I) I-EXPLORATION +muy I-EXPLORATION +bajo I-EXPLORATION +; I-EXPLORATION +siendo I-EXPLORATION +los I-EXPLORATION +hallazgos I-EXPLORATION +del I-EXPLORATION +estudio I-EXPLORATION +histológico I-EXPLORATION +sugestivos I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +sarcoma I-EXPLORATION +fusocelular I-EXPLORATION +de I-EXPLORATION +bajo I-EXPLORATION +grado I-EXPLORATION +de I-EXPLORATION +malignidad. I-EXPLORATION +Tras B-EVOLUTION +dos I-EVOLUTION +años I-EVOLUTION +de I-EVOLUTION +seguimiento I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +permanece I-EVOLUTION +asintomática I-EVOLUTION +y I-EVOLUTION +sin I-EVOLUTION +recidiva I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +enfermedad. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +45 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +ni I-PAST_MEDICAL_HISTORY +familiares I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +nota I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +chasquido I-PRESENT_ILLNESS +mandibular I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +relación I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +apertura I-PRESENT_ILLNESS +mandibular I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +tumoración I-PRESENT_ILLNESS +palpable I-PRESENT_ILLNESS +preauricular I-PRESENT_ILLNESS +dolorosa I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +mejoró I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +antiinflamatorios I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +esteroideos, I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +Urgencias I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Cirugía I-PRESENT_ILLNESS +Maxilofacial. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +A B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +presenta I-EXPLORATION +asimetría I-EXPLORATION +facial, I-EXPLORATION +y I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación I-EXPLORATION +se I-EXPLORATION +aprecia I-EXPLORATION +un I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION +consistencia I-EXPLORATION +en I-EXPLORATION +región I-EXPLORATION +preauricular I-EXPLORATION +izquierda, I-EXPLORATION +arco I-EXPLORATION +cigomático I-EXPLORATION +y I-EXPLORATION +ángulo I-EXPLORATION +mandibular I-EXPLORATION +izquierdo. I-EXPLORATION +Este I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION +consistencia I-EXPLORATION +se I-EXPLORATION +halla I-EXPLORATION +mal I-EXPLORATION +delimitado, I-EXPLORATION +sin I-EXPLORATION +poderse I-EXPLORATION +definir I-EXPLORATION +clara I-EXPLORATION +tumoración. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +cavidad I-EXPLORATION +oral I-EXPLORATION +se I-EXPLORATION +aprecia I-EXPLORATION +induración I-EXPLORATION +irregular I-EXPLORATION +del I-EXPLORATION +espacio I-EXPLORATION +masticador I-EXPLORATION +izquierdo, I-EXPLORATION +sospechosa I-EXPLORATION +de I-EXPLORATION +afectación I-EXPLORATION +tumoral. I-EXPLORATION +La I-EXPLORATION +paciente I-EXPLORATION +presentaba I-EXPLORATION +una I-EXPLORATION +apertura I-EXPLORATION +oral I-EXPLORATION +de I-EXPLORATION +40 I-EXPLORATION +mm. I-EXPLORATION +No I-EXPLORATION +presentaba I-EXPLORATION +adenopatías I-EXPLORATION +cervicales I-EXPLORATION +ni I-EXPLORATION +supraclaviculares I-EXPLORATION +palpables. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +las I-EXPLORATION +pruebas I-EXPLORATION +de I-EXPLORATION +imagen I-EXPLORATION +aparece I-EXPLORATION +una I-EXPLORATION +tumoración I-EXPLORATION +de I-EXPLORATION +carácter I-EXPLORATION +sólido I-EXPLORATION +en I-EXPLORATION +hemimandíbula I-EXPLORATION +izquierda, I-EXPLORATION +de I-EXPLORATION +2, I-EXPLORATION +5 I-EXPLORATION +x I-EXPLORATION +2 I-EXPLORATION +x I-EXPLORATION +1, I-EXPLORATION +8 I-EXPLORATION +cm I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +región I-EXPLORATION +del I-EXPLORATION +cóndilo I-EXPLORATION +mandibular, I-EXPLORATION +de I-EXPLORATION +bordes I-EXPLORATION +bien I-EXPLORATION +delimitados, I-EXPLORATION +que I-EXPLORATION +sugiere I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +agresiva, I-EXPLORATION +de I-EXPLORATION +probable I-EXPLORATION +origen I-EXPLORATION +óseo, I-EXPLORATION +objetivándose I-EXPLORATION +destrucción I-EXPLORATION +de I-EXPLORATION +rama I-EXPLORATION +mandibular I-EXPLORATION +izquierda I-EXPLORATION +de I-EXPLORATION +carácter I-EXPLORATION +lítico. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +punción-aspiración I-EXPLORATION +con I-EXPLORATION +aguja I-EXPLORATION +fina I-EXPLORATION +con I-EXPLORATION +diagnóstico I-EXPLORATION +anatomopatológico I-EXPLORATION +de I-EXPLORATION +tumor I-EXPLORATION +de I-EXPLORATION +células I-EXPLORATION +redondas, I-EXPLORATION +negativo I-EXPLORATION +para I-EXPLORATION +citoqueratinas, I-EXPLORATION +antígeno I-EXPLORATION +leucocitario I-EXPLORATION +común, I-EXPLORATION +sinaptofisina I-EXPLORATION +y I-EXPLORATION +CD99. I-EXPLORATION + I-EXPLORATION +Finalmente I-EXPLORATION +se I-EXPLORATION +confirmó I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +PNET I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +biopsia I-EXPLORATION +tumoral I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +mandaron I-EXPLORATION +5 I-EXPLORATION +fragmentos I-EXPLORATION +irregulares I-EXPLORATION +de I-EXPLORATION +tejido I-EXPLORATION +de I-EXPLORATION +color I-EXPLORATION +rojizo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +diagnosticaron I-EXPLORATION +como I-EXPLORATION +"tumoración I-EXPLORATION +de I-EXPLORATION +células I-EXPLORATION +redondas I-EXPLORATION +y I-EXPLORATION +pequeñas I-EXPLORATION +infiltrando I-EXPLORATION +hueso". I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +un I-EXPLORATION +estudio I-EXPLORATION +inmunohistoquímico I-EXPLORATION +sobre I-EXPLORATION +el I-EXPLORATION +material I-EXPLORATION +fijado I-EXPLORATION +en I-EXPLORATION +formol I-EXPLORATION +incluido I-EXPLORATION +en I-EXPLORATION +parafina I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +que I-EXPLORATION +tan I-EXPLORATION +solo I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +positividad I-EXPLORATION +con I-EXPLORATION +vimentina I-EXPLORATION +y I-EXPLORATION +CD99. I-EXPLORATION +El I-EXPLORATION +índice I-EXPLORATION +de I-EXPLORATION +proliferación I-EXPLORATION +medido I-EXPLORATION +como I-EXPLORATION +positividad I-EXPLORATION +nuclear I-EXPLORATION +con I-EXPLORATION +MIB-1 I-EXPLORATION +era I-EXPLORATION +de I-EXPLORATION +aproximadamente I-EXPLORATION +el I-EXPLORATION +15% I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +celularidad I-EXPLORATION +tumoral. I-EXPLORATION +Dado I-EXPLORATION +el I-EXPLORATION +escaso I-EXPLORATION +material I-EXPLORATION +examinado, I-EXPLORATION +no I-EXPLORATION +fue I-EXPLORATION +posible I-EXPLORATION +determinar I-EXPLORATION +si I-EXPLORATION +la I-EXPLORATION +tumoración I-EXPLORATION +correspondía I-EXPLORATION +a I-EXPLORATION +un I-EXPLORATION +tumor I-EXPLORATION +de I-EXPLORATION +Ewing I-EXPLORATION +o I-EXPLORATION +a I-EXPLORATION +un I-EXPLORATION +neuroepitelioma I-EXPLORATION +periférico. I-EXPLORATION +El I-EXPLORATION +análisis I-EXPLORATION +citogenético I-EXPLORATION +no I-EXPLORATION +fue I-EXPLORATION +realizado. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +TAC I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +gammagrafía I-EXPLORATION +ósea I-EXPLORATION +no I-EXPLORATION +mostraron I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +enfermedad I-EXPLORATION +metastásica. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +decidió I-TREATMENT +comenzar I-TREATMENT +tratamiento I-TREATMENT +quimioterápico I-TREATMENT +y I-TREATMENT +valorar I-TREATMENT +tratamiento I-TREATMENT +quirúrgico/radioterápico I-TREATMENT +según I-TREATMENT +la I-TREATMENT +respuesta. I-TREATMENT +Se I-TREATMENT +dieron I-TREATMENT +5 I-TREATMENT +ciclos I-TREATMENT +durante I-TREATMENT +4 I-TREATMENT +meses. I-TREATMENT +Tras B-EVOLUTION +el I-EVOLUTION +tercer I-EVOLUTION +ciclo I-EVOLUTION +precisó I-EVOLUTION +ingreso I-EVOLUTION +por I-EVOLUTION +neutropenia I-EVOLUTION +febril. I-EVOLUTION + I-EVOLUTION +La B-TREATMENT +resonancia I-TREATMENT +magnética I-TREATMENT +nuclear I-TREATMENT +(RMN) I-TREATMENT +tras I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +quimioterápico I-TREATMENT +sugería I-TREATMENT +la I-TREATMENT +posible I-TREATMENT +progresión I-TREATMENT +del I-TREATMENT +tumor, I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +dar I-TREATMENT +tratamiento I-TREATMENT +radioterápico I-TREATMENT +planificado I-TREATMENT +con I-TREATMENT +intención I-TREATMENT +radical, I-TREATMENT +durante I-TREATMENT +un I-TREATMENT +mes I-TREATMENT +y I-TREATMENT +medio. I-TREATMENT +La I-TREATMENT +irradiación I-TREATMENT +se I-TREATMENT +hizo I-TREATMENT +en I-TREATMENT +dos I-TREATMENT +fases, I-TREATMENT +con I-TREATMENT +una I-TREATMENT +dosis I-TREATMENT +total I-TREATMENT +sobre I-TREATMENT +tumor I-TREATMENT +y I-TREATMENT +margen I-TREATMENT +reducido I-TREATMENT +de I-TREATMENT +60 I-TREATMENT +Gy. I-TREATMENT +Después B-EVOLUTION +del I-EVOLUTION +tratamiento I-EVOLUTION +radioterápico I-EVOLUTION +presentó I-EVOLUTION +mucositis I-EVOLUTION +grado I-EVOLUTION +2, I-EVOLUTION +otitis I-EVOLUTION +externa I-EVOLUTION +y I-EVOLUTION +epitelitis I-EVOLUTION +grado I-EVOLUTION +2 I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +campo I-EVOLUTION +de I-EVOLUTION +tratamiento. I-EVOLUTION + I-EVOLUTION +En B-TREATMENT +la I-TREATMENT +TAC I-TREATMENT +de I-TREATMENT +control I-TREATMENT +se I-TREATMENT +objetivaron I-TREATMENT +hallazgos I-TREATMENT +compatibles I-TREATMENT +con I-TREATMENT +restos/recidiva I-TREATMENT +del I-TREATMENT +PNET I-TREATMENT +de I-TREATMENT +la I-TREATMENT +paciente, I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +tratar I-TREATMENT +con I-TREATMENT +otros I-TREATMENT +5 I-TREATMENT +ciclos I-TREATMENT +más I-TREATMENT +de I-TREATMENT +quimioterapia, I-TREATMENT +siguiendo I-TREATMENT +el I-TREATMENT +mismo I-TREATMENT +esquema I-TREATMENT +anterior, I-TREATMENT +durante I-TREATMENT +otros I-TREATMENT +4 I-TREATMENT +meses. I-TREATMENT + I-TREATMENT +Actualmente B-EVOLUTION +han I-EVOLUTION +pasado I-EVOLUTION +6 I-EVOLUTION +años I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +continúa I-EVOLUTION +libre I-EVOLUTION +de I-EVOLUTION +enfermedad, I-EVOLUTION +en I-EVOLUTION +tratamiento I-EVOLUTION +de I-EVOLUTION +rehabilitación I-EVOLUTION +dental. I-EVOLUTION + I-EVOLUTION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +9 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +patológicos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés, I-PAST_MEDICAL_HISTORY +remitido B-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +urgencias I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +dolor I-DERIVED_FROM/TO +precordial I-DERIVED_FROM/TO +intermitente I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +1 I-DERIVED_FROM/TO +mes I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +evolución, I-DERIVED_FROM/TO +asociado I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +alteración I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +electrocardiograma I-DERIVED_FROM/TO +(ECG): I-DERIVED_FROM/TO +atenuación I-DERIVED_FROM/TO +del I-DERIVED_FROM/TO +QRS I-DERIVED_FROM/TO +e I-DERIVED_FROM/TO +inversión I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +onda I-DERIVED_FROM/TO +T I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +derivaciones I-DERIVED_FROM/TO +precordiales. I-DERIVED_FROM/TO +No B-PRESENT_ILLNESS +refería I-PRESENT_ILLNESS +palpitaciones, I-PRESENT_ILLNESS +síntomas I-PRESENT_ILLNESS +vegetativos I-PRESENT_ILLNESS +ni I-PRESENT_ILLNESS +episodios I-PRESENT_ILLNESS +sincopales. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +A B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +presentaba I-EXPLORATION +buen I-EXPLORATION +aspecto I-EXPLORATION +general, I-EXPLORATION +manteniéndose I-EXPLORATION +hemodinámicamente I-EXPLORATION +estable, I-EXPLORATION +destacando I-EXPLORATION +dolor I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +musculatura I-EXPLORATION +torácica I-EXPLORATION +izquierda I-EXPLORATION +que I-EXPLORATION +aumentaba I-EXPLORATION +con I-EXPLORATION +la I-EXPLORATION +inspiración I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +movilización I-EXPLORATION +de I-EXPLORATION +miembros I-EXPLORATION +superiores. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +auscultación I-EXPLORATION +cardíaca I-EXPLORATION +se I-EXPLORATION +escuchaba I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION +ruidos I-EXPLORATION +cardíacos I-EXPLORATION +en I-EXPLORATION +precordio I-EXPLORATION +derecho I-EXPLORATION +y I-EXPLORATION +atenuados I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +izquierdo. I-EXPLORATION + I-EXPLORATION +Dado I-EXPLORATION +el I-EXPLORATION +tiempo I-EXPLORATION +de I-EXPLORATION +evolución I-EXPLORATION +del I-EXPLORATION +dolor I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +alteración I-EXPLORATION +electrocardiográfica I-EXPLORATION +referida, I-EXPLORATION +se I-EXPLORATION +repitió I-EXPLORATION +ECG, I-EXPLORATION +persistiendo I-EXPLORATION +eje I-EXPLORATION +QRS I-EXPLORATION +y I-EXPLORATION +onda I-EXPLORATION +P I-EXPLORATION +de I-EXPLORATION ++150°, I-EXPLORATION +QRS I-EXPLORATION +estrecho I-EXPLORATION +de I-EXPLORATION +voltaje I-EXPLORATION +atenuado I-EXPLORATION +en I-EXPLORATION +precordiales I-EXPLORATION +V3-V6 I-EXPLORATION +y I-EXPLORATION +ondas I-EXPLORATION +T I-EXPLORATION +negativas I-EXPLORATION +en I-EXPLORATION +V1-V4 I-EXPLORATION +y I-EXPLORATION +aVL. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +tórax I-EXPLORATION +se I-EXPLORATION +confirmó I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +dextrocardia, I-EXPLORATION +además I-EXPLORATION +se I-EXPLORATION +apreció I-EXPLORATION +burbuja I-EXPLORATION +gástrica I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +derecha I-EXPLORATION +y I-EXPLORATION +sombra I-EXPLORATION +hepática I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +izquierda, I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +sospechó I-EXPLORATION +situs I-EXPLORATION +inversus, I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +confirmó I-EXPLORATION +en I-EXPLORATION +ecografía I-EXPLORATION +abdominal. I-EXPLORATION + I-EXPLORATION +El B-DERIVED_FROM/TO +paciente I-DERIVED_FROM/TO +fue I-DERIVED_FROM/TO +remitido I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +Cardiología I-DERIVED_FROM/TO +Infantil I-DERIVED_FROM/TO +donde I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +realizó I-DERIVED_FROM/TO +ecocardiografía I-DERIVED_FROM/TO +evidenciándose I-DERIVED_FROM/TO +dextrocardia I-DERIVED_FROM/TO +especular I-DERIVED_FROM/TO +clásica I-DERIVED_FROM/TO +sin I-DERIVED_FROM/TO +malformaciones I-DERIVED_FROM/TO +cardíacas I-DERIVED_FROM/TO +asociadas. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +Ante B-TREATMENT +la I-TREATMENT +sospecha I-TREATMENT +de I-TREATMENT +etiología I-TREATMENT +músculo-esquelética, I-TREATMENT +el I-TREATMENT +dolor I-TREATMENT +torácico I-TREATMENT +se I-TREATMENT +trató I-TREATMENT +con I-TREATMENT +antiinflamatorios I-TREATMENT +con B-EVOLUTION +mejoría I-EVOLUTION +progresiva, I-EVOLUTION +encontrándose I-EVOLUTION +asintomático I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +momento I-EVOLUTION +de I-EVOLUTION +acudir I-EVOLUTION +a I-EVOLUTION +control. I-EVOLUTION + I-EVOLUTION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +83 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +diabetes I-PAST_MEDICAL_HISTORY +mellitus I-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +2 I-PAST_MEDICAL_HISTORY +ingresado B-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +raíz I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +hipoglucemia I-PRESENT_ILLNESS +severa I-PRESENT_ILLNESS +secundaria I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +antidiabéticos I-PRESENT_ILLNESS +orales. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Al B-EXPLORATION +ingreso I-EXPLORATION +presentaba I-EXPLORATION +traumatismo I-EXPLORATION +con I-EXPLORATION +herida I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +dorso I-EXPLORATION +del I-EXPLORATION +pie I-EXPLORATION +izquierdo I-EXPLORATION +que I-EXPLORATION +tuvo I-EXPLORATION +como I-EXPLORATION +consecuencia I-EXPLORATION +una I-EXPLORATION +úlcera I-EXPLORATION +por I-EXPLORATION +presión I-EXPLORATION +talar I-EXPLORATION +izquierda I-EXPLORATION +diagnosticada I-EXPLORATION +como I-EXPLORATION +pie I-EXPLORATION +diabético. I-EXPLORATION +Mediante I-EXPLORATION +cultivo I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +que I-EXPLORATION +era I-EXPLORATION +positivo I-EXPLORATION +para I-EXPLORATION +PAMR I-EXPLORATION +y I-EXPLORATION +SARM. I-EXPLORATION + I-EXPLORATION +Posteriormente I-EXPLORATION +mediante I-EXPLORATION +antibiograma I-EXPLORATION +se I-EXPLORATION +valoró I-EXPLORATION +que I-EXPLORATION +el I-EXPLORATION +PAMR I-EXPLORATION +era I-EXPLORATION +sensible I-EXPLORATION +únicamente I-EXPLORATION +a I-EXPLORATION +colistina I-EXPLORATION +(CMI I-EXPLORATION +< I-EXPLORATION +2) I-EXPLORATION +e I-EXPLORATION +intermedio I-EXPLORATION +a I-EXPLORATION +amikacina I-EXPLORATION +(CMI I-EXPLORATION += I-EXPLORATION +16) I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +SARM I-EXPLORATION +era I-EXPLORATION +sensible I-EXPLORATION +entre I-EXPLORATION +otros I-EXPLORATION +a I-EXPLORATION +cotrimoxazol I-EXPLORATION +(CMI I-EXPLORATION +≤ I-EXPLORATION +1/19). I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +crema I-TREATMENT +de I-TREATMENT +colistina I-TREATMENT +0, I-TREATMENT +1% I-TREATMENT +con I-TREATMENT +una I-TREATMENT +aplicación I-TREATMENT +diaria I-TREATMENT +en I-TREATMENT +la I-TREATMENT +cura I-TREATMENT +y I-TREATMENT +además I-TREATMENT +se I-TREATMENT +administró I-TREATMENT +cotrimoxazol I-TREATMENT +800/160mg I-TREATMENT +oral I-TREATMENT +cada I-TREATMENT +doce I-TREATMENT +horas I-TREATMENT +para I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +del I-TREATMENT +SARM. I-TREATMENT +La B-EVOLUTION +evolución I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +úlcera I-EVOLUTION +fue I-EVOLUTION +favorable. I-EVOLUTION +Según B-TREATMENT +criterio I-TREATMENT +médico, I-TREATMENT +se I-TREATMENT +finalizó I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +tópico I-TREATMENT +con I-TREATMENT +colistina I-TREATMENT +tras I-TREATMENT +23 I-TREATMENT +días, I-TREATMENT +realizando B-EXPLORATION +un I-EXPLORATION +cultivo I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +úlcera I-EXPLORATION +a I-EXPLORATION +los I-EXPLORATION +4 I-EXPLORATION +días I-EXPLORATION +cuyo I-EXPLORATION +resultado I-EXPLORATION +fue I-EXPLORATION +negativo I-EXPLORATION +a I-EXPLORATION +PAMR, I-EXPLORATION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +suspendió I-TREATMENT +el I-TREATMENT +tratamiento. I-TREATMENT +La B-EVOLUTION +mejoría I-EVOLUTION +clínica I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +úlcera I-EVOLUTION +al I-EVOLUTION +finalizar I-EVOLUTION +el I-EVOLUTION +tratamiento I-EVOLUTION +tópico I-EVOLUTION +con I-EVOLUTION +colistina I-EVOLUTION +fue I-EVOLUTION +notable. I-EVOLUTION +Se B-TREATMENT +continuó I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +cotrimoxazol I-TREATMENT +al I-TREATMENT +persistir I-TREATMENT +el I-TREATMENT +SARM. I-TREATMENT + I-TREATMENT +No I-TREATMENT +se I-TREATMENT +administró I-TREATMENT +en I-TREATMENT +ninguno I-TREATMENT +de I-TREATMENT +los I-TREATMENT +casos I-TREATMENT +tratamiento I-TREATMENT +sistémico I-TREATMENT +con I-TREATMENT +colistina I-TREATMENT +intravenosa. I-TREATMENT + I-TREATMENT +En I-TREATMENT +conclusión, I-TREATMENT +los I-TREATMENT +resultados I-TREATMENT +sugieren I-TREATMENT +que I-TREATMENT +el I-TREATMENT +preparado I-TREATMENT +de I-TREATMENT +colistina I-TREATMENT +0, I-TREATMENT +1% I-TREATMENT +elaborado I-TREATMENT +por I-TREATMENT +el I-TREATMENT +servicio I-TREATMENT +de I-TREATMENT +farmacia I-TREATMENT +podría I-TREATMENT +ser I-TREATMENT +útil I-TREATMENT +para I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +de I-TREATMENT +úlceras I-TREATMENT +infectadas I-TREATMENT +por I-TREATMENT +PAMR I-TREATMENT +negativizando I-TREATMENT +el I-TREATMENT +cultivo I-TREATMENT +del I-TREATMENT +exudado I-TREATMENT +en I-TREATMENT +uno I-TREATMENT +de I-TREATMENT +los I-TREATMENT +casos. I-TREATMENT + I-TREATMENT +No B-EVOLUTION +se I-EVOLUTION +pudo I-EVOLUTION +disponer I-EVOLUTION +de I-EVOLUTION +un I-EVOLUTION +cultivo I-EVOLUTION +posterior I-EVOLUTION +al I-EVOLUTION +tratamiento I-EVOLUTION +en I-EVOLUTION +uno I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +pacientes, I-EVOLUTION +aunque I-EVOLUTION +a I-EVOLUTION +criterio I-EVOLUTION +médico I-EVOLUTION +se I-EVOLUTION +observó I-EVOLUTION +crecimiento I-EVOLUTION +de I-EVOLUTION +bordes I-EVOLUTION +y I-EVOLUTION +tejido I-EVOLUTION +de I-EVOLUTION +granulación, I-EVOLUTION +indicativos I-EVOLUTION +de I-EVOLUTION +mejoría I-EVOLUTION +clínica. I-EVOLUTION + I-EVOLUTION +El I-EVOLUTION +aumento I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +casos I-EVOLUTION +de I-EVOLUTION +esta I-EVOLUTION +infección I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +falta I-EVOLUTION +de I-EVOLUTION +información I-EVOLUTION +en I-EVOLUTION +cuanto I-EVOLUTION +a I-EVOLUTION +eficacia I-EVOLUTION +y I-EVOLUTION +resultados I-EVOLUTION +plantea I-EVOLUTION +la I-EVOLUTION +necesidad I-EVOLUTION +de I-EVOLUTION +seguir I-EVOLUTION +investigando I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +campo I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +colistina I-EVOLUTION +tópica I-EVOLUTION +para I-EVOLUTION +llegar I-EVOLUTION +a I-EVOLUTION +conclusiones I-EVOLUTION +más I-EVOLUTION +sólidas I-EVOLUTION +sobre I-EVOLUTION +las I-EVOLUTION +posibilidades I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +utilización I-EVOLUTION +de I-EVOLUTION +este I-EVOLUTION +tratamiento. I-EVOLUTION + I-EVOLUTION +P. I-EVOLUTION +March I-EVOLUTION +López1, I-EVOLUTION +S. I-EVOLUTION +Redondo I-EVOLUTION +Capafons2, I-EVOLUTION +D. I-EVOLUTION +Cruz I-EVOLUTION +Guerrero3 I-EVOLUTION +y I-EVOLUTION +R. I-EVOLUTION +Garriga I-EVOLUTION +Biosca2 I-EVOLUTION +1Farmacéutico I-EVOLUTION +Residente. I-EVOLUTION +Servicio I-EVOLUTION +de I-EVOLUTION +Farmacia. I-EVOLUTION +Hospital I-EVOLUTION +Universitari I-EVOLUTION +Mútua I-EVOLUTION +Terrassa I-EVOLUTION +(Barcelona). I-EVOLUTION +España. I-EVOLUTION +2Farmacéutica I-EVOLUTION +Adjunta. I-EVOLUTION +Servicio I-EVOLUTION +de I-EVOLUTION +Farmacia. I-EVOLUTION +Hospital I-EVOLUTION +Universitari I-EVOLUTION +Mútua I-EVOLUTION +Terrassa I-EVOLUTION +(Barcelona). I-EVOLUTION +España. I-EVOLUTION +3Médico I-EVOLUTION +Adjunto. I-EVOLUTION +Centre I-EVOLUTION +Soci-Sanitari I-EVOLUTION +Residencia I-EVOLUTION +L´Ametlla I-EVOLUTION +del I-EVOLUTION +Vallés. I-EVOLUTION +Fundació I-EVOLUTION +Vallparadis. I-EVOLUTION +Grup I-EVOLUTION +Mútua I-EVOLUTION +Terrassa. I-EVOLUTION +Terrassa I-EVOLUTION +(Barcelona). I-EVOLUTION +España. I-EVOLUTION + I-EVOLUTION + +Paciente B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +femenino, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +historia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +obesidad, I-PAST_MEDICAL_HISTORY +diabetes I-PAST_MEDICAL_HISTORY +mellitus I-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +2, I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial I-PAST_MEDICAL_HISTORY +(HTA), I-PAST_MEDICAL_HISTORY +enfermedad I-PAST_MEDICAL_HISTORY +pulmonar I-PAST_MEDICAL_HISTORY +crónica I-PAST_MEDICAL_HISTORY +asociada I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +tabaquismo I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +hipotiroidismo I-PAST_MEDICAL_HISTORY +subclínico. I-PAST_MEDICAL_HISTORY +A B-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +71 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +evaluó I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +mal I-PRESENT_ILLNESS +control I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +HTA I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +diabetes I-PRESENT_ILLNESS +mellitus. I-PRESENT_ILLNESS +Al B-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +se I-EXPLORATION +observaba I-EXPLORATION +facies I-EXPLORATION +cushingoide I-EXPLORATION +y I-EXPLORATION +relleno I-EXPLORATION +de I-EXPLORATION +huecos I-EXPLORATION +supraclaviculares. I-EXPLORATION +Se I-EXPLORATION +solicitó I-EXPLORATION +cortisol I-EXPLORATION +libre I-EXPLORATION +urinario I-EXPLORATION +(CLU): I-EXPLORATION +236 I-EXPLORATION +ug/24 I-EXPLORATION +h I-EXPLORATION +(VN I-EXPLORATION +hasta I-EXPLORATION +100 I-EXPLORATION +ug/24 I-EXPLORATION +h), I-EXPLORATION +test I-EXPLORATION +de I-EXPLORATION +Nugent I-EXPLORATION +o I-EXPLORATION +de I-EXPLORATION +supresión I-EXPLORATION +nocturna I-EXPLORATION +con I-EXPLORATION +dexametasona I-EXPLORATION +(Dx) I-EXPLORATION +1 I-EXPLORATION +mg: I-EXPLORATION +11, I-EXPLORATION +1 I-EXPLORATION +ug/dl I-EXPLORATION +(VN I-EXPLORATION +< I-EXPLORATION +1, I-EXPLORATION +8 I-EXPLORATION +ug/dl), I-EXPLORATION +ACTH I-EXPLORATION +32, I-EXPLORATION +1pg/ml I-EXPLORATION +(VN I-EXPLORATION +hasta I-EXPLORATION +46 I-EXPLORATION +pg/ml). I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +estudio I-EXPLORATION +funcional: I-EXPLORATION +test I-EXPLORATION +de I-EXPLORATION +Dx/ I-EXPLORATION +desmopresina, I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +respuesta I-EXPLORATION +de I-EXPLORATION +cortisol I-EXPLORATION +postestímulo, I-EXPLORATION +sugiriendo I-EXPLORATION +origen I-EXPLORATION +hipofisiario. I-EXPLORATION +Se I-EXPLORATION +solicitó I-EXPLORATION +RM I-EXPLORATION +de I-EXPLORATION +silla I-EXPLORATION +turca I-EXPLORATION +que I-EXPLORATION +demostró I-EXPLORATION +adenoma I-EXPLORATION +posterolateral I-EXPLORATION +izquierdo I-EXPLORATION +de I-EXPLORATION +6 I-EXPLORATION +mm, I-EXPLORATION +que I-EXPLORATION +determina I-EXPLORATION +leve I-EXPLORATION +remodelación I-EXPLORATION +del I-EXPLORATION +piso I-EXPLORATION +selar. I-EXPLORATION +Por B-TREATMENT +distintas I-TREATMENT +razones, I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +no I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +cirugía. I-TREATMENT +En B-EXPLORATION +controles I-EXPLORATION +sucesivos I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +normalización I-EXPLORATION +del I-EXPLORATION +CLU I-EXPLORATION +sin I-EXPLORATION +mediar I-EXPLORATION +tratamiento. I-EXPLORATION +A I-EXPLORATION +los I-EXPLORATION +3 I-EXPLORATION +años I-EXPLORATION +tuvo I-EXPLORATION +un I-EXPLORATION +test I-EXPLORATION +de I-EXPLORATION +Nugent I-EXPLORATION +de I-EXPLORATION +3, I-EXPLORATION +5 I-EXPLORATION +ng/dl, I-EXPLORATION +ACTH: I-EXPLORATION +54, I-EXPLORATION +8 I-EXPLORATION +pg/ml I-EXPLORATION +y I-EXPLORATION +CLU: I-EXPLORATION +50, I-EXPLORATION +1 I-EXPLORATION +ug/24 I-EXPLORATION +h. I-EXPLORATION +Una I-EXPLORATION +nueva I-EXPLORATION +RM I-EXPLORATION +de I-EXPLORATION +silla I-EXPLORATION +turca I-EXPLORATION +mostró I-EXPLORATION +adenoma I-EXPLORATION +de I-EXPLORATION +similares I-EXPLORATION +características, I-EXPLORATION +sin I-EXPLORATION +evidencias I-EXPLORATION +de I-EXPLORATION +hemorragia I-EXPLORATION +intratumoral. I-EXPLORATION +A I-EXPLORATION +los I-EXPLORATION +7 I-EXPLORATION +años I-EXPLORATION +tiene I-EXPLORATION +CLU I-EXPLORATION +28, I-EXPLORATION +8 I-EXPLORATION +ug/24 I-EXPLORATION +h, I-EXPLORATION +la I-EXPLORATION +diabetes I-EXPLORATION +mellitus I-EXPLORATION +mantiene I-EXPLORATION +un I-EXPLORATION +control I-EXPLORATION +adecuado I-EXPLORATION +para I-EXPLORATION +la I-EXPLORATION +edad I-EXPLORATION +(HbA1c: I-EXPLORATION +7, I-EXPLORATION +6%) I-EXPLORATION +y I-EXPLORATION +ha I-EXPLORATION +disminuido I-EXPLORATION +10 I-EXPLORATION +kilos I-EXPLORATION +de I-EXPLORATION +peso I-EXPLORATION +desde I-EXPLORATION +su I-EXPLORATION +evaluación I-EXPLORATION +inicial. I-EXPLORATION + I-EXPLORATION +Ambas B-EVOLUTION +pacientes I-EVOLUTION +aún I-EVOLUTION +sobreviven, I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +82 I-EVOLUTION +y I-EVOLUTION +88 I-EVOLUTION +años, I-EVOLUTION +respectivamente I-EVOLUTION +y I-EVOLUTION +no I-EVOLUTION +manifiestan I-EVOLUTION +clínica I-EVOLUTION +de I-EVOLUTION +hiperfunción I-EVOLUTION +endocrina. I-EVOLUTION + I-EVOLUTION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +66 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +diabetes I-PAST_MEDICAL_HISTORY +mellitus I-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +2 I-PAST_MEDICAL_HISTORY +insulino-requiriente, I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial, I-PAST_MEDICAL_HISTORY +dislipide-mia, I-PAST_MEDICAL_HISTORY +gota, I-PAST_MEDICAL_HISTORY +glaucoma I-PAST_MEDICAL_HISTORY +bilateral I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +meningo-encefalitis I-PAST_MEDICAL_HISTORY +hacía I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +sido I-PAST_MEDICAL_HISTORY +tratada I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +otro I-PAST_MEDICAL_HISTORY +hospital. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Consultó B-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +brusco I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +pocas I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +sensación I-PRESENT_ILLNESS +febril I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +calofríos, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +alteraciones I-PRESENT_ILLNESS +conductuales I-PRESENT_ILLNESS +(agresividad I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +familiares) I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +posteriormente I-PRESENT_ILLNESS +rápido I-PRESENT_ILLNESS +compromiso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +conciencia. I-PRESENT_ILLNESS +Una B-EXPLORATION +medición I-EXPLORATION +de I-EXPLORATION +glicemia I-EXPLORATION +capilar I-EXPLORATION +en I-EXPLORATION +domicilio I-EXPLORATION +descartó I-EXPLORATION +una I-EXPLORATION +hipoglicemia. I-EXPLORATION +Ingresó I-EXPLORATION +a I-EXPLORATION +un I-EXPLORATION +centro I-EXPLORATION +asistencial I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +puntaje I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +escala I-EXPLORATION +Glasgow I-EXPLORATION +de I-EXPLORATION +coma I-EXPLORATION +(GCS) I-EXPLORATION +de I-EXPLORATION +14 I-EXPLORATION +puntos, I-EXPLORATION +confuso, I-EXPLORATION +desorientado I-EXPLORATION +y I-EXPLORATION +con I-EXPLORATION +agitación I-EXPLORATION +psicomotora I-EXPLORATION +(que I-EXPLORATION +se I-EXPLORATION +contuvo I-EXPLORATION +farmacológicamente I-EXPLORATION +con I-EXPLORATION +propofol, I-EXPLORATION +ketamina I-EXPLORATION +y I-EXPLORATION +lorazepam) I-EXPLORATION +y I-EXPLORATION +signos I-EXPLORATION +meníngeos I-EXPLORATION +negativos. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +un I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +imágenes I-EXPLORATION +con I-EXPLORATION +tomografía I-EXPLORATION +axial I-EXPLORATION +computarizada I-EXPLORATION +(TAC) I-EXPLORATION +y I-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION +(RM) I-EXPLORATION +de I-EXPLORATION +encéfalo I-EXPLORATION +que I-EXPLORATION +fueron I-EXPLORATION +informadas I-EXPLORATION +como I-EXPLORATION +normales. I-EXPLORATION +El I-EXPLORATION +análisis I-EXPLORATION +del I-EXPLORATION +LCR I-EXPLORATION +reveló I-EXPLORATION +un I-EXPLORATION +líquido I-EXPLORATION +incoloro, I-EXPLORATION +glucorraquia I-EXPLORATION +de I-EXPLORATION +132 I-EXPLORATION +mg/dL I-EXPLORATION +(glicemia I-EXPLORATION +de I-EXPLORATION +199 I-EXPLORATION +mg/dL), I-EXPLORATION +proteínas I-EXPLORATION +249 I-EXPLORATION +mg/dL, I-EXPLORATION +pleocitosis I-EXPLORATION +de I-EXPLORATION +940 I-EXPLORATION +céls/mm3 I-EXPLORATION +con I-EXPLORATION +36% I-EXPLORATION +polimorfonucleares I-EXPLORATION +y I-EXPLORATION +64% I-EXPLORATION +mononucleares, I-EXPLORATION +hematíes I-EXPLORATION +100 I-EXPLORATION +céls/mm3, I-EXPLORATION +100% I-EXPLORATION +frescos I-EXPLORATION +y I-EXPLORATION +tinción I-EXPLORATION +de I-EXPLORATION +Gram I-EXPLORATION +sin I-EXPLORATION +bacterias I-EXPLORATION +visibles. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +microbiológico I-EXPLORATION +del I-EXPLORATION +LCR I-EXPLORATION +con I-EXPLORATION +cultivo I-EXPLORATION +y I-EXPLORATION +reacción I-EXPLORATION +de I-EXPLORATION +polimerasa I-EXPLORATION +en I-EXPLORATION +cadena I-EXPLORATION +(RPC) I-EXPLORATION +para I-EXPLORATION +virus I-EXPLORATION +varicela I-EXPLORATION +zoster, I-EXPLORATION +virus I-EXPLORATION +herpes I-EXPLORATION +simplex I-EXPLORATION +1, I-EXPLORATION +2 I-EXPLORATION +y I-EXPLORATION +6, I-EXPLORATION +citomegalovirus, I-EXPLORATION +test I-EXPLORATION +de I-EXPLORATION +látex I-EXPLORATION +para I-EXPLORATION +N. I-EXPLORATION +meningitidis, I-EXPLORATION +hemocultivos I-EXPLORATION +y I-EXPLORATION +urocultivo, I-EXPLORATION +fueron I-EXPLORATION +todos I-EXPLORATION +negativos. I-EXPLORATION +En I-EXPLORATION +los I-EXPLORATION +exámenes I-EXPLORATION +generales I-EXPLORATION +destacaba I-EXPLORATION +una I-EXPLORATION +leucocitosis I-EXPLORATION +de I-EXPLORATION +14.850 I-EXPLORATION +céls/mm3, I-EXPLORATION +neutrofilia I-EXPLORATION +(82%), I-EXPLORATION +velocidad I-EXPLORATION +de I-EXPLORATION +eritrosedimentación I-EXPLORATION +(VHS) I-EXPLORATION +discretamente I-EXPLORATION +elevada I-EXPLORATION +(21 I-EXPLORATION +mm/h), I-EXPLORATION +pruebas I-EXPLORATION +bioquímicas I-EXPLORATION +y I-EXPLORATION +hepáticas I-EXPLORATION +normales, I-EXPLORATION +salvo I-EXPLORATION +una I-EXPLORATION +hiperglicemia I-EXPLORATION +y I-EXPLORATION +alza I-EXPLORATION +leve I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +creatinina I-EXPLORATION +plasmática I-EXPLORATION +(1, I-EXPLORATION +3 I-EXPLORATION +mg/dL). I-EXPLORATION +Los I-EXPLORATION +valores I-EXPLORATION +de I-EXPLORATION +proteína I-EXPLORATION +C I-EXPLORATION +reactiva I-EXPLORATION +fueron I-EXPLORATION +normales I-EXPLORATION +(5, I-EXPLORATION +5 I-EXPLORATION +mg/L) I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +procalcitonina I-EXPLORATION +bajos I-EXPLORATION +(< I-EXPLORATION +0, I-EXPLORATION +05 I-EXPLORATION +ng/mL). I-EXPLORATION +Evolucionó B-TREATMENT +con I-TREATMENT +una I-TREATMENT +hipotensión I-TREATMENT +arterial I-TREATMENT +(96/56 I-TREATMENT +mm I-TREATMENT +Hg) I-TREATMENT +que I-TREATMENT +respondió I-TREATMENT +a I-TREATMENT +la I-TREATMENT +administración I-TREATMENT +de I-TREATMENT +volumen, I-TREATMENT +además I-TREATMENT +de I-TREATMENT +compromiso I-TREATMENT +de I-TREATMENT +conciencia I-TREATMENT +fluctuante I-TREATMENT +(Glasgow I-TREATMENT +bajó I-TREATMENT +a I-TREATMENT +11). I-TREATMENT +Se I-TREATMENT +inició I-TREATMENT +terapia I-TREATMENT +antimicrobiana I-TREATMENT +empírica I-TREATMENT +con I-TREATMENT +ceftriaxona, I-TREATMENT +ampicilina I-TREATMENT +y I-TREATMENT +aciclovir I-TREATMENT +i.v. I-TREATMENT +y I-TREATMENT +glucocorticoides I-TREATMENT +(dexametasona I-TREATMENT +8 I-TREATMENT +mg). I-TREATMENT +Se B-DERIVED_FROM/TO +trasladó I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +nuestro I-DERIVED_FROM/TO +hospital I-DERIVED_FROM/TO +donde I-DERIVED_FROM/TO +ingresó I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +Glasgow I-DERIVED_FROM/TO +fluctuante I-DERIVED_FROM/TO +(entre I-DERIVED_FROM/TO +10 I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +13 I-DERIVED_FROM/TO +puntos), I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +hemodinamia I-DERIVED_FROM/TO +estable, I-DERIVED_FROM/TO +febril I-DERIVED_FROM/TO +(38, I-DERIVED_FROM/TO +5 I-DERIVED_FROM/TO +oC), I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +reflejos I-DERIVED_FROM/TO +osteotendíneos I-DERIVED_FROM/TO +exacerbados, I-DERIVED_FROM/TO +sin I-DERIVED_FROM/TO +focalidad I-DERIVED_FROM/TO +neurológica, I-DERIVED_FROM/TO +signos I-DERIVED_FROM/TO +meníngeos I-DERIVED_FROM/TO +o I-DERIVED_FROM/TO +lesiones I-DERIVED_FROM/TO +embólicas I-DERIVED_FROM/TO +sistémicas I-DERIVED_FROM/TO +o I-DERIVED_FROM/TO +cutáneas. I-DERIVED_FROM/TO +Se B-EXPLORATION +repitió I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +LCR, I-EXPLORATION +en I-EXPLORATION +cuyo I-EXPLORATION +citoquímico I-EXPLORATION +las I-EXPLORATION +proteínas I-EXPLORATION +disminuyeron I-EXPLORATION +a I-EXPLORATION +81 I-EXPLORATION +mg/dL I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +pleocitosis I-EXPLORATION +a I-EXPLORATION +40 I-EXPLORATION +céls/mm3. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +en I-EXPLORATION +LCR I-EXPLORATION +para I-EXPLORATION +tuberculosis I-EXPLORATION +(adenosina I-EXPLORATION +deaminasa, I-EXPLORATION +baciloscopia I-EXPLORATION +y I-EXPLORATION +cultivo I-EXPLORATION +de I-EXPLORATION +Koch), I-EXPLORATION +enterovirus I-EXPLORATION +(RPC) I-EXPLORATION +y I-EXPLORATION +hongos I-EXPLORATION +(tinta I-EXPLORATION +china I-EXPLORATION +y I-EXPLORATION +cultivo) I-EXPLORATION +fueron I-EXPLORATION +negativos I-EXPLORATION +y/o I-EXPLORATION +normales. I-EXPLORATION +Se I-EXPLORATION +descartó I-EXPLORATION +también I-EXPLORATION +una I-EXPLORATION +neumonía I-EXPLORATION +por I-EXPLORATION +imágenes I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +serología I-EXPLORATION +para I-EXPLORATION +VIH I-EXPLORATION +fue I-EXPLORATION +negativa. I-EXPLORATION + I-EXPLORATION +El B-EVOLUTION +paciente I-EVOLUTION +evolucionó I-EVOLUTION +favorablemente, I-EVOLUTION +se B-TREATMENT +logró I-TREATMENT +desconectar I-TREATMENT +del I-TREATMENT +ventilador I-TREATMENT +mecánico I-TREATMENT +a I-TREATMENT +las I-TREATMENT +24 I-TREATMENT +h I-TREATMENT +de I-TREATMENT +su I-TREATMENT +ingreso, I-TREATMENT +sin B-EVOLUTION +demostrar I-EVOLUTION +focalización I-EVOLUTION +neurológica I-EVOLUTION +alguna I-EVOLUTION +y I-EVOLUTION +recuperando I-EVOLUTION +totalmente I-EVOLUTION +sus I-EVOLUTION +funciones I-EVOLUTION +cerebrales I-EVOLUTION +superiores. I-EVOLUTION +Los B-TREATMENT +antimicrobianos I-TREATMENT +fueron I-TREATMENT +suspendidos I-TREATMENT +a I-TREATMENT +las I-TREATMENT +72 I-TREATMENT +h. I-TREATMENT +Al B-EXPLORATION +interrogatorio I-EXPLORATION +dirigido, I-EXPLORATION +el I-EXPLORATION +paciente I-EXPLORATION +no I-EXPLORATION +refirió I-EXPLORATION +ningún I-EXPLORATION +síntoma I-EXPLORATION +respiratorio I-EXPLORATION +alto I-EXPLORATION +o I-EXPLORATION +bajo I-EXPLORATION +(rinorrea, I-EXPLORATION +tos, I-EXPLORATION +odinofagia I-EXPLORATION +o I-EXPLORATION +disfonía) I-EXPLORATION +que I-EXPLORATION +justificara I-EXPLORATION +la I-EXPLORATION +búsqueda I-EXPLORATION +de I-EXPLORATION +virus I-EXPLORATION +respiratorios. I-EXPLORATION +Fue B-EVOLUTION +dado I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +al I-EVOLUTION +cuarto I-EVOLUTION +día I-EVOLUTION +de I-EVOLUTION +su I-EVOLUTION +ingreso. I-EVOLUTION + I-EVOLUTION +Se B-PAST_MEDICAL_HISTORY +obtuvieron I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +meningoencefalitis I-PAST_MEDICAL_HISTORY +ocurrida I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +atrás, I-PAST_MEDICAL_HISTORY +según I-PAST_MEDICAL_HISTORY la I-PAST_MEDICAL_HISTORY -lectura. I-PAST_MEDICAL_HISTORY -Titulado I-PAST_MEDICAL_HISTORY +epicrisis. I-PAST_MEDICAL_HISTORY +Había I-PAST_MEDICAL_HISTORY +estado I-PAST_MEDICAL_HISTORY +internado I-PAST_MEDICAL_HISTORY +12 I-PAST_MEDICAL_HISTORY +días, I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +ellos I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -administración, I-PAST_MEDICAL_HISTORY -ha I-PAST_MEDICAL_HISTORY -desempeñado I-PAST_MEDICAL_HISTORY -bien I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY +ventilación I-PAST_MEDICAL_HISTORY +mecánica. I-PAST_MEDICAL_HISTORY +El B-EXPLORATION +estudio I-EXPLORATION +del I-EXPLORATION +LCR I-EXPLORATION +indicó I-EXPLORATION +ausencia I-EXPLORATION +de I-EXPLORATION +bacterias I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +tinción I-EXPLORATION +de I-EXPLORATION +Gram, I-EXPLORATION +pleocitosis I-EXPLORATION +de I-EXPLORATION +70 I-EXPLORATION +céls/mm3 I-EXPLORATION +(60% I-EXPLORATION +mononuclear), I-EXPLORATION +proteínas I-EXPLORATION +de I-EXPLORATION +68 I-EXPLORATION +mg/dL I-EXPLORATION +y I-EXPLORATION +glucosa I-EXPLORATION +de I-EXPLORATION +135 I-EXPLORATION +mg/dL. I-EXPLORATION +El B-TREATMENT +cuadro I-TREATMENT +se I-TREATMENT +interpretó I-TREATMENT +como I-TREATMENT +viral, I-TREATMENT +tratándose I-TREATMENT +con I-TREATMENT +aciclovir I-TREATMENT +i.v. I-TREATMENT +por I-TREATMENT +10 I-TREATMENT +días, I-TREATMENT +sin I-TREATMENT +realizarse I-TREATMENT +estudio I-TREATMENT +viral I-TREATMENT +del I-TREATMENT +LCR. I-TREATMENT + I-TREATMENT +En B-PAST_MEDICAL_HISTORY +forma I-PAST_MEDICAL_HISTORY +dirigida I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +rescató I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -30 I-PAST_MEDICAL_HISTORY +vacunación I-PAST_MEDICAL_HISTORY +anual I-PAST_MEDICAL_HISTORY +contra I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +influenza I-PAST_MEDICAL_HISTORY +(vacuna I-PAST_MEDICAL_HISTORY +trivalente) I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +últimos I-PAST_MEDICAL_HISTORY +cuatro I-PAST_MEDICAL_HISTORY años I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -labor I-PAST_MEDICAL_HISTORY +consecutivos I-PAST_MEDICAL_HISTORY +(2011 I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +2015). I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +2014, I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +vacuna I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +sido I-PAST_MEDICAL_HISTORY +administrada I-PAST_MEDICAL_HISTORY +16 I-PAST_MEDICAL_HISTORY +días I-PAST_MEDICAL_HISTORY +antes I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +cuadro I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -jefe I-PAST_MEDICAL_HISTORY -administrativo I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -empresa. I-PAST_MEDICAL_HISTORY -Vive I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -esposa I-PAST_MEDICAL_HISTORY +meningoencefalitis I-PAST_MEDICAL_HISTORY +(Vaxigrip®, I-PAST_MEDICAL_HISTORY +Sanofi, I-PAST_MEDICAL_HISTORY +lote I-PAST_MEDICAL_HISTORY +K7375-2) I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -hijos I-PAST_MEDICAL_HISTORY -menores I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +último I-PAST_MEDICAL_HISTORY +episodio, I-PAST_MEDICAL_HISTORY +producido I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +2015, I-PAST_MEDICAL_HISTORY +20 I-PAST_MEDICAL_HISTORY +días I-PAST_MEDICAL_HISTORY +antes I-PAST_MEDICAL_HISTORY +(Influval®, I-PAST_MEDICAL_HISTORY +Abbott, I-PAST_MEDICAL_HISTORY +lote I-PAST_MEDICAL_HISTORY +HY01N). I-PAST_MEDICAL_HISTORY +El I-PAST_MEDICAL_HISTORY +análisis I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -edad. I-PAST_MEDICAL_HISTORY +causalidad, I-PAST_MEDICAL_HISTORY +según I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +puntuación I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Naranjo I-PAST_MEDICAL_HISTORY +dio I-PAST_MEDICAL_HISTORY +8 I-PAST_MEDICAL_HISTORY +puntos18. I-PAST_MEDICAL_HISTORY I-PAST_MEDICAL_HISTORY -Con I-PAST_MEDICAL_HISTORY -54 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -sufre I-PAST_MEDICAL_HISTORY + +Lactante B-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +4 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +episodio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +hipotonía I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +dificultad I-PRESENT_ILLNESS +respiratoria, I-PRESENT_ILLNESS +motivo I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +ingresó I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +hospital I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +origen. I-PRESENT_ILLNESS +Durante B-EXPLORATION +su I-EXPLORATION +ingreso I-EXPLORATION +se I-EXPLORATION +constató I-EXPLORATION +fiebre, I-EXPLORATION +deposiciones I-EXPLORATION +líquidas, I-EXPLORATION +hipoglucemia I-EXPLORATION +sintomática I-EXPLORATION +con I-EXPLORATION +clonias I-EXPLORATION +de I-EXPLORATION +extremidades I-EXPLORATION +de I-EXPLORATION +menos I-EXPLORATION +de I-EXPLORATION +30 I-EXPLORATION +segundos I-EXPLORATION +de I-EXPLORATION +duración I-EXPLORATION +y I-EXPLORATION +nistagmo, I-EXPLORATION +acidosis I-EXPLORATION +metabólica, I-EXPLORATION +hiperlactacidemia I-EXPLORATION +y I-EXPLORATION +coagulopatía I-EXPLORATION +moderada I-EXPLORATION +con I-EXPLORATION +sangrado I-EXPLORATION +digestivo. I-EXPLORATION +Sufrió B-EVOLUTION +deterioro I-EVOLUTION +hemodinámico I-EVOLUTION +progresivo I-EVOLUTION +hasta I-EVOLUTION +situación I-EVOLUTION +de I-EVOLUTION +shock, I-EVOLUTION +precisando I-EVOLUTION +expansión I-EVOLUTION +volumétrica I-EVOLUTION +y I-EVOLUTION +administración I-EVOLUTION +de I-EVOLUTION +dopamina, I-EVOLUTION +así I-EVOLUTION +como I-EVOLUTION +cefotaxima I-EVOLUTION +y I-EVOLUTION +clindamicina I-EVOLUTION +tras I-EVOLUTION +objetivar I-EVOLUTION +aumento I-EVOLUTION +de I-EVOLUTION +procalcitonina I-EVOLUTION +(59, I-EVOLUTION +1 I-EVOLUTION +ng/ml). I-EVOLUTION +Ante B-DERIVED_FROM/TO +sospecha I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +shock I-DERIVED_FROM/TO +séptico I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +origen I-DERIVED_FROM/TO +entérico, I-DERIVED_FROM/TO +fue I-DERIVED_FROM/TO +trasladado I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +las I-DERIVED_FROM/TO +primeras I-DERIVED_FROM/TO +24 I-DERIVED_FROM/TO +horas I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +nuestro I-DERIVED_FROM/TO +centro, I-DERIVED_FROM/TO +ingresando I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +Unidad I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Cuidados I-DERIVED_FROM/TO +Críticos I-DERIVED_FROM/TO +Pediátricos. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +Como B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +destacaba I-PAST_MEDICAL_HISTORY +prematuridad I-PAST_MEDICAL_HISTORY +tardía I-PAST_MEDICAL_HISTORY +(34 I-PAST_MEDICAL_HISTORY +semanas I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +edad I-PAST_MEDICAL_HISTORY +gestacional), I-PAST_MEDICAL_HISTORY +alimentación I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +fórmula I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +inicio I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +buena I-PAST_MEDICAL_HISTORY +ganancia I-PAST_MEDICAL_HISTORY +ponderoestatural, I-PAST_MEDICAL_HISTORY +refiriendo I-PAST_MEDICAL_HISTORY +episodios I-PAST_MEDICAL_HISTORY +frecuentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +llanto, I-PAST_MEDICAL_HISTORY +considerados I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +crisis I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +cólico. I-PAST_MEDICAL_HISTORY +Recibía I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY un I-PAST_MEDICAL_HISTORY -episodio I-PAST_MEDICAL_HISTORY +producto I-PAST_MEDICAL_HISTORY +homeopático I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +contenía I-PAST_MEDICAL_HISTORY +Argentum I-PAST_MEDICAL_HISTORY +nitricum I-PAST_MEDICAL_HISTORY +D5, I-PAST_MEDICAL_HISTORY +Chamomilla I-PAST_MEDICAL_HISTORY +D1, I-PAST_MEDICAL_HISTORY +China I-PAST_MEDICAL_HISTORY +D3 I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +Cuprum I-PAST_MEDICAL_HISTORY +aceticum I-PAST_MEDICAL_HISTORY +D4, I-PAST_MEDICAL_HISTORY +infusiones I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +manzanilla I-PAST_MEDICAL_HISTORY +adquiridas I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +farmacia I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +paracetamol I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +forma I-PAST_MEDICAL_HISTORY +puntual, I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +dosis I-PAST_MEDICAL_HISTORY +adecuada. I-PAST_MEDICAL_HISTORY +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +se I-EXPLORATION +objetivó I-EXPLORATION +palidez I-EXPLORATION +cutánea, I-EXPLORATION +sangrado I-EXPLORATION +a I-EXPLORATION +través I-EXPLORATION +de I-EXPLORATION +puntos I-EXPLORATION +de I-EXPLORATION +punción I-EXPLORATION +y I-EXPLORATION +capilaritis, I-EXPLORATION +distensión I-EXPLORATION +abdominal, I-EXPLORATION +hepatomegalia I-EXPLORATION +de I-EXPLORATION +3 I-EXPLORATION +cm, I-EXPLORATION +irritabilidad, I-EXPLORATION +hiperexcitabilidad I-EXPLORATION +y I-EXPLORATION +discreto I-EXPLORATION +nistagmo I-EXPLORATION +horizontal. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +constató I-EXPLORATION +fallo I-EXPLORATION +hepático I-EXPLORATION +agudo I-EXPLORATION +con I-EXPLORATION +hipertransaminasemia I-EXPLORATION +(aspartato I-EXPLORATION +aminotransferasa I-EXPLORATION +[AST] I-EXPLORATION +812 I-EXPLORATION +U/l, I-EXPLORATION +alanino I-EXPLORATION +aminotransferasa I-EXPLORATION +[ALT] I-EXPLORATION +1002 I-EXPLORATION +U/l), I-EXPLORATION +coagulopatía I-EXPLORATION +grave I-EXPLORATION +(actividad I-EXPLORATION +de I-EXPLORATION +protrombina I-EXPLORATION +22%, I-EXPLORATION +tiempo I-EXPLORATION +de I-EXPLORATION +tromboplastina I-EXPLORATION +parcial I-EXPLORATION +activada I-EXPLORATION +[TTPa] I-EXPLORATION +59 I-EXPLORATION +segundos, I-EXPLORATION +factor I-EXPLORATION +V I-EXPLORATION +Leiden I-EXPLORATION +34%, I-EXPLORATION +plaquetas I-EXPLORATION +86.000/μl), I-EXPLORATION +administrándose I-EXPLORATION +vitamina I-EXPLORATION +K I-EXPLORATION +y I-EXPLORATION +plasma. I-EXPLORATION +Presentó I-EXPLORATION +hipoglucemia I-EXPLORATION +(27 I-EXPLORATION +mg/dl) I-EXPLORATION +con I-EXPLORATION +cetonemia I-EXPLORATION +negativa, I-EXPLORATION +acidosis I-EXPLORATION +metabólica I-EXPLORATION +moderada I-EXPLORATION +(pH I-EXPLORATION +7, I-EXPLORATION +25, I-EXPLORATION +bicarbonato I-EXPLORATION +13 I-EXPLORATION +mmol/l, I-EXPLORATION +exceso I-EXPLORATION +de I-EXPLORATION +bases I-EXPLORATION +-12, I-EXPLORATION +7 I-EXPLORATION +mmol/l), I-EXPLORATION +precisando I-EXPLORATION +elevado I-EXPLORATION +aporte I-EXPLORATION +endovenoso I-EXPLORATION +de I-EXPLORATION +glucosa I-EXPLORATION +(14 I-EXPLORATION +mg/kg/min) I-EXPLORATION +y I-EXPLORATION +bicarbonato. I-EXPLORATION +Los I-EXPLORATION +niveles I-EXPLORATION +de I-EXPLORATION +bilirrubina I-EXPLORATION +total I-EXPLORATION +y I-EXPLORATION +directa, I-EXPLORATION +amonio I-EXPLORATION +y I-EXPLORATION +albúmina I-EXPLORATION +fueron I-EXPLORATION +normales. I-EXPLORATION +Presentó B-TREATMENT +febrícula I-TREATMENT +las I-TREATMENT +primeras I-TREATMENT +72 I-TREATMENT +horas, I-TREATMENT +aumento I-TREATMENT +de I-TREATMENT +proteína I-TREATMENT +C I-TREATMENT +reactiva I-TREATMENT +(56 I-TREATMENT +mg/l) I-TREATMENT +y I-TREATMENT +procalcitonina I-TREATMENT +(88 I-TREATMENT +ng/ml), I-TREATMENT +sustituyéndose I-TREATMENT +la I-TREATMENT +antibioterapia I-TREATMENT +por I-TREATMENT +piperacilina-tazobactam I-TREATMENT +ante I-TREATMENT +probable I-TREATMENT +clínica I-TREATMENT +infecciosa I-TREATMENT +entérica, I-TREATMENT +ampliándose I-TREATMENT +el I-TREATMENT +estudio I-TREATMENT +etiológico I-TREATMENT +infeccioso. I-TREATMENT +La B-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION +mostró I-EXPLORATION +ascitis I-EXPLORATION +y I-EXPLORATION +peristaltismo I-EXPLORATION +aumentado I-EXPLORATION +de I-EXPLORATION +asas I-EXPLORATION +intestinales, I-EXPLORATION +sin I-EXPLORATION +alteraciones I-EXPLORATION +hepáticas. I-EXPLORATION + I-EXPLORATION +Ante B-TREATMENT +la I-TREATMENT +insuficiencia I-TREATMENT +hepática I-TREATMENT +aguda I-TREATMENT +grave I-TREATMENT +con I-TREATMENT +sospecha I-TREATMENT +inicial I-TREATMENT +de I-TREATMENT +enfermedad I-TREATMENT +metabólica I-TREATMENT +descompensada, I-TREATMENT +se I-TREATMENT +efectuó I-TREATMENT +despistaje I-TREATMENT +metabólico I-TREATMENT +y I-TREATMENT +se I-TREATMENT +instauró I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +N-acetilcisteina, I-TREATMENT +y I-TREATMENT +NTBC I-TREATMENT +(2-[2-nitro-4-trifluorometibenzoil]-1-3-ciclohexanediona) I-TREATMENT +así I-TREATMENT +como I-TREATMENT +dieta I-TREATMENT +exenta I-TREATMENT +de I-TREATMENT +tirosina I-TREATMENT +ante I-TREATMENT +la I-TREATMENT +presunción I-TREATMENT +diagnóstica I-TREATMENT +de I-TREATMENT +tirosinemia. I-TREATMENT + I-TREATMENT +Se B-EVOLUTION +objetivó I-EVOLUTION +mejoría I-EVOLUTION +neurológica, I-EVOLUTION +hemodinámica, I-EVOLUTION +infecciosa I-EVOLUTION +y I-EVOLUTION +de I-EVOLUTION +función I-EVOLUTION +hepática I-EVOLUTION +progresivas, I-EVOLUTION +presentando I-EVOLUTION +a I-EVOLUTION +las I-EVOLUTION +60 I-EVOLUTION +horas I-EVOLUTION +de I-EVOLUTION +su I-EVOLUTION +ingreso I-EVOLUTION +actividad I-EVOLUTION +de I-EVOLUTION +protrombina I-EVOLUTION +del I-EVOLUTION +82%, I-EVOLUTION +AST I-EVOLUTION +148 I-EVOLUTION +U/l I-EVOLUTION +y I-EVOLUTION +ALT I-EVOLUTION +684 I-EVOLUTION +U/l. I-EVOLUTION +El B-EXPLORATION +estudio I-EXPLORATION +infeccioso I-EXPLORATION +ampliado I-EXPLORATION +resultó I-EXPLORATION +negativo, I-EXPLORATION +incluidos I-EXPLORATION +virus I-EXPLORATION +hepatotropos I-EXPLORATION +(VHA, I-EXPLORATION +VHB I-EXPLORATION +y I-EXPLORATION +VHC), I-EXPLORATION +influenzae I-EXPLORATION +(A, I-EXPLORATION +B), I-EXPLORATION +perfil I-EXPLORATION +TORCH, I-EXPLORATION +citoquímica I-EXPLORATION +y I-EXPLORATION +PCR I-EXPLORATION +virales I-EXPLORATION +en I-EXPLORATION +líquido I-EXPLORATION +cefalorraquídeo I-EXPLORATION +(LCR), I-EXPLORATION +y I-EXPLORATION +cultivos I-EXPLORATION +(sangre, I-EXPLORATION +LCR, I-EXPLORATION +orina, I-EXPLORATION +heces). I-EXPLORATION +También I-EXPLORATION +fue I-EXPLORATION +negativo I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +hepático I-EXPLORATION +autoinmune. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +metabólico I-EXPLORATION +se I-EXPLORATION +detectó I-EXPLORATION +excreción I-EXPLORATION +elevada I-EXPLORATION +de I-EXPLORATION +ácido I-EXPLORATION +homovanílico, I-EXPLORATION +ligeramente I-EXPLORATION +elevada I-EXPLORATION +de I-EXPLORATION +vanilmandélico I-EXPLORATION +y I-EXPLORATION +4-hidroxifenilpirúvico I-EXPLORATION +y I-EXPLORATION +leve I-EXPLORATION +hipoaminoacidemia. I-EXPLORATION +La I-EXPLORATION +espectometría I-EXPLORATION +de I-EXPLORATION +masas I-EXPLORATION +en I-EXPLORATION +tándem, I-EXPLORATION +alfafetoproteína I-EXPLORATION +en I-EXPLORATION +sangre I-EXPLORATION +y I-EXPLORATION +succinilacetona I-EXPLORATION +en I-EXPLORATION +orina I-EXPLORATION +fueron I-EXPLORATION +normales. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +reevaluó I-EXPLORATION +la I-EXPLORATION +anamnesis, I-EXPLORATION +registrándose I-EXPLORATION +la I-EXPLORATION +ingesta I-EXPLORATION +de I-EXPLORATION +forma I-EXPLORATION +mantenida I-EXPLORATION +durante I-EXPLORATION +los I-EXPLORATION +últimos I-EXPLORATION +dos I-EXPLORATION +meses I-EXPLORATION +de I-EXPLORATION +infusión I-EXPLORATION +elaborada I-EXPLORATION +con I-EXPLORATION +dos I-EXPLORATION +cucharadas I-EXPLORATION +de I-EXPLORATION +manzanilla, I-EXPLORATION +una I-EXPLORATION +estrella I-EXPLORATION +de I-EXPLORATION +anís I-EXPLORATION +estrellado I-EXPLORATION +(Illicium I-EXPLORATION +verum) I-EXPLORATION +y I-EXPLORATION +dos I-EXPLORATION +granos I-EXPLORATION +de I-EXPLORATION +matalahúva I-EXPLORATION +(anís I-EXPLORATION +verde I-EXPLORATION +o I-EXPLORATION +Pimpinella I-EXPLORATION +anisum) I-EXPLORATION +en I-EXPLORATION +500 I-EXPLORATION +ml I-EXPLORATION +de I-EXPLORATION +agua, I-EXPLORATION +con I-EXPLORATION +ingesta I-EXPLORATION +diaria I-EXPLORATION +de I-EXPLORATION +250 I-EXPLORATION +ml. I-EXPLORATION +Se B-EVOLUTION +contactó I-EVOLUTION +con I-EVOLUTION +el I-EVOLUTION +Servicio I-EVOLUTION +de I-EVOLUTION +Información I-EVOLUTION +Toxicológica, I-EVOLUTION +que I-EVOLUTION +recomendó I-EVOLUTION +determinar I-EVOLUTION +la I-EVOLUTION +posible I-EVOLUTION +existencia I-EVOLUTION +de I-EVOLUTION +contaminación I-EVOLUTION +con I-EVOLUTION +Illicium I-EVOLUTION +anisatum, I-EVOLUTION +de I-EVOLUTION +conocido I-EVOLUTION +efecto I-EVOLUTION +tóxico, I-EVOLUTION +que I-EVOLUTION +justificara I-EVOLUTION +el I-EVOLUTION +cuadro I-EVOLUTION +clínico I-EVOLUTION +mediante I-EVOLUTION +un I-EVOLUTION +sencillo I-EVOLUTION +procedimiento I-EVOLUTION +que I-EVOLUTION +sugiere I-EVOLUTION +su I-EVOLUTION +presencia: I-EVOLUTION +a B-EXPLORATION +un I-EXPLORATION +fragmento I-EXPLORATION +de I-EXPLORATION +estrella I-EXPLORATION +de I-EXPLORATION +anís I-EXPLORATION +estrellado I-EXPLORATION +se I-EXPLORATION +añadieron I-EXPLORATION +3 I-EXPLORATION +ml I-EXPLORATION +de I-EXPLORATION +alcohol I-EXPLORATION +96o I-EXPLORATION +y, I-EXPLORATION +tras I-EXPLORATION +hervir I-EXPLORATION +y I-EXPLORATION +filtrar, I-EXPLORATION +se I-EXPLORATION +añadieron I-EXPLORATION +al I-EXPLORATION +líquido I-EXPLORATION +obtenido I-EXPLORATION +cinco I-EXPLORATION +gotas I-EXPLORATION +de I-EXPLORATION +agua. I-EXPLORATION +La I-EXPLORATION +ausencia I-EXPLORATION +de I-EXPLORATION +turbidez I-EXPLORATION +sugirió I-EXPLORATION +la I-EXPLORATION +contaminación I-EXPLORATION +con I-EXPLORATION +Illicium I-EXPLORATION +anisatum. I-EXPLORATION +La B-EVOLUTION +evolución I-EVOLUTION +posterior I-EVOLUTION +fue I-EVOLUTION +satisfactoria I-EVOLUTION +con I-EVOLUTION +recuperación I-EVOLUTION +clínica I-EVOLUTION +y I-EVOLUTION +analítica I-EVOLUTION +completa I-EVOLUTION +del I-EVOLUTION +paciente. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +87 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +patológicos I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -mutismo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -desconexión I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -medio I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -hipotonía. I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -sospecha I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -origen I-PAST_MEDICAL_HISTORY -epiléptico I-PAST_MEDICAL_HISTORY +hepatitis I-PAST_MEDICAL_HISTORY +C I-PAST_MEDICAL_HISTORY +crónica I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -remite I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -servicio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -neurología, I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -tras I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -estudio I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -cataloga I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +constancia I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -crisis I-PAST_MEDICAL_HISTORY -parciales I-PAST_MEDICAL_HISTORY -complejas. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -EEG I-PAST_MEDICAL_HISTORY -inicial I-PAST_MEDICAL_HISTORY -(con I-PAST_MEDICAL_HISTORY -fotoestimulación I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -privación I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -sueño) I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -reflejan I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -paroxismos, I-PAST_MEDICAL_HISTORY -solo I-PAST_MEDICAL_HISTORY -hay I-PAST_MEDICAL_HISTORY -actividad I-PAST_MEDICAL_HISTORY +traumatismo I-PAST_MEDICAL_HISTORY +abdominal I-PAST_MEDICAL_HISTORY +previo I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +inespecífico I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +malestar I-PRESENT_ILLNESS +general, I-PRESENT_ILLNESS +náuseas I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +vómitos I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +varias I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +motivo I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +cual I-PRESENT_ILLNESS +fue I-PRESENT_ILLNESS +visitada I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +médico I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +familia I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +domicilio I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +le I-PRESENT_ILLNESS +administró I-PRESENT_ILLNESS +metoclopramida. I-PRESENT_ILLNESS +Falleció B-EVOLUTION +a I-EVOLUTION +las I-EVOLUTION +pocas I-EVOLUTION +horas I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +atención I-EVOLUTION +médica, I-EVOLUTION +motivo I-EVOLUTION +por I-EVOLUTION +el I-EVOLUTION +cual I-EVOLUTION +se I-EVOLUTION +practicó I-EVOLUTION +autopsia I-EVOLUTION +judicial. I-EVOLUTION + I-EVOLUTION +Del B-EXPLORATION +examen I-EXPLORATION +externo I-EXPLORATION +destacó I-EXPLORATION +la I-EXPLORATION +palidez I-EXPLORATION +cutáneo-mucosa I-EXPLORATION +y I-EXPLORATION +disposición I-EXPLORATION +en I-EXPLORATION +martillo I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +segundos I-EXPLORATION +dedos I-EXPLORATION +de I-EXPLORATION +ambos I-EXPLORATION +pies. I-EXPLORATION +Durante I-EXPLORATION +el I-EXPLORATION +examen I-EXPLORATION +interno I-EXPLORATION +se I-EXPLORATION +detectó I-EXPLORATION +calcificación I-EXPLORATION +mitral, I-EXPLORATION +ateromatosis I-EXPLORATION +coronaria I-EXPLORATION +con I-EXPLORATION +obstrucción I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +mismas I-EXPLORATION +de I-EXPLORATION +entre I-EXPLORATION +un I-EXPLORATION +25-50%, I-EXPLORATION +hipertrofia I-EXPLORATION +ventricular I-EXPLORATION +concéntrica, I-EXPLORATION +ateromatosis I-EXPLORATION +generalizada I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +grandes I-EXPLORATION +vasos I-EXPLORATION +y I-EXPLORATION +hemoperitoneo I-EXPLORATION +de I-EXPLORATION +3.000 I-EXPLORATION +cc, I-EXPLORATION +parcialmente I-EXPLORATION +coagulado. I-EXPLORATION +Hígado I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +peso I-EXPLORATION +de I-EXPLORATION +1.585 I-EXPLORATION +g I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +que I-EXPLORATION +macroscópicamente I-EXPLORATION +se I-EXPLORATION +apreciaba I-EXPLORATION +una I-EXPLORATION +cirrosis I-EXPLORATION +macronodular I-EXPLORATION +generalizada I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +lóbulo I-EXPLORATION +hepático I-EXPLORATION +izquierdo I-EXPLORATION +una I-EXPLORATION +tumoración I-EXPLORATION +esférica I-EXPLORATION +de I-EXPLORATION +6 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +diámetro, I-EXPLORATION +sin I-EXPLORATION +pedículo, I-EXPLORATION +blanda I-EXPLORATION +y I-EXPLORATION +móvil I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación, I-EXPLORATION +con I-EXPLORATION +cápsula I-EXPLORATION +de I-EXPLORATION +color I-EXPLORATION +gris-amarillento, I-EXPLORATION +muy I-EXPLORATION +vascularizada, I-EXPLORATION +que I-EXPLORATION +presentaba I-EXPLORATION +una I-EXPLORATION +rotura I-EXPLORATION +parcial. I-EXPLORATION +Al I-EXPLORATION +corte I-EXPLORATION +se I-EXPLORATION +apreció I-EXPLORATION +que I-EXPLORATION +la I-EXPLORATION +tumoración I-EXPLORATION +hepática I-EXPLORATION +tenía I-EXPLORATION +una I-EXPLORATION +coloración I-EXPLORATION +más I-EXPLORATION +pálida I-EXPLORATION +que I-EXPLORATION +el I-EXPLORATION +tejido I-EXPLORATION +circundante, I-EXPLORATION +de I-EXPLORATION +aspecto I-EXPLORATION +heterogéneo, I-EXPLORATION +con I-EXPLORATION +escasa I-EXPLORATION +pigmentación I-EXPLORATION +biliar I-EXPLORATION +y I-EXPLORATION +zonas I-EXPLORATION +necrohemorrágicas I-EXPLORATION +cercanas I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +zona I-EXPLORATION +de I-EXPLORATION +rotura I-EXPLORATION +capsular. I-EXPLORATION +La I-EXPLORATION +histopatología I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +tumoración I-EXPLORATION +informó I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +carcinoma I-EXPLORATION +hepatocelular I-EXPLORATION +de I-EXPLORATION +alto I-EXPLORATION +grado. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +interpretó I-EXPLORATION +la I-EXPLORATION +causa I-EXPLORATION +de I-EXPLORATION +muerte I-EXPLORATION +como I-EXPLORATION +consecuencia I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +shock I-EXPLORATION +hipovolémico I-EXPLORATION +secundario I-EXPLORATION +a I-EXPLORATION +hemoperitoneo I-EXPLORATION +por I-EXPLORATION +rotura I-EXPLORATION +del I-EXPLORATION +carcinoma I-EXPLORATION +hepatocelular I-EXPLORATION +(según I-EXPLORATION +clasificación I-EXPLORATION +CIE I-EXPLORATION +10: I-EXPLORATION +C22.0). I-EXPLORATION +Siendo I-EXPLORATION +este I-EXPLORATION +tipo I-EXPLORATION +de I-EXPLORATION +complicación I-EXPLORATION +es I-EXPLORATION +extremadamente I-EXPLORATION +infrecuente I-EXPLORATION +en I-EXPLORATION +nuestro I-EXPLORATION +medio. I-EXPLORATION + I-EXPLORATION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +55 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -fondo I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY +cirrosis I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +hepatitis I-PAST_MEDICAL_HISTORY +C, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +ingresa I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +ictericia, I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +síndrome I-PRESENT_ILLNESS +constitucional I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tres I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +analítica I-EXPLORATION +presentaba I-EXPLORATION +elevación I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +bilirrubina I-EXPLORATION +y I-EXPLORATION +enzimas I-EXPLORATION +de I-EXPLORATION +colestasis. I-EXPLORATION +La I-EXPLORATION +TC I-EXPLORATION +mostró I-EXPLORATION +múltiples I-EXPLORATION +lesiones I-EXPLORATION +en I-EXPLORATION +ambos I-EXPLORATION +lóbulos I-EXPLORATION +hepáticos I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION +metástasis I-EXPLORATION +versus I-EXPLORATION +hepatocarcinoma I-EXPLORATION +multicéntrico I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +imagen I-EXPLORATION +nodular I-EXPLORATION +en I-EXPLORATION +bazo. I-EXPLORATION +A B-EVOLUTION +las I-EVOLUTION +dos I-EVOLUTION +semanas I-EVOLUTION +del I-EVOLUTION +ingreso I-EVOLUTION +falleció I-EVOLUTION +por I-EVOLUTION +un I-EVOLUTION +cuadro I-EVOLUTION +de I-EVOLUTION +insuficiencia I-EVOLUTION +hepática I-EVOLUTION +con I-EVOLUTION +una I-EVOLUTION +autopsia I-EVOLUTION +compatible I-EVOLUTION +con I-EVOLUTION +ASH I-EVOLUTION +con I-EVOLUTION +metástasis I-EVOLUTION +esplénicas. I-EVOLUTION + I-EVOLUTION + +Una B-PRESENT_ILLNESS +niña I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +9 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +cirrosis I-PRESENT_ILLNESS +fue B-DERIVED_FROM/TO +derivada I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +nuestro I-DERIVED_FROM/TO +centro I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +evaluación I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +trasplante I-DERIVED_FROM/TO +hepático. I-DERIVED_FROM/TO +Se B-EXPLORATION +presentó I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +cuadro I-EXPLORATION +referido I-EXPLORATION +como I-EXPLORATION +de I-EXPLORATION +reciente I-EXPLORATION +comienzo, I-EXPLORATION +aunque I-EXPLORATION +por I-EXPLORATION +el I-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +y I-EXPLORATION +los I-EXPLORATION +resultados I-EXPLORATION +de I-EXPLORATION +estudios I-EXPLORATION +se I-EXPLORATION +trataba I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +hepatopatía I-EXPLORATION +crónica. I-EXPLORATION +Presentaba I-EXPLORATION +estigmas I-EXPLORATION +de I-EXPLORATION +cronicidad I-EXPLORATION +como I-EXPLORATION +eritema I-EXPLORATION +palmar, I-EXPLORATION +telangiectasias, I-EXPLORATION +circulación I-EXPLORATION +colateral I-EXPLORATION +en I-EXPLORATION +pared I-EXPLORATION +abdominal I-EXPLORATION +y I-EXPLORATION +esplenomegalia. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION +se I-EXPLORATION +constató I-EXPLORATION +un I-EXPLORATION +hígado I-EXPLORATION +de I-EXPLORATION +pequeño I-EXPLORATION +tamaño I-EXPLORATION +con I-EXPLORATION +heterogeneidad I-EXPLORATION +y I-EXPLORATION +bazo I-EXPLORATION +con I-EXPLORATION +diámetro I-EXPLORATION +longitudinal I-EXPLORATION +aumentado. I-EXPLORATION +No B-TREATMENT +recibía I-TREATMENT +medicación I-TREATMENT +antes I-TREATMENT +de I-TREATMENT +la I-TREATMENT +admisión I-TREATMENT +en I-TREATMENT +nuestro I-TREATMENT +hospital. I-TREATMENT +En B-PAST_MEDICAL_HISTORY un I-PAST_MEDICAL_HISTORY -ritmo I-PAST_MEDICAL_HISTORY -alpha I-PAST_MEDICAL_HISTORY -occipital I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -9 I-PAST_MEDICAL_HISTORY -Hz, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -signos I-PAST_MEDICAL_HISTORY -irritativos I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -focalidad. I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -inicia I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -valproato I-PAST_MEDICAL_HISTORY -sódico I-PAST_MEDICAL_HISTORY -(no I-PAST_MEDICAL_HISTORY -sabemos I-PAST_MEDICAL_HISTORY -dosis I-PAST_MEDICAL_HISTORY +contexto I-PAST_MEDICAL_HISTORY +social I-PAST_MEDICAL_HISTORY +complejo I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -duración) I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -respuesta I-PAST_MEDICAL_HISTORY -prácticamente I-PAST_MEDICAL_HISTORY -nula I-PAST_MEDICAL_HISTORY -y, I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -repetirse I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -epsiodios, I-PAST_MEDICAL_HISTORY -abandona I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -medicación I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -seguimiento. I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -familia I-PAST_MEDICAL_HISTORY -describe I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -persistencia I-PAST_MEDICAL_HISTORY +poca I-PAST_MEDICAL_HISTORY +percepción I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY la I-PAST_MEDICAL_HISTORY -clínica I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -episodios I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -mutismo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -desconexión I-PAST_MEDICAL_HISTORY -recurrentes, I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -frecuencia I-PAST_MEDICAL_HISTORY -cada I-PAST_MEDICAL_HISTORY -vez I-PAST_MEDICAL_HISTORY -mayor. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Cumplidos I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -56 I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -ingresa I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -servicio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -neurología I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -presentar I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -episodio I-PAST_MEDICAL_HISTORY -súbito I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -disartria, I-PAST_MEDICAL_HISTORY -parestesias I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -extremidad I-PAST_MEDICAL_HISTORY -superior I-PAST_MEDICAL_HISTORY -derecha, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -desconexión I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -medio I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -movimientos I-PAST_MEDICAL_HISTORY -masticatorios I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -fijación I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY +enfermedad, I-PAST_MEDICAL_HISTORY la I-PAST_MEDICAL_HISTORY -mirada. I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -realiza I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -nuevo I-PAST_MEDICAL_HISTORY -EEG I-PAST_MEDICAL_HISTORY -donde I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -aprecia I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -leve I-PAST_MEDICAL_HISTORY -disfunción I-PAST_MEDICAL_HISTORY +familia I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +consultado I-PAST_MEDICAL_HISTORY +previamente. I-PAST_MEDICAL_HISTORY +Tampoco I-PAST_MEDICAL_HISTORY +tenía I-PAST_MEDICAL_HISTORY +seguimiento I-PAST_MEDICAL_HISTORY +periódico I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -región I-PAST_MEDICAL_HISTORY -temporal I-PAST_MEDICAL_HISTORY -izquierda I-PAST_MEDICAL_HISTORY -sobre I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -actividad I-PAST_MEDICAL_HISTORY +salud. I-PAST_MEDICAL_HISTORY +Al B-EXPLORATION +ingreso, I-EXPLORATION +el I-EXPLORATION +puntaje I-EXPLORATION +de I-EXPLORATION +gravedad I-EXPLORATION +PELD I-EXPLORATION +(Pediatric I-EXPLORATION +End-Stage I-EXPLORATION +Liver I-EXPLORATION +Disease, I-EXPLORATION +hepatopatía I-EXPLORATION +terminal I-EXPLORATION +pediátrica) I-EXPLORATION +era I-EXPLORATION +de I-EXPLORATION +24, I-EXPLORATION +con I-EXPLORATION +bilirrubina I-EXPLORATION +de I-EXPLORATION +15 I-EXPLORATION +mg/dl, I-EXPLORATION +un I-EXPLORATION +valor I-EXPLORATION +de I-EXPLORATION +relación I-EXPLORATION +internacional I-EXPLORATION +normalizada I-EXPLORATION +(RIN) I-EXPLORATION +de I-EXPLORATION +2, I-EXPLORATION +5, I-EXPLORATION +albúmina I-EXPLORATION +de I-EXPLORATION +2, I-EXPLORATION +5 I-EXPLORATION +g/dl; I-EXPLORATION +su I-EXPLORATION +peso I-EXPLORATION +y I-EXPLORATION +talla I-EXPLORATION +eran I-EXPLORATION +de I-EXPLORATION +30 I-EXPLORATION +kg I-EXPLORATION +y I-EXPLORATION +127 I-EXPLORATION +cm, I-EXPLORATION +respectivamente. I-EXPLORATION +Mientras B-EVOLUTION +esperaba I-EVOLUTION +en I-EVOLUTION +lista I-EVOLUTION +de I-EVOLUTION +trasplante I-EVOLUTION +hepático, I-EVOLUTION +desarrolló I-EVOLUTION +encefalopatía I-EVOLUTION +hepática I-EVOLUTION +espontánea, I-EVOLUTION +de I-EVOLUTION +tipo I-EVOLUTION +C, I-EVOLUTION +grado I-EVOLUTION +II-III1 I-EVOLUTION +con I-EVOLUTION +períodos I-EVOLUTION +de I-EVOLUTION +conducta I-EVOLUTION +inapropiada I-EVOLUTION +que I-EVOLUTION +alternaban I-EVOLUTION +con I-EVOLUTION +confusión I-EVOLUTION +y I-EVOLUTION +excitación. I-EVOLUTION +Previamente, I-EVOLUTION +no I-EVOLUTION +había I-EVOLUTION +presentado I-EVOLUTION +episodios I-EVOLUTION +de I-EVOLUTION +encefalopatía. I-EVOLUTION +Su B-EXPLORATION +amonio I-EXPLORATION +sérico I-EXPLORATION +aumentó I-EXPLORATION +de I-EXPLORATION +139 I-EXPLORATION +µg% I-EXPLORATION +a I-EXPLORATION +324 I-EXPLORATION +µg% I-EXPLORATION +(valor I-EXPLORATION +normal I-EXPLORATION +de I-EXPLORATION +referencia I-EXPLORATION +19-82 I-EXPLORATION +µg%). I-EXPLORATION +Se I-EXPLORATION +descartaron I-EXPLORATION +factores I-EXPLORATION +precipitantes I-EXPLORATION +conocidos I-EXPLORATION +de I-EXPLORATION +encefalopatía I-EXPLORATION +hepática, I-EXPLORATION +como I-EXPLORATION +medicaciones, I-EXPLORATION +sangrado I-EXPLORATION +gastrointestinal, I-EXPLORATION +infecciones I-EXPLORATION +bacterianas, I-EXPLORATION +constipación, I-EXPLORATION +fallo I-EXPLORATION +renal, I-EXPLORATION +desequilibrios I-EXPLORATION +electrolíticos, I-EXPLORATION +hipovolemia I-EXPLORATION +o I-EXPLORATION +hipoxemia. I-EXPLORATION +La I-EXPLORATION +paciente I-EXPLORATION +no I-EXPLORATION +tenía I-EXPLORATION +antecedentes I-EXPLORATION +de I-EXPLORATION +ascitis I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +ecografía I-EXPLORATION +no I-EXPLORATION +mostró I-EXPLORATION +líquido I-EXPLORATION +libre I-EXPLORATION +abdominal. I-EXPLORATION +Se B-TREATMENT +indicó I-TREATMENT +una I-TREATMENT +dieta I-TREATMENT +con I-TREATMENT +restricción I-TREATMENT +de I-TREATMENT +proteínas I-TREATMENT +(0, I-TREATMENT +8 I-TREATMENT +g/kg/día) I-TREATMENT +y I-TREATMENT +lactulosa I-TREATMENT +por I-TREATMENT +vía I-TREATMENT +oral I-TREATMENT +(40 I-TREATMENT +ml/día, I-TREATMENT +divididos I-TREATMENT +en I-TREATMENT +4 I-TREATMENT +tomas), I-TREATMENT +logrando I-TREATMENT +3-4 I-TREATMENT +deposiciones I-TREATMENT +blandas I-TREATMENT +por I-TREATMENT +día. I-TREATMENT +A B-EVOLUTION +pesar I-EVOLUTION +de I-EVOLUTION +estas I-EVOLUTION +medidas, I-EVOLUTION +el I-EVOLUTION +estado I-EVOLUTION +neurológico I-EVOLUTION +no I-EVOLUTION +mejoró I-EVOLUTION +luego I-EVOLUTION +de I-EVOLUTION +4 I-EVOLUTION +días. I-EVOLUTION +Sobre B-TREATMENT +la I-TREATMENT +base I-TREATMENT +de I-TREATMENT +experiencias I-TREATMENT +en I-TREATMENT +pacientes I-TREATMENT +adultos, I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +agregar I-TREATMENT +rifaximina I-TREATMENT +(20 I-TREATMENT +mg/kg/día, I-TREATMENT +por I-TREATMENT +vía I-TREATMENT +oral, I-TREATMENT +divididos I-TREATMENT +en I-TREATMENT +dos I-TREATMENT +tomas), I-TREATMENT +con I-TREATMENT +previa I-TREATMENT +firma I-TREATMENT +del I-TREATMENT +consentimiento I-TREATMENT +informado I-TREATMENT +por I-TREATMENT +parte I-TREATMENT +de I-TREATMENT +los I-TREATMENT +padres. I-TREATMENT +La B-EVOLUTION +paciente I-EVOLUTION +mostró I-EVOLUTION +mejoría I-EVOLUTION +clínica I-EVOLUTION +en I-EVOLUTION +3 I-EVOLUTION +días, I-EVOLUTION +sin I-EVOLUTION +confusión I-EVOLUTION +ni I-EVOLUTION +excitación I-EVOLUTION +y I-EVOLUTION +con I-EVOLUTION +ritmo I-EVOLUTION +sueño/ I-EVOLUTION +vigilia I-EVOLUTION +normal. I-EVOLUTION +La I-EVOLUTION +concentración I-EVOLUTION +de I-EVOLUTION +amonio I-EVOLUTION +descendió I-EVOLUTION +gradualmente I-EVOLUTION +(236 I-EVOLUTION +µg% I-EVOLUTION +y I-EVOLUTION +162 I-EVOLUTION +µg%, I-EVOLUTION +4 I-EVOLUTION +y I-EVOLUTION +10 I-EVOLUTION +días I-EVOLUTION +luego I-EVOLUTION +de I-EVOLUTION +iniciado I-EVOLUTION +el I-EVOLUTION +tratamiento, I-EVOLUTION +respectivamente). I-EVOLUTION +No I-EVOLUTION +presentó I-EVOLUTION +cefaleas, I-EVOLUTION +dolor I-EVOLUTION +abdominal, I-EVOLUTION +náuseas I-EVOLUTION +ni I-EVOLUTION +vómitos I-EVOLUTION +relacionados I-EVOLUTION +con I-EVOLUTION +el I-EVOLUTION +tratamiento I-EVOLUTION +con I-EVOLUTION +rifaximina. I-EVOLUTION +Finalmente, B-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +recibió I-TREATMENT +trasplante I-TREATMENT +hepático I-TREATMENT +pasado I-TREATMENT +un I-TREATMENT +mes I-TREATMENT +del I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +rifaximina, I-TREATMENT +sin I-TREATMENT +complicaciones. I-TREATMENT + I-TREATMENT + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +74 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +enfermedad I-PRESENT_ILLNESS +renal I-PRESENT_ILLNESS +crónica I-PRESENT_ILLNESS +(ERC) I-PRESENT_ILLNESS +estadio I-PRESENT_ILLNESS +5 I-PRESENT_ILLNESS +atribuida I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +nefroangioes-clerosis, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -fondo I-PAST_MEDICAL_HISTORY -normal. I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -TAC I-PAST_MEDICAL_HISTORY -craneal, I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -RM I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial, I-PAST_MEDICAL_HISTORY +hiperparatiroidismo I-PAST_MEDICAL_HISTORY +secundario, I-PAST_MEDICAL_HISTORY +síndrome I-PAST_MEDICAL_HISTORY +anémico I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -Angio-RM I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -evidenciaron I-PAST_MEDICAL_HISTORY -cambios I-PAST_MEDICAL_HISTORY -patológicos. I-PAST_MEDICAL_HISTORY -Al I-PAST_MEDICAL_HISTORY -alta I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Probable I-PAST_MEDICAL_HISTORY -episodio I-PAST_MEDICAL_HISTORY +leucemia I-PAST_MEDICAL_HISTORY +linfática I-PAST_MEDICAL_HISTORY +crónica I-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +B, I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +eligió I-PAST_MEDICAL_HISTORY +terapia I-PAST_MEDICAL_HISTORY +sustitutiva I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -migraña I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -aura I-PAST_MEDICAL_HISTORY -visual I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hipercolesterolemia, I-PAST_MEDICAL_HISTORY -pautándose I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -valproato I-PAST_MEDICAL_HISTORY -sódico I-PAST_MEDICAL_HISTORY -(500 I-PAST_MEDICAL_HISTORY -mg/día), I-PAST_MEDICAL_HISTORY -atorvastatina I-PAST_MEDICAL_HISTORY -(80 I-PAST_MEDICAL_HISTORY -mg/día) I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -ácido I-PAST_MEDICAL_HISTORY -acetilsalicílico I-PAST_MEDICAL_HISTORY -(300 I-PAST_MEDICAL_HISTORY -mg/día). I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY +DP I-PAST_MEDICAL_HISTORY +tras I-PAST_MEDICAL_HISTORY el I-PAST_MEDICAL_HISTORY -seguimiento I-PAST_MEDICAL_HISTORY -ambulatorio I-PAST_MEDICAL_HISTORY -posterior I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -practica I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -SPECT I-PAST_MEDICAL_HISTORY -donde I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -aprecia I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -mínimo I-PAST_MEDICAL_HISTORY -defecto I-PAST_MEDICAL_HISTORY +proceso I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -perfusión I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -región I-PAST_MEDICAL_HISTORY -temporoparietal I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -lado I-PAST_MEDICAL_HISTORY -izquierdo. I-PAST_MEDICAL_HISTORY +toma I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +decisión. I-PAST_MEDICAL_HISTORY I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -semana I-PAST_MEDICAL_HISTORY -posterior I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -alta I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -desaparece I-PAST_MEDICAL_HISTORY -varias I-PAST_MEDICAL_HISTORY -horas I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -domicilio. I-PAST_MEDICAL_HISTORY -Le I-PAST_MEDICAL_HISTORY -encuentran I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -coche, I-PAST_MEDICAL_HISTORY -aparcado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -arcén, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -estado I-PAST_MEDICAL_HISTORY +Tiene I-PAST_MEDICAL_HISTORY +4 I-PAST_MEDICAL_HISTORY +hijos I-PAST_MEDICAL_HISTORY +pero I-PAST_MEDICAL_HISTORY +vive I-PAST_MEDICAL_HISTORY +acompañada I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -mutismo I-PAST_MEDICAL_HISTORY -acinético I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -respuesta I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -estímulos. I-PAST_MEDICAL_HISTORY -Estudian I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -caso I-PAST_MEDICAL_HISTORY -Medicina I-PAST_MEDICAL_HISTORY -Interna I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -Neurología I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY +dos, I-PAST_MEDICAL_HISTORY +cuida I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +nietos, I-PAST_MEDICAL_HISTORY no I-PAST_MEDICAL_HISTORY -encuentran I-PAST_MEDICAL_HISTORY -datos I-PAST_MEDICAL_HISTORY -patológicos I-PAST_MEDICAL_HISTORY -justificativos I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY +sabe I-PAST_MEDICAL_HISTORY +leer I-PAST_MEDICAL_HISTORY +ni I-PAST_MEDICAL_HISTORY +escribir, I-PAST_MEDICAL_HISTORY +pero I-PAST_MEDICAL_HISTORY +es I-PAST_MEDICAL_HISTORY +independiente I-PAST_MEDICAL_HISTORY +para I-PAST_MEDICAL_HISTORY las I-PAST_MEDICAL_HISTORY -pruebas I-PAST_MEDICAL_HISTORY -complementarias. I-PAST_MEDICAL_HISTORY -Sí I-PAST_MEDICAL_HISTORY -constatan I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -conflictiva I-PAST_MEDICAL_HISTORY -importante I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -nivel I-PAST_MEDICAL_HISTORY -laboral I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -relacional, I-PAST_MEDICAL_HISTORY -sospechando I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -episodio I-PAST_MEDICAL_HISTORY +actividades I-PAST_MEDICAL_HISTORY +diarias I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +instrumentales: I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +(Enero I-PAST_MEDICAL_HISTORY +2014) I-PAST_MEDICAL_HISTORY += I-PAST_MEDICAL_HISTORY +Barthel I-PAST_MEDICAL_HISTORY +100%, I-PAST_MEDICAL_HISTORY +Lawton-Brody I-PAST_MEDICAL_HISTORY +8/8, I-PAST_MEDICAL_HISTORY +Calidad I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +vida I-PAST_MEDICAL_HISTORY +(sf-12): I-PAST_MEDICAL_HISTORY +PCS I-PAST_MEDICAL_HISTORY +50.6, I-PAST_MEDICAL_HISTORY +MCS I-PAST_MEDICAL_HISTORY +59, I-PAST_MEDICAL_HISTORY +7 I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +El I-PAST_MEDICAL_HISTORY +10/04/2013 B-TREATMENT +se I-TREATMENT +colocó I-TREATMENT +catéter I-TREATMENT +peritoneal I-TREATMENT +e I-TREATMENT +inició I-TREATMENT +DPCA I-TREATMENT +en I-TREATMENT +domicilio I-TREATMENT +el I-TREATMENT +22/5/2013, I-TREATMENT +siendo I-TREATMENT +la I-TREATMENT +propia I-TREATMENT +paciente I-TREATMENT +la I-TREATMENT +cuidadora I-TREATMENT +principal. I-TREATMENT + I-TREATMENT +El I-TREATMENT +tratamiento I-TREATMENT +de I-TREATMENT +DPCA I-TREATMENT +inicial I-TREATMENT +fue I-TREATMENT +de: I-TREATMENT +3 I-TREATMENT +intercambios/ I-TREATMENT +día I-TREATMENT +(2 I-TREATMENT +con I-TREATMENT +Phisioneal I-TREATMENT +35 I-TREATMENT +1, I-TREATMENT +36% I-TREATMENT +de I-TREATMENT +glucosa I-TREATMENT +y I-TREATMENT +1 I-TREATMENT +con I-TREATMENT +Extraneal, I-TREATMENT +con I-TREATMENT +volúmenes I-TREATMENT +de I-TREATMENT +2000 I-TREATMENT +ml). I-TREATMENT +Diariamente I-TREATMENT +ultrafiltraba I-TREATMENT +500 I-TREATMENT +ml I-TREATMENT +con I-TREATMENT +los I-TREATMENT +intercambios I-TREATMENT +y I-TREATMENT +mantenía I-TREATMENT +un I-TREATMENT +volumen I-TREATMENT +de I-TREATMENT +diuresis I-TREATMENT +de I-TREATMENT +1500 I-TREATMENT +ml. I-TREATMENT +El B-EXPLORATION +resultado I-EXPLORATION +del I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +membrana I-EXPLORATION +peritoneal I-EXPLORATION +antes I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +ultima I-EXPLORATION +peritonitis I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +membrana I-EXPLORATION +peritoneal I-EXPLORATION +HA I-EXPLORATION +(transportador I-EXPLORATION +medio I-EXPLORATION +alto). I-EXPLORATION + I-EXPLORATION +En B-EVOLUTION +8 I-EVOLUTION +meses I-EVOLUTION +presentó I-EVOLUTION +4 I-EVOLUTION +episodios I-EVOLUTION +de I-EVOLUTION +peritonitis, I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +cuales I-EVOLUTION +3 I-EVOLUTION +fueron I-EVOLUTION +recidivante, I-EVOLUTION +con I-EVOLUTION +cultivo I-EVOLUTION +positivo I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +misma I-EVOLUTION +bacteria I-EVOLUTION +(Staphylococcus I-EVOLUTION +epidermidis). I-EVOLUTION + I-EVOLUTION +Se B-TREATMENT +administró I-TREATMENT +tratamiento I-TREATMENT +antibiótico I-TREATMENT +protocolizado: I-TREATMENT +Vancomicina I-TREATMENT +1gr/72h I-TREATMENT +intraperitoneal I-TREATMENT +(IP) I-TREATMENT +durante I-TREATMENT +15 I-TREATMENT +días I-TREATMENT +y I-TREATMENT +Fluconazol I-TREATMENT +via I-TREATMENT +oral I-TREATMENT +(vo) I-TREATMENT +durante I-TREATMENT +21 I-TREATMENT +días. I-TREATMENT +Tras I-TREATMENT +la I-TREATMENT +resolución I-TREATMENT +de I-TREATMENT +la I-TREATMENT +ultima I-TREATMENT +infección I-TREATMENT +peritoneal I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +realizar, I-TREATMENT +además, I-TREATMENT +sellados I-TREATMENT +del I-TREATMENT +catéter I-TREATMENT +con I-TREATMENT +Daptomicina I-TREATMENT +(35 I-TREATMENT +mg I-TREATMENT +en I-TREATMENT +7, I-TREATMENT +2 I-TREATMENT +ml I-TREATMENT +de I-TREATMENT +ringer/24h I-TREATMENT +después I-TREATMENT +del I-TREATMENT +último I-TREATMENT +intercambio I-TREATMENT +del I-TREATMENT +día) I-TREATMENT +medicación I-TREATMENT +que I-TREATMENT +se I-TREATMENT +preparaba I-TREATMENT +en I-TREATMENT +el I-TREATMENT +hospital, I-TREATMENT +que I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +recogía I-TREATMENT +semanalmente I-TREATMENT +y I-TREATMENT +se I-TREATMENT +auto I-TREATMENT +administraba I-TREATMENT +después I-TREATMENT +del I-TREATMENT +último I-TREATMENT +intercambio I-TREATMENT +del I-TREATMENT +día I-TREATMENT +en I-TREATMENT +el I-TREATMENT +domicilio. I-TREATMENT + I-TREATMENT +Episodio B-EVOLUTION +de I-EVOLUTION +peritonitis I-EVOLUTION +fúngica: I-EVOLUTION + I-EVOLUTION +Durante I-EVOLUTION +el I-EVOLUTION +periodo I-EVOLUTION +de I-EVOLUTION +sellado I-EVOLUTION +(14/8/2014) I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +avisa I-EVOLUTION +al I-EVOLUTION +teléfono I-EVOLUTION +de I-EVOLUTION +urgencias, I-EVOLUTION +por I-EVOLUTION +líquido I-EVOLUTION +turbio, I-EVOLUTION +dolor I-EVOLUTION +abdominal I-EVOLUTION +y I-EVOLUTION +malestar I-EVOLUTION +general. I-EVOLUTION +Se B-EXPLORATION +realizó I-EXPLORATION +cultivo I-EXPLORATION +de I-EXPLORATION +líquido I-EXPLORATION +peritoneal I-EXPLORATION +protocolizado I-EXPLORATION +y I-EXPLORATION +quedó I-EXPLORATION +ingresada I-EXPLORATION +en I-EXPLORATION +espera I-EXPLORATION +de I-EXPLORATION +resultados. I-EXPLORATION +Tras B-TREATMENT +el I-TREATMENT +resultado I-TREATMENT +del I-TREATMENT +recuento I-TREATMENT +celular, I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +antibiótico I-TREATMENT +empírico I-TREATMENT +con I-TREATMENT +Vancomicina I-TREATMENT +1gr/72h I-TREATMENT +y I-TREATMENT +Ceftazidima I-TREATMENT +1gr/24h I-TREATMENT +IP. I-TREATMENT +El B-EXPLORATION +cultivo I-EXPLORATION +mostró I-EXPLORATION +crecimiento I-EXPLORATION +de I-EXPLORATION +BGN I-EXPLORATION +(Klebsiella I-EXPLORATION +oxytoca I-EXPLORATION +y I-EXPLORATION +Acinetobacter I-EXPLORATION +sp I-EXPLORATION +multisensible), I-EXPLORATION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +mantuvo I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +Ceftazidima I-TREATMENT +1gr/24h/IP, I-TREATMENT +añadiéndose I-TREATMENT +Gentamicina I-TREATMENT +40mgr/24h/IP I-TREATMENT +y I-TREATMENT +Ciprofloxacino I-TREATMENT +500 I-TREATMENT +mg/12h I-TREATMENT +vo. I-TREATMENT + I-TREATMENT +Ante B-EVOLUTION +la I-EVOLUTION +mejoría I-EVOLUTION +clínica I-EVOLUTION +(efluente I-EVOLUTION +claro I-EVOLUTION +y I-EVOLUTION +sin I-EVOLUTION +problemas I-EVOLUTION +de I-EVOLUTION +drenaje) I-EVOLUTION +se I-EVOLUTION +decidió I-EVOLUTION +alta I-EVOLUTION +a I-EVOLUTION +domicilio. I-EVOLUTION +Se B-TREATMENT +realizó I-TREATMENT +reentrenamiento I-TREATMENT +de I-TREATMENT +la I-TREATMENT +técnica I-TREATMENT +y I-TREATMENT +manejo I-TREATMENT +de I-TREATMENT +la I-TREATMENT +medicación I-TREATMENT +antibiótica I-TREATMENT +domiciliaria I-TREATMENT +(tratamiento I-TREATMENT +IP I-TREATMENT +durante I-TREATMENT +21 I-TREATMENT +días). I-TREATMENT + I-TREATMENT +A B-EVOLUTION +los I-EVOLUTION +ocho I-EVOLUTION +días, I-EVOLUTION +acude I-EVOLUTION +nuevamente I-EVOLUTION +a I-EVOLUTION +urgencias I-EVOLUTION +por I-EVOLUTION +líquido I-EVOLUTION +turbio, I-EVOLUTION +apareciendo B-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +cultivo I-EXPLORATION +un I-EXPLORATION +nuevo I-EXPLORATION +patógeno I-EXPLORATION +(Cándida I-EXPLORATION +parapsilosis) I-EXPLORATION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +añadió I-TREATMENT +al I-TREATMENT +tratamiento I-TREATMENT +Fluconazol I-TREATMENT +200 I-TREATMENT +mg I-TREATMENT +vo/24h, I-TREATMENT +y I-TREATMENT +quedó I-TREATMENT +nuevamente I-TREATMENT +ingresada. I-TREATMENT + I-TREATMENT +Debido B-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +mala I-EVOLUTION +respuesta I-EVOLUTION +al I-EVOLUTION +tratamiento I-EVOLUTION +se B-TREATMENT +decidió I-TREATMENT +retirar I-TREATMENT +el I-TREATMENT +catéter I-TREATMENT +Tenckoff, I-TREATMENT +como I-TREATMENT +recomienda I-TREATMENT +el I-TREATMENT +protocolo, I-TREATMENT +y I-TREATMENT +transferirla I-TREATMENT +a I-TREATMENT +Hemodiálisis I-TREATMENT +definitivamente. I-TREATMENT + I-TREATMENT +Se I-TREATMENT +le I-TREATMENT +coloco I-TREATMENT +un I-TREATMENT +catéter I-TREATMENT +venoso I-TREATMENT +bilumen I-TREATMENT +(yugular I-TREATMENT +derecho) I-TREATMENT +provisional, I-TREATMENT +en I-TREATMENT +espera I-TREATMENT +de I-TREATMENT +programar I-TREATMENT +intervención I-TREATMENT +quirúrgica I-TREATMENT +de I-TREATMENT +fístula I-TREATMENT +arterio-venosa I-TREATMENT +interna I-TREATMENT +en I-TREATMENT +codo I-TREATMENT +derecho I-TREATMENT +(5/09/2014). I-TREATMENT + I-TREATMENT +Cinco B-EVOLUTION +días I-EVOLUTION +después, I-EVOLUTION +se I-EVOLUTION +recambió I-EVOLUTION +el I-EVOLUTION +catéter I-EVOLUTION +venoso I-EVOLUTION +por I-EVOLUTION +disfunción I-EVOLUTION +y I-EVOLUTION +se I-EVOLUTION +visualizó I-EVOLUTION +mediante I-EVOLUTION +angio I-EVOLUTION +TAC, I-EVOLUTION +importante I-EVOLUTION +trombo I-EVOLUTION +en I-EVOLUTION +vena I-EVOLUTION +yugular I-EVOLUTION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +precisó I-TREATMENT +cirugía, I-TREATMENT +ingreso I-TREATMENT +en I-TREATMENT +cuidados I-TREATMENT +intensivos I-TREATMENT +y I-TREATMENT +colocación I-TREATMENT +de I-TREATMENT +un I-TREATMENT +nuevo I-TREATMENT +catéter I-TREATMENT +(ubicación I-TREATMENT +femoral). I-TREATMENT +Este B-EVOLUTION +nuevo I-EVOLUTION +catéter, I-EVOLUTION +también, I-EVOLUTION +presentó I-EVOLUTION +trombosis I-EVOLUTION +venosa I-EVOLUTION +no I-EVOLUTION +oclusiva, I-EVOLUTION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +precisó I-TREATMENT +anticoagulación I-TREATMENT +y I-TREATMENT +retirada I-TREATMENT +en I-TREATMENT +2-3 I-TREATMENT +semanas. I-TREATMENT + I-TREATMENT +A B-EVOLUTION +pesar I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +utilización I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +fistula I-EVOLUTION +arterio-venosa I-EVOLUTION +interna I-EVOLUTION +al I-EVOLUTION +mes I-EVOLUTION +de I-EVOLUTION +su I-EVOLUTION +intervención, I-EVOLUTION +se I-EVOLUTION +observó I-EVOLUTION +mala I-EVOLUTION +adaptación I-EVOLUTION +al I-EVOLUTION +tratamiento I-EVOLUTION +de I-EVOLUTION +HD I-EVOLUTION +por I-EVOLUTION +continuas I-EVOLUTION +hipotensiones, I-EVOLUTION +dificultad I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +canalización I-EVOLUTION +venosa I-EVOLUTION +y I-EVOLUTION +dolor I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +extremidad I-EVOLUTION +por I-EVOLUTION +síndrome I-EVOLUTION +de I-EVOLUTION +"robo". I-EVOLUTION + I-EVOLUTION +La I-EVOLUTION +calidad I-EVOLUTION +de I-EVOLUTION +vida I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +había I-EVOLUTION +empeorado I-EVOLUTION +notablemente, I-EVOLUTION +tras I-EVOLUTION +el I-EVOLUTION +ingreso I-EVOLUTION +de I-EVOLUTION +74 I-EVOLUTION +días I-EVOLUTION +y I-EVOLUTION +el I-EVOLUTION +traspaso I-EVOLUTION +a I-EVOLUTION +hemodiálisis: I-EVOLUTION + I-EVOLUTION +(Octubre I-EVOLUTION +2014) I-EVOLUTION += I-EVOLUTION +Barthel I-EVOLUTION +95%, I-EVOLUTION +Lawton-Brody I-EVOLUTION +6/8, I-EVOLUTION +Calidad I-EVOLUTION +de I-EVOLUTION +vida I-EVOLUTION +(sf-12): I-EVOLUTION +PCS I-EVOLUTION +20, I-EVOLUTION +1, I-EVOLUTION +MCS I-EVOLUTION +40, I-EVOLUTION +3 I-EVOLUTION + I-EVOLUTION +Debido I-EVOLUTION +a I-EVOLUTION +las I-EVOLUTION +complicaciones, I-EVOLUTION +la I-EVOLUTION +mala I-EVOLUTION +adaptación I-EVOLUTION +a I-EVOLUTION +HD I-EVOLUTION +y B-TREATMENT +por I-TREATMENT +petición I-TREATMENT +de I-TREATMENT +la I-TREATMENT +paciente, I-TREATMENT +se I-TREATMENT +replanteó I-TREATMENT +volver I-TREATMENT +a I-TREATMENT +DP I-TREATMENT +con I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +de I-TREATMENT +cicladora I-TREATMENT +nocturna. I-TREATMENT + I-TREATMENT +Regreso I-TREATMENT +a I-TREATMENT +Dialisis I-TREATMENT +Peritoneal: I-TREATMENT + I-TREATMENT +Así I-TREATMENT +pues, I-TREATMENT +el I-TREATMENT +19/12/14 I-TREATMENT +se I-TREATMENT +colocó I-TREATMENT +catéter I-TREATMENT +Tenckoff I-TREATMENT +(vía I-TREATMENT +laparoscopia I-TREATMENT +para I-TREATMENT +poder I-TREATMENT +valorar I-TREATMENT +las I-TREATMENT +posibles I-TREATMENT +adherencias, I-TREATMENT +que I-TREATMENT +pueden I-TREATMENT +aparecer I-TREATMENT +tras I-TREATMENT +la I-TREATMENT +peritonitis I-TREATMENT +fúngicas) I-TREATMENT +y I-TREATMENT +como I-TREATMENT +no I-TREATMENT +hubieron I-TREATMENT +problemas, I-TREATMENT +en I-TREATMENT +1 I-TREATMENT +mes I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +reinició I-TREATMENT +terapia I-TREATMENT +domiciliaria I-TREATMENT +de I-TREATMENT +diálisis I-TREATMENT +peritoneal I-TREATMENT +automática I-TREATMENT +(DPA). I-TREATMENT +Como I-TREATMENT +cuidador I-TREATMENT +principal I-TREATMENT +quedó I-TREATMENT +la I-TREATMENT +hija I-TREATMENT +menor I-TREATMENT +de I-TREATMENT +la I-TREATMENT +paciente, I-TREATMENT +que I-TREATMENT +aunque I-TREATMENT +no I-TREATMENT +vive I-TREATMENT +con I-TREATMENT +ella I-TREATMENT +realizaba I-TREATMENT +el I-TREATMENT +montaje I-TREATMENT +y I-TREATMENT +conexión I-TREATMENT +desplazándose I-TREATMENT +al I-TREATMENT +domicilio I-TREATMENT +diariamente. I-TREATMENT +La I-TREATMENT +desconexión, I-TREATMENT +solución I-TREATMENT +de I-TREATMENT +alarmas I-TREATMENT +nocturnas I-TREATMENT +y I-TREATMENT +desmontaje I-TREATMENT +de I-TREATMENT +la I-TREATMENT +maquina, I-TREATMENT +lo I-TREATMENT +realiza I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +sin I-TREATMENT +supervisión. I-TREATMENT + I-TREATMENT +El I-TREATMENT +tratamiento I-TREATMENT +pautado I-TREATMENT +con I-TREATMENT +cicladora I-TREATMENT +fue I-TREATMENT +de: I-TREATMENT +8 I-TREATMENT +horas, I-TREATMENT +4 I-TREATMENT +ciclos I-TREATMENT +de I-TREATMENT +2000 I-TREATMENT +ml I-TREATMENT +(Phisioneal I-TREATMENT +35 I-TREATMENT +1, I-TREATMENT +36%), I-TREATMENT +80 I-TREATMENT +minutos I-TREATMENT +de I-TREATMENT +permanencia I-TREATMENT +y I-TREATMENT +día I-TREATMENT +seco. I-TREATMENT + I-TREATMENT +Diariamente B-EVOLUTION +tiene I-EVOLUTION +una I-EVOLUTION +ultrafiltrafiltración I-EVOLUTION +con I-EVOLUTION +el I-EVOLUTION +tratamiento I-EVOLUTION +de I-EVOLUTION +400-500 I-EVOLUTION +ml I-EVOLUTION +y I-EVOLUTION +mantiene I-EVOLUTION +un I-EVOLUTION +volumen I-EVOLUTION +de I-EVOLUTION +diuresis I-EVOLUTION +de I-EVOLUTION +1500 I-EVOLUTION +ml. I-EVOLUTION +El I-EVOLUTION +test I-EVOLUTION +de I-EVOLUTION +equilibrio I-EVOLUTION +peritoneal I-EVOLUTION +se I-EVOLUTION +mantuvo I-EVOLUTION +igual I-EVOLUTION +que I-EVOLUTION +al I-EVOLUTION +inicio. I-EVOLUTION + I-EVOLUTION +Actualmente I-EVOLUTION +lleva I-EVOLUTION +> I-EVOLUTION +de I-EVOLUTION +1 I-EVOLUTION +año I-EVOLUTION +sin I-EVOLUTION +ningún I-EVOLUTION +tipo I-EVOLUTION +de I-EVOLUTION +problema, I-EVOLUTION +recuperando I-EVOLUTION +prácticamente I-EVOLUTION +la I-EVOLUTION +autonomía I-EVOLUTION +y I-EVOLUTION +calidad I-EVOLUTION +de I-EVOLUTION +vida I-EVOLUTION +del I-EVOLUTION +inicio: I-EVOLUTION + I-EVOLUTION +(Septiembre I-EVOLUTION +2015) I-EVOLUTION += I-EVOLUTION +Barthel I-EVOLUTION +100%, I-EVOLUTION +Lawton-Brody I-EVOLUTION +8/8, I-EVOLUTION +Calidad I-EVOLUTION +de I-EVOLUTION +vida I-EVOLUTION +(sf-12): I-EVOLUTION +PCS I-EVOLUTION +43, I-EVOLUTION +6, I-EVOLUTION +MCS I-EVOLUTION +51, I-EVOLUTION +5 I-EVOLUTION + I-EVOLUTION +Las B-TREATMENT +guías I-TREATMENT +SEN I-TREATMENT +recomiendan I-TREATMENT +realizar I-TREATMENT +reentrenamiento I-TREATMENT +después I-TREATMENT +de I-TREATMENT +cada I-TREATMENT +episodio I-TREATMENT +de I-TREATMENT +peritonitis. I-TREATMENT +El I-TREATMENT +objetivo I-TREATMENT +es I-TREATMENT +buscar I-TREATMENT +causas I-TREATMENT +posibles, I-TREATMENT +evaluar I-TREATMENT +la I-TREATMENT +capacitación I-TREATMENT +del I-TREATMENT +responsable I-TREATMENT +y I-TREATMENT +rectificar I-TREATMENT +aquellos I-TREATMENT +procedimientos I-TREATMENT +erróneos. I-TREATMENT +Esta I-TREATMENT +metodología I-TREATMENT +nos I-TREATMENT +ayuda I-TREATMENT +a I-TREATMENT +revelar I-TREATMENT +la I-TREATMENT +posible I-TREATMENT +causa I-TREATMENT +de I-TREATMENT +la I-TREATMENT +infección. I-TREATMENT +En I-TREATMENT +nuestro I-TREATMENT +caso, I-TREATMENT +el I-TREATMENT +resultado I-TREATMENT +indicó I-TREATMENT +que I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +no I-TREATMENT +había I-TREATMENT +seguido I-TREATMENT +las I-TREATMENT +medidas I-TREATMENT +de I-TREATMENT +asepsia I-TREATMENT +recomendadas I-TREATMENT +en I-TREATMENT +la I-TREATMENT +manipulación I-TREATMENT +del I-TREATMENT +antibiótico I-TREATMENT +para I-TREATMENT +el I-TREATMENT +sellado. I-TREATMENT + I-TREATMENT +Con I-TREATMENT +el I-TREATMENT +primer I-TREATMENT +resultado I-TREATMENT +del I-TREATMENT +cultivo I-TREATMENT +del I-TREATMENT +líquido I-TREATMENT +peritoneal I-TREATMENT +se I-TREATMENT +diagnosticó I-TREATMENT +la I-TREATMENT +peritonitis I-TREATMENT +bacteriana, I-TREATMENT +pero I-TREATMENT +acabo I-TREATMENT +añadiendose, I-TREATMENT +también, I-TREATMENT +una I-TREATMENT +peritonitis I-TREATMENT +fúngica. I-TREATMENT +Así I-TREATMENT +pues, I-TREATMENT +la I-TREATMENT +infección I-TREATMENT +fúngica I-TREATMENT +condicionó I-TREATMENT +la I-TREATMENT +retirada I-TREATMENT +del I-TREATMENT +catéter I-TREATMENT +peritoneal I-TREATMENT +y I-TREATMENT +el I-TREATMENT +abandono I-TREATMENT +del I-TREATMENT +programa I-TREATMENT +de I-TREATMENT +diálisis I-TREATMENT +peritoneal. I-TREATMENT +El I-TREATMENT +equipo I-TREATMENT +multidisciplinar I-TREATMENT +tomó I-TREATMENT +la I-TREATMENT +decisión I-TREATMENT +de I-TREATMENT +transferirla I-TREATMENT +a I-TREATMENT +HD I-TREATMENT +definitivamente I-TREATMENT +tras I-TREATMENT +el I-TREATMENT +diagnostico I-TREATMENT +de I-TREATMENT +peritonitis I-TREATMENT +fúngica. I-TREATMENT + I-TREATMENT +Muchos I-TREATMENT +autores I-TREATMENT +describen I-TREATMENT +que I-TREATMENT +la I-TREATMENT +supervivencia I-TREATMENT +de I-TREATMENT +la I-TREATMENT +técnica I-TREATMENT +tras I-TREATMENT +una I-TREATMENT +peritonitis I-TREATMENT +fúngica I-TREATMENT +por I-TREATMENT +Candidas I-TREATMENT +no I-TREATMENT +Albicans I-TREATMENT +es I-TREATMENT +muy I-TREATMENT +baja, I-TREATMENT +y I-TREATMENT +además I-TREATMENT +existen I-TREATMENT +pocos I-TREATMENT +pacientes I-TREATMENT +que I-TREATMENT +pueden I-TREATMENT +retornar I-TREATMENT +de I-TREATMENT +nuevo I-TREATMENT +a I-TREATMENT +la I-TREATMENT +terapia I-TREATMENT +de I-TREATMENT +DP I-TREATMENT +tras I-TREATMENT +el I-TREATMENT +suceso, I-TREATMENT +así I-TREATMENT +lo I-TREATMENT +describen I-TREATMENT +García-Martos1, I-TREATMENT +2 I-TREATMENT +y I-TREATMENT +Molina3 I-TREATMENT +en I-TREATMENT +sus I-TREATMENT +estudios. I-TREATMENT + I-TREATMENT +Las I-TREATMENT +causas I-TREATMENT +de I-TREATMENT +que I-TREATMENT +nos I-TREATMENT +planteáramos I-TREATMENT +que I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +volviera I-TREATMENT +a I-TREATMENT +DP, I-TREATMENT +fueron: I-TREATMENT +la I-TREATMENT +mala I-TREATMENT +adaptación I-TREATMENT +a I-TREATMENT +la I-TREATMENT +HD, I-TREATMENT +las I-TREATMENT +complicaciones I-TREATMENT +surgidas I-TREATMENT +durante I-TREATMENT +el I-TREATMENT +traspaso I-TREATMENT +a I-TREATMENT +hemodiálisis I-TREATMENT +y I-TREATMENT +la I-TREATMENT +petición I-TREATMENT +de I-TREATMENT +la I-TREATMENT +propia I-TREATMENT +paciente. I-TREATMENT +También I-TREATMENT +se I-TREATMENT +tuvo I-TREATMENT +en I-TREATMENT +cuenta I-TREATMENT +la I-TREATMENT +recomendación I-TREATMENT +de I-TREATMENT +las I-TREATMENT +guías I-TREATMENT +sobre I-TREATMENT +la I-TREATMENT +posibilidad I-TREATMENT +de I-TREATMENT +reinserción I-TREATMENT +de I-TREATMENT +un I-TREATMENT +nuevo I-TREATMENT +catéter I-TREATMENT +peritoneal I-TREATMENT +a I-TREATMENT +las I-TREATMENT +4-6 I-TREATMENT +semanas I-TREATMENT +de I-TREATMENT +la I-TREATMENT +resolución I-TREATMENT +del I-TREATMENT +cuadro I-TREATMENT +clínico. I-TREATMENT + I-TREATMENT +Una I-TREATMENT +vez I-TREATMENT +tomada I-TREATMENT +la I-TREATMENT +decisión I-TREATMENT +de I-TREATMENT +regresar I-TREATMENT +al I-TREATMENT +programa I-TREATMENT +de I-TREATMENT +DP, I-TREATMENT +estaba I-TREATMENT +claro I-TREATMENT +que I-TREATMENT +era I-TREATMENT +necesario I-TREATMENT +un I-TREATMENT +cambio I-TREATMENT +de I-TREATMENT +estrategia, I-TREATMENT +de I-TREATMENT +manera I-TREATMENT +que I-TREATMENT +se I-TREATMENT +propuso I-TREATMENT +iniciar I-TREATMENT +en I-TREATMENT +forma I-TREATMENT +de I-TREATMENT +cicladora I-TREATMENT +automática, I-TREATMENT +con I-TREATMENT +la I-TREATMENT +finalidad I-TREATMENT +de I-TREATMENT +disminuir I-TREATMENT +el I-TREATMENT +número I-TREATMENT +de I-TREATMENT +manipulaciones I-TREATMENT +del I-TREATMENT +paciente/familia I-TREATMENT +con I-TREATMENT +el I-TREATMENT +catéter. I-TREATMENT +Pero I-TREATMENT +también, I-TREATMENT +era I-TREATMENT +imprescindible I-TREATMENT +evitar I-TREATMENT +nuevos I-TREATMENT +episodios I-TREATMENT +de I-TREATMENT +infección, I-TREATMENT +por I-TREATMENT +eso, I-TREATMENT +se I-TREATMENT +pensó I-TREATMENT +en I-TREATMENT +buscar I-TREATMENT +un I-TREATMENT +nuevo I-TREATMENT +responsable I-TREATMENT +para I-TREATMENT +realizar I-TREATMENT +la I-TREATMENT +técnica I-TREATMENT +y I-TREATMENT +todo I-TREATMENT +ello I-TREATMENT +nos I-TREATMENT +condujo I-TREATMENT +a I-TREATMENT +reiniciar I-TREATMENT +el I-TREATMENT +proceso I-TREATMENT +de I-TREATMENT +entrenamiento I-TREATMENT +con I-TREATMENT +la I-TREATMENT +hija I-TREATMENT +y I-TREATMENT +puesta I-TREATMENT +en I-TREATMENT +marcha I-TREATMENT +de I-TREATMENT +la I-TREATMENT +técnica I-TREATMENT +en I-TREATMENT +casa. I-TREATMENT + I-TREATMENT + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +68 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +lesión I-PRESENT_ILLNESS +tumoral I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +aspecto I-PRESENT_ILLNESS +esclerodermiforme I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +zona I-PRESENT_ILLNESS +central I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +párpado I-PRESENT_ILLNESS +inferior I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +deja I-PRESENT_ILLNESS +libre I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +borde I-PRESENT_ILLNESS +palpebral. I-PRESENT_ILLNESS +Bajo B-TREATMENT +anestesia I-TREATMENT +local I-TREATMENT +y I-TREATMENT +sedación I-TREATMENT +se I-TREATMENT +procede I-TREATMENT +a I-TREATMENT +exéresis I-TREATMENT +amplia I-TREATMENT +de I-TREATMENT +la I-TREATMENT +lesión I-TREATMENT +cutánea I-TREATMENT +respetando I-TREATMENT +la I-TREATMENT +lamela I-TREATMENT +interna I-TREATMENT +y I-TREATMENT +reconstrucción I-TREATMENT +mediante I-TREATMENT +colgajo I-TREATMENT +miocutáneo I-TREATMENT +del I-TREATMENT +músculo I-TREATMENT +orbicular I-TREATMENT +en I-TREATMENT +isla I-TREATMENT +con I-TREATMENT +unas I-TREATMENT +dimensiones I-TREATMENT +de I-TREATMENT +25 I-TREATMENT +x I-TREATMENT +17 I-TREATMENT +mm. I-TREATMENT +La B-EXPLORATION +anatomía I-EXPLORATION +patológica I-EXPLORATION +informó I-EXPLORATION +de I-EXPLORATION +carcinoma I-EXPLORATION +basocelular. I-EXPLORATION +En B-EVOLUTION +las I-EVOLUTION +Fig. I-EVOLUTION +4 I-EVOLUTION +y I-EVOLUTION +5 I-EVOLUTION +presentamos I-EVOLUTION +el I-EVOLUTION +resultado I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +12 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +intervención. I-EVOLUTION + I-EVOLUTION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +27 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +residente B-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -fuga I-PAST_MEDICAL_HISTORY -disociativa. I-PAST_MEDICAL_HISTORY -Piden I-PAST_MEDICAL_HISTORY -entonces I-PAST_MEDICAL_HISTORY -interconsulta I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -psiquiatría, I-PAST_MEDICAL_HISTORY -siendo I-PAST_MEDICAL_HISTORY -éste I-PAST_MEDICAL_HISTORY -es I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -primer I-PAST_MEDICAL_HISTORY -contacto I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY +Santiago, I-PAST_MEDICAL_HISTORY +soltero I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +heterosexual, I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -dicha I-PAST_MEDICAL_HISTORY -especialidad. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY diagnóstico I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -primer I-PAST_MEDICAL_HISTORY -ingreso I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -unidad I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -agudos I-PAST_MEDICAL_HISTORY +infección I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +VIH I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +septiembre I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -psiquiatría I-PAST_MEDICAL_HISTORY -es I-PAST_MEDICAL_HISTORY -catatonia I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -filiar. I-PAST_MEDICAL_HISTORY -Presenta I-PAST_MEDICAL_HISTORY -mutismo I-PAST_MEDICAL_HISTORY +2003 I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -ausencia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -respuesta I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -estímulos I-PAST_MEDICAL_HISTORY -persistente I-PAST_MEDICAL_HISTORY -tras I-PAST_MEDICAL_HISTORY -7 I-PAST_MEDICAL_HISTORY -días I-PAST_MEDICAL_HISTORY +serología I-PAST_MEDICAL_HISTORY +confirmatoria I-PAST_MEDICAL_HISTORY +efectuada I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +laboratorio I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -diazepam I-PAST_MEDICAL_HISTORY -(40 I-PAST_MEDICAL_HISTORY -mg/día). I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -decide I-PAST_MEDICAL_HISTORY -administrar I-PAST_MEDICAL_HISTORY -TEC I-PAST_MEDICAL_HISTORY -(7 I-PAST_MEDICAL_HISTORY -sesiones) I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -iniciar I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -antidepresivo I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -venlafaxina I-PAST_MEDICAL_HISTORY -(150 I-PAST_MEDICAL_HISTORY -mg/día). I-PAST_MEDICAL_HISTORY -A I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -largo I-PAST_MEDICAL_HISTORY +referencia I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +Instituto I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -sesiones I-PAST_MEDICAL_HISTORY +Salud I-PAST_MEDICAL_HISTORY +Pública I-PAST_MEDICAL_HISTORY +(ISP). I-PAST_MEDICAL_HISTORY +Fue I-PAST_MEDICAL_HISTORY +catalogado I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +etapa I-PAST_MEDICAL_HISTORY +A, I-PAST_MEDICAL_HISTORY +nunca I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +realizó I-PAST_MEDICAL_HISTORY +determinación I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -TEC I-PAST_MEDICAL_HISTORY -recupera I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -discurso I-PAST_MEDICAL_HISTORY -espontáneo, I-PAST_MEDICAL_HISTORY -pero I-PAST_MEDICAL_HISTORY -persiste I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -dificultad I-PAST_MEDICAL_HISTORY +linfocitos I-PAST_MEDICAL_HISTORY +CD4 I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +tuvo I-PAST_MEDICAL_HISTORY +controles I-PAST_MEDICAL_HISTORY +irregulares I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +otra I-PAST_MEDICAL_HISTORY +policlínica. I-PAST_MEDICAL_HISTORY +Desde I-PAST_MEDICAL_HISTORY +hacía I-PAST_MEDICAL_HISTORY +10 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +vivía I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY la I-PAST_MEDICAL_HISTORY -expresión I-PAST_MEDICAL_HISTORY -(anomia I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -palilalia), I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -amnesia I-PAST_MEDICAL_HISTORY -lacunar I-PAST_MEDICAL_HISTORY -completa I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -episodio, I-PAST_MEDICAL_HISTORY +calle, I-PAST_MEDICAL_HISTORY +dedicado I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +comercio I-PAST_MEDICAL_HISTORY +ambulante I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -amnesia I-PAST_MEDICAL_HISTORY -incompleta I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -eventos I-PAST_MEDICAL_HISTORY -ocurridos I-PAST_MEDICAL_HISTORY +alojaba I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY +residencia I-PAST_MEDICAL_HISTORY +para I-PAST_MEDICAL_HISTORY +individuos I-PAST_MEDICAL_HISTORY +indigentes. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Desde I-PAST_MEDICAL_HISTORY +abril I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +2005 I-PAST_MEDICAL_HISTORY +presentó I-PAST_MEDICAL_HISTORY un I-PAST_MEDICAL_HISTORY -periodo I-PAST_MEDICAL_HISTORY -anterior I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY -largo I-PAST_MEDICAL_HISTORY -(de I-PAST_MEDICAL_HISTORY -semanas). I-PAST_MEDICAL_HISTORY -Tras I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -alta I-PAST_MEDICAL_HISTORY -hospitalaria I-PAST_MEDICAL_HISTORY -persisten I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -episodios I-PAST_MEDICAL_HISTORY +aumento I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -amnesia, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -sensación I-PAST_MEDICAL_HISTORY +volumen I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +región I-PAST_MEDICAL_HISTORY +frontal, I-PAST_MEDICAL_HISTORY +asociándose, I-PAST_MEDICAL_HISTORY +además, I-PAST_MEDICAL_HISTORY +lesiones I-PAST_MEDICAL_HISTORY +papulares I-PAST_MEDICAL_HISTORY +eritematosas I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +extremidades, I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +lo I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +consultó I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +policlínica I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -bloqueo I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -nivel I-PAST_MEDICAL_HISTORY -motor I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -lenguaje. I-PAST_MEDICAL_HISTORY -Tiene I-PAST_MEDICAL_HISTORY -dificultades I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -hacer I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -vida I-PAST_MEDICAL_HISTORY -autónoma, I-PAST_MEDICAL_HISTORY -incluyendo I-PAST_MEDICAL_HISTORY -aspectos I-PAST_MEDICAL_HISTORY -básicos I-PAST_MEDICAL_HISTORY +Infectología-VIH, I-PAST_MEDICAL_HISTORY del I-PAST_MEDICAL_HISTORY -autocuidado, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -aparece I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -cuadro I-PAST_MEDICAL_HISTORY -secundario I-PAST_MEDICAL_HISTORY +Hospital I-PAST_MEDICAL_HISTORY +San I-PAST_MEDICAL_HISTORY +Juan I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -angustia I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -ánimo I-PAST_MEDICAL_HISTORY -bajo I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -motiva I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -segundo I-PAST_MEDICAL_HISTORY -ingreso I-PAST_MEDICAL_HISTORY -psiquiátrico, I-PAST_MEDICAL_HISTORY +Dios, I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +agosto I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -varias I-PAST_MEDICAL_HISTORY -semanas. I-PAST_MEDICAL_HISTORY +2005. I-PAST_MEDICAL_HISTORY Se I-PAST_MEDICAL_HISTORY -describen I-PAST_MEDICAL_HISTORY -entonces I-PAST_MEDICAL_HISTORY -"episodios I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ausencia I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -síntomas I-PAST_MEDICAL_HISTORY -disociativos I-PAST_MEDICAL_HISTORY +observaba I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +absceso I-PAST_MEDICAL_HISTORY +frontal I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -amnesia I-PAST_MEDICAL_HISTORY -posterior" I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -son I-PAST_MEDICAL_HISTORY -etiquetados I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -conversivos, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -recuperación I-PAST_MEDICAL_HISTORY -parcial I-PAST_MEDICAL_HISTORY +lesiones I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -amnesia. I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -modifica I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -antidepresivo I-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +forúnculos I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +ambas I-PAST_MEDICAL_HISTORY +extremidades, I-PAST_MEDICAL_HISTORY +siendo I-PAST_MEDICAL_HISTORY +enviado I-PAST_MEDICAL_HISTORY a I-PAST_MEDICAL_HISTORY -escitalopram I-PAST_MEDICAL_HISTORY -(20 I-PAST_MEDICAL_HISTORY -mg/día), I-PAST_MEDICAL_HISTORY -añadiendo I-PAST_MEDICAL_HISTORY -clorazepato I-PAST_MEDICAL_HISTORY -dipotásico I-PAST_MEDICAL_HISTORY -(15 I-PAST_MEDICAL_HISTORY -mg/día) I-PAST_MEDICAL_HISTORY +servicio I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +urgencia I-PAST_MEDICAL_HISTORY +para I-PAST_MEDICAL_HISTORY +debridamiento I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +absceso I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -trazodona I-PAST_MEDICAL_HISTORY -(100 I-PAST_MEDICAL_HISTORY -mg/día). I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -alta I-PAST_MEDICAL_HISTORY -es I-PAST_MEDICAL_HISTORY -amnesia I-PAST_MEDICAL_HISTORY -disociativa. I-PAST_MEDICAL_HISTORY -Un I-PAST_MEDICAL_HISTORY -mes I-PAST_MEDICAL_HISTORY -después I-PAST_MEDICAL_HISTORY -precisa I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -tercer I-PAST_MEDICAL_HISTORY -ingreso I-PAST_MEDICAL_HISTORY -psiquiátrico I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -intensa I-PAST_MEDICAL_HISTORY -angustia, I-PAST_MEDICAL_HISTORY -desesperanza, I-PAST_MEDICAL_HISTORY -ideación I-PAST_MEDICAL_HISTORY -autolítica, I-PAST_MEDICAL_HISTORY -persistencia I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +obtención I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY +cultivos. I-PAST_MEDICAL_HISTORY +Acudió B-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +control I-PRESENT_ILLNESS +después I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +semanas, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +progresión I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +absceso I-PRESENT_ILLNESS +frontal I-PRESENT_ILLNESS +(5 I-PRESENT_ILLNESS +x I-PRESENT_ILLNESS +4 I-PRESENT_ILLNESS +cm I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +diámetro), I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +área I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +necrosis I-PRESENT_ILLNESS +central I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +borde I-PRESENT_ILLNESS +eritematoso I-PRESENT_ILLNESS +extenso, I-PRESENT_ILLNESS +coincidiendo I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +aparición I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +nuevas I-PRESENT_ILLNESS +lesiones I-PRESENT_ILLNESS +papulares I-PRESENT_ILLNESS +eritematosas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +1 I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS +cm. I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +diámetro I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +cara, I-PRESENT_ILLNESS +principalmente, I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +zona I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +barba, I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +extremidades I-PRESENT_ILLNESS +inferiores- I-PRESENT_ILLNESS +algunas I-PRESENT_ILLNESS +subcutáneas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +consistencia I-PRESENT_ILLNESS +blanda, I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +dolorosas- I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +lesiones I-PRESENT_ILLNESS +violáceas I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +región I-PRESENT_ILLNESS +anterior I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +tórax I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +extremidades I-PRESENT_ILLNESS +inferiores. I-PRESENT_ILLNESS +También I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +apreció I-PRESENT_ILLNESS +compromiso I-PRESENT_ILLNESS +mucoso, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +lesiones I-PRESENT_ILLNESS +exofiticas I-PRESENT_ILLNESS +costrosas I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +ángulo I-PRESENT_ILLNESS +interno I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +ojo, I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS +cm I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +diámetro, I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +ambas I-PRESENT_ILLNESS +conjuntivas I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +lesiones I-PRESENT_ILLNESS +exofíticas I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +ulceración I-PRESENT_ILLNESS +central I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +mucosa I-PRESENT_ILLNESS +oral, I-PRESENT_ILLNESS +localizadas I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +región I-PRESENT_ILLNESS +vestibular I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +labio I-PRESENT_ILLNESS +inferior, I-PRESENT_ILLNESS +paladar I-PRESENT_ILLNESS +duro I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +blando. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +En B-EXPLORATION +el I-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +general I-EXPLORATION +se I-EXPLORATION +destacó I-EXPLORATION +un I-EXPLORATION +paciente I-EXPLORATION +en I-EXPLORATION +malas I-EXPLORATION +condiciones I-EXPLORATION +higiénicas, I-EXPLORATION +pálido, I-EXPLORATION +con I-EXPLORATION +candidiasis I-EXPLORATION +orofaríngea, I-EXPLORATION +T° I-EXPLORATION +axilar I-EXPLORATION +de I-EXPLORATION +37, I-EXPLORATION +5° I-EXPLORATION +C, I-EXPLORATION +un I-EXPLORATION +índice I-EXPLORATION +de I-EXPLORATION +masa I-EXPLORATION +corporal I-EXPLORATION +de I-EXPLORATION +18, I-EXPLORATION +sin I-EXPLORATION +adenopatías I-EXPLORATION +regionales. I-EXPLORATION +El I-EXPLORATION +examen I-EXPLORATION +cardiovascular I-EXPLORATION +no I-EXPLORATION +reveló I-EXPLORATION +alteraciones I-EXPLORATION +y I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +apreció I-EXPLORATION +visceromegalia I-EXPLORATION +abdominal. I-EXPLORATION +No I-EXPLORATION +presentaba I-EXPLORATION +compromiso I-EXPLORATION +neurológico I-EXPLORATION +clínico. I-EXPLORATION + I-EXPLORATION +Otros B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +relevantes I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +aparecieron I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY la I-PAST_MEDICAL_HISTORY +historia I-PAST_MEDICAL_HISTORY clínica I-PAST_MEDICAL_HISTORY -amnésica, I-PAST_MEDICAL_HISTORY +fueron I-PAST_MEDICAL_HISTORY +viajes I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +mochilero I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +Perú I-PAST_MEDICAL_HISTORY +(Tacna) I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +2001 I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -deterioro I-PAST_MEDICAL_HISTORY -grave I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -funcionamiento I-PAST_MEDICAL_HISTORY -global. I-PAST_MEDICAL_HISTORY -Por B-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -alta I-DERIVED_FROM/TO -frecuencia I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -ingresos I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -deterioro I-DERIVED_FROM/TO -funcional I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -le I-DERIVED_FROM/TO -deriva I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -unidad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -subagudos, I-DERIVED_FROM/TO -donde I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -le I-DERIVED_FROM/TO -diagnostica I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -trastorno I-DERIVED_FROM/TO -esquizofrénico. I-DERIVED_FROM/TO -Para I-DERIVED_FROM/TO -ello I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -basan I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -evolución I-DERIVED_FROM/TO -tórpida, I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -falta I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -repuesta I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -medicación I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -ruptura I-DERIVED_FROM/TO -biográfica, I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -pesar I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -ausencia I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -clínica I-DERIVED_FROM/TO -psicótica I-DERIVED_FROM/TO -positiva. I-DERIVED_FROM/TO -Le B-TREATMENT -pautan I-TREATMENT -olanzapina I-TREATMENT -(20 I-TREATMENT -mg/día) I-TREATMENT +a I-PAST_MEDICAL_HISTORY +Bolivia I-PAST_MEDICAL_HISTORY +(Ororuro) I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +2003. I-PAST_MEDICAL_HISTORY +No I-PAST_MEDICAL_HISTORY +tenía I-PAST_MEDICAL_HISTORY +mascotas; I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +embargo, I-PAST_MEDICAL_HISTORY +refirió I-PAST_MEDICAL_HISTORY +tener I-PAST_MEDICAL_HISTORY +contacto, I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +forma I-PAST_MEDICAL_HISTORY +frecuente, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +gatos I-PAST_MEDICAL_HISTORY +callejeros I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +todas I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +edades, I-PAST_MEDICAL_HISTORY +habiendo I-PAST_MEDICAL_HISTORY +sido I-PAST_MEDICAL_HISTORY +rasguñado I-PAST_MEDICAL_HISTORY +ocasionalmente. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Se B-EVOLUTION +decidió, I-EVOLUTION +entonces, I-EVOLUTION +su I-EVOLUTION +hospitalización I-EVOLUTION +para I-EVOLUTION +realizar I-EVOLUTION +estudios. I-EVOLUTION +De B-EXPLORATION +los I-EXPLORATION +exámenes I-EXPLORATION +generales I-EXPLORATION +destacó I-EXPLORATION +un I-EXPLORATION +hematocrito I-EXPLORATION +de I-EXPLORATION +31% I-EXPLORATION +con I-EXPLORATION +VCM I-EXPLORATION +80 I-EXPLORATION +fl I-EXPLORATION +y I-EXPLORATION +CHCM I-EXPLORATION +32%, I-EXPLORATION +leucocitos I-EXPLORATION +de I-EXPLORATION +5.700 I-EXPLORATION +céls/mm3, I-EXPLORATION +sin I-EXPLORATION +desviación I-EXPLORATION +a I-EXPLORATION +izquierda I-EXPLORATION +y I-EXPLORATION +plaquetas I-EXPLORATION +310.000 I-EXPLORATION +céls/mmm3, I-EXPLORATION +VHS I-EXPLORATION +81 I-EXPLORATION +mm/h, I-EXPLORATION +sin I-EXPLORATION +alteración I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +pruebas I-EXPLORATION +de I-EXPLORATION +función I-EXPLORATION +hepática, I-EXPLORATION +con I-EXPLORATION +fosfatasa I-EXPLORATION +alcalina I-EXPLORATION +de I-EXPLORATION +85 I-EXPLORATION +U/L I-EXPLORATION +y I-EXPLORATION +LDH I-EXPLORATION +185 I-EXPLORATION +U/L. I-EXPLORATION +Del I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +su I-EXPLORATION +patología I-EXPLORATION +de I-EXPLORATION +base, I-EXPLORATION +tenía I-EXPLORATION +una I-EXPLORATION +carga I-EXPLORATION +viral I-EXPLORATION +para I-EXPLORATION +VIH I-EXPLORATION +(Nuclisens I-EXPLORATION +HIV-1 I-EXPLORATION +QT, I-EXPLORATION +Biomérieux) I-EXPLORATION +de I-EXPLORATION +130.000 I-EXPLORATION +copias I-EXPLORATION +ARN I-EXPLORATION +viral/ml I-EXPLORATION +y I-EXPLORATION +un I-EXPLORATION +recuento I-EXPLORATION +de I-EXPLORATION +linfocitos I-EXPLORATION +CD4 I-EXPLORATION +de I-EXPLORATION +83 I-EXPLORATION +céls/mm3. I-EXPLORATION +Los I-EXPLORATION +hemocultivos I-EXPLORATION +automatizados I-EXPLORATION +aeróbicos I-EXPLORATION +fueron I-EXPLORATION +negativos I-EXPLORATION +a I-EXPLORATION +los I-EXPLORATION +siete I-EXPLORATION +días I-EXPLORATION +de I-EXPLORATION +incubación, I-EXPLORATION +el I-EXPLORATION +cultivo I-EXPLORATION +de I-EXPLORATION +secreción I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +biopsia I-EXPLORATION +de I-EXPLORATION +lesión I-EXPLORATION +frontal I-EXPLORATION +también I-EXPLORATION +fue I-EXPLORATION +negativo I-EXPLORATION +para I-EXPLORATION +bacterias, I-EXPLORATION +lo I-EXPLORATION +mismo I-EXPLORATION +la I-EXPLORATION +baciloscopia I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +cultivo I-EXPLORATION +de I-EXPLORATION +micobacterias. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +imágenes I-EXPLORATION +realizado I-EXPLORATION +mostró: I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +tórax I-EXPLORATION +normal, I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION +sin I-EXPLORATION +hallazgos I-EXPLORATION +patológicos I-EXPLORATION +y I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +cráneo I-EXPLORATION +sin I-EXPLORATION +lesiones I-EXPLORATION +osteolíticas. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +envió I-EXPLORATION +una I-EXPLORATION +muestra I-EXPLORATION +de I-EXPLORATION +suero I-EXPLORATION +para I-EXPLORATION +la I-EXPLORATION +determinación I-EXPLORATION +de I-EXPLORATION +anticuerpos I-EXPLORATION +IgG I-EXPLORATION +para I-EXPLORATION +B. I-EXPLORATION +henselae I-EXPLORATION +y I-EXPLORATION +B. I-EXPLORATION +quintana I-EXPLORATION +por I-EXPLORATION +inmunofluorescencia I-EXPLORATION +(Focus®) I-EXPLORATION +al I-EXPLORATION +Laboratorio I-EXPLORATION +de I-EXPLORATION +Infectología I-EXPLORATION +y I-EXPLORATION +Virología I-EXPLORATION +Molecular I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +Pontificia I-EXPLORATION +Universidad I-EXPLORATION +Católica I-EXPLORATION +de I-EXPLORATION +Chile, I-EXPLORATION +que I-EXPLORATION +resultó I-EXPLORATION +con I-EXPLORATION +títulos I-EXPLORATION +> I-EXPLORATION +1/256 I-EXPLORATION +para I-EXPLORATION +B. I-EXPLORATION +henselae I-EXPLORATION +y I-EXPLORATION +> I-EXPLORATION +1: I-EXPLORATION +64 I-EXPLORATION +para I-EXPLORATION +B. I-EXPLORATION +quintana. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +le I-EXPLORATION +efectuó I-EXPLORATION +biopsia I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +lesión I-EXPLORATION +cutánea I-EXPLORATION +frontal I-EXPLORATION +cuyo I-EXPLORATION +informe I-EXPLORATION +indicó: I-EXPLORATION +piel I-EXPLORATION +ulcerada I-EXPLORATION +por I-EXPLORATION +epitelio I-EXPLORATION +escamoso I-EXPLORATION +maduro, I-EXPLORATION +proliferación I-EXPLORATION +lobulillar I-EXPLORATION +de I-EXPLORATION +vasos I-EXPLORATION +de I-EXPLORATION +pequeño I-EXPLORATION +calibre, I-EXPLORATION +abundantes I-EXPLORATION +polimorfos I-EXPLORATION +nucleares I-EXPLORATION +intersticiales, I-EXPLORATION +algunos I-EXPLORATION +con I-EXPLORATION +cariorrexis. I-EXPLORATION +La I-EXPLORATION +tinción I-EXPLORATION +de I-EXPLORATION +Warthin I-EXPLORATION +Starry I-EXPLORATION +demostró I-EXPLORATION +estructuras I-EXPLORATION +cocobacilares I-EXPLORATION +en I-EXPLORATION +acúmulos I-EXPLORATION +sugerentes I-EXPLORATION +de I-EXPLORATION +Bartonella I-EXPLORATION +sp. I-EXPLORATION + I-EXPLORATION +Dada B-TREATMENT +la I-TREATMENT +alta I-TREATMENT +sospecha I-TREATMENT +clínica, I-TREATMENT +después I-TREATMENT +de I-TREATMENT +tomar I-TREATMENT +cultivos I-TREATMENT +y I-TREATMENT +biopsia, I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +azitromicina I-TREATMENT +500 I-TREATMENT +mg/d I-TREATMENT +v.o. I-TREATMENT +más I-TREATMENT +ciprofloxacina I-TREATMENT +500 I-TREATMENT +mg I-TREATMENT +c/12 I-TREATMENT +hs I-TREATMENT +v.o. I-TREATMENT +Se I-TREATMENT +realizó I-TREATMENT +una I-TREATMENT +cirugía I-TREATMENT +de I-TREATMENT +resección I-TREATMENT +de I-TREATMENT +las I-TREATMENT +lesiones I-TREATMENT +exofiticas I-TREATMENT +conjuntivales I-TREATMENT +bilaterales, I-TREATMENT +las B-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +enviaron I-EXPLORATION +a I-EXPLORATION +estudio I-EXPLORATION +histológico I-EXPLORATION +que I-EXPLORATION +concluyó: I-EXPLORATION +tejido I-EXPLORATION +conectivo I-EXPLORATION +con I-EXPLORATION +epitelio I-EXPLORATION +escamoso I-EXPLORATION +y I-EXPLORATION +cilíndrico I-EXPLORATION +hiperplásico, I-EXPLORATION +proceso I-EXPLORATION +inflamatorio I-EXPLORATION +agudo I-EXPLORATION +y I-EXPLORATION +crónico, I-EXPLORATION +abundantes I-EXPLORATION +vasos I-EXPLORATION +de I-EXPLORATION +neoformación, I-EXPLORATION +material I-EXPLORATION +amorfo I-EXPLORATION +intersticial. I-EXPLORATION +La I-EXPLORATION +tinción I-EXPLORATION +de I-EXPLORATION +Warthin I-EXPLORATION +Starry I-EXPLORATION +demostró I-EXPLORATION +estructuras I-EXPLORATION +sugerentes I-EXPLORATION +de I-EXPLORATION +Bartonella I-EXPLORATION +spp, I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +angiomatosis I-EXPLORATION +bacilar. I-EXPLORATION + I-EXPLORATION +Para I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +molecular I-EXPLORATION +se I-EXPLORATION +efectuó I-EXPLORATION +una I-EXPLORATION +biopsia I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +nódulo I-EXPLORATION +violáceo I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +región I-EXPLORATION +abdominal I-EXPLORATION +anterior I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +envió I-EXPLORATION +al I-EXPLORATION +Laboratorio I-EXPLORATION +de I-EXPLORATION +Biología I-EXPLORATION +Molecular I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +Pontificia I-EXPLORATION +Universidad I-EXPLORATION +Católica I-EXPLORATION +de I-EXPLORATION +Chile. I-EXPLORATION +La I-EXPLORATION +extracción I-EXPLORATION +del I-EXPLORATION +ADN I-EXPLORATION +del I-EXPLORATION +tejido I-EXPLORATION +subcutáneo I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +utilizando I-EXPLORATION +un I-EXPLORATION +método I-EXPLORATION +comercial I-EXPLORATION +(QIAamp I-EXPLORATION +Tissue I-EXPLORATION +kit, I-EXPLORATION +Qiagen®), I-EXPLORATION +según I-EXPLORATION +las I-EXPLORATION +recomendaciones I-EXPLORATION +del I-EXPLORATION +fabricante. I-EXPLORATION +La I-EXPLORATION +amplificación I-EXPLORATION +del I-EXPLORATION +gen I-EXPLORATION +que I-EXPLORATION +codifica I-EXPLORATION +para I-EXPLORATION +el I-EXPLORATION +16S I-EXPLORATION +ARNr I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +con I-EXPLORATION +partidores I-EXPLORATION +universales15. I-EXPLORATION +Posteriormente, I-EXPLORATION +se I-EXPLORATION +secuenció I-EXPLORATION +el I-EXPLORATION +producto I-EXPLORATION +amplificado I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +evaluó I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +analizador I-EXPLORATION +genético I-EXPLORATION +ABI I-EXPLORATION +310. I-EXPLORATION +Para I-EXPLORATION +la I-EXPLORATION +comparación I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +secuencia I-EXPLORATION +nucleotídica I-EXPLORATION +obtenida I-EXPLORATION +con I-EXPLORATION +las I-EXPLORATION +secuencias I-EXPLORATION +depositadas I-EXPLORATION +en I-EXPLORATION +banco I-EXPLORATION +de I-EXPLORATION +genes I-EXPLORATION +Genebank, I-EXPLORATION +se I-EXPLORATION +utilizó I-EXPLORATION +al I-EXPLORATION +programa I-EXPLORATION +BLAST. I-EXPLORATION +Se I-EXPLORATION +encontró I-EXPLORATION +una I-EXPLORATION +homología I-EXPLORATION +de I-EXPLORATION +100% I-EXPLORATION +sobre I-EXPLORATION +418 I-EXPLORATION +pares I-EXPLORATION +de I-EXPLORATION +bases I-EXPLORATION +depositadas I-EXPLORATION +con I-EXPLORATION +la I-EXPLORATION +especie I-EXPLORATION +B. I-EXPLORATION +quintana I-EXPLORATION +subespecie I-EXPLORATION +Toulouse, I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +confirmó, I-EXPLORATION +posteriormente, I-EXPLORATION +por I-EXPLORATION +amplificación I-EXPLORATION +y I-EXPLORATION +secuenciación I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +segmentos I-EXPLORATION +ITS I-EXPLORATION +y I-EXPLORATION +336, I-EXPLORATION +que I-EXPLORATION +son I-EXPLORATION +específicos I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +de I-EXPLORATION +género I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +especie, I-EXPLORATION +respectivamente. I-EXPLORATION + I-EXPLORATION +Previo B-TREATMENT +al I-TREATMENT +alta, I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +terapia I-TREATMENT +antiretroviral I-TREATMENT +con I-TREATMENT +zidovudina, I-TREATMENT +lamivudina I-TREATMENT y I-TREATMENT -ceden I-TREATMENT -parcialmente I-TREATMENT -la I-TREATMENT -angustia I-TREATMENT +efavirenz I-TREATMENT +con I-TREATMENT +diagnóstico I-TREATMENT +de I-TREATMENT +infección I-TREATMENT +por I-TREATMENT +VIH I-TREATMENT +en I-TREATMENT +etapa I-TREATMENT +B-3 I-TREATMENT y I-TREATMENT -la I-TREATMENT -ideación I-TREATMENT -autolítica, I-TREATMENT -persistendo B-EVOLUTION -los I-EVOLUTION -episodios I-EVOLUTION +angiomatosis I-TREATMENT +bacilar I-TREATMENT +por I-TREATMENT +B. I-TREATMENT +quintana. I-TREATMENT +La B-EVOLUTION +evolución I-EVOLUTION +posterior I-EVOLUTION +al I-EVOLUTION +inicio I-EVOLUTION de I-EVOLUTION -amnesia I-EVOLUTION +la I-EVOLUTION +antibioterapia I-EVOLUTION +ha I-EVOLUTION +sido I-EVOLUTION +satisfactoria, I-EVOLUTION +con I-EVOLUTION +regresión I-EVOLUTION +del I-EVOLUTION +compromiso I-EVOLUTION +cutáneo I-EVOLUTION y I-EVOLUTION -cefaleas. I-EVOLUTION +mucoso I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +cuatro I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +tratamiento. I-EVOLUTION I-EVOLUTION -La B-DERIVED_FROM/TO -importante I-DERIVED_FROM/TO -desestructuración I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -sufría I-DERIVED_FROM/TO + +Paciente B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +44 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +remitida B-DERIVED_FROM/TO +por I-DERIVED_FROM/TO el I-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -todos I-DERIVED_FROM/TO -los I-DERIVED_FROM/TO -ámbitos I-DERIVED_FROM/TO -vitales I-DERIVED_FROM/TO -motiva I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -derivación I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -unidad I-DERIVED_FROM/TO +médico I-DERIVED_FROM/TO de I-DERIVED_FROM/TO -rehabilitación I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -centro, I-DERIVED_FROM/TO -donde I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -procede I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -revisar I-DERIVED_FROM/TO -toda I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -historia I-DERIVED_FROM/TO +cabecera I-DERIVED_FROM/TO al I-DERIVED_FROM/TO -considerar I-DERIVED_FROM/TO +Servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Cirugía I-DERIVED_FROM/TO +Oral I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +Maxilofacial I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +presentar I-DERIVED_FROM/TO +una I-DERIVED_FROM/TO +tumoración I-DERIVED_FROM/TO +parotídea, I-DERIVED_FROM/TO que I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -diagnóstico I-DERIVED_FROM/TO -hasta I-DERIVED_FROM/TO -ese I-DERIVED_FROM/TO -momento I-DERIVED_FROM/TO -era I-DERIVED_FROM/TO -impreciso. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -Constatamos B-FAMILY_HISTORY -que I-FAMILY_HISTORY -no I-FAMILY_HISTORY -existían I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -de I-FAMILY_HISTORY -enfermedades I-FAMILY_HISTORY -psiquiátricas I-FAMILY_HISTORY -o I-FAMILY_HISTORY -neurológicas. I-FAMILY_HISTORY -El B-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -es I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -quinto I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -fratria I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -seis I-PAST_MEDICAL_HISTORY -hermanos, I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -embarazo, I-PAST_MEDICAL_HISTORY -parto I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -desarrollo I-PAST_MEDICAL_HISTORY -madurativo I-PAST_MEDICAL_HISTORY -fueron I-PAST_MEDICAL_HISTORY -normales. I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -escolarizó I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -4 I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -describe I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -infancia I-PAST_MEDICAL_HISTORY -"feliz I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -normal", I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -buena I-PAST_MEDICAL_HISTORY -rendimiento I-PAST_MEDICAL_HISTORY -académico I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -funcionamiento I-PAST_MEDICAL_HISTORY -social. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -El B-EXPLORATION -paciente I-EXPLORATION -describe I-EXPLORATION +a I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +palpación I-DERIVED_FROM/TO +parecía I-DERIVED_FROM/TO +constar I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +un I-DERIVED_FROM/TO +único I-DERIVED_FROM/TO +nódulo. I-DERIVED_FROM/TO +Con B-EXPLORATION +la I-EXPLORATION +sospecha I-EXPLORATION +de I-EXPLORATION +tumoración I-EXPLORATION +benigna I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +punción I-EXPLORATION +aspiración I-EXPLORATION +con I-EXPLORATION +aguja I-EXPLORATION +fina I-EXPLORATION +de I-EXPLORATION +23-G I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +Servicio I-EXPLORATION +de I-EXPLORATION +Anatomía I-EXPLORATION +Patológica, I-EXPLORATION +fijando I-EXPLORATION +el I-EXPLORATION +material I-EXPLORATION +obtenido, I-EXPLORATION +de I-EXPLORATION +manera I-EXPLORATION +inmediata, I-EXPLORATION +en I-EXPLORATION +alcohol I-EXPLORATION +de I-EXPLORATION +95% I-EXPLORATION +y I-EXPLORATION +reservando I-EXPLORATION +uno I-EXPLORATION +de I-EXPLORATION los I-EXPLORATION -episodios I-EXPLORATION -amnésicos I-EXPLORATION -como I-EXPLORATION -momentos I-EXPLORATION +aspirados I-EXPLORATION +para I-EXPLORATION +secado I-EXPLORATION +al I-EXPLORATION +aire. I-EXPLORATION +Las I-EXPLORATION +muestras I-EXPLORATION +fijadas I-EXPLORATION +en I-EXPLORATION +alcohol I-EXPLORATION +se I-EXPLORATION +tiñeron I-EXPLORATION +siguiendo I-EXPLORATION +la I-EXPLORATION +técnica I-EXPLORATION de I-EXPLORATION -"pérdida I-EXPLORATION +Papanicolaou, I-EXPLORATION +mientras I-EXPLORATION +que I-EXPLORATION +los I-EXPLORATION +secados I-EXPLORATION +al I-EXPLORATION +aire I-EXPLORATION +se I-EXPLORATION +colorean I-EXPLORATION +con I-EXPLORATION +la I-EXPLORATION +técnica I-EXPLORATION de I-EXPLORATION -consciencia" I-EXPLORATION +Diff- I-EXPLORATION +Quick. I-EXPLORATION + I-EXPLORATION +Citológicamente I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +compuesta I-EXPLORATION de I-EXPLORATION -minutos I-EXPLORATION +células I-EXPLORATION +epiteliales I-EXPLORATION +y I-EXPLORATION +ductales I-EXPLORATION +sobre I-EXPLORATION +un I-EXPLORATION +fondo I-EXPLORATION +basofílico I-EXPLORATION +fibrilar I-EXPLORATION +y I-EXPLORATION +mixomatoso, I-EXPLORATION +además I-EXPLORATION +se I-EXPLORATION +aprecia I-EXPLORATION +un I-EXPLORATION +material I-EXPLORATION +condroide I-EXPLORATION +y I-EXPLORATION +fragmentos I-EXPLORATION de I-EXPLORATION -duración I-EXPLORATION -sin I-EXPLORATION +estroma I-EXPLORATION +eosinófilo I-EXPLORATION +fibrilar. I-EXPLORATION +El B-TREATMENT +diagnóstico I-TREATMENT +citológico I-TREATMENT +fue I-TREATMENT +de I-TREATMENT +adenoma I-TREATMENT +pleomorfo I-TREATMENT +(AP) I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +parotidectomía I-TREATMENT +total I-TREATMENT +con I-TREATMENT +preservación I-TREATMENT +del I-TREATMENT +nervio I-TREATMENT +facial. I-TREATMENT + I-TREATMENT +La B-EXPLORATION +pieza I-EXPLORATION +quirúrgica I-EXPLORATION +se I-EXPLORATION +incluyó I-EXPLORATION +en I-EXPLORATION +formaldehído I-EXPLORATION +al I-EXPLORATION +10% I-EXPLORATION +observando I-EXPLORATION +macroscópicamente I-EXPLORATION un I-EXPLORATION -desencadenante I-EXPLORATION -identificado, I-EXPLORATION -con I-EXPLORATION -cefalea I-EXPLORATION +tumor I-EXPLORATION +de I-EXPLORATION +2x2 I-EXPLORATION +cm, I-EXPLORATION +de I-EXPLORATION +consistencia I-EXPLORATION +blando-elástica I-EXPLORATION y I-EXPLORATION -estado I-EXPLORATION +coloración I-EXPLORATION +blanquecina, I-EXPLORATION +parcialmente I-EXPLORATION +encapsulado, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +nodular I-EXPLORATION +polilobulada I-EXPLORATION de I-EXPLORATION -ensoñación I-EXPLORATION -posterior. I-EXPLORATION -Hay I-EXPLORATION -amnesia I-EXPLORATION +1, I-EXPLORATION +5 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +apariencia I-EXPLORATION +linfoide, I-EXPLORATION +separada I-EXPLORATION del I-EXPLORATION -episodio. I-EXPLORATION -La I-EXPLORATION -frecuencia I-EXPLORATION -inicialmente I-EXPLORATION -es I-EXPLORATION -mensual I-EXPLORATION -o I-EXPLORATION -semanal, I-EXPLORATION -pero I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -tiempo I-EXPLORATION -llega I-EXPLORATION -a I-EXPLORATION -ser I-EXPLORATION -diaria. I-EXPLORATION -Verbaliza I-EXPLORATION -fallos I-EXPLORATION -en I-EXPLORATION +tumor I-EXPLORATION +principal I-EXPLORATION +por I-EXPLORATION +un I-EXPLORATION +fino I-EXPLORATION +cordón I-EXPLORATION +estromal. I-EXPLORATION +Tras I-EXPLORATION la I-EXPLORATION -memoria I-EXPLORATION -autobiográfica, I-EXPLORATION -incluyendo I-EXPLORATION -hechos I-EXPLORATION -concretos I-EXPLORATION -e I-EXPLORATION -importantes I-EXPLORATION -en I-EXPLORATION +fijación I-EXPLORATION +se I-EXPLORATION +secciona I-EXPLORATION la I-EXPLORATION -crianza I-EXPLORATION +pieza I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +totalidad I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +procesa I-EXPLORATION de I-EXPLORATION -sus I-EXPLORATION -hijos, I-EXPLORATION +manera I-EXPLORATION +rutinaria I-EXPLORATION +para I-EXPLORATION +obtener I-EXPLORATION +los I-EXPLORATION +bloques I-EXPLORATION de I-EXPLORATION +parafina. I-EXPLORATION +La I-EXPLORATION +tinción I-EXPLORATION +empleada I-EXPLORATION +para I-EXPLORATION la I-EXPLORATION -relación I-EXPLORATION -conyugal I-EXPLORATION +observación I-EXPLORATION +microscópica I-EXPLORATION +es I-EXPLORATION +hematoxilina-eosina I-EXPLORATION +clásica. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +microscópico I-EXPLORATION +muestra I-EXPLORATION +un I-EXPLORATION +tumor I-EXPLORATION +principal I-EXPLORATION +bien I-EXPLORATION +circunscrito, I-EXPLORATION +rodeado I-EXPLORATION +por I-EXPLORATION +una I-EXPLORATION +pseudocápsula I-EXPLORATION +conectiva, I-EXPLORATION +compuesto I-EXPLORATION +por I-EXPLORATION +una I-EXPLORATION +población I-EXPLORATION +celular I-EXPLORATION +bifásica I-EXPLORATION +de I-EXPLORATION +epitelio I-EXPLORATION +glandular I-EXPLORATION y I-EXPLORATION -otros I-EXPLORATION -eventos, I-EXPLORATION +células I-EXPLORATION +mioepiteliales I-EXPLORATION +rodeadas I-EXPLORATION +por I-EXPLORATION +un I-EXPLORATION +material I-EXPLORATION +fibrilar I-EXPLORATION +mixoide, I-EXPLORATION +por I-EXPLORATION lo I-EXPLORATION -cual I-EXPLORATION -es I-EXPLORATION -motivo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +confirma I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION de I-EXPLORATION -alarma I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -familia. I-EXPLORATION -Ésta I-EXPLORATION -constata I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION +adenoma I-EXPLORATION +pleomorfo. I-EXPLORATION +Los I-EXPLORATION +otros I-EXPLORATION +nódulos I-EXPLORATION +eran I-EXPLORATION +ganglios I-EXPLORATION +linfáticos, I-EXPLORATION +pero I-EXPLORATION +apareció I-EXPLORATION +una I-EXPLORATION +nueva I-EXPLORATION +lesión, I-EXPLORATION +de I-EXPLORATION +pequeña I-EXPLORATION +talla, I-EXPLORATION +muy I-EXPLORATION +cercana I-EXPLORATION +al I-EXPLORATION +tumor I-EXPLORATION +mixto, I-EXPLORATION de I-EXPLORATION +apariencia I-EXPLORATION +quística I-EXPLORATION +y I-EXPLORATION +papilar, I-EXPLORATION +constituida I-EXPLORATION +por I-EXPLORATION una I-EXPLORATION -amnesia I-EXPLORATION -episódica I-EXPLORATION -recurrente. I-EXPLORATION -Según I-EXPLORATION -ellos I-EXPLORATION -en I-EXPLORATION +doble I-EXPLORATION +hilera I-EXPLORATION +de I-EXPLORATION +células I-EXPLORATION +oncocíticas I-EXPLORATION +rodeando I-EXPLORATION los I-EXPLORATION -episodios I-EXPLORATION -puede I-EXPLORATION -haber I-EXPLORATION -momentos I-EXPLORATION +espacios I-EXPLORATION +quísticos I-EXPLORATION +con I-EXPLORATION +estroma I-EXPLORATION +linfoide I-EXPLORATION +adyacente. I-EXPLORATION +El I-EXPLORATION +diagnóstico I-EXPLORATION +histopatológico I-EXPLORATION +definitivo I-EXPLORATION +fue I-EXPLORATION +de I-EXPLORATION +adenoma I-EXPLORATION +pleomorfo I-EXPLORATION +y I-EXPLORATION +tumor I-EXPLORATION +de I-EXPLORATION +Warthin I-EXPLORATION +sincrónicos I-EXPLORATION +de I-EXPLORATION +parótida I-EXPLORATION +derecha. I-EXPLORATION + I-EXPLORATION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +74 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +hábitos I-PAST_MEDICAL_HISTORY +tóxicos, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +tiroidectomía I-PAST_MEDICAL_HISTORY +total I-PAST_MEDICAL_HISTORY +más I-PAST_MEDICAL_HISTORY +linfadenectomía I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +carcinoma I-PAST_MEDICAL_HISTORY +papilar I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +tiroides I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +levotiroxina I-PAST_MEDICAL_HISTORY +sódica I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +hipercolesterolemia I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +pravastatina. I-PAST_MEDICAL_HISTORY +La B-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +consultó I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +tos I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +expectoración I-PRESENT_ILLNESS +blanquecina, I-PRESENT_ILLNESS +fiebre, I-PRESENT_ILLNESS +sudoración I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +disnea. I-PRESENT_ILLNESS +Inicialmente B-TREATMENT +fue I-TREATMENT +tratada I-TREATMENT +con I-TREATMENT +dos I-TREATMENT +ciclos I-TREATMENT +de I-TREATMENT +antibióticos I-TREATMENT +con I-TREATMENT +mejoría I-TREATMENT +de I-TREATMENT +la I-TREATMENT +fiebre. I-TREATMENT +Posteriormente B-PRESENT_ILLNESS +comenzó I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +expectoración I-PRESENT_ILLNESS +hemoptoica, I-PRESENT_ILLNESS +autolimitada I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +siguientes. I-PRESENT_ILLNESS +No I-PRESENT_ILLNESS +refería I-PRESENT_ILLNESS +síndrome I-PRESENT_ILLNESS +general. I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +destacaba I-EXPLORATION +un I-EXPLORATION +índice I-EXPLORATION de I-EXPLORATION -estupor, I-EXPLORATION -a I-EXPLORATION -menudo I-EXPLORATION +masa I-EXPLORATION +corporal I-EXPLORATION +(IMC) I-EXPLORATION +de I-EXPLORATION +38, I-EXPLORATION +67 I-EXPLORATION +compatible I-EXPLORATION con I-EXPLORATION -automatismos I-EXPLORATION -motores I-EXPLORATION -masticatorios, I-EXPLORATION -pero I-EXPLORATION +obesidad I-EXPLORATION +grado I-EXPLORATION +2 I-EXPLORATION +y I-EXPLORATION +roncus I-EXPLORATION +espiratorios I-EXPLORATION +bilaterales. I-EXPLORATION +La I-EXPLORATION +analítica I-EXPLORATION no I-EXPLORATION -aprecian I-EXPLORATION -pérdida I-EXPLORATION -de I-EXPLORATION -consciencia I-EXPLORATION +mostró I-EXPLORATION +alteraciones I-EXPLORATION y I-EXPLORATION el I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION +Mantoux I-EXPLORATION +fue I-EXPLORATION +negativo. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION las I-EXPLORATION -funciones I-EXPLORATION -cognitivas I-EXPLORATION -parecen I-EXPLORATION -normales. I-EXPLORATION -Confirman I-EXPLORATION -la I-EXPLORATION -pérdida I-EXPLORATION +pruebas I-EXPLORATION de I-EXPLORATION -memoria I-EXPLORATION +función I-EXPLORATION +pulmonar I-EXPLORATION +se I-EXPLORATION +objetivó I-EXPLORATION +una I-EXPLORATION +obstrucción I-EXPLORATION +muy I-EXPLORATION +leve I-EXPLORATION +al I-EXPLORATION +flujo I-EXPLORATION +aéreo I-EXPLORATION +(capacidad I-EXPLORATION +vital I-EXPLORATION +forzada I-EXPLORATION +[CVF] I-EXPLORATION +2.570 I-EXPLORATION +cc I-EXPLORATION +(110% I-EXPLORATION +del I-EXPLORATION +valor I-EXPLORATION +teórico); I-EXPLORATION +volumen I-EXPLORATION +espirado I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +primer I-EXPLORATION +segundo I-EXPLORATION +[VEF1] I-EXPLORATION +1.730 I-EXPLORATION +cc I-EXPLORATION +(92,7%); I-EXPLORATION +FEV1/FVC I-EXPLORATION +67%; I-EXPLORATION +test I-EXPLORATION +broncodilatador I-EXPLORATION +negativo). I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +radiografía I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -episodios I-EXPLORATION -y I-EXPLORATION +tórax I-EXPLORATION +puso I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -datos I-EXPLORATION -autobiográficos I-EXPLORATION -previos, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -la I-EXPLORATION -dificultad I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -retención I-EXPLORATION +manifiesto I-EXPLORATION +un I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION -recuerdos I-EXPLORATION -generados I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -días I-EXPLORATION -y I-EXPLORATION -semanas I-EXPLORATION -posteriores I-EXPLORATION -(por I-EXPLORATION -ejemplo, I-EXPLORATION -durante I-EXPLORATION -los I-EXPLORATION -ingresos). I-EXPLORATION - I-EXPLORATION -A I-EXPLORATION +densidad I-EXPLORATION +a I-EXPLORATION nivel I-EXPLORATION -psicopatológico I-EXPLORATION -solo I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -clínica I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -episodio I-EXPLORATION -depresivo I-EXPLORATION -mayor, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -interpreta I-EXPLORATION -como I-EXPLORATION -secundario I-EXPLORATION -al I-EXPLORATION -grave I-EXPLORATION -y I-EXPLORATION -progresivo I-EXPLORATION -deterioro. I-EXPLORATION - I-EXPLORATION +del I-EXPLORATION +lóbulo I-EXPLORATION +inferior I-EXPLORATION +derecho I-EXPLORATION +(LID). I-EXPLORATION La I-EXPLORATION -evaluación I-EXPLORATION -neuropsicológica I-EXPLORATION -indica I-EXPLORATION -dificultades I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -memoria I-EXPLORATION -prospectiva, I-EXPLORATION +tomografía I-EXPLORATION +computarizada I-EXPLORATION +(TC) I-EXPLORATION +de I-EXPLORATION +tórax I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +atelectasia I-EXPLORATION sin I-EXPLORATION -problemas I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -memorias I-EXPLORATION -inmediata I-EXPLORATION +broncograma I-EXPLORATION +aéreo I-EXPLORATION +del I-EXPLORATION +segmento I-EXPLORATION +anterior I-EXPLORATION +del I-EXPLORATION +LID I-EXPLORATION y I-EXPLORATION +dilatación I-EXPLORATION +proximal I-EXPLORATION +del I-EXPLORATION +bronquio I-EXPLORATION de I-EXPLORATION -trabajo. I-EXPLORATION -Tiene I-EXPLORATION -dificultades I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -memoria I-EXPLORATION -a I-EXPLORATION -largo I-EXPLORATION -plazo I-EXPLORATION -visual I-EXPLORATION -y I-EXPLORATION -verbal, I-EXPLORATION -y I-EXPLORATION -dificultades I-EXPLORATION -para I-EXPLORATION -recuperar I-EXPLORATION -información I-EXPLORATION +dicho I-EXPLORATION +segmento, I-EXPLORATION +ocupado I-EXPLORATION +por I-EXPLORATION +material I-EXPLORATION +hipodenso I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +densidad I-EXPLORATION +grasa I-EXPLORATION de I-EXPLORATION -episodios I-EXPLORATION -pasados. I-EXPLORATION -No I-EXPLORATION -hay I-EXPLORATION -un I-EXPLORATION -deterioro I-EXPLORATION -cognitivo I-EXPLORATION -global I-EXPLORATION -(están I-EXPLORATION -preservados I-EXPLORATION +aspecto I-EXPLORATION +nodular, I-EXPLORATION +de I-EXPLORATION +1, I-EXPLORATION +6 I-EXPLORATION +cm.. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +fibrobroncoscopia I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +polipoide I-EXPLORATION +de I-EXPLORATION +superficie I-EXPLORATION +lisa I-EXPLORATION +que I-EXPLORATION +obstruía I-EXPLORATION +por I-EXPLORATION +completo I-EXPLORATION el I-EXPLORATION -lenguaje, I-EXPLORATION -las I-EXPLORATION -gnosias I-EXPLORATION -y I-EXPLORATION -las I-EXPLORATION -praxias). I-EXPLORATION -Destaca I-EXPLORATION +bronquio I-EXPLORATION +basal I-EXPLORATION +anterior I-EXPLORATION +del I-EXPLORATION +LID. I-EXPLORATION +La I-EXPLORATION +biopsia I-EXPLORATION +bronquial I-EXPLORATION +mostró I-EXPLORATION una I-EXPLORATION -marcada I-EXPLORATION -lentitud I-EXPLORATION -generalizada, I-EXPLORATION -en I-EXPLORATION -tareas I-EXPLORATION +proliferación I-EXPLORATION +bronquial I-EXPLORATION +de I-EXPLORATION +tejido I-EXPLORATION +adiposo I-EXPLORATION +maduro I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +lipoma I-EXPLORATION +endobronquial. I-EXPLORATION + I-EXPLORATION +Con B-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT +de I-TREATMENT +lipoma I-TREATMENT +endobronquial I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +tratamiento I-TREATMENT +endoscópico I-TREATMENT +mediante I-TREATMENT +resección I-TREATMENT +láser. I-TREATMENT +Se I-TREATMENT +procedió I-TREATMENT +a I-TREATMENT +fotocoagulación I-TREATMENT +superficial I-TREATMENT +con I-TREATMENT +láser I-TREATMENT +de I-TREATMENT +la I-TREATMENT +lesión. I-TREATMENT +Se I-TREATMENT +realizó I-TREATMENT +un I-TREATMENT +intento I-TREATMENT +infructuoso I-TREATMENT +de I-TREATMENT +extracción I-TREATMENT +con I-TREATMENT +asa I-TREATMENT +de I-TREATMENT +diatermia I-TREATMENT +por I-TREATMENT +dificultad I-TREATMENT +para I-TREATMENT +ver I-TREATMENT +la I-TREATMENT +parte I-TREATMENT +distal I-TREATMENT +de I-TREATMENT +la I-TREATMENT +lesión, I-TREATMENT +extrayéndose I-TREATMENT +sólo I-TREATMENT +una I-TREATMENT +parte I-TREATMENT +de I-TREATMENT +la I-TREATMENT +lesión, I-TREATMENT +que I-TREATMENT +se I-TREATMENT +envió I-TREATMENT +para I-TREATMENT +análisis I-TREATMENT +anatomopatológico, I-TREATMENT +quedando I-TREATMENT +el I-TREATMENT +resto I-TREATMENT +de I-TREATMENT +la I-TREATMENT +tumoración I-TREATMENT +fotocoagulada I-TREATMENT +de I-TREATMENT +forma I-TREATMENT +superficial. I-TREATMENT +Un B-EVOLUTION +mes I-EVOLUTION +después, I-EVOLUTION +se I-EVOLUTION +realizó I-EVOLUTION +un I-EVOLUTION +segundo I-EVOLUTION +procedimiento, I-EVOLUTION +siendo I-EVOLUTION +extraído I-EVOLUTION +todo I-EVOLUTION +el I-EVOLUTION +material I-EVOLUTION +restante. I-EVOLUTION +No I-EVOLUTION +se I-EVOLUTION +objetivaron I-EVOLUTION +complicaciones I-EVOLUTION +tras I-EVOLUTION +los I-EVOLUTION +procedimientos. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +36 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +patológicos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +madre I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +hijo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +5 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +edad, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +valorar I-PRESENT_ILLNESS +aumento I-PRESENT_ILLNESS +mamario I-PRESENT_ILLNESS +bilateral. I-PRESENT_ILLNESS +Presenta B-EXPLORATION +atrofia I-EXPLORATION +mamaria I-EXPLORATION +moderada I-EXPLORATION con I-EXPLORATION +ptosis I-EXPLORATION +muy I-EXPLORATION +leve. I-EXPLORATION +La I-EXPLORATION +piel I-EXPLORATION +es I-EXPLORATION +de I-EXPLORATION +buena I-EXPLORATION +calidad, I-EXPLORATION +hidratada I-EXPLORATION y I-EXPLORATION sin I-EXPLORATION -componente I-EXPLORATION -motor, I-EXPLORATION -que I-EXPLORATION -podría I-EXPLORATION -explicarse I-EXPLORATION -por I-EXPLORATION -su I-EXPLORATION -cuadro I-EXPLORATION -afectivo. I-EXPLORATION -Aun I-EXPLORATION -así, I-EXPLORATION -las I-EXPLORATION -dificultades I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -memoria I-EXPLORATION -a I-EXPLORATION -largo I-EXPLORATION -plazo I-EXPLORATION -no I-EXPLORATION +estrías. I-EXPLORATION +No I-EXPLORATION se I-EXPLORATION -explican I-EXPLORATION -por I-EXPLORATION -causas I-EXPLORATION -motivacionales, I-EXPLORATION -ya I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION +palpan I-EXPLORATION +nódulos I-EXPLORATION +mamarios I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION paciente I-EXPLORATION -se I-EXPLORATION -esforzó I-EXPLORATION -en I-EXPLORATION -realizar I-EXPLORATION -las I-EXPLORATION -pruebas. I-EXPLORATION -La I-EXPLORATION -conclusión I-EXPLORATION -es I-EXPLORATION -que I-EXPLORATION -estos I-EXPLORATION -hallazgos I-EXPLORATION no I-EXPLORATION -se I-EXPLORATION -explican I-EXPLORATION -solo I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION +refiere I-EXPLORATION +ningún I-EXPLORATION +antecedente I-EXPLORATION +patológico I-EXPLORATION +mamario I-EXPLORATION de I-EXPLORATION -problemas I-EXPLORATION -psiquiátricos. I-EXPLORATION - I-EXPLORATION +relevancia. I-EXPLORATION En I-EXPLORATION -base I-EXPLORATION -a I-EXPLORATION -todo I-EXPLORATION -lo I-EXPLORATION -expuesto I-EXPLORATION +las I-EXPLORATION +mamografías I-EXPLORATION +recientes I-EXPLORATION +no I-EXPLORATION se I-EXPLORATION -plantea I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -amnesia I-EXPLORATION -epiléptica I-EXPLORATION -transitoria, I-EXPLORATION -ya I-EXPLORATION -que I-EXPLORATION -consideramos I-EXPLORATION -cumplidos I-EXPLORATION -los I-EXPLORATION -criterios I-EXPLORATION -diagnósticos I-EXPLORATION -definidos I-EXPLORATION -para I-EXPLORATION -dicha I-EXPLORATION -dicha I-EXPLORATION -entidad. I-EXPLORATION +detectó I-EXPLORATION +ninguna I-EXPLORATION +patología. I-EXPLORATION I-EXPLORATION -Como B-TREATMENT -medida I-TREATMENT -farmacológica I-TREATMENT -inicial, I-TREATMENT +Tras B-TREATMENT +la I-TREATMENT +consulta I-TREATMENT y I-TREATMENT -de I-TREATMENT -cara I-TREATMENT +exploración I-TREATMENT +clínica I-TREATMENT +se I-TREATMENT +decide I-TREATMENT +llevar I-TREATMENT a I-TREATMENT -descartar I-TREATMENT -un I-TREATMENT -origen I-TREATMENT -funcional I-TREATMENT +cabo I-TREATMENT +una I-TREATMENT +cirugía I-TREATMENT de I-TREATMENT -la I-TREATMENT -clínica, I-TREATMENT -se I-TREATMENT -retira I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -antipsicótico. I-TREATMENT -Se I-TREATMENT -pauta I-TREATMENT -tratamiento I-TREATMENT -antidepresivo I-TREATMENT +aumento I-TREATMENT +mamario I-TREATMENT +bilateral I-TREATMENT +por I-TREATMENT +vía I-TREATMENT +periareolar I-TREATMENT +inferior, I-TREATMENT con I-TREATMENT -venlafaxina I-TREATMENT -(225 I-TREATMENT -mg/día), I-TREATMENT -mirtazapina I-TREATMENT -(30 I-TREATMENT -mg/día) I-TREATMENT -y I-TREATMENT -aripiprazol I-TREATMENT -(como I-TREATMENT -potenciador I-TREATMENT -antidepresivo, I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT +disección I-TREATMENT de I-TREATMENT -5 I-TREATMENT -mg/día), I-TREATMENT -y B-EVOLUTION -mejora I-EVOLUTION -significativamente I-EVOLUTION -la I-EVOLUTION -clínica I-EVOLUTION -afectiva I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -primeros I-EVOLUTION -meses. I-EVOLUTION -Como B-TREATMENT -persistían I-TREATMENT -los I-TREATMENT -paroxismos I-TREATMENT -amnésicos I-TREATMENT -tras I-TREATMENT -la I-TREATMENT -resolución I-TREATMENT -del I-TREATMENT -cuadro I-TREATMENT -afectivo, I-TREATMENT +bolsillo I-TREATMENT +subpectoral I-TREATMENT y I-TREATMENT -con I-TREATMENT -la I-TREATMENT -sospecha I-TREATMENT +colocación I-TREATMENT de I-TREATMENT -un I-TREATMENT -cuadro I-TREATMENT +prótesis I-TREATMENT +anatómicas I-TREATMENT de I-TREATMENT -amnesia I-TREATMENT -epiléptica I-TREATMENT -transitoria, I-TREATMENT +gel I-TREATMENT +de I-TREATMENT +silicona I-TREATMENT +(McGhan® I-TREATMENT +Style I-TREATMENT +140 I-TREATMENT +MM I-TREATMENT +de I-TREATMENT +320 I-TREATMENT +cc.). I-TREATMENT + I-TREATMENT +La I-TREATMENT +intervención I-TREATMENT se I-TREATMENT -introduce I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -levetiracetam I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT -crecientes I-TREATMENT -(hasta I-TREATMENT -1500 I-TREATMENT -mg/ I-TREATMENT -12 I-TREATMENT -horas). I-TREATMENT -Durante B-EVOLUTION -las I-EVOLUTION -primeras I-EVOLUTION -semanas I-EVOLUTION +realizó I-TREATMENT +bajo I-TREATMENT +anestesia I-TREATMENT +general I-TREATMENT +y I-TREATMENT +transcurrió I-TREATMENT +sin I-TREATMENT +incidencias; I-TREATMENT +la B-EVOLUTION +paciente I-EVOLUTION +fue I-EVOLUTION +dada I-EVOLUTION de I-EVOLUTION -incremento I-EVOLUTION -presentó I-EVOLUTION -episodios I-EVOLUTION -aislados I-EVOLUTION +alta I-EVOLUTION +al I-EVOLUTION +día I-EVOLUTION +siguiente. I-EVOLUTION +A I-EVOLUTION +los I-EVOLUTION +7 I-EVOLUTION +días I-EVOLUTION de I-EVOLUTION -amnesia, I-EVOLUTION -que I-EVOLUTION -no I-EVOLUTION +postoperatorio I-EVOLUTION se I-EVOLUTION -han I-EVOLUTION -vuelto I-EVOLUTION -a I-EVOLUTION -registrar I-EVOLUTION -posteriormente I-EVOLUTION -durante I-EVOLUTION -4 I-EVOLUTION -meses. I-EVOLUTION -El I-EVOLUTION -paciente, I-EVOLUTION -actualmente I-EVOLUTION -asintomático, I-EVOLUTION -continúa I-EVOLUTION -en I-EVOLUTION +encuentra I-EVOLUTION +bien, I-EVOLUTION el I-EVOLUTION -programa I-EVOLUTION +aspecto I-EVOLUTION de I-EVOLUTION -rehabilitación I-EVOLUTION -psicosocial I-EVOLUTION -para I-EVOLUTION +las I-EVOLUTION +mamas I-EVOLUTION +es I-EVOLUTION +normal, I-EVOLUTION la I-EVOLUTION -recuperación I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -adecuado I-EVOLUTION -funcionamiento I-EVOLUTION -personal I-EVOLUTION +simetría I-EVOLUTION +es I-EVOLUTION +adecuada I-EVOLUTION y I-EVOLUTION -reincorporación I-EVOLUTION -a I-EVOLUTION -su I-EVOLUTION -domicilio. I-EVOLUTION - I-EVOLUTION - -Hombre B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -65 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -diabetes I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cardiopatía I-PAST_MEDICAL_HISTORY -isquémica I-PAST_MEDICAL_HISTORY -revascularizada I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -disfunción I-PAST_MEDICAL_HISTORY -sistólica I-PAST_MEDICAL_HISTORY -leve I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -ateromatosis I-PAST_MEDICAL_HISTORY -generalizada. I-PAST_MEDICAL_HISTORY -Estaba I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -enalapril I-PAST_MEDICAL_HISTORY -(40 I-PAST_MEDICAL_HISTORY -mg/día), I-PAST_MEDICAL_HISTORY -atenolol I-PAST_MEDICAL_HISTORY -(50 I-PAST_MEDICAL_HISTORY -mg/día), I-PAST_MEDICAL_HISTORY -ácido I-PAST_MEDICAL_HISTORY -acetilsalicílico I-PAST_MEDICAL_HISTORY -(300 I-PAST_MEDICAL_HISTORY -mg/día), I-PAST_MEDICAL_HISTORY -fenofibrato I-PAST_MEDICAL_HISTORY -(200 I-PAST_MEDICAL_HISTORY -mg/día) I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -combinación I-PAST_MEDICAL_HISTORY -fija I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -rosiglitazona/metformina I-PAST_MEDICAL_HISTORY -(2/500 I-PAST_MEDICAL_HISTORY -mg/12 I-PAST_MEDICAL_HISTORY -horas). I-PAST_MEDICAL_HISTORY -Es B-PRESENT_ILLNESS -ingresado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -deterioro I-PRESENT_ILLNESS -agudo I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -estado I-PRESENT_ILLNESS -general, I-PRESENT_ILLNESS -disminución I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -nivel I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -conciencia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -taquipnea. I-PRESENT_ILLNESS -Había I-PRESENT_ILLNESS -presentado I-PRESENT_ILLNESS -cinco I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -epigastralgia I-PRESENT_ILLNESS -asociada I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -náuseas, I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -diarrea, I-PRESENT_ILLNESS -continuando I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -habitual. I-PRESENT_ILLNESS -En B-EXPLORATION +las I-EVOLUTION +molestias I-EVOLUTION +son I-EVOLUTION +de I-EVOLUTION +escasa I-EVOLUTION +relevancia. I-EVOLUTION +La I-EVOLUTION +paciente I-EVOLUTION +refiere I-EVOLUTION +que I-EVOLUTION +nota I-EVOLUTION +tensión I-EVOLUTION +en I-EVOLUTION +las I-EVOLUTION +mamas, I-EVOLUTION +pero I-EVOLUTION +sin I-EVOLUTION +dolor I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +palpación. I-EVOLUTION +La B-EXPLORATION +cicatrización I-EXPLORATION +es I-EXPLORATION +correcta. I-EXPLORATION + I-EXPLORATION +A B-EVOLUTION +los I-EVOLUTION +15 I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +postoperatorio I-EVOLUTION +acude I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +consulta I-EVOLUTION +presentando I-EVOLUTION +aumento I-EVOLUTION +simétrico I-EVOLUTION +del I-EVOLUTION +volumen I-EVOLUTION +mamario I-EVOLUTION +y I-EVOLUTION +drenaje I-EVOLUTION +espontáneo I-EVOLUTION +de I-EVOLUTION +material I-EVOLUTION +líquido I-EVOLUTION +de I-EVOLUTION +coloración I-EVOLUTION +blanquecina I-EVOLUTION +a I-EVOLUTION +través I-EVOLUTION +de I-EVOLUTION +una I-EVOLUTION +pequeña I-EVOLUTION +dehiscencia I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +herida I-EVOLUTION +periareolar I-EVOLUTION +derecha. I-EVOLUTION +No B-EXPLORATION +ha I-EXPLORATION +presentado I-EXPLORATION +fiebre I-EXPLORATION +y I-EXPLORATION +las I-EXPLORATION +mamas I-EXPLORATION +no I-EXPLORATION +muestran I-EXPLORATION +signos I-EXPLORATION +inflamatorios. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +margen I-EXPLORATION +lateral I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -tenía I-EXPLORATION -una I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION +cicatriz I-EXPLORATION +se I-EXPLORATION +aprecia I-EXPLORATION +un I-EXPLORATION +pequeño I-EXPLORATION de I-EXPLORATION -100/60 I-EXPLORATION -mmHg, I-EXPLORATION -saturación I-EXPLORATION +fecto I-EXPLORATION de I-EXPLORATION -oxígeno I-EXPLORATION -del I-EXPLORATION -84% I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION +2 I-EXPLORATION +mm. I-EXPLORATION +por I-EXPLORATION +el I-EXPLORATION +que I-EXPLORATION +drena I-EXPLORATION +material, I-EXPLORATION +que I-EXPLORATION +al I-EXPLORATION +exprimir I-EXPLORATION la I-EXPLORATION -auscultación I-EXPLORATION +mama I-EXPLORATION +aumenta I-EXPLORATION +su I-EXPLORATION +caudal. I-EXPLORATION +Sospechando B-TREATMENT +la I-TREATMENT +existencia I-TREATMENT +de I-TREATMENT +un I-TREATMENT +absceso I-TREATMENT +retroareolar I-TREATMENT +y I-TREATMENT +decidimos I-TREATMENT +dilatar I-TREATMENT +dicho I-TREATMENT +defecto I-TREATMENT +usando I-TREATMENT +una I-TREATMENT +pinza I-TREATMENT +de I-TREATMENT +hemostasia, I-TREATMENT +momento I-TREATMENT +en I-TREATMENT +el I-TREATMENT +que I-TREATMENT +se I-TREATMENT +produce I-TREATMENT +el I-TREATMENT +drenaje I-TREATMENT +espontáneo I-TREATMENT +de I-TREATMENT +una I-TREATMENT +gran I-TREATMENT +cantidad I-TREATMENT +del I-TREATMENT +citado I-TREATMENT +material. I-TREATMENT +Al I-TREATMENT +proceder I-TREATMENT +a I-TREATMENT +la I-TREATMENT +expresión I-TREATMENT +de I-TREATMENT +la I-TREATMENT +mama I-TREATMENT +se I-TREATMENT +aprecia I-TREATMENT +igualmente I-TREATMENT +que I-TREATMENT +el I-TREATMENT +material I-TREATMENT +drena I-TREATMENT +por I-TREATMENT +el I-TREATMENT +pezón I-TREATMENT +y I-TREATMENT +al I-TREATMENT +hacer I-TREATMENT +la I-TREATMENT +misma I-TREATMENT +maniobra I-TREATMENT +en I-TREATMENT +la I-TREATMENT +mama I-TREATMENT +izquierda, I-TREATMENT +se I-TREATMENT +aprecia I-TREATMENT +también I-TREATMENT +este I-TREATMENT +drenaje I-TREATMENT +por I-TREATMENT +el I-TREATMENT +pezón. I-TREATMENT +Tomamos B-EXPLORATION +muestra I-EXPLORATION +para I-EXPLORATION +cultivo, I-EXPLORATION +siendo I-EXPLORATION +el I-EXPLORATION +resultado I-EXPLORATION +negativo. I-EXPLORATION +Ante I-EXPLORATION +estos I-EXPLORATION +hallazgos I-EXPLORATION +pensamos I-EXPLORATION +que I-EXPLORATION +la I-EXPLORATION +tumefacción I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +mamas I-EXPLORATION se I-EXPLORATION -objetivaron I-EXPLORATION -crepitantes I-EXPLORATION -en I-EXPLORATION -base I-EXPLORATION -pulmonar I-EXPLORATION -derecha I-EXPLORATION -y I-EXPLORATION -soplo I-EXPLORATION -vascular I-EXPLORATION -abdominal. I-EXPLORATION +debe I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +producción I-EXPLORATION +de I-EXPLORATION +leche. I-EXPLORATION I-EXPLORATION -En I-EXPLORATION +Recomendamos I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION +paciente I-EXPLORATION +realizar I-EXPLORATION +una I-EXPLORATION analítica I-EXPLORATION -tenía I-EXPLORATION -Cr I-EXPLORATION -plasmática I-EXPLORATION -de I-EXPLORATION -21, I-EXPLORATION -4 I-EXPLORATION -mg/dl, I-EXPLORATION -glucosa I-EXPLORATION -de I-EXPLORATION -126 I-EXPLORATION -mg/dl, I-EXPLORATION -potasio I-EXPLORATION -de I-EXPLORATION -6, I-EXPLORATION -6 I-EXPLORATION -mEq/l, I-EXPLORATION -creatín I-EXPLORATION -fosfoquinasa I-EXPLORATION -(CPK) I-EXPLORATION +para I-EXPLORATION +estudiar I-EXPLORATION +los I-EXPLORATION +niveles I-EXPLORATION de I-EXPLORATION -315 I-EXPLORATION -con I-EXPLORATION -troponina I-EXPLORATION -I I-EXPLORATION -normal, I-EXPLORATION +prolactina I-EXPLORATION +(PRL) I-EXPLORATION y I-EXPLORATION -ácido I-EXPLORATION -láctico I-EXPLORATION -de I-EXPLORATION -10, I-EXPLORATION -2 I-EXPLORATION -mmol/l. I-EXPLORATION -Además, I-EXPLORATION -tenía I-EXPLORATION -leucocitos I-EXPLORATION -de I-EXPLORATION -16.210/µl, I-EXPLORATION +se I-EXPLORATION +realiza I-EXPLORATION +consulta I-EXPLORATION con I-EXPLORATION -hemoglobina I-EXPLORATION +Ginecología I-EXPLORATION +que I-EXPLORATION +recomienda I-EXPLORATION +una I-EXPLORATION +ecografía I-EXPLORATION +mamaria I-EXPLORATION +bilateral, I-EXPLORATION +TAC I-EXPLORATION +craneal I-EXPLORATION +y I-EXPLORATION +análisis I-EXPLORATION de I-EXPLORATION -13, I-EXPLORATION -3 I-EXPLORATION -g/dl I-EXPLORATION +hormonas I-EXPLORATION +tiroideas I-EXPLORATION y I-EXPLORATION -plaquetas I-EXPLORATION +suprarrenales. I-EXPLORATION +Los I-EXPLORATION +resultados I-EXPLORATION de I-EXPLORATION -407 I-EXPLORATION -x I-EXPLORATION -1.000/µl. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION +todas I-EXPLORATION +estas I-EXPLORATION +pruebas I-EXPLORATION +no I-EXPLORATION +mostraron I-EXPLORATION +signos I-EXPLORATION +patológicos. I-EXPLORATION +La I-EXPLORATION +ecografía I-EXPLORATION +mamaria I-EXPLORATION +reveló I-EXPLORATION +un I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION -tórax I-EXPLORATION +la I-EXPLORATION +densidad I-EXPLORATION +del I-EXPLORATION +tejido I-EXPLORATION +mamario I-EXPLORATION +y I-EXPLORATION +no I-EXPLORATION se I-EXPLORATION -objetivó I-EXPLORATION -condensación I-EXPLORATION +apreció I-EXPLORATION +líquido I-EXPLORATION en I-EXPLORATION -base I-EXPLORATION -derecha. I-EXPLORATION -Fue B-TREATMENT -trasladado I-TREATMENT -a I-TREATMENT -la I-TREATMENT -UCI, I-TREATMENT -donde I-TREATMENT +el I-EXPLORATION +bolsillo I-EXPLORATION +que I-EXPLORATION +alojaba I-EXPLORATION +la I-EXPLORATION +prótesis. I-EXPLORATION +Aún B-TREATMENT +así I-TREATMENT se I-TREATMENT -le I-TREATMENT -realizó I-TREATMENT -intubación I-TREATMENT -orotraqueal, I-TREATMENT -ventilación I-TREATMENT -mecánica I-TREATMENT -y I-TREATMENT +decide I-TREATMENT +instaurar I-TREATMENT tratamiento I-TREATMENT con I-TREATMENT -fármacos I-TREATMENT -vasoactivos, I-TREATMENT +bromocriptina I-TREATMENT +por I-TREATMENT +vía I-TREATMENT +oral I-TREATMENT +de I-TREATMENT +forma I-TREATMENT +empírica, I-TREATMENT a I-TREATMENT -pesar I-TREATMENT +una I-TREATMENT +dosis I-TREATMENT +inicial I-TREATMENT de I-TREATMENT -lo I-TREATMENT -cual I-TREATMENT -presentó I-TREATMENT -parada I-TREATMENT -cardiorrespiratoria I-TREATMENT +1, I-TREATMENT +25 I-TREATMENT +mg., I-TREATMENT +3 I-TREATMENT +veces I-TREATMENT +al I-TREATMENT +día. I-TREATMENT +Después I-TREATMENT +de I-TREATMENT +una I-TREATMENT +semana I-TREATMENT de I-TREATMENT +tratamiento I-TREATMENT +y I-TREATMENT +al I-TREATMENT +no I-TREATMENT +obtener I-TREATMENT +respuesta, I-TREATMENT +se I-TREATMENT +aumentó I-TREATMENT la I-TREATMENT -que I-TREATMENT -fue I-TREATMENT -reanimado. I-TREATMENT -Se I-TREATMENT -inició I-TREATMENT +dosis I-TREATMENT +hasta I-TREATMENT +2, I-TREATMENT +5 I-TREATMENT +mg. I-TREATMENT +3 I-TREATMENT +veces I-TREATMENT +al I-TREATMENT +día. I-TREATMENT +El I-TREATMENT tratamiento I-TREATMENT -con I-TREATMENT -hemofiltración I-TREATMENT -venovenosa I-TREATMENT -continua I-TREATMENT -que I-TREATMENT se I-TREATMENT -mantuvo I-TREATMENT -durante I-TREATMENT -cinco I-TREATMENT -días I-TREATMENT -con B-EVOLUTION -mejoría I-EVOLUTION -progresiva; I-EVOLUTION +mantendría I-TREATMENT +hasta I-TREATMENT +2 I-TREATMENT +semanas I-TREATMENT +después I-TREATMENT +del I-TREATMENT +cese I-TREATMENT +de I-TREATMENT +la I-TREATMENT +secreción. I-TREATMENT + I-TREATMENT +A B-EVOLUTION +pesar I-EVOLUTION +del I-EVOLUTION +tratamiento I-EVOLUTION +la I-EVOLUTION +evolución I-EVOLUTION fue I-EVOLUTION -dado I-EVOLUTION +tórpida I-EVOLUTION +y I-EVOLUTION +el I-EVOLUTION +cuadro I-EVOLUTION de I-EVOLUTION -alta I-EVOLUTION +galactorrea I-EVOLUTION +no I-EVOLUTION +cesó, I-EVOLUTION +continuando I-EVOLUTION +el I-EVOLUTION +drenaje I-EVOLUTION +de I-EVOLUTION +leche I-EVOLUTION +a I-EVOLUTION +través I-EVOLUTION de I-EVOLUTION la I-EVOLUTION -UCI I-EVOLUTION -con I-EVOLUTION -Cr I-EVOLUTION -plasmática I-EVOLUTION +herida I-EVOLUTION de I-EVOLUTION -3, I-EVOLUTION -5 I-EVOLUTION -mg/dl, I-EVOLUTION -potasio I-EVOLUTION -3, I-EVOLUTION -3 I-EVOLUTION -mEq/l, I-EVOLUTION -pH I-EVOLUTION +la I-EVOLUTION +mama I-EVOLUTION +derecha. I-EVOLUTION +Ambas I-EVOLUTION +mamas I-EVOLUTION +continuaban I-EVOLUTION +turgentes. I-EVOLUTION +Se B-TREATMENT +mantiene I-TREATMENT +a I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +con I-TREATMENT +vendajes I-TREATMENT +moderadamente I-TREATMENT +compresivos I-TREATMENT +considerando I-TREATMENT +que I-TREATMENT +el I-TREATMENT +drenaje I-TREATMENT +continuo I-TREATMENT +de I-TREATMENT +leche I-TREATMENT +por I-TREATMENT +la I-TREATMENT +fístula I-TREATMENT +de I-TREATMENT +la I-TREATMENT +herida I-TREATMENT +puede I-TREATMENT +ser I-TREATMENT +un I-TREATMENT +estímulo I-TREATMENT +mantenido I-TREATMENT +para I-TREATMENT +la I-TREATMENT +lactancia, I-TREATMENT +así I-TREATMENT +como I-TREATMENT +para I-TREATMENT +sellar I-TREATMENT +posibles I-TREATMENT +espacios I-TREATMENT +muertos I-TREATMENT +en I-TREATMENT +el I-TREATMENT +bolsillo I-TREATMENT +o I-TREATMENT +en I-TREATMENT +el I-TREATMENT +tejido I-TREATMENT +mamario. I-TREATMENT + I-TREATMENT +Al B-EVOLUTION +cabo I-EVOLUTION de I-EVOLUTION -7, I-EVOLUTION -39 I-EVOLUTION +2 I-EVOLUTION +meses I-EVOLUTION +en I-EVOLUTION +los I-EVOLUTION +que I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +fue I-EVOLUTION +sometida I-EVOLUTION +a I-EVOLUTION +revisiones I-EVOLUTION y I-EVOLUTION -bicarbonato I-EVOLUTION -plasmático I-EVOLUTION +curas I-EVOLUTION +semanales, I-EVOLUTION +el I-EVOLUTION +cuadro I-EVOLUTION de I-EVOLUTION -20, I-EVOLUTION -6 I-EVOLUTION -mE/l. I-EVOLUTION +galactorrea I-EVOLUTION +cesó, I-EVOLUTION +deteniéndose I-EVOLUTION +el I-EVOLUTION +drenaje I-EVOLUTION +de I-EVOLUTION +leche I-EVOLUTION +a I-EVOLUTION +través I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +herida I-EVOLUTION +y I-EVOLUTION +disminuyendo I-EVOLUTION +la I-EVOLUTION +turgencia I-EVOLUTION +en I-EVOLUTION +ambas I-EVOLUTION +mamas. I-EVOLUTION I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -31 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -referida B-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Dermatología I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -valoración I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -función I-DERIVED_FROM/TO -renal I-DERIVED_FROM/TO -tras B-PAST_MEDICAL_HISTORY -contar I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -epidermólisis I-PAST_MEDICAL_HISTORY -bullosa I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -nacimiento I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -disfagia I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -alimentos I-PAST_MEDICAL_HISTORY -sólidos I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -ameritó I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -endoscópico. I-PAST_MEDICAL_HISTORY -Endocrinología B-PRESENT_ILLNESS -descarta I-PRESENT_ILLNESS -hipotiroidismo I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -insuficiencia I-PRESENT_ILLNESS -suprarrenal I-PRESENT_ILLNESS -asociada. I-PRESENT_ILLNESS -Sin I-PRESENT_ILLNESS -diagnóstico I-PRESENT_ILLNESS -previo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -enfermedad I-PRESENT_ILLNESS -renal I-PRESENT_ILLNESS -crónica I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -último I-PRESENT_ILLNESS -año, I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS -enviada I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -azoemia. I-PRESENT_ILLNESS -A B-EXPLORATION -su I-EXPLORATION -ingreso I-EXPLORATION -presenta: I-EXPLORATION -peso I-EXPLORATION -45kg, I-EXPLORATION -talla I-EXPLORATION -1, I-EXPLORATION -55m, I-EXPLORATION -palidez I-EXPLORATION -tegumentaria I-EXPLORATION -+, I-EXPLORATION -alopecia I-EXPLORATION -parcial, I-EXPLORATION -cavidad I-EXPLORATION -oral I-EXPLORATION -con I-EXPLORATION -costras I-EXPLORATION -hemáticas I-EXPLORATION -escasas I-EXPLORATION -diseminadas, I-EXPLORATION -microstomía I-EXPLORATION -con I-EXPLORATION -fijación I-EXPLORATION -lingual I-EXPLORATION -a I-EXPLORATION -piso I-EXPLORATION -de I-EXPLORATION -cavidad I-EXPLORATION -oral, I-EXPLORATION -eritema I-EXPLORATION -generalizado, I-EXPLORATION -zonas I-EXPLORATION -de I-EXPLORATION -dermoabrasión I-EXPLORATION -con I-EXPLORATION -formación I-EXPLORATION -de I-EXPLORATION -ampollas I-EXPLORATION -diseminadas I-EXPLORATION -respetando I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -cervical, I-EXPLORATION -deformidad I-EXPLORATION -de I-EXPLORATION -ambas I-EXPLORATION -manos, I-EXPLORATION -cicatrices I-EXPLORATION -bilaterales I-EXPLORATION -y I-EXPLORATION -zonas I-EXPLORATION -de I-EXPLORATION -eritema. I-EXPLORATION - I-EXPLORATION -Alteraciones I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -relevantes: I-EXPLORATION -hemoglobina I-EXPLORATION -9, I-EXPLORATION -1g/dl, I-EXPLORATION -K I-EXPLORATION -7, I-EXPLORATION -2mmol/l, I-EXPLORATION -urea I-EXPLORATION -345mg/dl, I-EXPLORATION -creatinina I-EXPLORATION -9, I-EXPLORATION -5mg/dl, I-EXPLORATION -albúmina I-EXPLORATION -2g/dl; I-EXPLORATION -Examen I-EXPLORATION -general I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION -(EGO) I-EXPLORATION -Densidad I-EXPLORATION -urinaria I-EXPLORATION -(DU) I-EXPLORATION -1009, I-EXPLORATION -pH I-EXPLORATION -5, I-EXPLORATION -5, I-EXPLORATION -proteínas I-EXPLORATION -+, I-EXPLORATION -eritrocitos I-EXPLORATION -150cels/μl; I-EXPLORATION -gasometría I-EXPLORATION -arterial: I-EXPLORATION -Ph I-EXPLORATION -7, I-EXPLORATION -21, I-EXPLORATION -PCo2 I-EXPLORATION -27, I-EXPLORATION -PO2 I-EXPLORATION -92%, I-EXPLORATION -Sat I-EXPLORATION -92%, I-EXPLORATION -HCO3 I-EXPLORATION -7, I-EXPLORATION -6; I-EXPLORATION -proteinuria I-EXPLORATION -de I-EXPLORATION -24h: I-EXPLORATION -1, I-EXPLORATION -8g/día; I-EXPLORATION -volumen I-EXPLORATION -urinario: I-EXPLORATION -1500cc; I-EXPLORATION -ultrasonido I-EXPLORATION -del I-EXPLORATION -riñón I-EXPLORATION -derecho I-EXPLORATION -7, I-EXPLORATION -5 I-EXPLORATION -x I-EXPLORATION -2, I-EXPLORATION -5cm, I-EXPLORATION -y I-EXPLORATION -del I-EXPLORATION -riñón I-EXPLORATION -izquierdo I-EXPLORATION -7, I-EXPLORATION -1 I-EXPLORATION -x I-EXPLORATION -2, I-EXPLORATION -6cm, I-EXPLORATION -relación I-EXPLORATION -corteza I-EXPLORATION -médula I-EXPLORATION -perdida. I-EXPLORATION -Electrocardiograma: I-EXPLORATION -ondas I-EXPLORATION -T I-EXPLORATION -picudas I-EXPLORATION -y I-EXPLORATION -simétricas I-EXPLORATION -con I-EXPLORATION -extrasístoles I-EXPLORATION -ventriculares I-EXPLORATION -aisladas I-EXPLORATION -en I-EXPLORATION -todas I-EXPLORATION -las I-EXPLORATION -derivaciones I-EXPLORATION -precordiales. I-EXPLORATION +Sin I-EVOLUTION +embargo, I-EVOLUTION +2 I-EVOLUTION +semanas I-EVOLUTION +después I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +acude I-EVOLUTION +de I-EVOLUTION +nuevo I-EVOLUTION +presentando I-EVOLUTION +en I-EVOLUTION +esta I-EVOLUTION +ocasión I-EVOLUTION +aumento I-EVOLUTION +de I-EVOLUTION +volumen I-EVOLUTION +mamario I-EVOLUTION +unilateral I-EVOLUTION +derecho. I-EVOLUTION +Se B-EXPLORATION +realiza I-EXPLORATION +nueva I-EXPLORATION +ecografía I-EXPLORATION +mamaria I-EXPLORATION +que I-EXPLORATION +revela I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +seroma I-EXPLORATION +intracapsular I-EXPLORATION +derecho. I-EXPLORATION Se B-TREATMENT -decide I-TREATMENT -la I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -catéter I-TREATMENT -permanente I-TREATMENT -tunelizado I-TREATMENT -ante I-TREATMENT -el I-TREATMENT -riesgo I-TREATMENT -de I-TREATMENT -incremento I-TREATMENT +procede I-TREATMENT +al I-TREATMENT +drenaje I-TREATMENT +del I-TREATMENT +mismo I-TREATMENT +bajo I-TREATMENT +condiciones I-TREATMENT de I-TREATMENT -infección I-TREATMENT -con I-TREATMENT -catéter I-TREATMENT -Tenckhoff. I-TREATMENT +asepsia I-TREATMENT +y I-TREATMENT +éste I-TREATMENT +se I-TREATMENT +resuelve I-TREATMENT +en I-TREATMENT +7 I-TREATMENT +días; I-TREATMENT +pero B-EVOLUTION +la I-EVOLUTION +morfología I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +mama I-EVOLUTION +comienza I-EVOLUTION +a I-EVOLUTION +verse I-EVOLUTION +afectada I-EVOLUTION +de I-EVOLUTION +tal I-EVOLUTION +forma I-EVOLUTION +que I-EVOLUTION +el I-EVOLUTION +trayecto I-EVOLUTION +a I-EVOLUTION +través I-EVOLUTION +del I-EVOLUTION +cual I-EVOLUTION +drenaba I-EVOLUTION +la I-EVOLUTION +leche I-EVOLUTION +se I-EVOLUTION +retrae I-EVOLUTION +deformando I-EVOLUTION +la I-EVOLUTION +areola. I-EVOLUTION +Se I-EVOLUTION +constata I-EVOLUTION +también I-EVOLUTION +que I-EVOLUTION +la I-EVOLUTION +mama I-EVOLUTION +desarrolla I-EVOLUTION +un I-EVOLUTION +grado I-EVOLUTION +incipiente I-EVOLUTION +de I-EVOLUTION +contractura I-EVOLUTION +capsular. I-EVOLUTION +Optamos B-TREATMENT +por I-TREATMENT +llevar I-TREATMENT +a I-TREATMENT +cabo I-TREATMENT +revisión I-TREATMENT +quirúrgica I-TREATMENT +debido I-TREATMENT +sobre I-TREATMENT +todo I-TREATMENT +a I-TREATMENT +la I-TREATMENT +deformidad I-TREATMENT +provocada I-TREATMENT +por I-TREATMENT +la I-TREATMENT +fístula I-TREATMENT +areolar. I-TREATMENT I-TREATMENT -Previa I-TREATMENT -monitorización I-TREATMENT -cardiológica, I-TREATMENT -monitoreo I-TREATMENT -de I-TREATMENT +La I-TREATMENT +paciente I-TREATMENT +es I-TREATMENT +intervenida I-TREATMENT +procediendo I-TREATMENT +a I-TREATMENT la I-TREATMENT -presión I-TREATMENT -arterial I-TREATMENT +revisión I-TREATMENT +del I-TREATMENT +bolsillo I-TREATMENT +en I-TREATMENT +el I-TREATMENT +que I-TREATMENT no I-TREATMENT -invasivo I-TREATMENT -y I-TREATMENT -oximetría I-TREATMENT +se I-TREATMENT +aprecia I-TREATMENT +la I-TREATMENT +existencia I-TREATMENT de I-TREATMENT -pulso, I-TREATMENT +ninguna I-TREATMENT +colección I-TREATMENT +líquida, I-TREATMENT +tan I-TREATMENT +solo I-TREATMENT +escasos I-TREATMENT +depósitos I-TREATMENT +blanquecinos I-TREATMENT +que I-TREATMENT se I-TREATMENT -administra I-TREATMENT -analgésico I-TREATMENT -intravenoso I-TREATMENT -y I-TREATMENT -sedación. I-TREATMENT -Se I-TREATMENT -identifica I-TREATMENT +analizan I-TREATMENT +Practicamos I-TREATMENT +capsulotomías, I-TREATMENT +recolocación I-TREATMENT +de I-TREATMENT la I-TREATMENT -región I-TREATMENT -yugular I-TREATMENT -derecha I-TREATMENT +prótesis I-TREATMENT +que I-TREATMENT +permanecía I-TREATMENT +intacta I-TREATMENT y I-TREATMENT -el I-TREATMENT -sitio I-TREATMENT +sin I-TREATMENT +depósitos I-TREATMENT +en I-TREATMENT +su I-TREATMENT +superficie I-TREATMENT +y I-TREATMENT +reparación I-TREATMENT de I-TREATMENT -salida I-TREATMENT -con I-TREATMENT -el I-TREATMENT -mínimo I-TREATMENT -daño I-TREATMENT -epitelial, I-TREATMENT +la I-TREATMENT +retracción I-TREATMENT +areolar. I-TREATMENT +El B-EXPLORATION +informe I-EXPLORATION +anatomopatológico I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +depósitos I-EXPLORATION +blanquecinos I-EXPLORATION +hallados I-EXPLORATION +describe I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION +de I-EXPLORATION +fibrosis I-EXPLORATION +hialinizada I-EXPLORATION +con I-EXPLORATION +infiltración I-EXPLORATION +crónica I-EXPLORATION +granulomatosa I-EXPLORATION +e I-EXPLORATION +infiltrado I-EXPLORATION +de I-EXPLORATION +histiocitos. I-EXPLORATION + I-EXPLORATION +Durante B-EVOLUTION +este I-EVOLUTION +segundo I-EVOLUTION +postoperatorio I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +no I-EVOLUTION +desarrolla I-EVOLUTION +galactorrea I-EVOLUTION +y I-EVOLUTION +se I-EVOLUTION +recupera I-EVOLUTION +sin I-EVOLUTION +incidencias. I-EVOLUTION +Sin I-EVOLUTION +embargo, I-EVOLUTION +después I-EVOLUTION +de I-EVOLUTION +1 I-EVOLUTION +año I-EVOLUTION +la I-EVOLUTION +mama I-EVOLUTION +derecha I-EVOLUTION +desarrolla I-EVOLUTION +contractura I-EVOLUTION +capsular I-EVOLUTION +grado I-EVOLUTION +III I-EVOLUTION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT se I-TREATMENT -tuneliza I-TREATMENT -el I-TREATMENT -catéter I-TREATMENT +decide I-TREATMENT +reintervenir I-TREATMENT +nuevamente, I-TREATMENT +realizando I-TREATMENT +capsulectomía I-TREATMENT +parcial I-TREATMENT +debido I-TREATMENT +a I-TREATMENT +que I-TREATMENT +los I-TREATMENT +tegumentos I-TREATMENT +se I-TREATMENT +han I-TREATMENT +adelgazado I-TREATMENT y I-TREATMENT se I-TREATMENT -coloca I-TREATMENT -catéter I-TREATMENT -Permacath, I-TREATMENT -verificando I-TREATMENT -su I-TREATMENT -posición I-TREATMENT -con I-TREATMENT -radiografía I-TREATMENT +considera I-TREATMENT +el I-TREATMENT +riesgo I-TREATMENT de I-TREATMENT -tórax I-TREATMENT -portátil. I-TREATMENT -Se I-TREATMENT -obtiene I-TREATMENT -retorno I-TREATMENT -arterial I-TREATMENT +afectar I-TREATMENT +la I-TREATMENT +integridad I-TREATMENT +de I-TREATMENT +la I-TREATMENT +piel I-TREATMENT +durante I-TREATMENT +la I-TREATMENT +realización I-TREATMENT +de I-TREATMENT +una I-TREATMENT +capsulectomia I-TREATMENT +total, I-TREATMENT y I-TREATMENT -venoso I-TREATMENT -adecuado, I-TREATMENT +capsulorrafia I-TREATMENT +medial I-TREATMENT por I-TREATMENT -lo I-TREATMENT +ser I-TREATMENT +esta I-TREATMENT +la I-TREATMENT +zona I-TREATMENT +en I-TREATMENT +la I-TREATMENT que I-TREATMENT -se I-TREATMENT -sutura I-TREATMENT +el I-TREATMENT +adelgazamiento I-TREATMENT +de I-TREATMENT +los I-TREATMENT +tejidos I-TREATMENT +es I-TREATMENT +mayor. I-TREATMENT +Cambiamos I-TREATMENT la I-TREATMENT -piel. I-TREATMENT -Inicia I-TREATMENT -hemodiálisis I-TREATMENT -con B-EVOLUTION -remisión I-EVOLUTION +prótesis I-TREATMENT +por I-TREATMENT +otra I-TREATMENT +de I-TREATMENT +idénticas I-TREATMENT +carácterísticas. I-TREATMENT +En B-EVOLUTION +el I-EVOLUTION +postoperatorio I-EVOLUTION +de I-EVOLUTION +esta I-EVOLUTION +nueva I-EVOLUTION +intervención I-EVOLUTION +detectamos I-EVOLUTION +como I-EVOLUTION +única I-EVOLUTION +complicación I-EVOLUTION +un I-EVOLUTION +síndrome I-EVOLUTION de I-EVOLUTION +Mondor I-EVOLUTION +en I-EVOLUTION la I-EVOLUTION -sintomatología, I-EVOLUTION -siendo I-EVOLUTION -egresada I-EVOLUTION -por I-EVOLUTION -mejoría I-EVOLUTION -clínica I-EVOLUTION -e B-TREATMENT -incorporándose I-TREATMENT -a I-TREATMENT -programa I-TREATMENT -de I-TREATMENT -hemodiálisis I-TREATMENT -crónica. I-TREATMENT - I-TREATMENT - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -40 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -catéter I-PAST_MEDICAL_HISTORY -cuello I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cisne I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -cuffs I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Dacron I-PAST_MEDICAL_HISTORY -implantado I-PAST_MEDICAL_HISTORY -seis I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes. I-PAST_MEDICAL_HISTORY -A I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -tres I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -inicio I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -programa I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -DP, I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -cuff I-PAST_MEDICAL_HISTORY -externo I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -extruido I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -parte I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -infección I-PAST_MEDICAL_HISTORY -recurrente I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -orificio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -salida. I-PAST_MEDICAL_HISTORY -Tres B-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -después, I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -revisión I-PRESENT_ILLNESS -periódica, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -inspección I-PRESENT_ILLNESS -reveló I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -pequeño I-PRESENT_ILLNESS -orificio I-PRESENT_ILLNESS -cerca I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -restos I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -cuff I-PRESENT_ILLNESS -externo I-PRESENT_ILLNESS -extruido. I-PRESENT_ILLNESS +mama I-EVOLUTION +derecha. I-EVOLUTION + I-EVOLUTION +Al I-EVOLUTION +cabo I-EVOLUTION +de I-EVOLUTION +2 I-EVOLUTION +años I-EVOLUTION +de I-EVOLUTION +postoperatorio I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +presenta I-EVOLUTION +nuevamente I-EVOLUTION +signos I-EVOLUTION +compatibles I-EVOLUTION +con I-EVOLUTION +contractura I-EVOLUTION +capsular I-EVOLUTION +recidivada I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +mama I-EVOLUTION +derecha, I-EVOLUTION +con I-EVOLUTION +notable I-EVOLUTION +afectación I-EVOLUTION +estética I-EVOLUTION +y I-EVOLUTION +de I-EVOLUTION +aparición I-EVOLUTION +más I-EVOLUTION +lenta I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +mama I-EVOLUTION +izquierda. I-EVOLUTION El B-TREATMENT -agujero I-TREATMENT -no I-TREATMENT -alcanzaba I-TREATMENT +tratamiento I-TREATMENT +quirúrgico I-TREATMENT +que I-TREATMENT +podría I-TREATMENT +plantearse I-TREATMENT +en I-TREATMENT +esta I-TREATMENT +ocasión I-TREATMENT +sería: I-TREATMENT +en I-TREATMENT la I-TREATMENT -luz I-TREATMENT -del I-TREATMENT -catéter, I-TREATMENT -pero I-TREATMENT -para I-TREATMENT -prevenir I-TREATMENT -una I-TREATMENT -perforación I-TREATMENT -completa I-TREATMENT -decidimos I-TREATMENT -reforzar I-TREATMENT -dicho I-TREATMENT -punto. I-TREATMENT -Para I-TREATMENT -ello, I-TREATMENT -envolvimos I-TREATMENT -el I-TREATMENT -punto I-TREATMENT +mama I-TREATMENT +derecha I-TREATMENT +nueva I-TREATMENT +capsulectomía, I-TREATMENT +si I-TREATMENT +los I-TREATMENT +tegumentos I-TREATMENT +lo I-TREATMENT +permiten, I-TREATMENT +pudiendo I-TREATMENT +precisar I-TREATMENT +de I-TREATMENT +refuerzo I-TREATMENT +mediante I-TREATMENT +malla I-TREATMENT de I-TREATMENT +material I-TREATMENT +sintético I-TREATMENT +o I-TREATMENT +biológico I-TREATMENT +en I-TREATMENT la I-TREATMENT -perforación I-TREATMENT -con I-TREATMENT -el I-TREATMENT -molde I-TREATMENT +región I-TREATMENT +ínferomedial, I-TREATMENT y I-TREATMENT -rellenamos I-TREATMENT -este I-TREATMENT -con I-TREATMENT -el I-TREATMENT -adhesivo I-TREATMENT +en I-TREATMENT +la I-TREATMENT +mama I-TREATMENT +izquierda I-TREATMENT +capsulectomía I-TREATMENT +y I-TREATMENT +recambio I-TREATMENT de I-TREATMENT -silicona. I-TREATMENT -El I-TREATMENT -segmento I-TREATMENT +prótesis. I-TREATMENT +No I-TREATMENT +se I-TREATMENT +descarta I-TREATMENT +la I-TREATMENT +necesidad I-TREATMENT de I-TREATMENT -catéter I-TREATMENT +añadir I-TREATMENT +procedimientos I-TREATMENT de I-TREATMENT -extensión I-TREATMENT +mastopexia I-TREATMENT +para I-TREATMENT +corregir I-TREATMENT +la I-TREATMENT +posición I-TREATMENT del I-TREATMENT -kit I-TREATMENT -no I-TREATMENT -era I-TREATMENT -necesario I-TREATMENT -en I-TREATMENT -ese I-TREATMENT -caso, I-TREATMENT -puesto I-TREATMENT -que I-TREATMENT -no I-TREATMENT -había I-TREATMENT -rotura I-TREATMENT -completa. I-TREATMENT -La B-EVOLUTION -diálisis I-EVOLUTION -no I-EVOLUTION -se I-EVOLUTION -interrumpió I-EVOLUTION -y I-EVOLUTION -no I-EVOLUTION -hubo I-EVOLUTION -complicaciones I-EVOLUTION -infecciosas I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -procedimiento. I-EVOLUTION - I-EVOLUTION +complejo I-TREATMENT +teloareolar. I-TREATMENT + I-TREATMENT Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -57 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -portadora B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -catéter I-PAST_MEDICAL_HISTORY -autoposicionante. I-PAST_MEDICAL_HISTORY -Tras I-PAST_MEDICAL_HISTORY -cuatro I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -DP, I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -observó I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -pequeña I-PAST_MEDICAL_HISTORY -interrupción I-PAST_MEDICAL_HISTORY -o I-PAST_MEDICAL_HISTORY -desaparición I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -línea I-PAST_MEDICAL_HISTORY -radioopaca I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -catéter, I-PAST_MEDICAL_HISTORY -pero I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -examen I-PAST_MEDICAL_HISTORY -cuidadoso I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -catéter I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -reveló I-PAST_MEDICAL_HISTORY -ningún I-PAST_MEDICAL_HISTORY -punto I-PAST_MEDICAL_HISTORY +40 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +natural B-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -fuga. I-PAST_MEDICAL_HISTORY -Sin B-PRESENT_ILLNESS -embargo, I-PRESENT_ILLNESS -nueve I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -después, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -presencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -fuga I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -dializado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -través I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -agujero I-PRESENT_ILLNESS -localizado I-PRESENT_ILLNESS -justo I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -punto I-PRESENT_ILLNESS -donde I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -línea I-PRESENT_ILLNESS -radioopaca I-PRESENT_ILLNESS +Filipinas, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS había I-PRESENT_ILLNESS -desaparecido. I-PRESENT_ILLNESS -Se B-TREATMENT -le I-TREATMENT -administró I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -profiláctico I-TREATMENT +regresado I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +país I-PRESENT_ILLNESS +15 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +antes, I-PRESENT_ILLNESS +ingresa I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +pancreatitis I-PRESENT_ILLNESS +aguda. I-PRESENT_ILLNESS +Presenta B-EXPLORATION +leucocitosis I-EXPLORATION +con I-EXPLORATION +eosinofilia, I-EXPLORATION +hipertransaminasemia I-EXPLORATION +leve I-EXPLORATION +(< I-EXPLORATION +90 I-EXPLORATION +mg/dl) I-EXPLORATION +y I-EXPLORATION +bilirrubina I-EXPLORATION +normal. I-EXPLORATION +Se I-EXPLORATION +realiza I-EXPLORATION +una I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +una I-EXPLORATION +vesícula I-EXPLORATION +distendida I-EXPLORATION +con I-EXPLORATION +paredes I-EXPLORATION +engrosadas I-EXPLORATION +y, I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +interior, I-EXPLORATION +una I-EXPLORATION +estructura I-EXPLORATION +alargada I-EXPLORATION +hiperecogénica I-EXPLORATION +con I-EXPLORATION +movimientos I-EXPLORATION +ondulatorios I-EXPLORATION +espontáneos. I-EXPLORATION +Se I-EXPLORATION +extendía I-EXPLORATION +por I-EXPLORATION +el I-EXPLORATION +conducto I-EXPLORATION +biliar I-EXPLORATION +principal I-EXPLORATION +desde I-EXPLORATION +la I-EXPLORATION +vesícula I-EXPLORATION +hasta I-EXPLORATION +la I-EXPLORATION +papila. I-EXPLORATION +Ante B-TREATMENT +este I-TREATMENT +hallazgo, I-TREATMENT +se I-TREATMENT +administra I-TREATMENT +albendazol I-TREATMENT y I-TREATMENT se I-TREATMENT -procedió I-TREATMENT -a I-TREATMENT +realiza I-TREATMENT una I-TREATMENT -reparación I-TREATMENT -del I-TREATMENT -catéter, I-TREATMENT -usando I-TREATMENT +colangiopancreatografía I-TREATMENT +retrógrada I-TREATMENT +endoscópica I-TREATMENT +(CPRE) I-TREATMENT +24 I-TREATMENT +horas I-TREATMENT +después I-TREATMENT +para I-TREATMENT +extraer I-TREATMENT el I-TREATMENT -segmento I-TREATMENT -de I-TREATMENT -catéter I-TREATMENT -de I-TREATMENT -extensión I-TREATMENT -del I-TREATMENT -kit. I-TREATMENT -No B-EVOLUTION -se I-EVOLUTION -registró I-EVOLUTION -ningún I-EVOLUTION -tipo I-EVOLUTION -de I-EVOLUTION -complicación I-EVOLUTION -posterior. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -síndrome I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Laurence-Moon-Biedl. I-PAST_MEDICAL_HISTORY -Inició I-PAST_MEDICAL_HISTORY -hemodiálisis I-PAST_MEDICAL_HISTORY -(HD) I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -11 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -Recibió I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -primer I-PAST_MEDICAL_HISTORY -trasplante I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -siguiente, I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -fracasó I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -trombosis I-PAST_MEDICAL_HISTORY -venosa I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -injerto. I-PAST_MEDICAL_HISTORY -Fue B-DERIVED_FROM/TO -derivada I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -DP I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -dificultades I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -acceso I-DERIVED_FROM/TO -vascular I-DERIVED_FROM/TO -2 I-DERIVED_FROM/TO -años I-DERIVED_FROM/TO -después. I-DERIVED_FROM/TO -Sufrió B-PAST_MEDICAL_HISTORY -varias I-PAST_MEDICAL_HISTORY -peritonitis I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hiperparatiroidismo I-PAST_MEDICAL_HISTORY -grave. I-PAST_MEDICAL_HISTORY -Inicialmente, I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -peritoneo I-PAST_MEDICAL_HISTORY -era I-PAST_MEDICAL_HISTORY -medio-alto I-PAST_MEDICAL_HISTORY -transportador. I-PAST_MEDICAL_HISTORY -Tras B-PRESENT_ILLNESS -12 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -técnica, I-PRESENT_ILLNESS -sufrió I-PRESENT_ILLNESS -nueva I-PRESENT_ILLNESS -peritonitis I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -infección I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -túnel I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -eventración I-PRESENT_ILLNESS -peritoneal I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -orificio I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -catéter. I-PRESENT_ILLNESS -En B-EXPLORATION +parásito. I-TREATMENT +Sin B-EXPLORATION +embargo, I-EXPLORATION la I-EXPLORATION -radiografías I-EXPLORATION +papila I-EXPLORATION +estaba I-EXPLORATION +rasgada I-EXPLORATION +y I-EXPLORATION +no I-EXPLORATION se I-EXPLORATION -apreció I-EXPLORATION -esclerosis I-EXPLORATION +objetivó I-EXPLORATION +el I-EXPLORATION +mismo. I-EXPLORATION +Una I-EXPLORATION +nueva I-EXPLORATION +ecografía I-EXPLORATION y I-EXPLORATION -calcificación I-EXPLORATION -del I-EXPLORATION -peritoneo, I-EXPLORATION -comprimiendo I-EXPLORATION -vísceras I-EXPLORATION -abdominales. I-EXPLORATION -Se B-TREATMENT -trató I-TREATMENT -con I-TREATMENT -antibióticos, I-TREATMENT -retirada I-TREATMENT -del I-TREATMENT -catéter I-TREATMENT -y I-TREATMENT -transferencia I-TREATMENT -a I-TREATMENT -HD. I-TREATMENT -Posteriormente, B-EVOLUTION -presentó I-EVOLUTION -isquemia I-EVOLUTION -aguda I-EVOLUTION -en I-EVOLUTION -miembro I-EVOLUTION -inferior I-EVOLUTION -derecho, I-EVOLUTION -por I-EVOLUTION -obstrucción I-EVOLUTION -femoropoplítea. I-EVOLUTION -La B-TREATMENT -situación I-TREATMENT -clínica I-TREATMENT -de I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -desestimó I-TREATMENT -tratamiento I-TREATMENT -quirúrgico I-TREATMENT -y B-EVOLUTION -falleció I-EVOLUTION -poco I-EVOLUTION -después. I-EVOLUTION +una I-EXPLORATION +colangiorresonancia I-EXPLORATION +magnética I-EXPLORATION +confirmaron I-EXPLORATION +la I-EXPLORATION +ausencia I-EXPLORATION +de I-EXPLORATION +parásito I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +vía I-EXPLORATION +biliar. I-EXPLORATION +La B-EVOLUTION +paciente I-EVOLUTION +evolucionó I-EVOLUTION +favorablemente I-EVOLUTION +y I-EVOLUTION +fue I-EVOLUTION +dada I-EVOLUTION +de I-EVOLUTION +alta. I-EVOLUTION I-EVOLUTION -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -78 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -Medicina I-PRESENT_ILLNESS -Interna I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -hospital, I-PRESENT_ILLNESS -procedente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -consultas I-PRESENT_ILLNESS -externas, I-PRESENT_ILLNESS -refiriendo I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -número I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -deposiciones I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -junto I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -8-10 I-PRESENT_ILLNESS -kg I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso, I-PRESENT_ILLNESS +Se B-PRESENT_ILLNESS +practicó I-PRESENT_ILLNESS +autopsia I-PRESENT_ILLNESS a I-PRESENT_ILLNESS -raíz I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -iniciar I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -quimioterápico I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -tercera I-PRESENT_ILLNESS -línea I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -Rituximab I-PRESENT_ILLNESS -(4 I-PRESENT_ILLNESS -sesiones). I-PRESENT_ILLNESS -En B-TREATMENT -principio I-TREATMENT -se I-TREATMENT -atribuyó I-TREATMENT -a I-TREATMENT -la I-TREATMENT -infección I-TREATMENT -por I-TREATMENT -Clostridium I-TREATMENT -difficile I-TREATMENT -(ELISA I-TREATMENT -y I-TREATMENT -cultivo I-TREATMENT -positivos), I-TREATMENT -y I-TREATMENT -fue I-TREATMENT -tratado I-TREATMENT -convenientemente I-TREATMENT -con I-TREATMENT -metronidazol, I-TREATMENT -obteniendo B-EVOLUTION -una I-EVOLUTION -mejoría I-EVOLUTION -inicial I-EVOLUTION -del I-EVOLUTION -cuadro I-EVOLUTION -gastrointestinal, I-EVOLUTION -pero I-EVOLUTION -sin I-EVOLUTION -llegar I-EVOLUTION -a I-EVOLUTION -una I-EVOLUTION -remisión I-EVOLUTION -completa; I-EVOLUTION -teniendo I-EVOLUTION -entre I-EVOLUTION -8-10 I-EVOLUTION -deposiciones I-EVOLUTION -diarias, I-EVOLUTION -de I-EVOLUTION -consistencia I-EVOLUTION -líquida, I-EVOLUTION -inicialmente I-EVOLUTION -sin I-EVOLUTION -productos I-EVOLUTION -patológicos I-EVOLUTION -añadidos. I-EVOLUTION -No I-EVOLUTION -presentaba I-EVOLUTION -fiebre, I-EVOLUTION -náuseas, I-EVOLUTION -vómitos I-EVOLUTION -ni I-EVOLUTION -intolerancia I-EVOLUTION -oral, I-EVOLUTION -sólo I-EVOLUTION -deposición I-EVOLUTION -líquida I-EVOLUTION -cada I-EVOLUTION -vez I-EVOLUTION -que I-EVOLUTION -ingería I-EVOLUTION -comida, I-EVOLUTION -durante I-EVOLUTION -los I-EVOLUTION -últimos I-EVOLUTION -3-4 I-EVOLUTION -meses I-EVOLUTION -había I-EVOLUTION -perdido I-EVOLUTION -entre I-EVOLUTION -8-10 I-EVOLUTION -kg. I-EVOLUTION -Entre B-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -destacaba I-PAST_MEDICAL_HISTORY -Leucemia I-PAST_MEDICAL_HISTORY -Linfática I-PAST_MEDICAL_HISTORY -Crónica I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -B I-PAST_MEDICAL_HISTORY -estadio I-PAST_MEDICAL_HISTORY -C3 I-PAST_MEDICAL_HISTORY -(LLC) I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY +23 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +buen I-PAST_MEDICAL_HISTORY +desarrollo I-PAST_MEDICAL_HISTORY +óseo I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +muscular, I-PAST_MEDICAL_HISTORY +pastora I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +rebaño I-PAST_MEDICAL_HISTORY +caprino, I-PAST_MEDICAL_HISTORY +quien I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +encontrada I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +vida I-PAST_MEDICAL_HISTORY +después I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +ser I-PAST_MEDICAL_HISTORY +atacada I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +felino I-PAST_MEDICAL_HISTORY +salvaje I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -julio I-PAST_MEDICAL_HISTORY -2004; I-PAST_MEDICAL_HISTORY -siendo I-PAST_MEDICAL_HISTORY -tratado I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -quimioterapia I-PAST_MEDICAL_HISTORY -(ciclofosfamida I-PAST_MEDICAL_HISTORY -+ I-PAST_MEDICAL_HISTORY -fludarabina) I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +zona I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +pre-Puna I-PAST_MEDICAL_HISTORY +salteña, I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -mayo I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +Finca I-PAST_MEDICAL_HISTORY +El I-PAST_MEDICAL_HISTORY +Alfarcito, I-PAST_MEDICAL_HISTORY +situada I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +entrada I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +Cerro I-PAST_MEDICAL_HISTORY +Negro, I-PAST_MEDICAL_HISTORY +departamento I-PAST_MEDICAL_HISTORY +Rosario I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -06. I-PAST_MEDICAL_HISTORY -Actualmente I-PAST_MEDICAL_HISTORY -estaba I-PAST_MEDICAL_HISTORY +Lerma I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -dieta I-PAST_MEDICAL_HISTORY -astringente I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -sal, I-PAST_MEDICAL_HISTORY -Omeprazol I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -mg: I-PAST_MEDICAL_HISTORY -1-0-0; I-PAST_MEDICAL_HISTORY -Mastical®: I-PAST_MEDICAL_HISTORY -1-1-1; I-PAST_MEDICAL_HISTORY -Vitamina I-PAST_MEDICAL_HISTORY -D3: I-PAST_MEDICAL_HISTORY -6 I-PAST_MEDICAL_HISTORY -gotas/día; I-PAST_MEDICAL_HISTORY -Coroprés® I-PAST_MEDICAL_HISTORY -6, I-PAST_MEDICAL_HISTORY -25: I-PAST_MEDICAL_HISTORY -½-0-½; I-PAST_MEDICAL_HISTORY -Prednisona®: I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -mg/día I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -Neupogen®: I-PAST_MEDICAL_HISTORY -500 I-PAST_MEDICAL_HISTORY -mg/3 I-PAST_MEDICAL_HISTORY -semanas. I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -destacaba I-EXPLORATION -TA I-EXPLORATION -130/80, I-EXPLORATION -Fc I-EXPLORATION -80 I-EXPLORATION -lpm, I-EXPLORATION -apirético, I-EXPLORATION -talla I-EXPLORATION -176 I-EXPLORATION +la I-PAST_MEDICAL_HISTORY +Provincia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Salta, I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +Noroeste I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +República I-PAST_MEDICAL_HISTORY +Argentina. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Al B-EXPLORATION +examen I-EXPLORATION +externo I-EXPLORATION +presentaba I-EXPLORATION +las I-EXPLORATION +siguientes I-EXPLORATION +lesiones I-EXPLORATION +traumáticas. I-EXPLORATION + I-EXPLORATION +Tres I-EXPLORATION +excoriaciones I-EXPLORATION +en I-EXPLORATION +región I-EXPLORATION +maxilar I-EXPLORATION +y I-EXPLORATION +submaxilar I-EXPLORATION +inferior I-EXPLORATION +izquierda, I-EXPLORATION +inmediatamente I-EXPLORATION +por I-EXPLORATION +debajo I-EXPLORATION +de I-EXPLORATION +éstas, I-EXPLORATION +en I-EXPLORATION +región I-EXPLORATION +anterior I-EXPLORATION +y I-EXPLORATION +lateral I-EXPLORATION +izquierda I-EXPLORATION +del I-EXPLORATION +cuello, I-EXPLORATION +presentaba I-EXPLORATION +tres I-EXPLORATION +heridas I-EXPLORATION +cortantes, I-EXPLORATION +de I-EXPLORATION +bordes I-EXPLORATION +irregulares I-EXPLORATION +con I-EXPLORATION +retracción I-EXPLORATION +e I-EXPLORATION +infiltración I-EXPLORATION +hemática, I-EXPLORATION +separadas I-EXPLORATION +una I-EXPLORATION +de I-EXPLORATION +otra I-EXPLORATION +por I-EXPLORATION +puentes I-EXPLORATION +cutáneos, I-EXPLORATION +las I-EXPLORATION +mismas I-EXPLORATION +medían I-EXPLORATION +4x2 I-EXPLORATION cm, I-EXPLORATION -peso I-EXPLORATION -69 I-EXPLORATION -kg, I-EXPLORATION -IMC I-EXPLORATION -22. I-EXPLORATION -Sequedad I-EXPLORATION +3, I-EXPLORATION +5x1, I-EXPLORATION +5 I-EXPLORATION +cm I-EXPLORATION +y I-EXPLORATION +2, I-EXPLORATION +5x1 I-EXPLORATION +cm I-EXPLORATION +respectivamente, I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION +lesiones I-EXPLORATION +por I-EXPLORATION +garras I-EXPLORATION +de I-EXPLORATION +felino. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +región I-EXPLORATION +clavicular I-EXPLORATION +izquierda I-EXPLORATION +presentaba I-EXPLORATION +excoriaciones I-EXPLORATION +pequeñas I-EXPLORATION +sobre I-EXPLORATION +equimosis. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +región I-EXPLORATION +posterior I-EXPLORATION +del I-EXPLORATION +cuello, I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +parte I-EXPLORATION +media, I-EXPLORATION +herida I-EXPLORATION de I-EXPLORATION -mucosas, I-EXPLORATION -adenopatías I-EXPLORATION -latero I-EXPLORATION -cervicales I-EXPLORATION -estables. I-EXPLORATION -Hipoventilación I-EXPLORATION -pulmonar I-EXPLORATION -bases. I-EXPLORATION -Abdomen: I-EXPLORATION -Hepatomegalia I-EXPLORATION +bordes I-EXPLORATION +irregulares, I-EXPLORATION +retraídos I-EXPLORATION +e I-EXPLORATION +infiltrados, I-EXPLORATION de I-EXPLORATION -2 I-EXPLORATION +3 I-EXPLORATION cm I-EXPLORATION +de I-EXPLORATION +longitud I-EXPLORATION +que I-EXPLORATION +interesa I-EXPLORATION +piel, I-EXPLORATION +tejido I-EXPLORATION +celular I-EXPLORATION +subcutáneo I-EXPLORATION +y I-EXPLORATION +músculos I-EXPLORATION +angular I-EXPLORATION +y I-EXPLORATION +escaleno; I-EXPLORATION con I-EXPLORATION -esplenomegalia I-EXPLORATION -con I-EXPLORATION -borde I-EXPLORATION -esplénico I-EXPLORATION +un I-EXPLORATION +trayecto I-EXPLORATION +descendente I-EXPLORATION +de I-EXPLORATION +arriba I-EXPLORATION +hacia I-EXPLORATION +abajo. I-EXPLORATION + I-EXPLORATION +Presentaba I-EXPLORATION +herida I-EXPLORATION +de I-EXPLORATION +bordes I-EXPLORATION +irregulares I-EXPLORATION +en I-EXPLORATION +dedo I-EXPLORATION +pulgar I-EXPLORATION +de I-EXPLORATION +mano I-EXPLORATION +izquierda I-EXPLORATION a I-EXPLORATION -5-6 I-EXPLORATION -cm I-EXPLORATION +la I-EXPLORATION +altura I-EXPLORATION del I-EXPLORATION -reborde I-EXPLORATION -costal. I-EXPLORATION -Resto I-EXPLORATION -sin I-EXPLORATION -interés. I-EXPLORATION -En I-EXPLORATION +pliegue I-EXPLORATION +entre I-EXPLORATION la I-EXPLORATION -analítica I-EXPLORATION -practicada I-EXPLORATION -al I-EXPLORATION -ingreso I-EXPLORATION -destacaba I-EXPLORATION +articulación I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -hipoproteinemia, I-EXPLORATION -anemia, I-EXPLORATION -linfopenia I-EXPLORATION +1a I-EXPLORATION con I-EXPLORATION -marcadores I-EXPLORATION -inflamatorios I-EXPLORATION -elevados I-EXPLORATION -(ver I-EXPLORATION -en I-EXPLORATION la I-EXPLORATION -tabla I-EXPLORATION -noviembre). I-EXPLORATION -Las I-EXPLORATION -pruebas I-EXPLORATION -complementarias I-EXPLORATION -realizadas I-EXPLORATION -durante I-EXPLORATION -su I-EXPLORATION -ingreso I-EXPLORATION -fueron: I-EXPLORATION -ecografía I-EXPLORATION -hepática I-EXPLORATION -hepatopatía I-EXPLORATION -crónica I-EXPLORATION -con I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -hipertensión I-EXPLORATION -portal. I-EXPLORATION -Esplenomegalia. I-EXPLORATION -Dilatación I-EXPLORATION -del I-EXPLORATION -eje I-EXPLORATION -espleno-portal. I-EXPLORATION -No I-EXPLORATION -líquido I-EXPLORATION -libre I-EXPLORATION -peritoneal. I-EXPLORATION -Colelitiasis. I-EXPLORATION -Múltiples I-EXPLORATION -quistes I-EXPLORATION -simples I-EXPLORATION -renales. I-EXPLORATION -Panendoscopia I-EXPLORATION -oral: I-EXPLORATION -normal. I-EXPLORATION -Colonoscopia: I-EXPLORATION -pólipo I-EXPLORATION -sesil I-EXPLORATION -en I-EXPLORATION -colon I-EXPLORATION -transverso. I-EXPLORATION -Rx I-EXPLORATION -tórax: I-EXPLORATION -sin I-EXPLORATION -hallazgos I-EXPLORATION -significativos. I-EXPLORATION -Biopsia I-EXPLORATION -duodenal: I-EXPLORATION -sin I-EXPLORATION -alteraciones I-EXPLORATION -patológicas. I-EXPLORATION -Rojo I-EXPLORATION -Congo I-EXPLORATION -biopsia I-EXPLORATION -duodenal: I-EXPLORATION -negativo.- I-EXPLORATION -D-Xilosa: I-EXPLORATION -patológico I-EXPLORATION -Elastasa I-EXPLORATION +2a I-EXPLORATION +falange. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +examen I-EXPLORATION +interno I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +que I-EXPLORATION +las I-EXPLORATION +lesiones I-EXPLORATION +descritas I-EXPLORATION en I-EXPLORATION -heces: I-EXPLORATION -positiva I-EXPLORATION -Coprocultivo: I-EXPLORATION -negativo. I-EXPLORATION -Hemocultivos I-EXPLORATION +región I-EXPLORATION +anterior I-EXPLORATION y I-EXPLORATION -urinocultivo: I-EXPLORATION -negativo. I-EXPLORATION -Parásitos I-EXPLORATION -en I-EXPLORATION -heces I-EXPLORATION -negativo. I-EXPLORATION -Serología I-EXPLORATION +lateral I-EXPLORATION +izquierda I-EXPLORATION +del I-EXPLORATION +cuello I-EXPLORATION +comprometían I-EXPLORATION +el I-EXPLORATION +tejido I-EXPLORATION +celular I-EXPLORATION +subcutáneo, I-EXPLORATION +aponeurosis I-EXPLORATION +superficial I-EXPLORATION +y I-EXPLORATION +profunda I-EXPLORATION de I-EXPLORATION -enterobacterias: I-EXPLORATION -negativa. I-EXPLORATION -Tránsito I-EXPLORATION -gastrointestinal: I-EXPLORATION -sin I-EXPLORATION -alteraciones I-EXPLORATION -significativas. I-EXPLORATION -Biopsia I-EXPLORATION +cuello, I-EXPLORATION +músculos I-EXPLORATION +esternocleidomastoideo, I-EXPLORATION +esternocleidohioideo I-EXPLORATION +y I-EXPLORATION +esternohioideo, I-EXPLORATION de I-EXPLORATION -médula I-EXPLORATION -ósea: I-EXPLORATION -pequeña I-EXPLORATION -población I-EXPLORATION -monoclonal, I-EXPLORATION -sin I-EXPLORATION -relevancia. I-EXPLORATION +aspecto I-EXPLORATION +desgarrado. I-EXPLORATION I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -presentaba I-EVOLUTION -diarreas I-EVOLUTION -incoercibles I-EVOLUTION -con I-EVOLUTION -12-15 I-EVOLUTION -deposiciones I-EVOLUTION -al I-EVOLUTION -día I-EVOLUTION -a I-EVOLUTION -pesar I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -medidas I-EVOLUTION -higiénicodietéticas, I-EVOLUTION -y I-EVOLUTION -deterioro I-EVOLUTION -nutricional I-EVOLUTION -progresivo, I-EVOLUTION -presentando I-EVOLUTION -una I-EVOLUTION -desnutrición I-EVOLUTION -moderada I-EVOLUTION -(ver I-EVOLUTION -tabla I-EVOLUTION -mes I-EVOLUTION -de I-EVOLUTION -noviembre), I-EVOLUTION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -iniciar I-TREATMENT -nutrición I-TREATMENT -parenteral I-TREATMENT -(NP) I-TREATMENT -a I-TREATMENT -la I-TREATMENT -semana I-TREATMENT -del I-TREATMENT -ingreso, I-TREATMENT -utilizándose I-TREATMENT -un I-TREATMENT -catéter I-TREATMENT -central I-TREATMENT -de I-TREATMENT -inserción I-TREATMENT -periférica I-TREATMENT -(PICC), I-TREATMENT -al I-TREATMENT -mes I-TREATMENT -de I-TREATMENT -iniciar I-TREATMENT -la I-TREATMENT -NP, I-TREATMENT -y B-EVOLUTION -dada I-EVOLUTION -la I-EVOLUTION -buena I-EVOLUTION -evolución I-EVOLUTION -clínico-analítica I-EVOLUTION -de I-EVOLUTION -nuestro I-EVOLUTION -paciente I-EVOLUTION -(ver I-EVOLUTION -tabla I-EVOLUTION -diciembre), I-EVOLUTION -se B-TREATMENT -decidió I-TREATMENT -introducir I-TREATMENT -de I-TREATMENT -forma I-TREATMENT -conjunta I-TREATMENT -nutrición I-TREATMENT -parenteral I-TREATMENT -y I-TREATMENT -nutrición I-TREATMENT -enteral I-TREATMENT -(NE) I-TREATMENT -en I-TREATMENT -forma I-TREATMENT -de I-TREATMENT -suplementos I-TREATMENT -hiperproteicos I-TREATMENT -(600 I-TREATMENT -kcal/día), I-TREATMENT -aumentando I-TREATMENT -de I-TREATMENT -forma I-TREATMENT -progresiva I-TREATMENT -el I-TREATMENT -aporte I-TREATMENT -calórico. I-TREATMENT -Dada B-EVOLUTION -la I-EVOLUTION -buena I-EVOLUTION -tolerancia, I-EVOLUTION -con I-EVOLUTION -disminución I-EVOLUTION -del I-EVOLUTION -número I-EVOLUTION -de I-EVOLUTION -deposiciones I-EVOLUTION -diarias, I-EVOLUTION -1 I-EVOLUTION -ó I-EVOLUTION -2, I-EVOLUTION -se B-TREATMENT -añadió I-TREATMENT -dieta I-TREATMENT -astringente I-TREATMENT -hasta I-TREATMENT -completar I-TREATMENT -sus I-TREATMENT -necesidades I-TREATMENT -energéticas I-TREATMENT -1.600 I-TREATMENT -kcal. I-TREATMENT -A I-TREATMENT -los I-TREATMENT -10 I-TREATMENT -días I-TREATMENT -de I-TREATMENT -la I-TREATMENT -introducción I-TREATMENT -de I-TREATMENT -la I-TREATMENT -nutrición I-TREATMENT -enteral I-TREATMENT -se I-TREATMENT -suspende I-TREATMENT -la I-TREATMENT -nutrición I-TREATMENT -parenteral I-TREATMENT -por B-EVOLUTION -buena I-EVOLUTION -tolerancia I-EVOLUTION -y I-EVOLUTION -estabilidad I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -parámetros I-EVOLUTION -nutricionales I-EVOLUTION -(ver I-EVOLUTION -tabla I-EVOLUTION -mes I-EVOLUTION -de I-EVOLUTION -febrero). I-EVOLUTION - I-EVOLUTION -Previamente B-EXPLORATION -al I-EXPLORATION -alta I-EXPLORATION -se I-EXPLORATION -repitieron I-EXPLORATION -los I-EXPLORATION -cultivos I-EXPLORATION +Compromiso I-EXPLORATION de I-EXPLORATION -heces, I-EXPLORATION -previamente I-EXPLORATION -negativos, I-EXPLORATION -aislándose I-EXPLORATION -quistes I-EXPLORATION +vasos I-EXPLORATION +superficiales I-EXPLORATION +y I-EXPLORATION +profundos, I-EXPLORATION +con I-EXPLORATION +sección I-EXPLORATION +completa I-EXPLORATION de I-EXPLORATION -Criptosporidium I-EXPLORATION -parvum I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -heces I-EXPLORATION -siendo I-EXPLORATION la I-EXPLORATION -Tinción I-EXPLORATION -criptosporidium: I-EXPLORATION -positiva. I-EXPLORATION -Visualizándose I-EXPLORATION -abundantes I-EXPLORATION -quistes I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -heces. I-EXPLORATION +vena I-EXPLORATION +yugular I-EXPLORATION +interna I-EXPLORATION +izquierda; I-EXPLORATION +provocando I-EXPLORATION +una I-EXPLORATION +hemorragia I-EXPLORATION +aguda I-EXPLORATION +vital, I-EXPLORATION +la I-EXPLORATION +cual I-EXPLORATION +fue I-EXPLORATION +la I-EXPLORATION +causa I-EXPLORATION +del I-EXPLORATION +deceso. I-EXPLORATION I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -tratado I-TREATMENT -con I-TREATMENT -azitromicina I-TREATMENT -más I-TREATMENT -paramomicina, I-TREATMENT -mejorando B-EVOLUTION -las I-EVOLUTION -molestias I-EVOLUTION -gastrointestinales, I-EVOLUTION -estando I-EVOLUTION -asintomático I-EVOLUTION -actualmente, I-EVOLUTION -podemos I-EVOLUTION -ver I-EVOLUTION -la I-EVOLUTION -evolución I-EVOLUTION -y I-EVOLUTION -mejoría I-EVOLUTION -a I-EVOLUTION -lo I-EVOLUTION -largo I-EVOLUTION -del I-EVOLUTION -tratamiento I-EVOLUTION -inicialmente I-EVOLUTION -nutricional I-EVOLUTION -(ver I-EVOLUTION -tabla I-EVOLUTION -mes I-EVOLUTION -de I-EVOLUTION -febrero) I-EVOLUTION -y B-TREATMENT -posteriormente I-TREATMENT -añadiéndose I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -específico I-TREATMENT -antibiótico, I-TREATMENT -estando B-EVOLUTION -actualmente I-EVOLUTION -asintomático I-EVOLUTION -sin I-EVOLUTION -diarrea I-EVOLUTION -y I-EVOLUTION -buena I-EVOLUTION -tolerancia I-EVOLUTION -oral, I-EVOLUTION -con I-EVOLUTION -normalización I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -parámetros I-EVOLUTION -nutricionales I-EVOLUTION -tanto I-EVOLUTION -bioquímicas I-EVOLUTION -como I-EVOLUTION -antropométricos I-EVOLUTION -peso I-EVOLUTION -74 I-EVOLUTION -kg, I-EVOLUTION -IMC I-EVOLUTION -23 I-EVOLUTION -(ver I-EVOLUTION -tabla I-EVOLUTION -mes I-EVOLUTION -abril). I-EVOLUTION - I-EVOLUTION -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS +Se B-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -55 I-PRESENT_ILLNESS +50 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -enfermedad I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -Crohn I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +diagnosticada I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +carcinoma I-PRESENT_ILLNESS +urotelial I-PRESENT_ILLNESS +sólido I-PRESENT_ILLNESS +infiltrante I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -larga I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS +alto I-PRESENT_ILLNESS +grado, I-PRESENT_ILLNESS +pobremente I-PRESENT_ILLNESS +diferenciado, I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -múltiples I-PRESENT_ILLNESS -fístulas I-PRESENT_ILLNESS +infiltración I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +lámina I-PRESENT_ILLNESS +propia I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -resecciones I-PRESENT_ILLNESS -intestinales I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -mala I-PRESENT_ILLNESS -respuesta I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -médico. I-PRESENT_ILLNESS -Tras B-TREATMENT +muscular. I-PRESENT_ILLNESS +Se B-TREATMENT +realiza I-TREATMENT +cistectomía I-TREATMENT +radical I-TREATMENT +y I-TREATMENT +ureterosigmoidostomia I-TREATMENT +destubulizada I-TREATMENT +(Mainz I-TREATMENT +II) I-TREATMENT +implantándose I-TREATMENT +ambos I-TREATMENT +uréteres I-TREATMENT +en I-TREATMENT +cara I-TREATMENT +lateral I-TREATMENT +izquierda I-TREATMENT +de I-TREATMENT la I-TREATMENT -última I-TREATMENT -intervención I-TREATMENT -quirúrgica I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -exclusión I-TREATMENT -intestinal I-TREATMENT +bolsa I-TREATMENT con I-TREATMENT -gastrostomía I-TREATMENT +colocación I-TREATMENT de I-TREATMENT -descarga I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -nutrición I-TREATMENT -parenteral. I-TREATMENT -Estaba B-EXPLORATION -diagnosticado I-EXPLORATION -de I-EXPLORATION -hepatopatía I-EXPLORATION -crónica I-EXPLORATION -no I-EXPLORATION -filiada I-EXPLORATION -con I-EXPLORATION -trombosis I-EXPLORATION -portal, I-EXPLORATION -varices I-EXPLORATION -esofágicas I-EXPLORATION -y I-EXPLORATION -pancitopenia I-EXPLORATION -leve. I-EXPLORATION -El I-EXPLORATION -paciente I-EXPLORATION -presentaba I-EXPLORATION -peso I-EXPLORATION -al I-EXPLORATION -alta I-EXPLORATION -de I-EXPLORATION -50 I-EXPLORATION -kg, I-EXPLORATION -talla I-EXPLORATION -de I-EXPLORATION -170 I-EXPLORATION -cm I-EXPLORATION -e I-EXPLORATION -IMC I-EXPLORATION -de I-EXPLORATION -17, I-EXPLORATION -3 I-EXPLORATION -kg/m2. I-EXPLORATION -Al B-TREATMENT -alta I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -Nutrición I-TREATMENT -Parenteral I-TREATMENT -Domiciliaria I-TREATMENT -(NPD) I-TREATMENT -diaria I-TREATMENT -compuesta I-TREATMENT +catéteres I-TREATMENT +que I-TREATMENT +salen I-TREATMENT por I-TREATMENT -35 I-TREATMENT -kcal/kg/día I-TREATMENT -(14g I-TREATMENT -de I-TREATMENT -nitrógeno, I-TREATMENT -225 I-TREATMENT -g I-TREATMENT -de I-TREATMENT -glucosa, I-TREATMENT -50 I-TREATMENT -g I-TREATMENT +contraincisión I-TREATMENT +a I-TREATMENT +bolsa I-TREATMENT de I-TREATMENT -lípidos I-TREATMENT -MCT/LCT). I-TREATMENT - I-TREATMENT -Durante B-EVOLUTION +urostomía. I-TREATMENT +A B-EVOLUTION los I-EVOLUTION -primeros I-EVOLUTION -meses I-EVOLUTION +10 I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION la I-EVOLUTION -evolución I-EVOLUTION -fue I-EVOLUTION -favorable I-EVOLUTION +cirugía I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +comienza I-EVOLUTION con I-EVOLUTION -mejoría I-EVOLUTION -del I-EVOLUTION -estado I-EVOLUTION -general, I-EVOLUTION +dolor I-EVOLUTION +abdominal I-EVOLUTION +en I-EVOLUTION +flanco I-EVOLUTION +derecho I-EVOLUTION +con I-EVOLUTION +signos I-EVOLUTION de I-EVOLUTION -la I-EVOLUTION -pancitopenia, I-EVOLUTION -parámetros I-EVOLUTION -nutricionales I-EVOLUTION -y I-EVOLUTION -función I-EVOLUTION -hepática. I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -se I-EVOLUTION -produjo I-EVOLUTION -un I-EVOLUTION -deterioro I-EVOLUTION +irritación I-EVOLUTION +peritoneal I-EVOLUTION +asociado I-EVOLUTION +a I-EVOLUTION +leucocitosis. I-EVOLUTION +Se I-EVOLUTION +objetiva I-EVOLUTION +migración I-EVOLUTION +subcutánea I-EVOLUTION de I-EVOLUTION +catéter I-EVOLUTION +izquierdo. I-EVOLUTION +Se B-EXPLORATION +realiza I-EXPLORATION +TC I-EXPLORATION +urgente I-EXPLORATION +identificándose I-EXPLORATION +el I-EXPLORATION +catéter I-EXPLORATION +tipo I-EXPLORATION +pig-tail I-EXPLORATION +con I-EXPLORATION +rizo I-EXPLORATION +en I-EXPLORATION +pelvis I-EXPLORATION +renal I-EXPLORATION +izquierda I-EXPLORATION +que I-EXPLORATION +lleva I-EXPLORATION +un I-EXPLORATION +trayecto I-EXPLORATION +normal I-EXPLORATION +hasta I-EXPLORATION +la I-EXPLORATION +parte I-EXPLORATION +anterior I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +neovejiga, I-EXPLORATION +saliendo I-EXPLORATION +por I-EXPLORATION +la I-EXPLORATION +parte I-EXPLORATION +posterior I-EXPLORATION +y I-EXPLORATION +presentando I-EXPLORATION +desde I-EXPLORATION +entonces I-EXPLORATION +una I-EXPLORATION +trayectoria I-EXPLORATION +ascendente I-EXPLORATION +anterior I-EXPLORATION +al I-EXPLORATION +ciego I-EXPLORATION +para I-EXPLORATION +posteriormente I-EXPLORATION +dirigirse I-EXPLORATION +a I-EXPLORATION +línea I-EXPLORATION +media, I-EXPLORATION +siempre I-EXPLORATION +superficial I-EXPLORATION +a I-EXPLORATION +las I-EXPLORATION +asas I-EXPLORATION +girando I-EXPLORATION +en I-EXPLORATION +última I-EXPLORATION +instancia I-EXPLORATION +hacia I-EXPLORATION +flanco I-EXPLORATION +derecho. I-EXPLORATION +La I-EXPLORATION +punta I-EXPLORATION +se I-EXPLORATION +localiza I-EXPLORATION +inmediatamente I-EXPLORATION +posterior I-EXPLORATION +al I-EXPLORATION +músculo I-EXPLORATION +recto I-EXPLORATION +abdominal I-EXPLORATION +anterior I-EXPLORATION +derecho. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +ven I-EXPLORATION +burbujas I-EXPLORATION +aéreas I-EXPLORATION +extraluminares I-EXPLORATION +que I-EXPLORATION +sugieran I-EXPLORATION +perforación. I-EXPLORATION +Se I-EXPLORATION +realiza I-EXPLORATION +colonoscopia I-EXPLORATION +urgente, I-EXPLORATION +introduciendo I-EXPLORATION +el I-EXPLORATION +endoscopio I-EXPLORATION +hasta I-EXPLORATION +20 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +margen I-EXPLORATION +anal. I-EXPLORATION +A I-EXPLORATION +ese I-EXPLORATION +nivel I-EXPLORATION +se I-EXPLORATION +objetiva I-EXPLORATION +neovejiga I-EXPLORATION +con I-EXPLORATION +catéter I-EXPLORATION +en I-EXPLORATION +unión I-EXPLORATION +uretero-vesical I-EXPLORATION +con I-EXPLORATION +salida I-EXPLORATION +por I-EXPLORATION +pared I-EXPLORATION +posterior, I-EXPLORATION +sin I-EXPLORATION +identificarse I-EXPLORATION +extremo I-EXPLORATION +distal. I-EXPLORATION +Se B-TREATMENT +extrae I-TREATMENT +catéter I-TREATMENT +con I-TREATMENT +pinza I-TREATMENT +sin I-TREATMENT +incidencias, I-TREATMENT +presentando B-EVOLUTION la I-EVOLUTION -función I-EVOLUTION -hepática I-EVOLUTION +paciente I-EVOLUTION +posteriormente I-EVOLUTION +buena I-EVOLUTION +evolución I-EVOLUTION +clínica, I-EVOLUTION con I-EVOLUTION -colestasis I-EVOLUTION -y I-EVOLUTION -empeoramiento I-EVOLUTION +desaparición I-EVOLUTION +del I-EVOLUTION +dolor I-EVOLUTION +abdominal, I-EVOLUTION +siendo I-EVOLUTION +dada I-EVOLUTION de I-EVOLUTION -la I-EVOLUTION -pancitopenia; I-EVOLUTION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -disminuyó I-TREATMENT -el I-TREATMENT -aporte I-TREATMENT +alta I-EVOLUTION +a I-EVOLUTION +las I-EVOLUTION +48 I-EVOLUTION +horas I-EVOLUTION +del I-EVOLUTION +procedimiento. I-EVOLUTION + I-EVOLUTION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +72 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +resección I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dorso I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +paredes I-PRESENT_ILLNESS +laterales I-PRESENT_ILLNESS +nasales I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +carcinoma I-PRESENT_ILLNESS +basocelular I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +múltiples I-PRESENT_ILLNESS +focos I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dorso I-PRESENT_ILLNESS +nasal. I-PRESENT_ILLNESS +Reconstrucción B-TREATMENT +con I-TREATMENT +colgajo I-TREATMENT +frontal I-TREATMENT +paramediano I-TREATMENT +con I-TREATMENT +base I-TREATMENT +estrecha I-TREATMENT +después I-TREATMENT de I-TREATMENT -grasas, I-TREATMENT -oligoelementos I-TREATMENT -y I-TREATMENT -vitaminas I-TREATMENT -liposolubles. I-TREATMENT -Posteriormente B-EVOLUTION -empeoró I-EVOLUTION -el I-EVOLUTION -estado I-EVOLUTION -general I-EVOLUTION +conocer I-TREATMENT +los I-TREATMENT +límites I-TREATMENT +quirúrgicos I-TREATMENT +negativos I-TREATMENT +de I-TREATMENT +la I-TREATMENT +biopsia I-TREATMENT +por I-TREATMENT +congelación. I-TREATMENT +Autonomización B-EVOLUTION del I-EVOLUTION -paciente I-EVOLUTION -con I-EVOLUTION -fiebre I-EVOLUTION -e I-EVOLUTION -ictericia I-EVOLUTION -intensa I-EVOLUTION -precisando I-EVOLUTION -ingreso I-EVOLUTION -hospitalario. I-EVOLUTION +colgajo I-EVOLUTION +a I-EVOLUTION +las I-EVOLUTION +3 I-EVOLUTION +semanas I-EVOLUTION +de I-EVOLUTION +postoperatorio. I-EVOLUTION + I-EVOLUTION + +Paciente B-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +19 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +6 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +intermitente, I-PRESENT_ILLNESS +astenia I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +distensión I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +progresiva. I-PRESENT_ILLNESS En B-EXPLORATION +el I-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +se I-EXPLORATION +evidencian I-EXPLORATION +hepatomegalia I-EXPLORATION +y I-EXPLORATION +onda I-EXPLORATION +ascítica I-EXPLORATION +positiva. I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION analítica I-EXPLORATION -del I-EXPLORATION -ingreso I-EXPLORATION -presentaba I-EXPLORATION -importante I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -bilirrubina, I-EXPLORATION -coagulopatía, I-EXPLORATION -trombocitopenia I-EXPLORATION -severa I-EXPLORATION -y I-EXPLORATION -disminución I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -niveles I-EXPLORATION +destaca: I-EXPLORATION +Mantoux I-EXPLORATION ++, I-EXPLORATION +CA I-EXPLORATION +125 I-EXPLORATION +797.7, I-EXPLORATION +leucocitos I-EXPLORATION +4.000, I-EXPLORATION +Hb I-EXPLORATION +9.7. I-EXPLORATION +TC I-EXPLORATION +toracoabdominal: I-EXPLORATION +ascitis, I-EXPLORATION +engrosamiento I-EXPLORATION de I-EXPLORATION -albúmina I-EXPLORATION +serosa I-EXPLORATION con I-EXPLORATION -ferritina I-EXPLORATION -en I-EXPLORATION -valores I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -mostró I-EXPLORATION -hepatopatía I-EXPLORATION -crónica I-EXPLORATION -sin I-EXPLORATION -datos I-EXPLORATION +múltiples I-EXPLORATION +lesiones I-EXPLORATION +nodulares I-EXPLORATION +sugestivas I-EXPLORATION de I-EXPLORATION -obstrucción I-EXPLORATION +implantes I-EXPLORATION +peritoneales, I-EXPLORATION +principalmente I-EXPLORATION +en I-EXPLORATION +epiplón. I-EXPLORATION +Leve I-EXPLORATION +esplenomegalia. I-EXPLORATION +Múltiples I-EXPLORATION +adenopatías I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -biliar, I-EXPLORATION -trombosis I-EXPLORATION -portal I-EXPLORATION +tamaño I-EXPLORATION +patológico, I-EXPLORATION +mesentéricas, I-EXPLORATION +en I-EXPLORATION +eje I-EXPLORATION +aortoilíaco, I-EXPLORATION +retrocurales I-EXPLORATION y I-EXPLORATION -esplenomegalia. I-EXPLORATION -La I-EXPLORATION +periceliacas. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +realiza I-EXPLORATION biopsia I-EXPLORATION -hepática I-EXPLORATION -presentaba I-EXPLORATION -una I-EXPLORATION -arquitectura I-EXPLORATION -mantenida, I-EXPLORATION -espacios I-EXPLORATION -porta I-EXPLORATION -con I-EXPLORATION -infiltrados I-EXPLORATION -inflamatorios I-EXPLORATION -y I-EXPLORATION -éstasis I-EXPLORATION -biliar I-EXPLORATION -de I-EXPLORATION -predominio I-EXPLORATION -centrolobulillar I-EXPLORATION -con I-EXPLORATION -fenómenos I-EXPLORATION +peritoneal I-EXPLORATION +ecoguiada I-EXPLORATION de I-EXPLORATION -necrosis I-EXPLORATION -hepatocitaria. I-EXPLORATION -En I-EXPLORATION la I-EXPLORATION -punción I-EXPLORATION +zona I-EXPLORATION de I-EXPLORATION -médula I-EXPLORATION -ósea I-EXPLORATION +mayor I-EXPLORATION +engrosamiento I-EXPLORATION +peritoneal I-EXPLORATION +y I-EXPLORATION se I-EXPLORATION -observó I-EXPLORATION -celularidad I-EXPLORATION -medular I-EXPLORATION -conservada I-EXPLORATION -con I-EXPLORATION -acúmulo I-EXPLORATION -de I-EXPLORATION -histiocitos I-EXPLORATION +toman I-EXPLORATION +muestras I-EXPLORATION +para I-EXPLORATION +cultivo, I-EXPLORATION con I-EXPLORATION -material I-EXPLORATION -lipofuccínico I-EXPLORATION -PAS+ I-EXPLORATION -(histiocitos I-EXPLORATION -azul I-EXPLORATION -marino) I-EXPLORATION -que I-EXPLORATION -constituían I-EXPLORATION -al I-EXPLORATION -menos I-EXPLORATION -el I-EXPLORATION -20% I-EXPLORATION +crecimiento I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -celularidad I-EXPLORATION -total, I-EXPLORATION -sin I-EXPLORATION -hemofagocitosis. I-EXPLORATION - I-EXPLORATION +Mycobacterium I-EXPLORATION +tuberculosis. I-EXPLORATION Se B-TREATMENT -le I-TREATMENT -administraron I-TREATMENT -3 I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -anti-TNFα I-TREATMENT -como I-TREATMENT +realiza I-TREATMENT tratamiento I-TREATMENT -de I-TREATMENT -su I-TREATMENT -enfermedad I-TREATMENT -de I-TREATMENT -base I-TREATMENT -además I-TREATMENT -de I-TREATMENT -s-adenosilmetionina, I-TREATMENT con I-TREATMENT -eliminación I-TREATMENT -total I-TREATMENT -de I-TREATMENT -las I-TREATMENT -grasas I-TREATMENT -en I-TREATMENT -la I-TREATMENT -nutrición I-TREATMENT -parenteral. I-TREATMENT -La B-EVOLUTION -evolución I-EVOLUTION -fue I-EVOLUTION -desfavorable I-EVOLUTION -presentando I-EVOLUTION -insuficiencia I-EVOLUTION -hepatocelular, I-EVOLUTION -encefalopatía I-EVOLUTION -hepática, I-EVOLUTION -hemorragia I-EVOLUTION -digestiva I-EVOLUTION -y I-EVOLUTION -neumonía I-EVOLUTION -nosocomial, I-EVOLUTION -evolucionando I-EVOLUTION -a I-EVOLUTION -fallo I-EVOLUTION -multiorgánico I-EVOLUTION +tuberculostáticos I-TREATMENT +con B-EVOLUTION +mejoría I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +clínica, I-EVOLUTION +desaparición I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +ascitis I-EVOLUTION y I-EVOLUTION -muerte. I-EVOLUTION +del I-EVOLUTION +engrosamiento I-EVOLUTION +peritoneal. I-EVOLUTION I-EVOLUTION -Un B-PRESENT_ILLNESS -hombre I-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -54 I-PRESENT_ILLNESS +59 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -médica I-PAST_MEDICAL_HISTORY -previa I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -hábitos I-PAST_MEDICAL_HISTORY -tóxicos, I-PAST_MEDICAL_HISTORY -ingresó B-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -historia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -periumbilical, I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -38 I-PRESENT_ILLNESS +en B-PAST_MEDICAL_HISTORY +DP I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +octubre I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +2012 I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +diabetes I-PAST_MEDICAL_HISTORY +mellitus I-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +2 I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +enfermedad I-PAST_MEDICAL_HISTORY +renal I-PAST_MEDICAL_HISTORY +crónica I-PAST_MEDICAL_HISTORY +secundaria I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +nefropatía I-PAST_MEDICAL_HISTORY +diabética. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Acude B-PRESENT_ILLNESS a I-PRESENT_ILLNESS -38, I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -°C, I-PRESENT_ILLNESS -meterorismo I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -náuseas I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -Un I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS -notó I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -masa I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -abdomen I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS +clínica I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS dolor I-PRESENT_ILLNESS abdominal I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -desaparición I-PRESENT_ILLNESS +líquido I-PRESENT_ILLNESS +peritoneal I-PRESENT_ILLNESS +turbio, I-PRESENT_ILLNESS +refiriendo I-PRESENT_ILLNESS +descenso I-PRESENT_ILLNESS de I-PRESENT_ILLNESS la I-PRESENT_ILLNESS -fiebre. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -tenía I-EXPLORATION -buen I-EXPLORATION -estado I-EXPLORATION -general. I-EXPLORATION -La I-EXPLORATION -temperatura, I-EXPLORATION -pulso, I-EXPLORATION -tensión I-EXPLORATION -arterial, I-EXPLORATION -cabeza, I-EXPLORATION -cuello, I-EXPLORATION -corazón I-EXPLORATION +ultrafiltración. I-PRESENT_ILLNESS +El B-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +sido I-PAST_MEDICAL_HISTORY +diagnosticado I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +semanas I-PAST_MEDICAL_HISTORY +antes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +neoformación I-PAST_MEDICAL_HISTORY +nasal. I-PAST_MEDICAL_HISTORY +Los B-EXPLORATION +resultados I-EXPLORATION +del I-EXPLORATION +líquido I-EXPLORATION +peritoneal I-EXPLORATION +eran: I-EXPLORATION +aspecto I-EXPLORATION +turbio, I-EXPLORATION +700 I-EXPLORATION +leucocitos/μl I-EXPLORATION +(mononucleares I-EXPLORATION +80% I-EXPLORATION y I-EXPLORATION -pulmones I-EXPLORATION -eran I-EXPLORATION -normales. I-EXPLORATION +polimorfonucleares I-EXPLORATION +20%), I-EXPLORATION +a I-EXPLORATION +pesar I-EXPLORATION +del I-EXPLORATION +predominio I-EXPLORATION +de I-EXPLORATION +mononucleares I-EXPLORATION +se I-EXPLORATION +inició I-EXPLORATION +terapia I-EXPLORATION +antibiótica I-EXPLORATION +empírica I-EXPLORATION +con I-EXPLORATION +vancomicina I-EXPLORATION +y I-EXPLORATION +ceftazidima I-EXPLORATION +intraperitoneal. I-EXPLORATION La I-EXPLORATION exploración I-EXPLORATION abdominal I-EXPLORATION -reveló I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -periumbilical I-EXPLORATION -izquierda, I-EXPLORATION -dura, I-EXPLORATION -dolorosa I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -diámetro I-EXPLORATION -de I-EXPLORATION -10 I-EXPLORATION -cm. I-EXPLORATION -No I-EXPLORATION -había I-EXPLORATION +no I-EXPLORATION +mostró I-EXPLORATION signos I-EXPLORATION de I-EXPLORATION -peritonismo I-EXPLORATION +irritación I-EXPLORATION +peritoneal I-EXPLORATION ni I-EXPLORATION -hepatoesplenomegalia. I-EXPLORATION +masas; I-EXPLORATION +el I-EXPLORATION +orificio I-EXPLORATION +de I-EXPLORATION +salida I-EXPLORATION +del I-EXPLORATION +catéter I-EXPLORATION +peritoneal I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +túnel I-EXPLORATION +eran I-EXPLORATION +normales. I-EXPLORATION En I-EXPLORATION los I-EXPLORATION -análisis I-EXPLORATION -presentaba I-EXPLORATION -14.000 I-EXPLORATION -leucocitos/mm3 I-EXPLORATION -con I-EXPLORATION -desviación I-EXPLORATION +datos I-EXPLORATION +analíticos I-EXPLORATION +en I-EXPLORATION +sangre I-EXPLORATION +destacaban: I-EXPLORATION +leucocitos I-EXPLORATION +37000/mm3, I-EXPLORATION +plaquetas I-EXPLORATION +640000/mm3, I-EXPLORATION +hemoglobina I-EXPLORATION +10, I-EXPLORATION +3g/dl, I-EXPLORATION +creatinina I-EXPLORATION +5, I-EXPLORATION +4mg/dl, I-EXPLORATION +urea I-EXPLORATION +180mg/dl, I-EXPLORATION +Na I-EXPLORATION +138mEq/l, I-EXPLORATION +K I-EXPLORATION +4mEq/l, I-EXPLORATION +calcio I-EXPLORATION +9, I-EXPLORATION +5mg/dl, I-EXPLORATION +fósforo I-EXPLORATION +4, I-EXPLORATION +8mg/dl, I-EXPLORATION +albúmina I-EXPLORATION +3, I-EXPLORATION +9mg/dl. I-EXPLORATION +Los I-EXPLORATION +cultivos I-EXPLORATION +del I-EXPLORATION +líquido I-EXPLORATION +peritoneal I-EXPLORATION +días I-EXPLORATION +después I-EXPLORATION +resultaron I-EXPLORATION +negativos. I-EXPLORATION +Se I-EXPLORATION +le I-EXPLORATION +realizó I-EXPLORATION +tomografía I-EXPLORATION +axial I-EXPLORATION +computarizada I-EXPLORATION +de I-EXPLORATION +cráneo, I-EXPLORATION +tórax I-EXPLORATION +y I-EXPLORATION +abdomen I-EXPLORATION +para I-EXPLORATION +completar I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +masa I-EXPLORATION +nasal I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +días I-EXPLORATION +siguientes, I-EXPLORATION +siendo I-EXPLORATION +informado I-EXPLORATION +de I-EXPLORATION +adenopatías I-EXPLORATION +mediastínicas I-EXPLORATION +y I-EXPLORATION +retroperitoneales I-EXPLORATION +diseminadas. I-EXPLORATION +La I-EXPLORATION +anatomía I-EXPLORATION +patológica I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +biopsia I-EXPLORATION +nasal I-EXPLORATION +se I-EXPLORATION +informó I-EXPLORATION +como I-EXPLORATION +linfoma I-EXPLORATION +no-Hodgkin I-EXPLORATION +de I-EXPLORATION +células I-EXPLORATION +B I-EXPLORATION +grandes I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +citología I-EXPLORATION +del I-EXPLORATION +líquido I-EXPLORATION +peritoneal I-EXPLORATION +demostró I-EXPLORATION +linfocitos I-EXPLORATION +atípicos. I-EXPLORATION +El B-TREATMENT +paciente I-TREATMENT +inició I-TREATMENT +su I-TREATMENT +tratamiento I-TREATMENT +quimioterápico I-TREATMENT +y I-TREATMENT +permaneció I-TREATMENT +en I-TREATMENT +la I-TREATMENT +técnica I-TREATMENT +de I-TREATMENT +DP I-TREATMENT +sin I-TREATMENT +más I-TREATMENT +incidencias I-TREATMENT +dialíticas. I-TREATMENT + I-TREATMENT +La B-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +clínica I-EXPLORATION +de I-EXPLORATION +dolor I-EXPLORATION +abdominal I-EXPLORATION +asociada I-EXPLORATION +a I-EXPLORATION +líquido I-EXPLORATION +peritoneal I-EXPLORATION +turbio I-EXPLORATION +en I-EXPLORATION +un I-EXPLORATION +paciente I-EXPLORATION +en I-EXPLORATION +DP I-EXPLORATION +generalmente I-EXPLORATION +se I-EXPLORATION +asocia I-EXPLORATION a I-EXPLORATION -izquierda I-EXPLORATION -y I-EXPLORATION una I-EXPLORATION -VSG I-EXPLORATION +peritonitis. I-EXPLORATION +Para I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION de I-EXPLORATION -94 I-EXPLORATION -mm/h. I-EXPLORATION -El I-EXPLORATION -hematocrito, I-EXPLORATION -recuento I-EXPLORATION -plaquetario, I-EXPLORATION -tiempos I-EXPLORATION +peritonitis I-EXPLORATION +bacteriana I-EXPLORATION +se I-EXPLORATION +requieren I-EXPLORATION +al I-EXPLORATION +menos I-EXPLORATION +dos I-EXPLORATION de I-EXPLORATION -coagulación, I-EXPLORATION -bioquímica I-EXPLORATION -general, I-EXPLORATION -orina I-EXPLORATION -elemental I-EXPLORATION -y I-EXPLORATION -sedimento I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION -simple I-EXPLORATION +las I-EXPLORATION +tres I-EXPLORATION +condiciones: I-EXPLORATION +dolor I-EXPLORATION +abdominal I-EXPLORATION +solo I-EXPLORATION +o I-EXPLORATION +acompañado I-EXPLORATION de I-EXPLORATION -abdomen I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION +otros I-EXPLORATION +síntomas I-EXPLORATION +abdominales, I-EXPLORATION +líquido I-EXPLORATION +peritoneal I-EXPLORATION +con I-EXPLORATION +más I-EXPLORATION de I-EXPLORATION -densidad I-EXPLORATION -en I-EXPLORATION -hipogastrio I-EXPLORATION +100 I-EXPLORATION +leucocitos/μl, I-EXPLORATION +siendo I-EXPLORATION +más I-EXPLORATION +del I-EXPLORATION +50% I-EXPLORATION +polimorfonucleares, I-EXPLORATION y I-EXPLORATION +cultivo I-EXPLORATION +o I-EXPLORATION +tinción I-EXPLORATION +de I-EXPLORATION +Gram I-EXPLORATION +que I-EXPLORATION +demuestre I-EXPLORATION la I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -demostró I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION +existencia I-EXPLORATION de I-EXPLORATION -ecogenicidad I-EXPLORATION -heterogénea I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -músculo I-EXPLORATION -recto I-EXPLORATION -izquierdo. I-EXPLORATION -La I-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION -descubrió I-EXPLORATION +microorganismos1. I-EXPLORATION + I-EXPLORATION +Es I-EXPLORATION +difícil I-EXPLORATION +diferenciar I-EXPLORATION una I-EXPLORATION -masa I-EXPLORATION -en I-EXPLORATION -pared I-EXPLORATION -abdominal I-EXPLORATION +infección I-EXPLORATION +peritoneal I-EXPLORATION con I-EXPLORATION -bordes I-EXPLORATION -infiltrativos I-EXPLORATION -localizada I-EXPLORATION +cultivo I-EXPLORATION +negativo I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +inflamación I-EXPLORATION +peritoneal I-EXPLORATION +no I-EXPLORATION +infecciosa I-EXPLORATION +(peritonitis I-EXPLORATION +estéril). I-EXPLORATION +Un I-EXPLORATION +cultivo I-EXPLORATION +peritoneal I-EXPLORATION +negativo I-EXPLORATION +generalmente I-EXPLORATION +se I-EXPLORATION +debe I-EXPLORATION +a I-EXPLORATION +fallos I-EXPLORATION +técnicos I-EXPLORATION en I-EXPLORATION el I-EXPLORATION -músculo I-EXPLORATION -recto I-EXPLORATION -izquierdo I-EXPLORATION +procesamiento I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +muestras, I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION que I-EXPLORATION -llega I-EXPLORATION -al I-EXPLORATION -epiplon I-EXPLORATION -mayor, I-EXPLORATION -sin I-EXPLORATION -afectación I-EXPLORATION -visceral. I-EXPLORATION -El I-EXPLORATION -tránsito I-EXPLORATION -gastrointestinal I-EXPLORATION -v I-EXPLORATION el I-EXPLORATION -enema I-EXPLORATION -opaco I-EXPLORATION -demostraron I-EXPLORATION -divertículos I-EXPLORATION +manejo I-EXPLORATION +resulta I-EXPLORATION +complicado, I-EXPLORATION +dado I-EXPLORATION +que I-EXPLORATION +existen I-EXPLORATION +peritonitis I-EXPLORATION +infecciosas I-EXPLORATION +sin I-EXPLORATION +crecimiento I-EXPLORATION +bacteriano I-EXPLORATION en I-EXPLORATION +el I-EXPLORATION +cultivo. I-EXPLORATION +Se I-EXPLORATION +aconseja I-EXPLORATION +revisar I-EXPLORATION la I-EXPLORATION -3ª I-EXPLORATION -porción I-EXPLORATION -duodenal I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -colon I-EXPLORATION -distal I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION +técnica I-EXPLORATION de I-EXPLORATION -diverticulitis I-EXPLORATION -o I-EXPLORATION -perforación. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -con I-EXPLORATION -aguja I-EXPLORATION +cultivo I-EXPLORATION +cuando I-EXPLORATION +estos I-EXPLORATION +sean I-EXPLORATION +negativos I-EXPLORATION +en I-EXPLORATION +más I-EXPLORATION +del I-EXPLORATION +20% I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -masa I-EXPLORATION -guiada I-EXPLORATION +las I-EXPLORATION +ocasiones I-EXPLORATION +e I-EXPLORATION +interrogar I-EXPLORATION por I-EXPLORATION -TAC I-EXPLORATION -y I-EXPLORATION el I-EXPLORATION -examen I-EXPLORATION -histológico I-EXPLORATION -reveló I-EXPLORATION +uso I-EXPLORATION +de I-EXPLORATION +antibióticos I-EXPLORATION +previos I-EXPLORATION +al I-EXPLORATION +paciente2. I-EXPLORATION +Para I-EXPLORATION +lograr I-EXPLORATION una I-EXPLORATION -reacción I-EXPLORATION -inflamatoria I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION +rapidez I-EXPLORATION +diagnóstica I-EXPLORATION +en I-EXPLORATION +casos I-EXPLORATION de I-EXPLORATION -colonias I-EXPLORATION +peritonitis I-EXPLORATION +estéril, I-EXPLORATION +las I-EXPLORATION +guías I-EXPLORATION de I-EXPLORATION -Actinomyces. I-EXPLORATION -Se B-TREATMENT -instauró I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -clindamicina I-TREATMENT -vía I-TREATMENT -oral I-TREATMENT -(600 I-TREATMENT -mg/6 I-TREATMENT -horas) I-TREATMENT -durante I-TREATMENT -45 I-TREATMENT -días I-TREATMENT -con I-TREATMENT -buena I-TREATMENT -respuesta I-TREATMENT -clínica I-TREATMENT -y I-TREATMENT -desaparición I-TREATMENT -de I-TREATMENT -la I-TREATMENT -masa. I-TREATMENT -El I-TREATMENT -tratamiento I-TREATMENT -se I-TREATMENT -cambió I-TREATMENT -a I-TREATMENT -Penicilina I-TREATMENT -V I-TREATMENT -vía I-TREATMENT -oral I-TREATMENT -(800 I-TREATMENT -mg/6 I-TREATMENT -horas) I-TREATMENT -durante I-TREATMENT -1 I-TREATMENT -año. I-TREATMENT -Un B-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION -realizado I-EXPLORATION -6 I-EXPLORATION -meses I-EXPLORATION -después I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION -Durante B-EVOLUTION -el I-EVOLUTION -año I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -no I-EVOLUTION -hubo I-EVOLUTION -reaparición I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -masa. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -31 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -excepto I-PAST_MEDICAL_HISTORY -fumador I-PAST_MEDICAL_HISTORY -moderado, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -haber I-PRESENT_ILLNESS -ingerido I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -forma I-PRESENT_ILLNESS -voluntaria, I-PRESENT_ILLNESS -aproximadamente I-PRESENT_ILLNESS -14 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -antes, I-PRESENT_ILLNESS -unos I-PRESENT_ILLNESS -100 I-PRESENT_ILLNESS -cc. I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Gramaxone® I-PRESENT_ILLNESS -extra I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -20%. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -refiere I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal, I-PRESENT_ILLNESS -molestias I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -cavidad I-PRESENT_ILLNESS -bucal I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -intensos I-PRESENT_ILLNESS -vómitos. I-PRESENT_ILLNESS -A B-EXPLORATION +DP I-EXPLORATION +españolas I-EXPLORATION +esquematizan I-EXPLORATION +teniendo I-EXPLORATION +en I-EXPLORATION +cuenta I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -inicial I-EXPLORATION +presencia I-EXPLORATION +o I-EXPLORATION +ausencia I-EXPLORATION +de I-EXPLORATION +células I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -paciente I-EXPLORATION +líquido I-EXPLORATION +peritoneal I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +tipo I-EXPLORATION +de I-EXPLORATION +células. I-EXPLORATION +Un I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION +polimorfornucleares I-EXPLORATION +puede I-EXPLORATION +ser I-EXPLORATION +por I-EXPLORATION +inflamación I-EXPLORATION +de I-EXPLORATION +víscera I-EXPLORATION +intraperitoneal I-EXPLORATION +o I-EXPLORATION +yuxtaperitoneal, I-EXPLORATION +medicamentos I-EXPLORATION +o I-EXPLORATION +líquido I-EXPLORATION +peritoneal I-EXPLORATION +contaminado I-EXPLORATION +por I-EXPLORATION +endotoxinas. I-EXPLORATION +Si I-EXPLORATION +están I-EXPLORATION +aumentados I-EXPLORATION +los I-EXPLORATION +eosinófilos, I-EXPLORATION se I-EXPLORATION -encontraba I-EXPLORATION -consciente I-EXPLORATION +sospechará I-EXPLORATION +reacción I-EXPLORATION +alérgica I-EXPLORATION +al I-EXPLORATION +material I-EXPLORATION +de I-EXPLORATION +diálisis, I-EXPLORATION +medicamentos, I-EXPLORATION +irritación I-EXPLORATION +peritoneal I-EXPLORATION +por I-EXPLORATION +sangre I-EXPLORATION +retrógrada I-EXPLORATION +o I-EXPLORATION +tras I-EXPLORATION +peritonitis I-EXPLORATION +por I-EXPLORATION +hongos I-EXPLORATION y I-EXPLORATION -orientado I-EXPLORATION -témporo-espacialmente, I-EXPLORATION -normotenso I-EXPLORATION -(140/80 I-EXPLORATION -mmHg), I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -frecuencia I-EXPLORATION -cardiaca I-EXPLORATION +parásitos. I-EXPLORATION +El I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION -94 I-EXPLORATION -latidos I-EXPLORATION +mononucleares I-EXPLORATION +puede I-EXPLORATION +asociarse I-EXPLORATION +a I-EXPLORATION +icodextrina, I-EXPLORATION +infección I-EXPLORATION +por I-EXPLORATION +micobacterias, I-EXPLORATION +hongos. I-EXPLORATION +Si I-EXPLORATION +además I-EXPLORATION +hay I-EXPLORATION +hematíes, I-EXPLORATION +se I-EXPLORATION +ha I-EXPLORATION +de I-EXPLORATION +considerar: I-EXPLORATION +ovulación, I-EXPLORATION +menstruación I-EXPLORATION +retrógrada, I-EXPLORATION +rotura I-EXPLORATION +de I-EXPLORATION +quiste I-EXPLORATION +ovárico, I-EXPLORATION +líquido I-EXPLORATION +hipertónico, I-EXPLORATION +adherencias I-EXPLORATION +peritoneales, I-EXPLORATION +ejercicio I-EXPLORATION +físico I-EXPLORATION +y I-EXPLORATION +trauma I-EXPLORATION por I-EXPLORATION -minuto I-EXPLORATION +catéter. I-EXPLORATION +Con I-EXPLORATION +elevados I-EXPLORATION +mononucleares I-EXPLORATION y I-EXPLORATION -una I-EXPLORATION -temperatura I-EXPLORATION -axilar I-EXPLORATION +células I-EXPLORATION +malignas, I-EXPLORATION +hay I-EXPLORATION +que I-EXPLORATION +pensar I-EXPLORATION +en I-EXPLORATION +un I-EXPLORATION +linfoma I-EXPLORATION +o I-EXPLORATION +metástasis I-EXPLORATION +peritoneales. I-EXPLORATION +Por I-EXPLORATION +otra I-EXPLORATION +parte, I-EXPLORATION +en I-EXPLORATION +ausencia I-EXPLORATION de I-EXPLORATION -37, I-EXPLORATION -3 I-EXPLORATION -ºC. I-EXPLORATION -La I-EXPLORATION -exploración I-EXPLORATION +células I-EXPLORATION +puede I-EXPLORATION +ser I-EXPLORATION +debido I-EXPLORATION +a I-EXPLORATION +un I-EXPLORATION +incremento I-EXPLORATION de I-EXPLORATION +fibrina I-EXPLORATION +o I-EXPLORATION +de I-EXPLORATION +triglicéridos3, I-EXPLORATION +4. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -cavidad I-EXPLORATION -oral I-EXPLORATION -reveló I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION +literatura I-EXPLORATION +se I-EXPLORATION +describen I-EXPLORATION +algunos I-EXPLORATION +casos I-EXPLORATION de I-EXPLORATION -lesiones I-EXPLORATION -eritematosas I-EXPLORATION +sospecha I-EXPLORATION +de I-EXPLORATION +peritonitis I-EXPLORATION en I-EXPLORATION -orofaringe. I-EXPLORATION -El I-EXPLORATION -abdomen I-EXPLORATION -era I-EXPLORATION -doloroso I-EXPLORATION +DP I-EXPLORATION +asociadas I-EXPLORATION a I-EXPLORATION +procesos I-EXPLORATION +tumorales, I-EXPLORATION +entre I-EXPLORATION +ellos, I-EXPLORATION +un I-EXPLORATION +paciente I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +carcinoma I-EXPLORATION +de I-EXPLORATION +células I-EXPLORATION +renales I-EXPLORATION +recurrente I-EXPLORATION +diagnosticado I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -palpación, I-EXPLORATION -sin I-EXPLORATION -defensa I-EXPLORATION -ni I-EXPLORATION -signos I-EXPLORATION +citología I-EXPLORATION de I-EXPLORATION -irritación I-EXPLORATION -peritoneal. I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -estudios I-EXPLORATION +líquido I-EXPLORATION +peritoneal5. I-EXPLORATION +Otro I-EXPLORATION +paciente I-EXPLORATION +presentó I-EXPLORATION +una I-EXPLORATION +peritonitis I-EXPLORATION +estéril I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +antecedente I-EXPLORATION de I-EXPLORATION -laboratorio I-EXPLORATION -destacaban: I-EXPLORATION -hemoglobina I-EXPLORATION -15 I-EXPLORATION -g/dl, I-EXPLORATION -hematocrito I-EXPLORATION -46%, I-EXPLORATION -leucocitos I-EXPLORATION -14.500/mm3 I-EXPLORATION -(84 I-EXPLORATION -% I-EXPLORATION -neutrófilos), I-EXPLORATION -plaquetas I-EXPLORATION -240000/mm3, I-EXPLORATION -glucosa I-EXPLORATION -200 I-EXPLORATION -mg/dl, I-EXPLORATION -GOT I-EXPLORATION -78 I-EXPLORATION -U/L, I-EXPLORATION -GPT I-EXPLORATION -91 I-EXPLORATION -U/L, I-EXPLORATION -creatinina I-EXPLORATION -2, I-EXPLORATION -1 I-EXPLORATION -mg/dl. I-EXPLORATION -El I-EXPLORATION -ionograma, I-EXPLORATION +un I-EXPLORATION +linfoma I-EXPLORATION +diagnosticado I-EXPLORATION +diez I-EXPLORATION +años I-EXPLORATION +antes. I-EXPLORATION +La I-EXPLORATION +citología I-EXPLORATION +del I-EXPLORATION +líquido I-EXPLORATION +peritoneal I-EXPLORATION +permitió I-EXPLORATION +observar I-EXPLORATION los I-EXPLORATION -tiempos I-EXPLORATION -de I-EXPLORATION -protrombina I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -tiempo I-EXPLORATION +linfocitos I-EXPLORATION +atípicos I-EXPLORATION +y, I-EXPLORATION +al I-EXPLORATION +igual I-EXPLORATION +que I-EXPLORATION +en I-EXPLORATION +nuestro I-EXPLORATION +caso, I-EXPLORATION +a I-EXPLORATION +pesar I-EXPLORATION de I-EXPLORATION -cefalina I-EXPLORATION -se I-EXPLORATION -encontraban I-EXPLORATION -dentro I-EXPLORATION +la I-EXPLORATION +invasión I-EXPLORATION +peritoneal, I-EXPLORATION +continuó I-EXPLORATION +con I-EXPLORATION +la I-EXPLORATION +técnica I-EXPLORATION de I-EXPLORATION -límites I-EXPLORATION -normales, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -los I-EXPLORATION -gases I-EXPLORATION -arteriales I-EXPLORATION -y I-EXPLORATION +DP6. I-EXPLORATION + I-EXPLORATION +Como I-EXPLORATION +conclusión I-EXPLORATION +del I-EXPLORATION +caso, I-EXPLORATION +debemos I-EXPLORATION +señalar I-EXPLORATION +que I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -equilibrio I-EXPLORATION -ácido-base. I-EXPLORATION -En I-EXPLORATION +diagnóstico I-EXPLORATION +diferencial I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +peritonitis I-EXPLORATION +estériles I-EXPLORATION +no I-EXPLORATION +debemos I-EXPLORATION +olvidar I-EXPLORATION la I-EXPLORATION -radiografía I-EXPLORATION +posible I-EXPLORATION +existencia I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +proceso I-EXPLORATION +neoplásico. I-EXPLORATION + I-EXPLORATION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +29 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +historia I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +vómitos I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +2007 I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +presentación I-PRESENT_ILLNESS +episódica. I-PRESENT_ILLNESS +Como B-PAST_MEDICAL_HISTORY +único I-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +refiere I-PAST_MEDICAL_HISTORY +consumo I-PAST_MEDICAL_HISTORY +crónico I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +cannabis I-PAST_MEDICAL_HISTORY +inhalado I-PAST_MEDICAL_HISTORY +(10-15 I-PAST_MEDICAL_HISTORY +porros I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +día). I-PAST_MEDICAL_HISTORY +Mediante B-EXPLORATION +tomografía I-EXPLORATION +computarizada I-EXPLORATION +(TC) I-EXPLORATION +abdominal I-EXPLORATION +es I-EXPLORATION +diagnosticado I-EXPLORATION de I-EXPLORATION -tórax I-EXPLORATION -destacaba I-EXPLORATION -un I-EXPLORATION -leve I-EXPLORATION -refuerzo I-EXPLORATION +síndrome I-EXPLORATION de I-EXPLORATION +pinza I-EXPLORATION +aortomesentérica I-EXPLORATION +tanto I-EXPLORATION +sobre I-EXPLORATION la I-EXPLORATION -trama I-EXPLORATION -bronquial. I-EXPLORATION -La I-EXPLORATION -determinación I-EXPLORATION -de I-EXPLORATION -ditionita I-EXPLORATION -sódica I-EXPLORATION -fue I-EXPLORATION -positiva. I-EXPLORATION -Inicialmente B-TREATMENT -además I-TREATMENT -de I-TREATMENT -sueroterapia I-TREATMENT -se I-TREATMENT -administró I-TREATMENT -manitol I-TREATMENT -al I-TREATMENT -20%, I-TREATMENT -carbón I-TREATMENT -activado I-TREATMENT -y I-TREATMENT -tierra I-TREATMENT -de I-TREATMENT -Füller I-TREATMENT -por I-TREATMENT -SNG, I-TREATMENT -así I-TREATMENT -como I-TREATMENT -vitamina I-TREATMENT -C I-TREATMENT -y I-TREATMENT -protectores I-TREATMENT -gástricos. I-TREATMENT -El I-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -trasladado I-TREATMENT -a I-TREATMENT +tercera I-EXPLORATION +porción I-EXPLORATION +duodenal I-EXPLORATION +como I-EXPLORATION +sobre I-EXPLORATION +la I-EXPLORATION +vena I-EXPLORATION +renal I-EXPLORATION +izquierda I-EXPLORATION +que B-TREATMENT +no I-TREATMENT +mejora I-TREATMENT +con I-TREATMENT la I-TREATMENT -Unidad I-TREATMENT -de I-TREATMENT -Cuidados I-TREATMENT -Intensivos I-TREATMENT -donde I-TREATMENT +ganancia I-TREATMENT +ponderal, I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT se I-TREATMENT -inició I-TREATMENT -hemoperfusión I-TREATMENT -con I-TREATMENT -cartuchos I-TREATMENT +decide I-TREATMENT +intervención I-TREATMENT +quirúrgica I-TREATMENT +(duodeno-yeyunostomía I-TREATMENT +en I-TREATMENT +septiembre I-TREATMENT de I-TREATMENT -carbón I-TREATMENT -activado. I-TREATMENT -Tras B-EVOLUTION -la I-EVOLUTION -primera I-EVOLUTION -sesión I-EVOLUTION -sufrió I-EVOLUTION -un I-EVOLUTION -episodio I-EVOLUTION -de I-EVOLUTION -hipotensión I-EVOLUTION -arterial I-EVOLUTION -severa I-EVOLUTION -que B-TREATMENT -requirió I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -aminas I-TREATMENT -vasoactivas. I-TREATMENT +2009). I-TREATMENT Posteriormente B-EVOLUTION -desarrolló I-EVOLUTION -un I-EVOLUTION -cuadro I-EVOLUTION +los I-EVOLUTION +episodios I-EVOLUTION de I-EVOLUTION -hematemesis I-EVOLUTION -y I-EVOLUTION -melenas. I-EVOLUTION -Durante B-TREATMENT -una I-TREATMENT -nueva I-TREATMENT -sesión I-TREATMENT -de I-TREATMENT -hemoperfusión I-TREATMENT -se I-TREATMENT -produjo I-TREATMENT -parada I-TREATMENT -respiratoria I-TREATMENT -que I-TREATMENT -obligó I-TREATMENT -a I-TREATMENT -intubación I-TREATMENT -orotraqueal I-TREATMENT -y I-TREATMENT -ventilación I-TREATMENT -mecánica. I-TREATMENT -En B-EVOLUTION -las I-EVOLUTION -horas I-EVOLUTION -siguientes I-EVOLUTION -presentó I-EVOLUTION -gran I-EVOLUTION -inestabilidad I-EVOLUTION -hemodinámica I-EVOLUTION -y I-EVOLUTION -parada I-EVOLUTION -cardiaca I-EVOLUTION -por I-EVOLUTION -disociación I-EVOLUTION -electromecánica I-EVOLUTION -que I-EVOLUTION -fue I-EVOLUTION -refractaria I-EVOLUTION +dolor I-EVOLUTION +continúan I-EVOLUTION +sin I-EVOLUTION +cambios I-EVOLUTION +pese I-EVOLUTION a I-EVOLUTION -todas I-EVOLUTION +la I-EVOLUTION +resolución I-EVOLUTION +radiológica I-EVOLUTION +de I-EVOLUTION las I-EVOLUTION -medidas I-EVOLUTION -terapéuticas, I-EVOLUTION -produciéndose I-EVOLUTION +alteraciones I-EVOLUTION +anatómicas. I-EVOLUTION +En B-EXPLORATION +el I-EXPLORATION +contexto I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +crisis I-EXPLORATION +de I-EXPLORATION +dolor I-EXPLORATION +con I-EXPLORATION +asistencia I-EXPLORATION +a I-EXPLORATION +Urgencias I-EXPLORATION +se I-EXPLORATION +objetivan I-EXPLORATION +ecográficamente I-EXPLORATION +varias I-EXPLORATION +invaginaciones I-EXPLORATION +intestinales I-EXPLORATION +en I-EXPLORATION +diferentes I-EXPLORATION +localizaciones I-EXPLORATION +del I-EXPLORATION +intestino I-EXPLORATION +delgado I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +resuelven I-EXPLORATION +de I-EXPLORATION +forma I-EXPLORATION +conservadora. I-EXPLORATION +En I-EXPLORATION +otras I-EXPLORATION +múltiples I-EXPLORATION +exploraciones I-EXPLORATION +realizadas I-EXPLORATION +en I-EXPLORATION +periodos I-EXPLORATION +asintomáticos I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +encuentra I-EXPLORATION +patología I-EXPLORATION +intestinal I-EXPLORATION +que I-EXPLORATION +justifique I-EXPLORATION +el I-EXPLORATION +cuadro. I-EXPLORATION +Durante B-EVOLUTION el I-EVOLUTION -exitus I-EVOLUTION -tras I-EVOLUTION -12 I-EVOLUTION -horas I-EVOLUTION +seguimiento I-EVOLUTION +en I-EVOLUTION +consultas, I-EVOLUTION +y I-EVOLUTION +coincidiendo I-EVOLUTION +con I-EVOLUTION +el I-EVOLUTION +abandono I-EVOLUTION +del I-EVOLUTION +consumo I-EVOLUTION de I-EVOLUTION -ingreso. I-EVOLUTION +cannabis, I-EVOLUTION +los I-EVOLUTION +episodios I-EVOLUTION +de I-EVOLUTION +dolor I-EVOLUTION +abdominal I-EVOLUTION +y I-EVOLUTION +vómitos I-EVOLUTION +desaparecen I-EVOLUTION +por I-EVOLUTION +completo, I-EVOLUTION +pudiendo I-EVOLUTION +ser I-EVOLUTION +dado I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +tras I-EVOLUTION +un I-EVOLUTION +año I-EVOLUTION +completamente I-EVOLUTION +asintomático. I-EVOLUTION I-EVOLUTION -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -75 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -hacía I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -deposiciones I-PRESENT_ILLNESS -líquidas I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -productos I-PRESENT_ILLNESS -patológicos I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -13 I-PRESENT_ILLNESS -kg I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso, I-PRESENT_ILLNESS -astenia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -artralgias I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -artritis I-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -muñeca I-PRESENT_ILLNESS -derecha I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -rodillas. I-PRESENT_ILLNESS -Estaba B-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY +77 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -artropatía I-PAST_MEDICAL_HISTORY +hepatitis I-PAST_MEDICAL_HISTORY +crónica I-PAST_MEDICAL_HISTORY por I-PAST_MEDICAL_HISTORY -pirofosfato I-PAST_MEDICAL_HISTORY +virus I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +hepatitis I-PAST_MEDICAL_HISTORY +C I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -artrosis. I-PAST_MEDICAL_HISTORY -Presentaba B-PRESENT_ILLNESS -además I-PRESENT_ILLNESS -cuadros I-PRESENT_ILLNESS +hernia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +hiato, I-PAST_MEDICAL_HISTORY +con B-PRESENT_ILLNESS +clínica I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -mareo I-PRESENT_ILLNESS -inespecífico I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -inestabilidad I-PRESENT_ILLNESS +disfagia I-PRESENT_ILLNESS +esofágica I-PRESENT_ILLNESS +progresiva I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -marcha. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -tenía I-EXPLORATION -malnutrición I-EXPLORATION -importante, I-EXPLORATION -edemas I-EXPLORATION -de I-EXPLORATION -miembros I-EXPLORATION -inferiores, I-EXPLORATION -limitación I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -mirada I-EXPLORATION -superior, I-EXPLORATION -discreta I-EXPLORATION -asimetría I-EXPLORATION -facial I-EXPLORATION -y I-EXPLORATION -marcha I-EXPLORATION -inestable I-EXPLORATION -con I-EXPLORATION -flexión I-EXPLORATION -ventral I-EXPLORATION -del I-EXPLORATION -tronco. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -tenía I-EXPLORATION -anemia I-EXPLORATION -microcítica I-EXPLORATION -y I-EXPLORATION +6 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +asociada I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +pirosis I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +episodios I-PRESENT_ILLNESS +ocasionales I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +regurgitación I-PRESENT_ILLNESS +alimentaria. I-PRESENT_ILLNESS +El B-EXPLORATION +EGD I-EXPLORATION +identificó I-EXPLORATION una I-EXPLORATION -albúmina I-EXPLORATION -de I-EXPLORATION -3, I-EXPLORATION -0 I-EXPLORATION -g/dl I-EXPLORATION -sin I-EXPLORATION -otras I-EXPLORATION -alteraciones. I-EXPLORATION -Grasa I-EXPLORATION -en I-EXPLORATION -heces I-EXPLORATION -de I-EXPLORATION -11, I-EXPLORATION -2 I-EXPLORATION -g/día. I-EXPLORATION -El I-EXPLORATION -tránsito I-EXPLORATION -gastrointestinal I-EXPLORATION -mostraba I-EXPLORATION -dilatación I-EXPLORATION +formación I-EXPLORATION +sacular I-EXPLORATION +anterior I-EXPLORATION de I-EXPLORATION -asas I-EXPLORATION +boca I-EXPLORATION +ancha I-EXPLORATION de I-EXPLORATION -intestino I-EXPLORATION -delgado I-EXPLORATION -con I-EXPLORATION -imagen I-EXPLORATION -sugerente I-EXPLORATION +3 I-EXPLORATION +cm I-EXPLORATION de I-EXPLORATION -malabsorción. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -endoscopia I-EXPLORATION -oral I-EXPLORATION -se I-EXPLORATION -objetivaron I-EXPLORATION -unas I-EXPLORATION -placas I-EXPLORATION -amarillentas I-EXPLORATION -en I-EXPLORATION -segunda I-EXPLORATION -porción I-EXPLORATION -duodenal I-EXPLORATION -que I-EXPLORATION +diámetro, I-EXPLORATION +situado I-EXPLORATION en I-EXPLORATION +los I-EXPLORATION +10 I-EXPLORATION +cm I-EXPLORATION +distales I-EXPLORATION +del I-EXPLORATION +esófago I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +hernia I-EXPLORATION +hiatal I-EXPLORATION +por I-EXPLORATION +deslizamiento. I-EXPLORATION +La I-EXPLORATION +endoscopia I-EXPLORATION +confirmó I-EXPLORATION la I-EXPLORATION -biopsia I-EXPLORATION -fueron I-EXPLORATION -compatibles I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +divertículo, I-EXPLORATION con I-EXPLORATION -enfermedad I-EXPLORATION +contenido I-EXPLORATION +alimentario I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +interior, I-EXPLORATION +a I-EXPLORATION +30 I-EXPLORATION +cm I-EXPLORATION de I-EXPLORATION -Whipple. I-EXPLORATION -Fue B-TREATMENT -tratada I-TREATMENT -con I-TREATMENT -penicilina I-TREATMENT -G I-TREATMENT -y I-TREATMENT -estreptomicina I-TREATMENT -dos I-TREATMENT -semanas I-TREATMENT -y I-TREATMENT -después I-TREATMENT -con I-TREATMENT -TM-SF I-TREATMENT -y B-EVOLUTION -al I-EVOLUTION -año I-EVOLUTION -de I-EVOLUTION -tratamiento I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -había I-EVOLUTION -ganado I-EVOLUTION -8 I-EVOLUTION -kg, I-EVOLUTION -había I-EVOLUTION -desaparecido I-EVOLUTION -la I-EVOLUTION -diarrea I-EVOLUTION -y I-EVOLUTION -había I-EVOLUTION -mejorado I-EVOLUTION -de I-EVOLUTION -forma I-EVOLUTION -importante I-EVOLUTION -la I-EVOLUTION -inestabilidad. I-EVOLUTION -En B-EXPLORATION la I-EXPLORATION -biopsia I-EXPLORATION -duodenal I-EXPLORATION -tras I-EXPLORATION -el I-EXPLORATION -tratamiento I-EXPLORATION -las I-EXPLORATION -zonas I-EXPLORATION -PAS I-EXPLORATION -positivas I-EXPLORATION -eran I-EXPLORATION -ya I-EXPLORATION -amorfas I-EXPLORATION -y I-EXPLORATION -al I-EXPLORATION -microscopio I-EXPLORATION -electrónico I-EXPLORATION -se I-EXPLORATION -veían I-EXPLORATION -membranas I-EXPLORATION -degeneradas I-EXPLORATION -sin I-EXPLORATION -bacilos I-EXPLORATION -viables. I-EXPLORATION -Se B-EVOLUTION -suspendió I-EVOLUTION -el I-EVOLUTION -tratamiento. I-EVOLUTION - I-EVOLUTION +arcada I-EXPLORATION +dentaria. I-EXPLORATION + I-EXPLORATION -Varón B-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -29 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -usuario B-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -drogas I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -vía I-PAST_MEDICAL_HISTORY -parenteral I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -diagnosticado I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -infección I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -VIH I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -seguía I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -antirretroviral I-PAST_MEDICAL_HISTORY +56 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -alta I-PAST_MEDICAL_HISTORY -resolución. I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -anamnesis, I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -refería, I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -hacía I-PRESENT_ILLNESS -unas I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -semanas, I-PRESENT_ILLNESS -anorexia, I-PRESENT_ILLNESS -cansancio, I-PRESENT_ILLNESS -adelgazamiento I-PRESENT_ILLNESS -cuantificado I-PRESENT_ILLNESS +interés, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -3-4 I-PRESENT_ILLNESS -kg I-PRESENT_ILLNESS +junio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -peso, I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -(39 I-PRESENT_ILLNESS -ºC) I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -escalofríos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS +1995 I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS dolor I-PRESENT_ILLNESS -intenso I-PRESENT_ILLNESS -localizado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nivel I-PRESENT_ILLNESS -dorsal I-PRESENT_ILLNESS -bajo I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +distensión I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +progresiva I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -característica I-PRESENT_ILLNESS -mecánicas. I-PRESENT_ILLNESS -En B-EXPLORATION +3 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +A B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION -física, I-EXPLORATION +física I-EXPLORATION se I-EXPLORATION -objetivaba I-EXPLORATION -mal I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION -destacando I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -venopunción I-EXPLORATION -periférica I-EXPLORATION -y I-EXPLORATION -dolor I-EXPLORATION -a I-EXPLORATION +constata I-EXPLORATION la I-EXPLORATION -palpación I-EXPLORATION -y I-EXPLORATION -percusión I-EXPLORATION +existencia I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -últimas I-EXPLORATION -vértebras I-EXPLORATION -dorsales. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -datos I-EXPLORATION -complementarios: I-EXPLORATION -los I-EXPLORATION -leucocitos, I-EXPLORATION -la I-EXPLORATION -fórmula I-EXPLORATION -leucocitaria, I-EXPLORATION -la I-EXPLORATION -hemoglobina, I-EXPLORATION -el I-EXPLORATION -hematócrito I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -plaquetas I-EXPLORATION -no I-EXPLORATION -mostraron I-EXPLORATION -alteraciones. I-EXPLORATION -VSG I-EXPLORATION +un I-EXPLORATION +abdomen I-EXPLORATION +distendido, I-EXPLORATION +con I-EXPLORATION +semiología I-EXPLORATION de I-EXPLORATION -50 I-EXPLORATION -mm I-EXPLORATION +ascitis, I-EXPLORATION +no I-EXPLORATION a I-EXPLORATION -la I-EXPLORATION -primera I-EXPLORATION -hora. I-EXPLORATION -Fibrinógeno I-EXPLORATION -495 I-EXPLORATION -mg/dL I-EXPLORATION -(N: I-EXPLORATION -200-450) I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION -parámetros I-EXPLORATION +tensión. I-EXPLORATION +No I-EXPLORATION +hay I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -coagulación, I-EXPLORATION -la I-EXPLORATION +hepatopatía I-EXPLORATION +ni I-EXPLORATION +insuficiencia I-EXPLORATION +cardíaca. I-EXPLORATION +Las I-EXPLORATION +exploraciones I-EXPLORATION +complementarias I-EXPLORATION +muestran I-EXPLORATION +una I-EXPLORATION bioquímica I-EXPLORATION +básica I-EXPLORATION +y I-EXPLORATION +hemograma I-EXPLORATION +sin I-EXPLORATION +alteraciones, I-EXPLORATION +unos I-EXPLORATION +marcadores I-EXPLORATION +tumorales I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +Ca I-EXPLORATION +125: I-EXPLORATION +35 I-EXPLORATION +Ul/ml, I-EXPLORATION +Ca I-EXPLORATION +19.9: I-EXPLORATION +37 I-EXPLORATION +Ul/ml I-EXPLORATION y I-EXPLORATION -el I-EXPLORATION -análisis I-EXPLORATION -elemental I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION +CEA: I-EXPLORATION +8 I-EXPLORATION +Ul/ml. I-EXPLORATION +Se I-EXPLORATION +intenta I-EXPLORATION +realizar I-EXPLORATION +paracentesis I-EXPLORATION +diagnóstica, I-EXPLORATION +pero I-EXPLORATION +es I-EXPLORATION +infructuosa I-EXPLORATION +en I-EXPLORATION +varios I-EXPLORATION +intentos. I-EXPLORATION Las I-EXPLORATION -determinaciones I-EXPLORATION +pruebas I-EXPLORATION de I-EXPLORATION -subpoblaciones I-EXPLORATION -linfocitarias I-EXPLORATION -CD4 I-EXPLORATION -fueron I-EXPLORATION +imagen I-EXPLORATION +hablan I-EXPLORATION de I-EXPLORATION -627/mm3 I-EXPLORATION -y I-EXPLORATION +una I-EXPLORATION +TAC I-EXPLORATION +abdomino-pélvica I-EXPLORATION +que I-EXPLORATION +muestra I-EXPLORATION la I-EXPLORATION -carga I-EXPLORATION -viral I-EXPLORATION +existencia I-EXPLORATION de I-EXPLORATION -VIH I-EXPLORATION -indetectable. I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -estudios I-EXPLORATION -microbiológicos, I-EXPLORATION -los I-EXPLORATION -hemocultivos I-EXPLORATION +ascitis, I-EXPLORATION +con I-EXPLORATION +adenopatías I-EXPLORATION y I-EXPLORATION -la I-EXPLORATION -serología I-EXPLORATION -de I-EXPLORATION -brucella I-EXPLORATION -resultaron I-EXPLORATION -negativas. I-EXPLORATION -El I-EXPLORATION -fondo I-EXPLORATION -de I-EXPLORATION -ojo I-EXPLORATION +varios I-EXPLORATION +nódulos I-EXPLORATION +peritoneales; I-EXPLORATION +una I-EXPLORATION +colonoscopia I-EXPLORATION +normal I-EXPLORATION y I-EXPLORATION +una I-EXPLORATION +ecografía I-EXPLORATION +ginecológica I-EXPLORATION +normal. I-EXPLORATION + I-EXPLORATION +Finalmente I-EXPLORATION la I-EXPLORATION -electromiografía I-EXPLORATION -no I-EXPLORATION -reflejaron I-EXPLORATION -hallazgos I-EXPLORATION -significativos; I-EXPLORATION -tampoco I-EXPLORATION +paciente I-EXPLORATION se I-EXPLORATION -constataron I-EXPLORATION -vegetaciones I-EXPLORATION +somete I-EXPLORATION +a I-EXPLORATION +laparotomía I-EXPLORATION +exploradora I-EXPLORATION +encontrándose I-EXPLORATION +una I-EXPLORATION +cantidad I-EXPLORATION +moderada I-EXPLORATION +de I-EXPLORATION +ascitis I-EXPLORATION +con I-EXPLORATION +abundante I-EXPLORATION +moco, I-EXPLORATION +múltiples I-EXPLORATION +adherencias I-EXPLORATION +a I-EXPLORATION +intestino I-EXPLORATION +y I-EXPLORATION +anejos I-EXPLORATION +ginecológicos, I-EXPLORATION +numerosos I-EXPLORATION +implantes I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -ecocardiográfica. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -RMN I-EXPLORATION +omento, I-EXPLORATION +pared I-EXPLORATION +abdominal I-EXPLORATION +y I-EXPLORATION +peritoneo I-EXPLORATION +y, I-EXPLORATION +un I-EXPLORATION +apéndice I-EXPLORATION +abierto I-EXPLORATION de I-EXPLORATION -columna I-EXPLORATION -se I-EXPLORATION -evidenciaron I-EXPLORATION -signos I-EXPLORATION -radiológicos I-EXPLORATION +aspecto I-EXPLORATION +mucoso. I-EXPLORATION +Se B-TREATMENT +practica I-TREATMENT +un I-TREATMENT +histerectomía I-TREATMENT +con I-TREATMENT +doble I-TREATMENT +anexectomía, I-TREATMENT +linfadenectomía I-TREATMENT +pélvica, I-TREATMENT +apendicectomía I-TREATMENT +y I-TREATMENT +hemicolectomía I-TREATMENT +derecha. I-TREATMENT +La I-TREATMENT +cirugía I-TREATMENT +no I-TREATMENT +es I-TREATMENT +radical, I-TREATMENT +permaneciendo I-TREATMENT +enfermedad I-TREATMENT +residual I-TREATMENT +superior I-TREATMENT +a I-TREATMENT +2 I-TREATMENT +cms. I-TREATMENT +El B-EXPLORATION +análisis I-EXPLORATION +anatomopatológico I-EXPLORATION de I-EXPLORATION -alteración I-EXPLORATION -morfológica I-EXPLORATION +las I-EXPLORATION +piezas I-EXPLORATION +informa I-EXPLORATION de I-EXPLORATION -cuerpos I-EXPLORATION -vertebrales I-EXPLORATION -D9-D10, I-EXPLORATION -con I-EXPLORATION -desaparición I-EXPLORATION -del I-EXPLORATION -disco I-EXPLORATION -y I-EXPLORATION -presencia I-EXPLORATION +una I-EXPLORATION +carcinomatosis I-EXPLORATION +peritoneal I-EXPLORATION +por I-EXPLORATION +adenocarcinoma I-EXPLORATION de I-EXPLORATION -masa I-EXPLORATION -paravertebral. I-EXPLORATION +apéndice; I-EXPLORATION +colon I-EXPLORATION +y I-EXPLORATION +ovario I-EXPLORATION +sin I-EXPLORATION +alteraciones. I-EXPLORATION I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -punción I-EXPLORATION -directa I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -masa I-EXPLORATION -paravertebral I-EXPLORATION +La I-EXPLORATION +TAC I-EXPLORATION +postcirugía I-EXPLORATION +muestra I-EXPLORATION +nódulos I-EXPLORATION +tumorales I-EXPLORATION +en I-EXPLORATION +epiplón I-EXPLORATION y I-EXPLORATION -se I-EXPLORATION -obtuvo I-EXPLORATION -material I-EXPLORATION -purulento I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -sometido I-EXPLORATION +peritoneo. I-EXPLORATION +Los I-EXPLORATION +marcadores I-EXPLORATION +tumorales I-EXPLORATION +habían I-EXPLORATION +descendido I-EXPLORATION a I-EXPLORATION -un I-EXPLORATION -examen I-EXPLORATION -microbiológico, I-EXPLORATION -siendo I-EXPLORATION -la I-EXPLORATION -determinación I-EXPLORATION -de I-EXPLORATION -BAAR I-EXPLORATION -negativa I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -cultivo I-EXPLORATION -positivo I-EXPLORATION -para I-EXPLORATION -Candida I-EXPLORATION -albicans. I-EXPLORATION +niveles I-EXPLORATION +normales I-EXPLORATION +(CEA: I-EXPLORATION +1, I-EXPLORATION +7 I-EXPLORATION +Ul/ml; I-EXPLORATION +Ca I-EXPLORATION +19.9: I-EXPLORATION +27 I-EXPLORATION +Ul/ I-EXPLORATION +ml). I-EXPLORATION + I-EXPLORATION Se B-TREATMENT -administró I-TREATMENT -tratamiento I-TREATMENT -secuencial I-TREATMENT +decide I-TREATMENT +administrar I-TREATMENT +quimioterapia I-TREATMENT con I-TREATMENT -anfotericina I-TREATMENT -B I-TREATMENT -liposomal I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT +esquema I-TREATMENT de I-TREATMENT -200 I-TREATMENT -mg/día I-TREATMENT +la I-TREATMENT +Clínica I-TREATMENT +Mayo I-TREATMENT +(5FU-FA). I-TREATMENT +La I-TREATMENT +paciente I-TREATMENT +recibe I-TREATMENT +tratamiento I-TREATMENT durante I-TREATMENT -15 I-TREATMENT -días, I-TREATMENT -seguido I-TREATMENT +un I-TREATMENT +año I-TREATMENT +con I-TREATMENT +un I-TREATMENT +total I-TREATMENT de I-TREATMENT -fluconazol I-TREATMENT -200 I-TREATMENT -mg/día I-TREATMENT -durante I-TREATMENT +12 I-TREATMENT +ciclos, I-TREATMENT +desapareciendo I-TREATMENT +las I-TREATMENT +imágenes I-TREATMENT +de I-TREATMENT +TAC I-TREATMENT +y I-TREATMENT +con I-TREATMENT +normalización I-TREATMENT +de I-TREATMENT +marcadores. I-TREATMENT +Desde I-TREATMENT +febrero I-TREATMENT +de I-TREATMENT +1997 I-TREATMENT +permanece I-TREATMENT +en I-TREATMENT +control I-TREATMENT +por I-TREATMENT +el I-TREATMENT +servicio I-TREATMENT +de I-TREATMENT +oncología I-TREATMENT +médica. I-TREATMENT +Durante B-EVOLUTION +el I-EVOLUTION +seguimiento, I-EVOLUTION +se I-EVOLUTION +aprecian I-EVOLUTION +nódulos I-EVOLUTION +peritoneales I-EVOLUTION +de I-EVOLUTION +lento I-EVOLUTION +crecimiento, I-EVOLUTION +con I-EVOLUTION +un I-EVOLUTION +ascenso I-EVOLUTION +progresivo I-EVOLUTION +de I-EVOLUTION +marcadores I-EVOLUTION +tumorales. I-EVOLUTION +Se B-TREATMENT +opta I-TREATMENT +por I-TREATMENT +la I-TREATMENT +abstención I-TREATMENT +terapéutica, I-TREATMENT +dado I-TREATMENT +que I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +permanece I-TREATMENT +asintomática. I-TREATMENT +Cuando B-EXPLORATION +el I-EXPLORATION +crecimiento I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +nódulos I-EXPLORATION +se I-EXPLORATION +hizo I-EXPLORATION +manifiesto, I-EXPLORATION +se I-EXPLORATION +solicitó I-EXPLORATION +punción I-EXPLORATION +biopsia, I-EXPLORATION +en I-EXPLORATION +junio I-EXPLORATION +de I-EXPLORATION +2001, I-EXPLORATION +que I-EXPLORATION +confirmó I-EXPLORATION +la I-EXPLORATION +recaída I-EXPLORATION +peritoneal I-EXPLORATION +de I-EXPLORATION +adenocarcinoma I-EXPLORATION +apendicular. I-EXPLORATION +En B-TREATMENT +ese I-TREATMENT +momento I-TREATMENT +se I-TREATMENT +decide I-TREATMENT +retratar I-TREATMENT +con I-TREATMENT +esquema I-TREATMENT +Clínica I-TREATMENT +Mayo I-TREATMENT +hasta I-TREATMENT un I-TREATMENT total I-TREATMENT de I-TREATMENT -6 I-TREATMENT -meses, I-TREATMENT -evolucionando B-EVOLUTION +8 I-TREATMENT +ciclos, I-TREATMENT +alcanzando I-TREATMENT +criterios I-TREATMENT +de I-TREATMENT +enfermedad I-TREATMENT +estable. I-TREATMENT +Se I-TREATMENT +decide I-TREATMENT +continuar I-TREATMENT +con I-TREATMENT +quimioterapia I-TREATMENT +de I-TREATMENT +tercera I-TREATMENT +línea I-TREATMENT +con I-TREATMENT +Tomudex-Oxaliplatino I-TREATMENT +(6 I-TREATMENT +ciclos). I-TREATMENT +La B-EVOLUTION +respuesta, I-EVOLUTION +en I-EVOLUTION +agosto I-EVOLUTION +de I-EVOLUTION +2002, I-EVOLUTION +fue I-EVOLUTION +nuevamente I-EVOLUTION +de I-EVOLUTION +estabilización. I-EVOLUTION +Desde I-EVOLUTION +entonces I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +permanece I-EVOLUTION +oligoasintomática I-EVOLUTION con I-EVOLUTION -buena I-EVOLUTION -respuesta I-EVOLUTION -clínica I-EVOLUTION +vida I-EVOLUTION +activa, I-EVOLUTION y I-EVOLUTION -radiológica I-EVOLUTION con I-EVOLUTION -marcada I-EVOLUTION -mejoría I-EVOLUTION +la I-EVOLUTION +presencia I-EVOLUTION +de I-EVOLUTION +múltiples I-EVOLUTION +nódulos I-EVOLUTION +peritoneales I-EVOLUTION +que I-EVOLUTION +forman I-EVOLUTION +una I-EVOLUTION +coraza I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +pared I-EVOLUTION +abdominal. I-EVOLUTION +En I-EVOLUTION +diciembre I-EVOLUTION de I-EVOLUTION +2003, I-EVOLUTION la I-EVOLUTION -lesión I-EVOLUTION +enfermedad I-EVOLUTION +progresa I-EVOLUTION +produciéndose I-EVOLUTION +compresión I-EVOLUTION +de I-EVOLUTION +cola I-EVOLUTION +de I-EVOLUTION +caballo I-EVOLUTION +secundaria I-EVOLUTION +a I-EVOLUTION +masa I-EVOLUTION +presacra. I-EVOLUTION +Recibe B-TREATMENT +radioterapia I-TREATMENT +paliativa, I-TREATMENT +aliviándose I-TREATMENT +el I-TREATMENT +dolor I-TREATMENT +y I-TREATMENT +sin I-TREATMENT +producirse I-TREATMENT +déficit I-TREATMENT +neurológico. I-TREATMENT +La B-EVOLUTION +situación I-EVOLUTION +de I-EVOLUTION +enfermedad I-EVOLUTION +a I-EVOLUTION +octubre I-EVOLUTION +de I-EVOLUTION +2004, I-EVOLUTION +es I-EVOLUTION +la I-EVOLUTION +de I-EVOLUTION +lento I-EVOLUTION +deterioro I-EVOLUTION +del I-EVOLUTION +estado I-EVOLUTION +general I-EVOLUTION +por I-EVOLUTION +progresión I-EVOLUTION +de I-EVOLUTION +enfermedad, I-EVOLUTION +con I-EVOLUTION +anemia I-EVOLUTION +y I-EVOLUTION +desnutrición I-EVOLUTION +por I-EVOLUTION +dificultad I-EVOLUTION en I-EVOLUTION la I-EVOLUTION -RMN. I-EVOLUTION +ingesta I-EVOLUTION +debido I-EVOLUTION +a I-EVOLUTION +cuadros I-EVOLUTION +suboclusivos. I-EVOLUTION I-EVOLUTION -Mujer B-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -69 I-PRESENT_ILLNESS +21 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -enfermedades I-PAST_MEDICAL_HISTORY -previas I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -tratamientos I-PAST_MEDICAL_HISTORY -habituales, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -inició I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -septiembre I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -1999 I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -clínica I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +tumoración I-PAST_MEDICAL_HISTORY +(osteosarcoma) I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +rodilla I-PAST_MEDICAL_HISTORY +derecha I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +7 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +edad. I-PAST_MEDICAL_HISTORY +Tras B-TREATMENT +recibir I-TREATMENT +múltiples I-TREATMENT +tratamientos I-TREATMENT +de I-TREATMENT +elongación I-TREATMENT +ósea, I-TREATMENT +fue I-TREATMENT +necesario I-TREATMENT +colocar I-TREATMENT +una I-TREATMENT +prótesis I-TREATMENT +total I-TREATMENT +de I-TREATMENT +rodilla. I-TREATMENT +Debido I-TREATMENT +a I-TREATMENT +la I-TREATMENT +existencia I-TREATMENT +de I-TREATMENT +múltiples I-TREATMENT +cicatrices, I-TREATMENT +la I-TREATMENT +piel I-TREATMENT +se I-TREATMENT +necrosó I-TREATMENT +y I-TREATMENT +la I-TREATMENT +prótesis I-TREATMENT +resultó I-TREATMENT +expuesta, I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +fue I-TREATMENT +necesario I-TREATMENT +cubrirla I-TREATMENT +con I-TREATMENT +2 I-TREATMENT +colgajos I-TREATMENT +de I-TREATMENT +gemelos I-TREATMENT +según I-TREATMENT +la I-TREATMENT +técnica I-TREATMENT +que I-TREATMENT +hemos I-TREATMENT +descrito. I-TREATMENT + I-TREATMENT + +Un B-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -15 I-PRESENT_ILLNESS +58 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +acudió I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +tipo I-PRESENT_ILLNESS +cólico, I-PRESENT_ILLNESS +náuseas, I-PRESENT_ILLNESS +vómitos I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +diarrea I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS días I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -consistente I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -ictericia I-PRESENT_ILLNESS -progresiva, I-PRESENT_ILLNESS -coluria, I-PRESENT_ILLNESS -hipocolia, I-PRESENT_ILLNESS -astenia I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +Su I-PRESENT_ILLNESS +hijo I-PRESENT_ILLNESS +presentaba I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +clínica I-PRESENT_ILLNESS +semejante I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -epigástrico I-PRESENT_ILLNESS -intermitente. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION +ambos I-PRESENT_ILLNESS +habían I-PRESENT_ILLNESS +ingerido I-PRESENT_ILLNESS +codornices I-PRESENT_ILLNESS +cocidas I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +antes. I-PRESENT_ILLNESS +El B-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +tenía I-PAST_MEDICAL_HISTORY +diagnósticos I-PAST_MEDICAL_HISTORY +previos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +hipertrofia I-PAST_MEDICAL_HISTORY +benigna I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +próstata I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +hipertension I-PAST_MEDICAL_HISTORY +arterial I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +antagonistas I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +receptores I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +angiotensina-II I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +torasemida, I-PAST_MEDICAL_HISTORY +así I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +episodio I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +dolor I-PAST_MEDICAL_HISTORY +abdominal I-PAST_MEDICAL_HISTORY +secundario I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +duodenitis I-PAST_MEDICAL_HISTORY +tras I-PAST_MEDICAL_HISTORY +toma I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +ibuprofeno I-PAST_MEDICAL_HISTORY +6 I-PAST_MEDICAL_HISTORY +meses I-PAST_MEDICAL_HISTORY +antes I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +resuelto I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +omeprazol. I-PAST_MEDICAL_HISTORY +Al B-EXPLORATION +ingreso I-EXPLORATION +el I-EXPLORATION +paciente I-EXPLORATION se I-EXPLORATION -apreciaron I-EXPLORATION -como I-EXPLORATION -únicos I-EXPLORATION -datos I-EXPLORATION -reseñables I-EXPLORATION -ictericia I-EXPLORATION -mucocutánea I-EXPLORATION -y I-EXPLORATION -hepatomegalia. I-EXPLORATION -Las I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -imagen, I-EXPLORATION -ecografía I-EXPLORATION +encontraba I-EXPLORATION +afebril I-EXPLORATION y I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computadorizada I-EXPLORATION -(TAC) I-EXPLORATION -abdominal, I-EXPLORATION -sólo I-EXPLORATION -mostraron I-EXPLORATION -una I-EXPLORATION -hepatomegalia I-EXPLORATION -homogénea. I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -análisis I-EXPLORATION -realizados I-EXPLORATION -destacaban I-EXPLORATION -transaminasa I-EXPLORATION -glutámico-oxalacética I-EXPLORATION -(GOT) I-EXPLORATION -775 I-EXPLORATION -UI/L, I-EXPLORATION -transaminasa I-EXPLORATION -glutámico-pirúvica I-EXPLORATION -(GPT) I-EXPLORATION -1116 I-EXPLORATION -UI/L, I-EXPLORATION -gammaglutamiltranspeptidasa I-EXPLORATION -(GGT) I-EXPLORATION -121 I-EXPLORATION -UI/L, I-EXPLORATION -fosfatasa I-EXPLORATION -alcalina I-EXPLORATION -(FA) I-EXPLORATION -362 I-EXPLORATION -UI/L, I-EXPLORATION -bilirrubina I-EXPLORATION -total I-EXPLORATION -15, I-EXPLORATION -9 I-EXPLORATION -mg/dl I-EXPLORATION -(directa I-EXPLORATION -6, I-EXPLORATION -4 I-EXPLORATION -mg/dl), I-EXPLORATION -anticuerpos I-EXPLORATION -antinucleares I-EXPLORATION -(ANA) I-EXPLORATION -positivos I-EXPLORATION -a I-EXPLORATION +el I-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +no I-EXPLORATION +mostró I-EXPLORATION +alteraciones I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +área I-EXPLORATION +abdominal, I-EXPLORATION +auscultación I-EXPLORATION +cardiaca I-EXPLORATION +ni I-EXPLORATION +respiratoria. I-EXPLORATION +Las I-EXPLORATION +pruebas I-EXPLORATION +complementarias I-EXPLORATION +mostraron I-EXPLORATION un I-EXPLORATION -título I-EXPLORATION +hemograma, I-EXPLORATION +función I-EXPLORATION +renal, I-EXPLORATION +valores I-EXPLORATION de I-EXPLORATION -1/640, I-EXPLORATION -e I-EXPLORATION -hipergammaglobulinemia I-EXPLORATION -policlonal I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION +amilasa, I-EXPLORATION +lipasa I-EXPLORATION +y I-EXPLORATION +pruebas I-EXPLORATION +de I-EXPLORATION +función I-EXPLORATION +hepática I-EXPLORATION +en I-EXPLORATION +rangos I-EXPLORATION +de I-EXPLORATION +normalidad, I-EXPLORATION +salvo I-EXPLORATION +el I-EXPLORATION valor I-EXPLORATION de I-EXPLORATION -IgG I-EXPLORATION +la I-EXPLORATION +bilirrubina I-EXPLORATION +sérica I-EXPLORATION de I-EXPLORATION -2110 I-EXPLORATION -mg/dl. I-EXPLORATION -Los I-EXPLORATION -anticuerpos I-EXPLORATION -antimitocondriales I-EXPLORATION -(AMA), I-EXPLORATION -anticuerpos I-EXPLORATION -antimúsculo I-EXPLORATION -liso I-EXPLORATION -(ASMA), I-EXPLORATION -anticuerpos I-EXPLORATION -anticitoplasma I-EXPLORATION +1, I-EXPLORATION +80 I-EXPLORATION +mg/dl I-EXPLORATION +(límite I-EXPLORATION +superior I-EXPLORATION de I-EXPLORATION -neutrófilo I-EXPLORATION -(ANCA) I-EXPLORATION +la I-EXPLORATION +normalidad I-EXPLORATION +1, I-EXPLORATION +2 I-EXPLORATION +mg/dl) I-EXPLORATION y I-EXPLORATION -anticuerpos I-EXPLORATION -antimicrosomales I-EXPLORATION +LDH I-EXPLORATION +(lactato I-EXPLORATION +deshidrogenasa) I-EXPLORATION de I-EXPLORATION -hígado I-EXPLORATION -y I-EXPLORATION -riñón I-EXPLORATION -(anti-LKM1) I-EXPLORATION -resultaron I-EXPLORATION -negativos, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -las I-EXPLORATION -serologías I-EXPLORATION -frente I-EXPLORATION +547 I-EXPLORATION +U/l I-EXPLORATION +(límite I-EXPLORATION +superior I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +normalidad I-EXPLORATION +460 I-EXPLORATION +U/l). I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +pequeños I-EXPLORATION +focos I-EXPLORATION +hiperecoicos I-EXPLORATION +móviles I-EXPLORATION +dentro I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +rama I-EXPLORATION +principal I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +vena I-EXPLORATION +porta, I-EXPLORATION +junto I-EXPLORATION a I-EXPLORATION -virus I-EXPLORATION +múltiples I-EXPLORATION +zonas I-EXPLORATION +hipoecogénicas I-EXPLORATION +distribuidas I-EXPLORATION +en I-EXPLORATION +ambos I-EXPLORATION +lóbulos I-EXPLORATION +hepáticos I-EXPLORATION +sugestivos I-EXPLORATION de I-EXPLORATION -hepatitis I-EXPLORATION -A I-EXPLORATION -(VHA), I-EXPLORATION -hepatitis I-EXPLORATION -B I-EXPLORATION -(VHB) I-EXPLORATION +gas. I-EXPLORATION +La I-EXPLORATION +vesícula I-EXPLORATION +biliar, I-EXPLORATION +la I-EXPLORATION +cabeza I-EXPLORATION +del I-EXPLORATION +páncreas I-EXPLORATION y I-EXPLORATION -hepatitis I-EXPLORATION -C I-EXPLORATION -(VHC). I-EXPLORATION -El B-EVOLUTION -cuadro I-EVOLUTION -cedió I-EVOLUTION -completamente I-EVOLUTION -en I-EVOLUTION -un I-EVOLUTION -mes I-EVOLUTION -sin I-EVOLUTION -tratamiento, I-EVOLUTION -produciéndose I-EVOLUTION -la I-EVOLUTION -normalización I-EVOLUTION -de I-EVOLUTION -todos I-EVOLUTION -los I-EVOLUTION -parámetros I-EVOLUTION -previamente I-EVOLUTION -alterados. I-EVOLUTION -Cuatro I-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -presentó I-EVOLUTION -un I-EVOLUTION -nuevo I-EVOLUTION -episodio I-EVOLUTION -de I-EVOLUTION -ictericia, I-EVOLUTION -coluria, I-EVOLUTION -acolia, I-EVOLUTION -astenia I-EVOLUTION -y I-EVOLUTION -dolor I-EVOLUTION -en I-EVOLUTION -hipocondrio I-EVOLUTION -derecho I-EVOLUTION -de I-EVOLUTION -10 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -evolución. I-EVOLUTION -En B-EXPLORATION las I-EXPLORATION -pruebas I-EXPLORATION +asas I-EXPLORATION de I-EXPLORATION -imagen I-EXPLORATION -únicamente I-EXPLORATION -se I-EXPLORATION -apreció I-EXPLORATION -una I-EXPLORATION -hepatomegalia I-EXPLORATION -homogénea. I-EXPLORATION -Los I-EXPLORATION -parámetros I-EXPLORATION +intestino I-EXPLORATION +delgado I-EXPLORATION +visualizadas I-EXPLORATION +no I-EXPLORATION +presentaban I-EXPLORATION +alteraciones I-EXPLORATION +y I-EXPLORATION +no I-EXPLORATION +existía I-EXPLORATION +líquido I-EXPLORATION +libre. I-EXPLORATION +La I-EXPLORATION +única I-EXPLORATION +causa I-EXPLORATION +posible I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +neumatosis I-EXPLORATION +podía I-EXPLORATION +ser I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +engrosamiento I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +pared I-EXPLORATION del I-EXPLORATION -autoanalizador I-EXPLORATION -mostraron I-EXPLORATION +estómago, I-EXPLORATION +en I-EXPLORATION +posible I-EXPLORATION +relación I-EXPLORATION +con I-EXPLORATION una I-EXPLORATION -GOT I-EXPLORATION -de I-EXPLORATION -1665 I-EXPLORATION -UI/L, I-EXPLORATION -GPT I-EXPLORATION +gastroduodenitis I-EXPLORATION +enfisematosa. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +tomografía I-EXPLORATION +computarizada I-EXPLORATION +(TAC) I-EXPLORATION +abdominopélvica, I-EXPLORATION +que I-EXPLORATION +confirmó I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -1366 I-EXPLORATION -UI/L, I-EXPLORATION -GGT I-EXPLORATION +gas I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +tronco I-EXPLORATION +y I-EXPLORATION +ramas I-EXPLORATION +distales I-EXPLORATION de I-EXPLORATION -69 I-EXPLORATION -UI/L, I-EXPLORATION -FA I-EXPLORATION +la I-EXPLORATION +vena I-EXPLORATION +porta I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +en I-EXPLORATION +ambos I-EXPLORATION +lóbulos I-EXPLORATION +hepáticos. I-EXPLORATION +Se I-EXPLORATION +descartó I-EXPLORATION +isquemia I-EXPLORATION +mesentérica, I-EXPLORATION +inflamación I-EXPLORATION de I-EXPLORATION -380 I-EXPLORATION -UI/L I-EXPLORATION +la I-EXPLORATION +vesícula I-EXPLORATION +biliar I-EXPLORATION y I-EXPLORATION -bilirrubina I-EXPLORATION +alteraciones I-EXPLORATION +pélvicas. I-EXPLORATION +Al I-EXPLORATION +contrario I-EXPLORATION +que I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +ecografía I-EXPLORATION +previa, I-EXPLORATION +las I-EXPLORATION +paredes I-EXPLORATION +del I-EXPLORATION +estómago I-EXPLORATION +parecían I-EXPLORATION +normales, I-EXPLORATION +aunque I-EXPLORATION +existía I-EXPLORATION +una I-EXPLORATION +mínima I-EXPLORATION +cantidad I-EXPLORATION de I-EXPLORATION -21.6 I-EXPLORATION -mg/dl. I-EXPLORATION -Los I-EXPLORATION -ANA I-EXPLORATION +gas I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +vasos I-EXPLORATION +cortos I-EXPLORATION +del I-EXPLORATION +estómago. I-EXPLORATION + I-EXPLORATION +Aunque I-EXPLORATION +la I-EXPLORATION +presentación I-EXPLORATION +del I-EXPLORATION +caso I-EXPLORATION +semejaba I-EXPLORATION +una I-EXPLORATION +gastroenteritis I-EXPLORATION +secundaria I-EXPLORATION +a I-EXPLORATION +una I-EXPLORATION +contaminación I-EXPLORATION +alimentaria, I-EXPLORATION +la I-EXPLORATION +neumatosis I-EXPLORATION +portal I-EXPLORATION +motivó I-EXPLORATION +el I-EXPLORATION +ingreso I-EXPLORATION +del I-EXPLORATION +paciente. I-EXPLORATION +Recibió B-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +amoxicilina-clavulámico I-TREATMENT +y I-TREATMENT +descoagulación I-TREATMENT +con I-TREATMENT +heparina I-TREATMENT +de I-TREATMENT +bajo I-TREATMENT +peso I-TREATMENT +molecular I-TREATMENT +subcutánea I-TREATMENT +por I-TREATMENT +el I-TREATMENT +riesgo I-TREATMENT +de I-TREATMENT +trombosis I-TREATMENT +portal I-TREATMENT +secundaria I-TREATMENT +a I-TREATMENT +pileflebitis. I-TREATMENT +Los B-EXPLORATION +coprocultivos I-EXPLORATION fueron I-EXPLORATION -nuevamente I-EXPLORATION -positivos I-EXPLORATION -(a I-EXPLORATION -título I-EXPLORATION +negativos I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +descartó I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -1/320) I-EXPLORATION -con I-EXPLORATION -negatividad I-EXPLORATION -del I-EXPLORATION -resto I-EXPLORATION +Entamoeba I-EXPLORATION +histolytica, I-EXPLORATION +huevos I-EXPLORATION +y I-EXPLORATION +parásitos. I-EXPLORATION +En I-EXPLORATION +un I-EXPLORATION +hemocultivo I-EXPLORATION de I-EXPLORATION -autoanticuerpos. I-EXPLORATION -Se I-EXPLORATION -practicó I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION +los I-EXPLORATION +dos I-EXPLORATION +extraídos I-EXPLORATION +creció I-EXPLORATION +Streptococus I-EXPLORATION +viridans. I-EXPLORATION +A I-EXPLORATION +los I-EXPLORATION +4 I-EXPLORATION +días I-EXPLORATION +de I-EXPLORATION +tratamiento I-EXPLORATION +se I-EXPLORATION +repitió I-EXPLORATION +la I-EXPLORATION +TAC I-EXPLORATION +abdominopélvica I-EXPLORATION que I-EXPLORATION mostró I-EXPLORATION -cierto I-EXPLORATION -grado I-EXPLORATION -de I-EXPLORATION -distorsión I-EXPLORATION -de I-EXPLORATION la I-EXPLORATION -arquitectura I-EXPLORATION -hepática I-EXPLORATION -con I-EXPLORATION -espacios I-EXPLORATION -porta I-EXPLORATION -ensanchados I-EXPLORATION -por I-EXPLORATION -infiltrado I-EXPLORATION -linfocitario, I-EXPLORATION -neutrófilos I-EXPLORATION -y I-EXPLORATION -escasos I-EXPLORATION -eosinófilos, I-EXPLORATION -con I-EXPLORATION -proliferación I-EXPLORATION -ductular I-EXPLORATION -periférica I-EXPLORATION -y I-EXPLORATION -rotura I-EXPLORATION +desaparición I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -membrana I-EXPLORATION -limitante I-EXPLORATION -e I-EXPLORATION -inflamación I-EXPLORATION -de I-EXPLORATION -algunos I-EXPLORATION -ductos, I-EXPLORATION -apreciándose I-EXPLORATION -además I-EXPLORATION -lobulillos I-EXPLORATION -con I-EXPLORATION -hepatocitos I-EXPLORATION -con I-EXPLORATION -focos I-EXPLORATION -de I-EXPLORATION -hiperplasia I-EXPLORATION -y I-EXPLORATION -colestasis, I-EXPLORATION -alguno I-EXPLORATION -de I-EXPLORATION -ellos I-EXPLORATION -necrótico, I-EXPLORATION -con I-EXPLORATION -escasas I-EXPLORATION -necrosis I-EXPLORATION -focales I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -parénquima. I-EXPLORATION -Se B-TREATMENT -instauró I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -prednisona I-TREATMENT -y I-TREATMENT -azatioprina, I-TREATMENT -que I-TREATMENT -se I-TREATMENT -mantuvo I-TREATMENT -durante I-TREATMENT -un I-TREATMENT -año, I-TREATMENT -obteniéndose I-TREATMENT -la I-TREATMENT -remisión I-TREATMENT -completa, I-TREATMENT -tanto I-TREATMENT -clínica I-TREATMENT -como I-TREATMENT -analítica. I-TREATMENT -Tras B-EVOLUTION -tres I-EVOLUTION -años I-EVOLUTION +neumatosis I-EXPLORATION +portal. I-EXPLORATION +El B-EVOLUTION +paciente I-EVOLUTION +fue I-EVOLUTION +dado I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +y I-EVOLUTION +visto I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +6 I-EVOLUTION +meses I-EVOLUTION +en I-EVOLUTION +consultas I-EVOLUTION +externas, I-EVOLUTION +encontrándose I-EVOLUTION +asintomático I-EVOLUTION +y I-EVOLUTION +con I-EVOLUTION +una I-EVOLUTION +ecografía I-EVOLUTION +abdominal I-EVOLUTION +dentro I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +límites I-EVOLUTION de I-EVOLUTION -seguimiento I-EVOLUTION la I-EVOLUTION -paciente I-EVOLUTION -permanece I-EVOLUTION -asintomática. I-EVOLUTION +normalidad. I-EVOLUTION I-EVOLUTION -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -21 I-PRESENT_ILLNESS +66 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -soldado I-PRESENT_ILLNESS -profesional, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -médicos I-PAST_MEDICAL_HISTORY -o I-PAST_MEDICAL_HISTORY -quirúrgicos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -que B-DERIVED_FROM/TO -acudió I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -urgencias I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -Hospital, I-DERIVED_FROM/TO -remitido I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -médico I-DERIVED_FROM/TO -militar, I-DERIVED_FROM/TO -relatando I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -cuadro I-DERIVED_FROM/TO -molestias I-DERIVED_FROM/TO -abdominales I-DERIVED_FROM/TO -inespecíficas I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -varios I-DERIVED_FROM/TO -días I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -evolución. I-DERIVED_FROM/TO -El B-PRESENT_ILLNESS -enfermo I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -encontraba I-PRESENT_ILLNESS -realizando I-PRESENT_ILLNESS -unas I-PRESENT_ILLNESS -maniobras I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -supervivencia I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -montaña. I-PRESENT_ILLNESS -Desde I-PRESENT_ILLNESS -hacía I-PRESENT_ILLNESS -18 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -dolor, I-PRESENT_ILLNESS -inicialmente I-PRESENT_ILLNESS -difuso, I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -focalizado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -fosa I-PRESENT_ILLNESS -ilíaca I-PRESENT_ILLNESS -derecha I-PRESENT_ILLNESS -(FID) I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -aumentado I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -intensidad. I-PRESENT_ILLNESS -Presentaba I-PRESENT_ILLNESS -anorexia I-PRESENT_ILLNESS -progresiva, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -alteraciones I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -tránsito I-PRESENT_ILLNESS -gastrointestinal. I-PRESENT_ILLNESS -La B-EXPLORATION -exploración I-EXPLORATION -mostraba I-EXPLORATION -un I-EXPLORATION -abdomen I-EXPLORATION -blando I-EXPLORATION -y I-EXPLORATION -depresible, I-EXPLORATION -muy I-EXPLORATION -doloroso I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -presión I-EXPLORATION -profunda I-EXPLORATION -en I-EXPLORATION -FID I-EXPLORATION -con I-EXPLORATION -defensa I-EXPLORATION -y I-EXPLORATION -reacción I-EXPLORATION -peritoneal I-EXPLORATION -acusada. I-EXPLORATION -La I-EXPLORATION -temperatura I-EXPLORATION -axilar I-EXPLORATION -era I-EXPLORATION -de I-EXPLORATION -38, I-EXPLORATION -5º, I-EXPLORATION -sin I-EXPLORATION -otros I-EXPLORATION -hallazgos I-EXPLORATION -reseñables. I-EXPLORATION -Los I-EXPLORATION -estudios I-EXPLORATION -radiológicos I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -y I-EXPLORATION -abdomen I-EXPLORATION -no I-EXPLORATION -reflejaban I-EXPLORATION -patología. I-EXPLORATION -Analítica: I-EXPLORATION -leucocitos, I-EXPLORATION -14.000 I-EXPLORATION -x I-EXPLORATION -109 I-EXPLORATION -/l I-EXPLORATION -(78% I-EXPLORATION -neutrófilos); I-EXPLORATION -hemoglobina, I-EXPLORATION -14, I-EXPLORATION -46 I-EXPLORATION -mg I-EXPLORATION -/dl; I-EXPLORATION -plaquetas, I-EXPLORATION -268.000 I-EXPLORATION -x I-EXPLORATION -109 I-EXPLORATION -/l. I-EXPLORATION -Resto, I-EXPLORATION -incluyendo I-EXPLORATION -química I-EXPLORATION -clínica, I-EXPLORATION -función I-EXPLORATION -hepática I-EXPLORATION -y I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -coagulación: I-EXPLORATION -normal. I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -mostraba I-EXPLORATION -una I-EXPLORATION -intensa I-EXPLORATION -meteorización I-EXPLORATION -del I-EXPLORATION -intestino I-EXPLORATION -delgado I-EXPLORATION +ingresada I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +tromboembolismo I-PRESENT_ILLNESS +pulmonar I-PRESENT_ILLNESS +bilateral I-PRESENT_ILLNESS +bajo I-PRESENT_ILLNESS +terapia I-PRESENT_ILLNESS +anticoagulante I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +enoxaparina, I-PRESENT_ILLNESS +iniciándose B-TREATMENT +a I-TREATMENT +las I-TREATMENT +72 I-TREATMENT +horas I-TREATMENT +paso I-TREATMENT +a I-TREATMENT +anticoagulación I-TREATMENT +oral I-TREATMENT +con I-TREATMENT +acenocumarol. I-TREATMENT +Al B-EVOLUTION +octavo I-EVOLUTION +día I-EVOLUTION +de I-EVOLUTION +ingreso, I-EVOLUTION +con I-EVOLUTION +un I-EVOLUTION +INR I-EVOLUTION +de I-EVOLUTION +2, I-EVOLUTION +1, I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +desarrolla, I-EVOLUTION +tras I-EVOLUTION +un I-EVOLUTION +episodio I-EVOLUTION +emético I-EVOLUTION +autolimitado, I-EVOLUTION +un I-EVOLUTION +cuadro I-EVOLUTION +de I-EVOLUTION +malestar I-EVOLUTION +general, I-EVOLUTION +sudación, I-EVOLUTION +tendencia I-EVOLUTION +a I-EVOLUTION +hipotensión I-EVOLUTION +arterial I-EVOLUTION +y I-EVOLUTION +dolor I-EVOLUTION +abdominal I-EVOLUTION +hipogástrico I-EVOLUTION +sin I-EVOLUTION +peritonismo, I-EVOLUTION +por B-EXPLORATION +lo I-EXPLORATION que I-EXPLORATION -impedía I-EXPLORATION -la I-EXPLORATION -visualización I-EXPLORATION -del I-EXPLORATION -ciego I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -apéndice I-EXPLORATION -vermiforme. I-EXPLORATION -No I-EXPLORATION se I-EXPLORATION -observaba I-EXPLORATION -líquido I-EXPLORATION -libre, I-EXPLORATION -en I-EXPLORATION -cantidad I-EXPLORATION -significativa, I-EXPLORATION -entre I-EXPLORATION -las I-EXPLORATION -asas I-EXPLORATION -o I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -fondo I-EXPLORATION -de I-EXPLORATION -saco I-EXPLORATION -de I-EXPLORATION -Douglas. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -indica I-EXPLORATION +practica I-EXPLORATION una I-EXPLORATION -laparotomía I-EXPLORATION -exploradora I-EXPLORATION -urgente I-EXPLORATION -bajo I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION -de I-EXPLORATION +ecografía I-EXPLORATION +que I-EXPLORATION +objetiva I-EXPLORATION una I-EXPLORATION -apendicitis I-EXPLORATION -aguda. I-EXPLORATION -Se B-TREATMENT -premedica I-TREATMENT -al I-TREATMENT -paciente I-TREATMENT -con I-TREATMENT -amoxicilina I-TREATMENT -y I-TREATMENT -ácido I-TREATMENT -clavulánico I-TREATMENT -1.000/200 I-TREATMENT -mg I-TREATMENT -intravenosos, I-TREATMENT -respectivamente, I-TREATMENT -unidosis. I-TREATMENT -A B-EXPLORATION -través I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -incisión I-EXPLORATION +colección I-EXPLORATION +líquida I-EXPLORATION +intraabdominal I-EXPLORATION +hipogástrica I-EXPLORATION de I-EXPLORATION -McBurney, I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION +15 I-EXPLORATION +x I-EXPLORATION +11 I-EXPLORATION +cm. I-EXPLORATION +Se I-EXPLORATION +realiza I-EXPLORATION una I-EXPLORATION -gran I-EXPLORATION -tumoración I-EXPLORATION -cecal I-EXPLORATION +tomografía I-EXPLORATION +axial I-EXPLORATION +computarizada I-EXPLORATION +(TAC) I-EXPLORATION +que I-EXPLORATION +muestra I-EXPLORATION +una I-EXPLORATION +colección I-EXPLORATION +hipogástrica I-EXPLORATION +subperitoneal I-EXPLORATION de I-EXPLORATION -consistencia I-EXPLORATION -dura I-EXPLORATION +15 I-EXPLORATION +x I-EXPLORATION +15 I-EXPLORATION +x I-EXPLORATION +11 I-EXPLORATION +cm, I-EXPLORATION +dependiente I-EXPLORATION +del I-EXPLORATION +recto I-EXPLORATION +abdominal I-EXPLORATION +anterior I-EXPLORATION +derecho I-EXPLORATION y I-EXPLORATION -múltiples I-EXPLORATION -adenopatías. I-EXPLORATION -Tras I-EXPLORATION -el I-EXPLORATION -cierre I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -incisión, I-EXPLORATION -se I-EXPLORATION -aborda I-EXPLORATION +que I-EXPLORATION +ocupa I-EXPLORATION +gran I-EXPLORATION +parte I-EXPLORATION de I-EXPLORATION -nuevo I-EXPLORATION la I-EXPLORATION cavidad I-EXPLORATION -a I-EXPLORATION -través I-EXPLORATION +pélvica. I-EXPLORATION +Se I-EXPLORATION +objetiva I-EXPLORATION +importante I-EXPLORATION +anemización I-EXPLORATION +(descenso I-EXPLORATION de I-EXPLORATION -una I-EXPLORATION -laparotomía I-EXPLORATION -media I-EXPLORATION -supra-infraumbilical. I-EXPLORATION -La I-EXPLORATION -masa, I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -aspecto I-EXPLORATION +la I-EXPLORATION +hemoglobina I-EXPLORATION de I-EXPLORATION -una I-EXPLORATION -perityphilitis, I-EXPLORATION -englobaba I-EXPLORATION -ciego, I-EXPLORATION -apéndice I-EXPLORATION -e I-EXPLORATION -íleon I-EXPLORATION -terminal. I-EXPLORATION -Se I-EXPLORATION -visualizaban I-EXPLORATION -y I-EXPLORATION -palpaban I-EXPLORATION -ganglios I-EXPLORATION -mesocólicos. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -retroperitoneo, I-EXPLORATION +4, I-EXPLORATION +2 I-EXPLORATION +g/dl I-EXPLORATION en I-EXPLORATION -contacto I-EXPLORATION -con I-EXPLORATION +72 I-EXPLORATION +horas), I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +ante I-EXPLORATION la I-EXPLORATION -gotiera I-EXPLORATION -parietocólica I-EXPLORATION -derecha, I-EXPLORATION -se I-EXPLORATION -drenó I-EXPLORATION -un I-EXPLORATION -absceso I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -pus I-EXPLORATION -cremoso, I-EXPLORATION -blanquecino I-EXPLORATION -e I-EXPLORATION -inodoro I-EXPLORATION -que I-EXPLORATION -contenía I-EXPLORATION -unos I-EXPLORATION -100 I-EXPLORATION -ó I-EXPLORATION -150 I-EXPLORATION -cc. I-EXPLORATION -Se I-EXPLORATION -tomaron I-EXPLORATION -muestras I-EXPLORATION -que I-EXPLORATION -fueron I-EXPLORATION -cultivadas I-EXPLORATION -en I-EXPLORATION -tioglicolato, I-EXPLORATION -agar I-EXPLORATION -sangre I-EXPLORATION -y I-EXPLORATION -agar I-EXPLORATION -chocolate I-EXPLORATION -y, I-EXPLORATION -posteriormente, I-EXPLORATION -analizadas I-EXPLORATION -mediante I-EXPLORATION +shock I-EXPLORATION +hemorrágico I-EXPLORATION +por I-EXPLORATION un I-EXPLORATION -sistema I-EXPLORATION -BACTEC I-EXPLORATION -9240®. I-EXPLORATION - I-EXPLORATION -Ante B-TREATMENT -las I-TREATMENT -dudas I-TREATMENT -sobre I-TREATMENT -el I-TREATMENT -origen I-TREATMENT -canceroso I-TREATMENT +gran I-EXPLORATION +hematoma I-EXPLORATION +de I-EXPLORATION +pared I-EXPLORATION +abdominal I-EXPLORATION +se B-TREATMENT +instaura I-TREATMENT +tratamiento I-TREATMENT +enérgico I-TREATMENT +con I-TREATMENT +reposición I-TREATMENT de I-TREATMENT -la I-TREATMENT -tumoración, I-TREATMENT +volemia, I-TREATMENT se I-TREATMENT -practicó I-TREATMENT -una I-TREATMENT -hemicolectomía I-TREATMENT -derecha I-TREATMENT -reglada, I-TREATMENT -con I-TREATMENT -intención I-TREATMENT -oncológica, I-TREATMENT -resecando I-TREATMENT -en I-TREATMENT +revierte I-TREATMENT la I-TREATMENT -pieza I-TREATMENT +anticoagulación I-TREATMENT +y I-TREATMENT +se I-TREATMENT +solicita I-TREATMENT +valoración I-TREATMENT quirúrgica I-TREATMENT -el I-TREATMENT +urgente. I-TREATMENT +Ante B-EVOLUTION +la I-EVOLUTION +persistencia I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +inestabilidad I-EVOLUTION +hemodinámica I-EVOLUTION +con I-EVOLUTION +el I-EVOLUTION +manejo I-EVOLUTION +conservador I-EVOLUTION +inicial I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +aparición I-EVOLUTION +de I-EVOLUTION +semiología I-EVOLUTION +de I-EVOLUTION +abdomen I-EVOLUTION +agudo, I-EVOLUTION +se B-TREATMENT +decide I-TREATMENT +practicar I-TREATMENT +laparotomía I-TREATMENT +urgente I-TREATMENT +que I-TREATMENT +muestra I-TREATMENT +"estallido" I-TREATMENT +del I-TREATMENT peritoneo I-TREATMENT parietal I-TREATMENT -afecto I-TREATMENT y I-TREATMENT -todas I-TREATMENT -las I-TREATMENT -adenopatías I-TREATMENT -palpables. I-TREATMENT -La I-TREATMENT -reconstrucción I-TREATMENT del I-TREATMENT -tránsito I-TREATMENT -digestivo I-TREATMENT +músculo I-TREATMENT +recto I-TREATMENT +anterior I-TREATMENT +derecho I-TREATMENT +con I-TREATMENT +gran I-TREATMENT +hemoperitoneo I-TREATMENT +secundario I-TREATMENT +que I-TREATMENT +diseca I-TREATMENT +todo I-TREATMENT +el I-TREATMENT +espacio I-TREATMENT +prevesical, I-TREATMENT +objetivándose I-TREATMENT +sangrado I-TREATMENT +arterial I-TREATMENT +por I-TREATMENT +laceración I-TREATMENT +de I-TREATMENT +la I-TREATMENT +arteria I-TREATMENT +epigástrica I-TREATMENT +derecha I-TREATMENT +que I-TREATMENT se I-TREATMENT -llevó I-TREATMENT +liga I-TREATMENT +y I-TREATMENT +sutura, I-TREATMENT +procediéndose I-TREATMENT a I-TREATMENT -cabo I-TREATMENT -mediante I-TREATMENT -una I-TREATMENT -anastomosis I-TREATMENT -íleo-cólica I-TREATMENT -latero-lateral I-TREATMENT -manual. I-TREATMENT +evacuar I-TREATMENT +aproximadamente I-TREATMENT +2 I-TREATMENT +litros I-TREATMENT +de I-TREATMENT +hemoperitoneo I-TREATMENT +con I-TREATMENT +grandes I-TREATMENT +coágulos I-TREATMENT +prevesicales, I-TREATMENT +y I-TREATMENT +cierre I-TREATMENT +con I-TREATMENT +malla I-TREATMENT +de I-TREATMENT +polipropileno I-TREATMENT +por I-TREATMENT +defecto I-TREATMENT +de I-TREATMENT +músculo I-TREATMENT +suprafascial. I-TREATMENT +Tras I-TREATMENT +soporte I-TREATMENT +en I-TREATMENT +Unidad I-TREATMENT +de I-TREATMENT +Cuidados I-TREATMENT +Intensivos I-TREATMENT +e I-TREATMENT +implantación I-TREATMENT +de I-TREATMENT +filtro I-TREATMENT +temporal I-TREATMENT +de I-TREATMENT +vena I-TREATMENT +cava I-TREATMENT +inferior, I-TREATMENT +la B-EVOLUTION +paciente I-EVOLUTION +fue I-EVOLUTION +dada I-EVOLUTION +de I-EVOLUTION +alta, I-EVOLUTION +reinstaurándose B-TREATMENT +terapia I-TREATMENT +anticoagulante I-TREATMENT +con I-TREATMENT +acenocumarol. I-TREATMENT I-TREATMENT -En B-EVOLUTION -postoperatorio I-EVOLUTION -inmediato, I-EVOLUTION -el I-EVOLUTION -enfermo I-EVOLUTION -presentó I-EVOLUTION -un I-EVOLUTION -pico I-EVOLUTION -febril I-EVOLUTION -vespertino, I-EVOLUTION -con I-EVOLUTION -temperatura I-EVOLUTION -superior I-EVOLUTION -a I-EVOLUTION -38, I-EVOLUTION -5º. I-EVOLUTION -Se B-EXPLORATION -extrajeron I-EXPLORATION -hemocultivos I-EXPLORATION +El B-EXPLORATION +hematoma I-EXPLORATION +de I-EXPLORATION +pared I-EXPLORATION +abdominal I-EXPLORATION +es I-EXPLORATION +una I-EXPLORATION +entidad I-EXPLORATION +infrecuente I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +difícil I-EXPLORATION +diagnóstico I-EXPLORATION que I-EXPLORATION -resultaron I-EXPLORATION -ser I-EXPLORATION -microbiológicamente I-EXPLORATION -estériles. I-EXPLORATION +generalmente I-EXPLORATION +está I-EXPLORATION +relacionada I-EXPLORATION +con I-EXPLORATION +la I-EXPLORATION +anticoagulación I-EXPLORATION +sistémica. I-EXPLORATION En I-EXPLORATION -el I-EXPLORATION -quinto I-EXPLORATION -día I-EXPLORATION -del I-EXPLORATION -postoperatorio I-EXPLORATION +su I-EXPLORATION +patogenia I-EXPLORATION se I-EXPLORATION -nos I-EXPLORATION -informa I-EXPLORATION +involucra I-EXPLORATION +la I-EXPLORATION +anticoagulación I-EXPLORATION +como I-EXPLORATION +factor I-EXPLORATION +predisponerte I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +contracción I-EXPLORATION +vigorosa I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +músculos I-EXPLORATION +rectos I-EXPLORATION del I-EXPLORATION -crecimiento I-EXPLORATION +abdomen I-EXPLORATION en I-EXPLORATION el I-EXPLORATION -cultivo I-EXPLORATION +seno I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -muestra I-EXPLORATION +movimientos I-EXPLORATION de I-EXPLORATION -líquido I-EXPLORATION -biológico I-EXPLORATION +Valsalva I-EXPLORATION +enérgicos I-EXPLORATION +y I-EXPLORATION +bruscos I-EXPLORATION +(tos, I-EXPLORATION +vómitos, I-EXPLORATION +estreñimiento) I-EXPLORATION +como I-EXPLORATION +factor I-EXPLORATION +desencadenante. I-EXPLORATION +En I-EXPLORATION +varios I-EXPLORATION +trabajos I-EXPLORATION +previos I-EXPLORATION +se I-EXPLORATION +ha I-EXPLORATION +documentado I-EXPLORATION +la I-EXPLORATION +laceración I-EXPLORATION de I-EXPLORATION -un I-EXPLORATION -bacilo I-EXPLORATION -gram I-EXPLORATION -positivo I-EXPLORATION +las I-EXPLORATION +arterias I-EXPLORATION +epigástricas I-EXPLORATION +como I-EXPLORATION +la I-EXPLORATION +causa I-EXPLORATION del I-EXPLORATION -género I-EXPLORATION -Listeria I-EXPLORATION -spp. I-EXPLORATION -A I-EXPLORATION -través I-EXPLORATION +hematoma I-EXPLORATION +de I-EXPLORATION +pared I-EXPLORATION +abdominal I-EXPLORATION +(1-6). I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +diagnóstico I-EXPLORATION +se I-EXPLORATION +basa I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +contexto I-EXPLORATION +clínico I-EXPLORATION +y I-EXPLORATION +los I-EXPLORATION +hallazgos I-EXPLORATION de I-EXPLORATION las I-EXPLORATION -técnicas I-EXPLORATION -habituales I-EXPLORATION +pruebas I-EXPLORATION de I-EXPLORATION -laboratorio I-EXPLORATION -y I-EXPLORATION -del I-EXPLORATION -serotipado, I-EXPLORATION -mediante I-EXPLORATION +imagen I-EXPLORATION +abdominal. I-EXPLORATION +La I-EXPLORATION +presentación I-EXPLORATION +clínica I-EXPLORATION +habitual I-EXPLORATION +consiste I-EXPLORATION +en I-EXPLORATION +dolor I-EXPLORATION +abdominal, I-EXPLORATION +pudiendo I-EXPLORATION +objetivarse I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -método I-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +abdominal I-EXPLORATION +con I-EXPLORATION +o I-EXPLORATION +sin I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +irritación I-EXPLORATION +peritoneal I-EXPLORATION +y/o I-EXPLORATION +un I-EXPLORATION +hematoma I-EXPLORATION +superficial. I-EXPLORATION +La I-EXPLORATION +ecografía I-EXPLORATION +suele I-EXPLORATION +documentar I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -aglutinación, I-EXPLORATION -el I-EXPLORATION -patógeno I-EXPLORATION -fue I-EXPLORATION -identificado, I-EXPLORATION -definitivamente, I-EXPLORATION -como I-EXPLORATION una I-EXPLORATION -Listeria I-EXPLORATION +colección I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -especie I-EXPLORATION -monocytoges I-EXPLORATION -perteneciente I-EXPLORATION -al I-EXPLORATION -serotipo I-EXPLORATION -4b. I-EXPLORATION -En I-EXPLORATION +pared I-EXPLORATION +abdominal I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +TAC I-EXPLORATION +es I-EXPLORATION +la I-EXPLORATION +técnica I-EXPLORATION +de I-EXPLORATION +elección I-EXPLORATION +ya I-EXPLORATION +que I-EXPLORATION +permite I-EXPLORATION +definir I-EXPLORATION +y I-EXPLORATION +precisar I-EXPLORATION +la I-EXPLORATION +extensión I-EXPLORATION +del I-EXPLORATION +proceso I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +afectación I-EXPLORATION +de I-EXPLORATION +órganos I-EXPLORATION +vecinos. I-EXPLORATION + I-EXPLORATION +Su I-EXPLORATION +manejo I-EXPLORATION +es, I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +general, I-EXPLORATION +conservador, I-EXPLORATION +incluso I-EXPLORATION +ante I-EXPLORATION +hallazgos I-EXPLORATION +clínicos I-EXPLORATION +de I-EXPLORATION +abdomen I-EXPLORATION +agudo I-EXPLORATION +(1,3), I-EXPLORATION +ya I-EXPLORATION +que I-EXPLORATION el I-EXPLORATION -antibiograma I-EXPLORATION +propio I-EXPLORATION +hematoma I-EXPLORATION +ejerce I-EXPLORATION +efecto I-EXPLORATION +de I-EXPLORATION +auto-taponamiento, I-EXPLORATION +siendo I-EXPLORATION +suficientes I-EXPLORATION el I-EXPLORATION -germen I-EXPLORATION -era I-EXPLORATION -sensible I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -ampicilina, I-EXPLORATION -cefotaxima, I-EXPLORATION -vancomicina, I-EXPLORATION -rifampicina, I-EXPLORATION -eritromicina, I-EXPLORATION -cotrimoxazol, I-EXPLORATION -ciprofloxacina I-EXPLORATION +tratamiento I-EXPLORATION +sintomático I-EXPLORATION y I-EXPLORATION -amoxicilina I-EXPLORATION -más I-EXPLORATION -ácido I-EXPLORATION -clavulánico. I-EXPLORATION -Dada B-EVOLUTION -la I-EVOLUTION -buena I-EVOLUTION -evolución I-EVOLUTION -clínica I-EVOLUTION -del I-EVOLUTION -paciente, I-EVOLUTION -con I-EVOLUTION -desaparición I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -fiebre, I-EVOLUTION -se B-TREATMENT -mantuvo I-TREATMENT -la I-TREATMENT -pauta I-TREATMENT -antibiótica, I-TREATMENT -consistente I-TREATMENT +la I-EXPLORATION +transfusión I-EXPLORATION +sanguínea I-EXPLORATION +en I-EXPLORATION +casos I-EXPLORATION +necesarios. I-EXPLORATION +No B-TREATMENT +obstante, I-TREATMENT +existen I-TREATMENT +situaciones I-TREATMENT en I-TREATMENT -3.000/600 I-TREATMENT -mg I-TREATMENT -de I-TREATMENT -amoxicilina I-TREATMENT +las I-TREATMENT +que I-TREATMENT +la I-TREATMENT +hemorragia I-TREATMENT +puede I-TREATMENT +ser I-TREATMENT +muy I-TREATMENT +severa I-TREATMENT y I-TREATMENT -ácido I-TREATMENT -clavulánico, I-TREATMENT -respectivamente, I-TREATMENT -repartidos I-TREATMENT -en I-TREATMENT -tres I-TREATMENT -dosis I-TREATMENT -intravenosas I-TREATMENT -diarias. I-TREATMENT -En B-EVOLUTION -el I-EVOLUTION -sexto I-EVOLUTION -día I-EVOLUTION -se I-EVOLUTION -inicia I-EVOLUTION -y I-EVOLUTION -progresa I-EVOLUTION -la I-EVOLUTION -tolerancia I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -alimentación I-EVOLUTION -por I-EVOLUTION -vía I-EVOLUTION -oral, I-EVOLUTION -con I-EVOLUTION -resultados I-EVOLUTION -positivos. I-EVOLUTION -En B-TREATMENT -el I-TREATMENT -día I-TREATMENT -catorce I-TREATMENT -del I-TREATMENT -postoperatorio, I-TREATMENT -como I-TREATMENT -medida I-TREATMENT -previa I-TREATMENT -al I-TREATMENT -alta, I-TREATMENT -se I-TREATMENT -suspende I-TREATMENT +llega I-TREATMENT +a I-TREATMENT +comprometer I-TREATMENT la I-TREATMENT -antibioterapia I-TREATMENT -intravenosa I-TREATMENT +vida, I-TREATMENT +precisándose I-TREATMENT +un I-TREATMENT +abordaje I-TREATMENT +quirúrgico I-TREATMENT +para I-TREATMENT +localizar I-TREATMENT +el I-TREATMENT +punto I-TREATMENT +sangrante I-TREATMENT y I-TREATMENT +drenar I-TREATMENT +el I-TREATMENT +hematoma. I-TREATMENT +También I-TREATMENT se I-TREATMENT -sustituye I-TREATMENT -por I-TREATMENT -una I-TREATMENT -pauta I-TREATMENT -oral I-TREATMENT +ha I-TREATMENT +descrito I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +exitoso I-TREATMENT +mediante I-TREATMENT +embolización I-TREATMENT +endovascular I-TREATMENT de I-TREATMENT -1.500/375 I-TREATMENT -mg I-TREATMENT +los I-TREATMENT +vasos I-TREATMENT +sangrantes I-TREATMENT +(1). I-TREATMENT +La I-TREATMENT +inestabilidad I-TREATMENT +hemodinámica I-TREATMENT +a I-TREATMENT +pesar I-TREATMENT +del I-TREATMENT +tratamiento I-TREATMENT +médico I-TREATMENT +intensivo I-TREATMENT +y/o I-TREATMENT +la I-TREATMENT +aparición I-TREATMENT de I-TREATMENT -amoxicilina I-TREATMENT -y I-TREATMENT -ácido I-TREATMENT -clavulánico I-TREATMENT -cada I-TREATMENT -24 I-TREATMENT -horas, I-TREATMENT -fraccionada I-TREATMENT +complicaciones I-TREATMENT +(hemoperitoneo, I-TREATMENT +sobre-infección, I-TREATMENT +etc.) I-TREATMENT +son I-TREATMENT +las I-TREATMENT +principales I-TREATMENT +indicaciones I-TREATMENT +del I-TREATMENT +tratamiento I-TREATMENT +quirúrgico, I-TREATMENT +como I-TREATMENT +ocurrió I-TREATMENT en I-TREATMENT -tres I-TREATMENT -dosis, I-TREATMENT +el I-TREATMENT +caso I-TREATMENT que I-TREATMENT -se I-TREATMENT -mantuvo I-TREATMENT -durante I-TREATMENT -una I-TREATMENT -semana I-TREATMENT -más. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -recibe I-EVOLUTION -el I-EVOLUTION -alta I-EVOLUTION -hospitalaria I-EVOLUTION -tres I-EVOLUTION -días I-EVOLUTION -después. I-EVOLUTION - I-EVOLUTION -Al I-EVOLUTION -año I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -intervención I-EVOLUTION -el I-EVOLUTION -enfermo I-EVOLUTION -se I-EVOLUTION -encontraba I-EVOLUTION -asintomático I-EVOLUTION -y I-EVOLUTION -desarrollando I-EVOLUTION -una I-EVOLUTION -actividad I-EVOLUTION -normal. I-EVOLUTION -Se B-EXPLORATION -solicitó I-EXPLORATION -una I-EXPLORATION -analítica I-EXPLORATION -completa, I-EXPLORATION -colonoscopia I-EXPLORATION +presentamos. I-TREATMENT + I-TREATMENT +Nuestra B-EXPLORATION +experiencia I-EXPLORATION +confirma I-EXPLORATION +la I-EXPLORATION +importancia I-EXPLORATION +del I-EXPLORATION +diagnóstico I-EXPLORATION +precoz I-EXPLORATION +del I-EXPLORATION +hematoma I-EXPLORATION +de I-EXPLORATION +pared I-EXPLORATION +abdominal I-EXPLORATION y I-EXPLORATION -TAC I-EXPLORATION +la I-EXPLORATION +necesidad I-EXPLORATION de I-EXPLORATION -abdomen I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION +llevar I-EXPLORATION +a I-EXPLORATION +cabo I-EXPLORATION +un I-EXPLORATION +manejo I-EXPLORATION +individualizado I-EXPLORATION +del I-EXPLORATION +mismo, I-EXPLORATION +ya I-EXPLORATION que I-EXPLORATION -no I-EXPLORATION se I-EXPLORATION -informaron I-EXPLORATION -hallazgos I-EXPLORATION -patológicos I-EXPLORATION -o I-EXPLORATION -sugerentes I-EXPLORATION +trata I-EXPLORATION de I-EXPLORATION -enfermedad I-EXPLORATION -inflamatoria I-EXPLORATION -intestinal. I-EXPLORATION +una I-EXPLORATION +entidad I-EXPLORATION +que, I-EXPLORATION +aunque I-EXPLORATION +generalmente I-EXPLORATION +es I-EXPLORATION +leve I-EXPLORATION +y I-EXPLORATION +autolimitada, I-EXPLORATION +puede I-EXPLORATION +presentar I-EXPLORATION +complicaciones I-EXPLORATION +de I-EXPLORATION +gran I-EXPLORATION +magnitud I-EXPLORATION +(shock I-EXPLORATION +hemorrágico I-EXPLORATION +refractario I-EXPLORATION +a I-EXPLORATION +soporte I-EXPLORATION +médico, I-EXPLORATION +hemoperitoneo, I-EXPLORATION +compromiso I-EXPLORATION +de I-EXPLORATION +vísceras I-EXPLORATION +abdomino-pélvicas, I-EXPLORATION +etc.) I-EXPLORATION +que B-TREATMENT +llegan I-TREATMENT +a I-TREATMENT +poner I-TREATMENT +en I-TREATMENT +peligro I-TREATMENT +la I-TREATMENT +vida I-TREATMENT +del I-TREATMENT +paciente I-TREATMENT +y I-TREATMENT +requieren I-TREATMENT +un I-TREATMENT +abordaje I-TREATMENT +quirúrgico. I-TREATMENT + I-TREATMENT +J. B-EXPLORATION +F. I-EXPLORATION +Varona, I-EXPLORATION +R. I-EXPLORATION +Díaz-Conradi1, I-EXPLORATION +M. I-EXPLORATION +Valle, I-EXPLORATION +F. I-EXPLORATION +Muñoz2 I-EXPLORATION +y I-EXPLORATION +M. I-EXPLORATION +A. I-EXPLORATION +Bufalá I-EXPLORATION +Departamentos I-EXPLORATION +de I-EXPLORATION +Medicina I-EXPLORATION +Interna, I-EXPLORATION +1Cirugía I-EXPLORATION +General I-EXPLORATION +y I-EXPLORATION +2Radiodiagnóstico. I-EXPLORATION +Hospital I-EXPLORATION +El I-EXPLORATION +Escorial. I-EXPLORATION +San I-EXPLORATION +Lorenzo I-EXPLORATION +del I-EXPLORATION +Escorial, I-EXPLORATION +Madrid I-EXPLORATION I-EXPLORATION -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +femenino I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -33 I-PRESENT_ILLNESS +43 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS con B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -exADVP I-PAST_MEDICAL_HISTORY +haber I-PAST_MEDICAL_HISTORY +vivido I-PAST_MEDICAL_HISTORY +7 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -sustitutivo I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -Metadona, I-PAST_MEDICAL_HISTORY -consumidor I-PAST_MEDICAL_HISTORY -habitual I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cocaína I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +Amazonas I-PAST_MEDICAL_HISTORY +(desde I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +28 I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -cannabis, I-PAST_MEDICAL_HISTORY -diagnosticado I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -HVC I-PAST_MEDICAL_HISTORY -(con I-PAST_MEDICAL_HISTORY -biopsia I-PAST_MEDICAL_HISTORY -hepática I-PAST_MEDICAL_HISTORY -realizada), I-PAST_MEDICAL_HISTORY -herida I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -asta I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -vaca I-PAST_MEDICAL_HISTORY -brava I-PAST_MEDICAL_HISTORY -EII, I-PAST_MEDICAL_HISTORY -intervenido I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -necrosis I-PAST_MEDICAL_HISTORY -avascular I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cadera I-PAST_MEDICAL_HISTORY -derecha, I-PAST_MEDICAL_HISTORY -fractura I-PAST_MEDICAL_HISTORY +hasta I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +35 I-PAST_MEDICAL_HISTORY +años), I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -hombro I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -muñeca I-PAST_MEDICAL_HISTORY -derecha. I-PAST_MEDICAL_HISTORY -Como I-PAST_MEDICAL_HISTORY +profesión I-PAST_MEDICAL_HISTORY +médica, I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +refiere I-PAST_MEDICAL_HISTORY +dispepsia I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY tratamiento I-PAST_MEDICAL_HISTORY -previo I-PAST_MEDICAL_HISTORY -llevaba I-PAST_MEDICAL_HISTORY -Tranxilium I-PAST_MEDICAL_HISTORY -50 I-PAST_MEDICAL_HISTORY -mg I-PAST_MEDICAL_HISTORY -1/2 I-PAST_MEDICAL_HISTORY -comprimido I-PAST_MEDICAL_HISTORY -cada I-PAST_MEDICAL_HISTORY -8 I-PAST_MEDICAL_HISTORY -horas. I-PAST_MEDICAL_HISTORY -Ingresa B-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -ser I-PRESENT_ILLNESS -encontrado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -domicilio I-PRESENT_ILLNESS +regular. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Consulta B-PRESENT_ILLNESS por I-PRESENT_ILLNESS -familiares I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -situación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -disminución I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -nivel I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -conciencia I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -restos I-PRESENT_ILLNESS +sudoración I-PRESENT_ILLNESS +nocturna I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -vómito I-PRESENT_ILLNESS -alimentario I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -edema I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -extremidad I-PRESENT_ILLNESS -superior I-PRESENT_ILLNESS -izquierda; I-PRESENT_ILLNESS -refería I-PRESENT_ILLNESS -haber I-PRESENT_ILLNESS -consumido I-PRESENT_ILLNESS -previamente I-PRESENT_ILLNESS -cocaína I-PRESENT_ILLNESS -vía I-PRESENT_ILLNESS -intranasal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -consumo I-PRESENT_ILLNESS +8 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -alcohol I-PRESENT_ILLNESS -concomitante I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -previas. I-PRESENT_ILLNESS -Así B-EXPLORATION -mismo I-EXPLORATION -refería I-EXPLORATION -dolor I-EXPLORATION -e I-EXPLORATION -inflamación I-EXPLORATION -en I-EXPLORATION -ESI. I-EXPLORATION -Presentaba, I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física, I-EXPLORATION -febrícula I-EXPLORATION +evolución. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Niega B-EXPLORATION +fiebre, I-EXPLORATION +pérdida I-EXPLORATION de I-EXPLORATION -37, I-EXPLORATION -5 I-EXPLORATION -ºC, I-EXPLORATION -TA I-EXPLORATION -120/90, I-EXPLORATION -consciente I-EXPLORATION -orientado I-EXPLORATION -con I-EXPLORATION -bajo I-EXPLORATION -nivel I-EXPLORATION +peso, I-EXPLORATION +tabaquismo, I-EXPLORATION +consumo I-EXPLORATION de I-EXPLORATION -conciencia I-EXPLORATION -sin I-EXPLORATION -focalidad I-EXPLORATION -neurológica, I-EXPLORATION -edema I-EXPLORATION +fármacos I-EXPLORATION +o I-EXPLORATION +drogas I-EXPLORATION +ilícitas. I-EXPLORATION + I-EXPLORATION +No I-EXPLORATION +presentaba I-EXPLORATION +datos I-EXPLORATION +significativos I-EXPLORATION +al I-EXPLORATION +exámen I-EXPLORATION +físico. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +le I-EXPLORATION +realizó I-EXPLORATION +laboratorio, I-EXPLORATION +velocidad I-EXPLORATION +de I-EXPLORATION +eritrosedimentación I-EXPLORATION +globular I-EXPLORATION +(VSG), I-EXPLORATION +hormonas I-EXPLORATION +tiroideas, I-EXPLORATION +proteinograma I-EXPLORATION +electroforético I-EXPLORATION y I-EXPLORATION -dolor I-EXPLORATION -con I-EXPLORATION -edema I-EXPLORATION -en I-EXPLORATION -ESI. I-EXPLORATION -Al I-EXPLORATION -realizar I-EXPLORATION -primera I-EXPLORATION -valoración I-EXPLORATION -realiza I-EXPLORATION -escasa I-EXPLORATION -emisión I-EXPLORATION +complemento, I-EXPLORATION +encontrándose I-EXPLORATION +todos I-EXPLORATION +dentro I-EXPLORATION +de I-EXPLORATION +límites I-EXPLORATION +normales. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +realizaron I-EXPLORATION +cultivos I-EXPLORATION de I-EXPLORATION +sangre I-EXPLORATION +y I-EXPLORATION orina I-EXPLORATION -colúrica. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -ECG I-EXPLORATION -un I-EXPLORATION -ritmo I-EXPLORATION -sinusal I-EXPLORATION -a I-EXPLORATION -105 I-EXPLORATION -lpm. I-EXPLORATION +que I-EXPLORATION +fueron I-EXPLORATION +negativos I-EXPLORATION +(3 I-EXPLORATION +pares I-EXPLORATION +de I-EXPLORATION +hemocultivos I-EXPLORATION +y I-EXPLORATION +2 I-EXPLORATION +cultivos I-EXPLORATION +de I-EXPLORATION +orina). I-EXPLORATION +Reacción I-EXPLORATION +de I-EXPLORATION +Mantoux I-EXPLORATION +y I-EXPLORATION +serologías I-EXPLORATION +virales, I-EXPLORATION +bacterianas I-EXPLORATION +y I-EXPLORATION +parasitarias I-EXPLORATION +negativas. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +agregaron I-EXPLORATION +factor I-EXPLORATION +reumatoideo, I-EXPLORATION +factor I-EXPLORATION +antinuclear, I-EXPLORATION +ANCA I-EXPLORATION +C I-EXPLORATION +y I-EXPLORATION +P, I-EXPLORATION +siendo I-EXPLORATION +todos I-EXPLORATION +negativos. I-EXPLORATION + I-EXPLORATION La I-EXPLORATION radiografía I-EXPLORATION de I-EXPLORATION tórax I-EXPLORATION -ligera I-EXPLORATION -cardiomegalia. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION +no I-EXPLORATION +evidenció I-EXPLORATION +patología. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +paciente I-EXPLORATION +presentaba I-EXPLORATION +dispepsia I-EXPLORATION +y I-EXPLORATION +pirosis, I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +sugiere I-EXPLORATION +enfermedad I-EXPLORATION +por I-EXPLORATION +RGE I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +endoscopia I-EXPLORATION +digestiva I-EXPLORATION +que I-EXPLORATION +evidenció I-EXPLORATION +esofagitis I-EXPLORATION +grado I-EXPLORATION +dos. I-EXPLORATION +Inició B-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +omeprazol I-TREATMENT +40 I-TREATMENT +mg/día, I-TREATMENT +desapareciendo B-EVOLUTION +los I-EVOLUTION +síntomas I-EVOLUTION +así I-EVOLUTION +como I-EVOLUTION +también I-EVOLUTION +la I-EVOLUTION +sudoración I-EVOLUTION +nocturna, I-EVOLUTION +y I-EVOLUTION +reapareciendo I-EVOLUTION +esta I-EVOLUTION +última I-EVOLUTION +al I-EVOLUTION +suspender I-EVOLUTION +el I-EVOLUTION +fármaco. I-EVOLUTION +Se B-EXPLORATION +realizó I-EXPLORATION +pHmetría I-EXPLORATION de I-EXPLORATION -sangre I-EXPLORATION -CPK I-EXPLORATION -33.255 I-EXPLORATION -U/L I-EXPLORATION -(normal I-EXPLORATION -10-80), I-EXPLORATION -ASAT I-EXPLORATION -1421 I-EXPLORATION -U/L I-EXPLORATION -(normal I-EXPLORATION -0-18), I-EXPLORATION -ALAT I-EXPLORATION -596 I-EXPLORATION -U/L I-EXPLORATION -(normal I-EXPLORATION -0-22), I-EXPLORATION -calcio I-EXPLORATION -9, I-EXPLORATION -4 I-EXPLORATION -mg/dL, I-EXPLORATION -amilasa I-EXPLORATION -396 I-EXPLORATION -U/L I-EXPLORATION -(normal I-EXPLORATION -36-128), I-EXPLORATION -urea I-EXPLORATION -135 I-EXPLORATION -mg/dL I-EXPLORATION -(normal I-EXPLORATION -10-50) I-EXPLORATION +control I-EXPLORATION +no I-EXPLORATION +demostrando I-EXPLORATION +reflujo. I-EXPLORATION + I-EXPLORATION + +Presentamos B-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +19 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +previamente I-PRESENT_ILLNESS +sano, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +precisó I-PRESENT_ILLNESS +hospitalización I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +ictericia, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +otras I-PRESENT_ILLNESS +alteraciones I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +exploración. I-PRESENT_ILLNESS +Confesó B-PAST_MEDICAL_HISTORY +haber I-PAST_MEDICAL_HISTORY +usado I-PAST_MEDICAL_HISTORY +estanozolol I-PAST_MEDICAL_HISTORY +50 I-PAST_MEDICAL_HISTORY +mg/48 I-PAST_MEDICAL_HISTORY +h I-PAST_MEDICAL_HISTORY +(Winstrol®), I-PAST_MEDICAL_HISTORY +enantato I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +metenolona I-PAST_MEDICAL_HISTORY +(Primobolan®) I-PAST_MEDICAL_HISTORY +100 I-PAST_MEDICAL_HISTORY +mg/96 I-PAST_MEDICAL_HISTORY +h I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +propionato I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +drostanolona I-PAST_MEDICAL_HISTORY +(Masteron®) I-PAST_MEDICAL_HISTORY +200 I-PAST_MEDICAL_HISTORY +mg/96 I-PAST_MEDICAL_HISTORY +h, I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +vía I-PAST_MEDICAL_HISTORY +intramuscular, I-PAST_MEDICAL_HISTORY +durante I-PAST_MEDICAL_HISTORY +56 I-PAST_MEDICAL_HISTORY +días, I-PAST_MEDICAL_HISTORY +interrumpiendo I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +consumo I-PAST_MEDICAL_HISTORY +diez I-PAST_MEDICAL_HISTORY +días I-PAST_MEDICAL_HISTORY +antes I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +ingreso. I-PAST_MEDICAL_HISTORY +Destacaba B-EXPLORATION +una I-EXPLORATION +bilirrubina I-EXPLORATION +de I-EXPLORATION +41, I-EXPLORATION +9 I-EXPLORATION +mg/dl I-EXPLORATION +con I-EXPLORATION +GPT I-EXPLORATION +114 I-EXPLORATION +UI/l I-EXPLORATION y I-EXPLORATION +GGT I-EXPLORATION +normal; I-EXPLORATION +la I-EXPLORATION creatinina I-EXPLORATION -11, I-EXPLORATION -8 I-EXPLORATION -mg/dL I-EXPLORATION -(normal I-EXPLORATION -0, I-EXPLORATION -6-1, I-EXPLORATION -2). I-EXPLORATION -El I-EXPLORATION -sedimento I-EXPLORATION -urinario I-EXPLORATION +máxima I-EXPLORATION fue I-EXPLORATION -normal. I-EXPLORATION +de I-EXPLORATION +1, I-EXPLORATION +2 I-EXPLORATION +mg/dl I-EXPLORATION +(día I-EXPLORATION ++39). I-EXPLORATION Se I-EXPLORATION -realizó I-EXPLORATION -determinación I-EXPLORATION +excluyeron I-EXPLORATION +otras I-EXPLORATION +causas I-EXPLORATION de I-EXPLORATION -tóxicos I-EXPLORATION -en I-EXPLORATION -orina I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -positivo I-EXPLORATION -para I-EXPLORATION -cannabinoides, I-EXPLORATION -metadona, I-EXPLORATION -benzodiacepinas I-EXPLORATION +hepatopatía, I-EXPLORATION +patología I-EXPLORATION +biliar I-EXPLORATION y I-EXPLORATION -cocaína. I-EXPLORATION -Los I-EXPLORATION -niveles I-EXPLORATION +trastornos I-EXPLORATION +vasculares. I-EXPLORATION +Una I-EXPLORATION +biopsia I-EXPLORATION +hepática I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +marcada I-EXPLORATION +colestasis I-EXPLORATION +parenquimatosa I-EXPLORATION +y I-EXPLORATION +canalicular I-EXPLORATION de I-EXPLORATION -etanol I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION -en I-EXPLORATION -cantidad I-EXPLORATION -no I-EXPLORATION -mensurable. I-EXPLORATION -Se B-TREATMENT -comenta I-TREATMENT -con I-TREATMENT -Servicio I-TREATMENT -de I-TREATMENT -Nefrología I-TREATMENT -que I-TREATMENT -realiza I-TREATMENT -varias I-TREATMENT -sesiones I-TREATMENT -de I-TREATMENT -hemodiálisis I-TREATMENT -hasta I-TREATMENT -entrar I-TREATMENT -en I-TREATMENT -fase I-TREATMENT +predominio I-EXPLORATION +centrolobulillar. I-EXPLORATION +La B-EVOLUTION +evolución I-EVOLUTION +fue I-EVOLUTION +lentamente I-EVOLUTION +favorable, I-EVOLUTION +con I-EVOLUTION +resolución I-EVOLUTION +espontánea I-EVOLUTION +ad I-EVOLUTION +integrum I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +tres I-EVOLUTION +meses. I-EVOLUTION + I-EVOLUTION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +38 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +fallo I-PRESENT_ILLNESS +intestinal I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +nutrición I-PRESENT_ILLNESS +parenteral I-PRESENT_ILLNESS +domiciliaria I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +18 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +Presentaba B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +obesidad I-PAST_MEDICAL_HISTORY +mórbida, I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +lo I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +sido I-PAST_MEDICAL_HISTORY +intervenido I-PAST_MEDICAL_HISTORY +quirúrgicamente I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +2002. I-PAST_MEDICAL_HISTORY +Tras B-TREATMENT +cuatro I-TREATMENT +años I-TREATMENT de I-TREATMENT -poliuria I-TREATMENT +buen I-TREATMENT +estado I-TREATMENT +general I-TREATMENT y I-TREATMENT -recuperación I-TREATMENT +una I-TREATMENT +reducción I-TREATMENT +importante I-TREATMENT de I-TREATMENT +peso I-TREATMENT +presentó I-TREATMENT +un I-TREATMENT +vólvulo I-TREATMENT +intestinal, I-TREATMENT +que I-TREATMENT +obligó I-TREATMENT +a I-TREATMENT la I-TREATMENT -función I-TREATMENT -renal I-TREATMENT -(creatinina I-TREATMENT +resección I-TREATMENT de I-TREATMENT -1.6 I-TREATMENT -mg/dL), I-TREATMENT -mejorando I-TREATMENT -los I-TREATMENT -parámetros I-TREATMENT -enzimas I-TREATMENT -hepáticos I-TREATMENT -(ASAT I-TREATMENT -47 I-TREATMENT -U/L, I-TREATMENT -ALAT I-TREATMENT -95 I-TREATMENT -U/L) I-TREATMENT +la I-TREATMENT +totalidad I-TREATMENT +del I-TREATMENT +intestino I-TREATMENT +delgado I-TREATMENT y I-TREATMENT -con I-TREATMENT -CPK I-TREATMENT -de I-TREATMENT -80 I-TREATMENT -U/L. I-TREATMENT +colon I-TREATMENT +derecho. I-TREATMENT El B-EVOLUTION +tracto I-EVOLUTION +digestivo I-EVOLUTION +quedó I-EVOLUTION +cerrado I-EVOLUTION +a I-EVOLUTION +nivel I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +cuarta I-EVOLUTION +porción I-EVOLUTION +duodenal I-EVOLUTION +sin I-EVOLUTION +continuidad I-EVOLUTION +con I-EVOLUTION +el I-EVOLUTION +colon I-EVOLUTION +transverso, I-EVOLUTION +por I-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +el I-EVOLUTION paciente I-EVOLUTION -es I-EVOLUTION -dado I-EVOLUTION +era I-EVOLUTION +portador I-EVOLUTION de I-EVOLUTION -alta. I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -6 I-EVOLUTION -días I-EVOLUTION -es I-EVOLUTION -traído I-EVOLUTION +una I-EVOLUTION +gastrostomía I-EVOLUTION de I-EVOLUTION -nuevo I-EVOLUTION -por I-EVOLUTION -familiares I-EVOLUTION -por I-EVOLUTION -presentar I-EVOLUTION -estado I-EVOLUTION -confusional I-EVOLUTION -y I-EVOLUTION -agitación I-EVOLUTION -psicomotriz I-EVOLUTION +descarga. I-EVOLUTION +Debido I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +pérdida I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +totalidad I-EVOLUTION +del I-EVOLUTION +intestino I-EVOLUTION +delgado, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +permaneció I-EVOLUTION con I-EVOLUTION -fiebre I-EVOLUTION +nutrición I-EVOLUTION +parenteral I-EVOLUTION +domiciliaria, I-EVOLUTION +sin I-EVOLUTION +la I-EVOLUTION +posibilidad I-EVOLUTION de I-EVOLUTION -39, I-EVOLUTION -5 I-EVOLUTION -ºC. I-EVOLUTION -Refería I-EVOLUTION -haber I-EVOLUTION -fumado I-EVOLUTION +ningún I-EVOLUTION +tipo I-EVOLUTION +de I-EVOLUTION +rehabilitación I-EVOLUTION +intestinal. I-EVOLUTION +El I-EVOLUTION +paciente I-EVOLUTION +fue I-EVOLUTION +remitido I-EVOLUTION +a I-EVOLUTION +nuestro I-EVOLUTION +centro I-EVOLUTION +para I-EVOLUTION +valorar I-EVOLUTION +la I-EVOLUTION +posibilidad I-EVOLUTION +de I-EVOLUTION +trasplante I-EVOLUTION +intestinal. I-EVOLUTION +Dadas I-EVOLUTION las I-EVOLUTION -horas I-EVOLUTION -previas I-EVOLUTION -50gr I-EVOLUTION +circunstancias I-EVOLUTION +del I-EVOLUTION +paciente I-EVOLUTION +y I-EVOLUTION +teniendo I-EVOLUTION +en I-EVOLUTION +cuenta I-EVOLUTION +que I-EVOLUTION +había I-EVOLUTION +presentado I-EVOLUTION +repetidos I-EVOLUTION +episodios I-EVOLUTION +de I-EVOLUTION +sepsis I-EVOLUTION +por I-EVOLUTION +catéter I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +último I-EVOLUTION +año, I-EVOLUTION +se I-EVOLUTION +indicó I-EVOLUTION +el I-EVOLUTION +trasplante I-EVOLUTION +intestinal I-EVOLUTION +aislado. I-EVOLUTION +El I-EVOLUTION +paciente I-EVOLUTION +fue I-EVOLUTION +incluido I-EVOLUTION +en I-EVOLUTION +lista I-EVOLUTION de I-EVOLUTION -cocaína I-EVOLUTION -mezclada I-EVOLUTION +espera I-EVOLUTION con I-EVOLUTION -amoniaco. I-EVOLUTION -Presentaba B-EXPLORATION -fiebre I-EXPLORATION -de I-EXPLORATION -40 I-EXPLORATION -°C, I-EXPLORATION -taquipnea I-EXPLORATION -a I-EXPLORATION -47 I-EXPLORATION -rpm I-EXPLORATION -y I-EXPLORATION -agitación I-EXPLORATION -psicomotriz, I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -auscultación I-EXPLORATION -pulmonar I-EXPLORATION -crepitantes I-EXPLORATION -bilaterales; I-EXPLORATION -la I-EXPLORATION -auscultación I-EXPLORATION -cardiaca I-EXPLORATION -reflejaba I-EXPLORATION -taquicardia I-EXPLORATION -sin I-EXPLORATION -soplos I-EXPLORATION -añadidos; I-EXPLORATION -no I-EXPLORATION -ingurgitación I-EXPLORATION -yugular; I-EXPLORATION -además I-EXPLORATION -se I-EXPLORATION -objetivó I-EXPLORATION -hipoxemia I-EXPLORATION -parcial I-EXPLORATION -moderada I-EXPLORATION -(pO2 I-EXPLORATION -76 I-EXPLORATION -mmHg, I-EXPLORATION -pCO2 I-EXPLORATION -40 I-EXPLORATION -mmHg, I-EXPLORATION -SatO2 I-EXPLORATION -80%, I-EXPLORATION -pH I-EXPLORATION -7, I-EXPLORATION -4, I-EXPLORATION -exceso I-EXPLORATION -base I-EXPLORATION -0 I-EXPLORATION -mmol/L. I-EXPLORATION -El I-EXPLORATION -ECG I-EXPLORATION -estaba I-EXPLORATION -en I-EXPLORATION -ritmo I-EXPLORATION -sinusal I-EXPLORATION -a I-EXPLORATION -108 I-EXPLORATION -lpm. I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -evidenciaba I-EXPLORATION -un I-EXPLORATION -infiltrado I-EXPLORATION -intersticial I-EXPLORATION -bilateral I-EXPLORATION -con I-EXPLORATION -leve I-EXPLORATION -cardiomegalia. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -de I-EXPLORATION -sangre I-EXPLORATION -destacaba I-EXPLORATION -leucocitos I-EXPLORATION -13.100 I-EXPLORATION -(normal I-EXPLORATION -3, I-EXPLORATION -5-10, I-EXPLORATION -5), I-EXPLORATION -ALAT I-EXPLORATION -221 I-EXPLORATION -U/L I-EXPLORATION -(normal I-EXPLORATION -0-22), I-EXPLORATION -ASAT I-EXPLORATION -338 I-EXPLORATION -U/L I-EXPLORATION -(normal I-EXPLORATION -0-18), I-EXPLORATION -creatinina I-EXPLORATION -2, I-EXPLORATION -9 I-EXPLORATION -mg/dL I-EXPLORATION -(normal I-EXPLORATION -0, I-EXPLORATION -6-1, I-EXPLORATION -2), I-EXPLORATION -calcio I-EXPLORATION -8, I-EXPLORATION -4 I-EXPLORATION -mg/dL, I-EXPLORATION -urea I-EXPLORATION -88 I-EXPLORATION -mg/dL I-EXPLORATION -(normal I-EXPLORATION -10-50), I-EXPLORATION -CPK I-EXPLORATION -776 I-EXPLORATION -U/L I-EXPLORATION -(normal I-EXPLORATION -10-80). I-EXPLORATION -Así I-EXPLORATION -mismo I-EXPLORATION -en I-EXPLORATION -orina I-EXPLORATION -se I-EXPLORATION -determinó I-EXPLORATION -positividad I-EXPLORATION -para I-EXPLORATION -cannabinoides, I-EXPLORATION -metadona I-EXPLORATION -y I-EXPLORATION -cocaína. I-EXPLORATION -Los I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -etanol I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION -fueron I-EXPLORATION -0, I-EXPLORATION -1 I-EXPLORATION -mg/L I-EXPLORATION -(normal I-EXPLORATION -0-0, I-EXPLORATION -5). I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT +un I-EVOLUTION +peso I-EVOLUTION +de I-EVOLUTION +60 I-EVOLUTION +kg, I-EVOLUTION +180 I-EVOLUTION +cm I-EVOLUTION +de I-EVOLUTION +altura I-EVOLUTION +y I-EVOLUTION +18, I-EVOLUTION +3 I-EVOLUTION +de I-EVOLUTION +índice I-EVOLUTION +de I-EVOLUTION +masa I-EVOLUTION +corporal. I-EVOLUTION + I-EVOLUTION +A B-TREATMENT +los I-TREATMENT +2 I-TREATMENT +meses I-TREATMENT +de I-TREATMENT +su I-TREATMENT +inclusión I-TREATMENT +en I-TREATMENT +lista I-TREATMENT +de I-TREATMENT +espera I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +el I-TREATMENT +trasplante I-TREATMENT +intestinal I-TREATMENT +con I-TREATMENT +un I-TREATMENT +donante I-TREATMENT +isogrupo. I-TREATMENT +Al I-TREATMENT +donante I-TREATMENT +se I-TREATMENT +le I-TREATMENT +administró I-TREATMENT +timoglobulina I-TREATMENT +a I-TREATMENT +dosis I-TREATMENT +de I-TREATMENT +2 I-TREATMENT +mg/kg I-TREATMENT +con I-TREATMENT +el I-TREATMENT +objetivo I-TREATMENT +de I-TREATMENT +deplecionar I-TREATMENT +al I-TREATMENT +máximo I-TREATMENT +el I-TREATMENT +número I-TREATMENT +de I-TREATMENT +linfocitos I-TREATMENT +y I-TREATMENT +así I-TREATMENT +disminuir I-TREATMENT +la I-TREATMENT +probabilidad I-TREATMENT +de I-TREATMENT +rechazo I-TREATMENT +y I-TREATMENT +de I-TREATMENT +enfermedad I-TREATMENT +de I-TREATMENT +injerto I-TREATMENT +contra I-TREATMENT +huésped. I-TREATMENT +El I-TREATMENT +receptor I-TREATMENT +presentaba I-TREATMENT +una I-TREATMENT +trasposición I-TREATMENT +de I-TREATMENT +los I-TREATMENT +grandes I-TREATMENT +vasos I-TREATMENT +con I-TREATMENT +la I-TREATMENT +vena I-TREATMENT +cava I-TREATMENT +situada I-TREATMENT +a I-TREATMENT +la I-TREATMENT +izquierda I-TREATMENT +de I-TREATMENT +la I-TREATMENT +arteria I-TREATMENT +aorta. I-TREATMENT +Este I-TREATMENT +problema I-TREATMENT +se I-TREATMENT +solucionó I-TREATMENT +con I-TREATMENT +una I-TREATMENT +rotación I-TREATMENT +del I-TREATMENT +injerto I-TREATMENT +de I-TREATMENT +180º I-TREATMENT +sobre I-TREATMENT +su I-TREATMENT +eje I-TREATMENT +mesentérico, I-TREATMENT +con I-TREATMENT +el I-TREATMENT +objetivo I-TREATMENT +de I-TREATMENT +que I-TREATMENT +la I-TREATMENT +vena I-TREATMENT +y I-TREATMENT +la I-TREATMENT +arteria I-TREATMENT +mesentérica I-TREATMENT +superior I-TREATMENT +del I-TREATMENT +injerto I-TREATMENT +coincidieran I-TREATMENT con I-TREATMENT -sueroterapia, I-TREATMENT -antibioticoterapia I-TREATMENT +la I-TREATMENT +vena I-TREATMENT +cava I-TREATMENT +y I-TREATMENT +la I-TREATMENT +arteria I-TREATMENT +aorta I-TREATMENT +del I-TREATMENT +receptor. I-TREATMENT +La I-TREATMENT +primera I-TREATMENT +asa I-TREATMENT +yeyunal I-TREATMENT +del I-TREATMENT +injerto I-TREATMENT +se I-TREATMENT +anastomosó I-TREATMENT de I-TREATMENT -amplio I-TREATMENT -expectro I-TREATMENT -empírica I-TREATMENT +forma I-TREATMENT +latero-lateral I-TREATMENT +a I-TREATMENT +la I-TREATMENT +cuarta I-TREATMENT +porción I-TREATMENT +duodenal I-TREATMENT y I-TREATMENT -oxigenoterapia I-TREATMENT +el I-TREATMENT +íleon I-TREATMENT +terminal I-TREATMENT +del I-TREATMENT +injerto I-TREATMENT +al I-TREATMENT +colon I-TREATMENT +transverso I-TREATMENT +de I-TREATMENT +forma I-TREATMENT +latero-terminal I-TREATMENT +dejando I-TREATMENT +una I-TREATMENT +ileostomía I-TREATMENT en I-TREATMENT -ventimask I-TREATMENT -a I-TREATMENT -10 I-TREATMENT -L I-TREATMENT -(no I-TREATMENT -precisó I-TREATMENT -ventilación I-TREATMENT -mecánica), I-TREATMENT +forma I-TREATMENT +de I-TREATMENT +"chimenea" I-TREATMENT +para I-TREATMENT +poder I-TREATMENT +acceder I-TREATMENT con I-TREATMENT -evolución I-TREATMENT -favorable, I-TREATMENT -precisando I-TREATMENT -sedación I-TREATMENT -mientras I-TREATMENT -persistió I-TREATMENT -inicialmente I-TREATMENT +facilidad I-TREATMENT +a I-TREATMENT la I-TREATMENT -agitación I-TREATMENT -psicomotriz. I-TREATMENT -Al B-EXPLORATION -alta I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION -tórax I-EXPLORATION -mostraba I-EXPLORATION -practica I-EXPLORATION -resolución I-EXPLORATION -infiltrado I-EXPLORATION -bilateral, I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -creatinina I-EXPLORATION -0, I-EXPLORATION -9 I-EXPLORATION -mg/dL, I-EXPLORATION -ASAT I-EXPLORATION -41 I-EXPLORATION -U/L, I-EXPLORATION -ALAT I-EXPLORATION -149 I-EXPLORATION -U/L, I-EXPLORATION -leucocitos I-EXPLORATION -7.000, I-EXPLORATION -urea I-EXPLORATION -32. I-EXPLORATION - I-EXPLORATION - -Varón B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -30 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -edad I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -previos, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -ingresó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -astenia I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -hacía I-PRESENT_ILLNESS -20 I-PRESENT_ILLNESS -días. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -además I-EXPLORATION -de I-EXPLORATION -fiebre I-EXPLORATION -(39 I-EXPLORATION -ºC), I-EXPLORATION -presentaba I-EXPLORATION -una I-EXPLORATION -adenopatía I-EXPLORATION -supraclavicular I-EXPLORATION -derecha I-EXPLORATION -de I-EXPLORATION -1 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -y I-EXPLORATION -otras I-EXPLORATION -tres I-EXPLORATION -algo I-EXPLORATION -más I-EXPLORATION -pequeñas I-EXPLORATION -en I-EXPLORATION -región I-EXPLORATION -latero-cervical I-EXPLORATION -derecha I-EXPLORATION -y I-EXPLORATION -adenopatías I-EXPLORATION -menores I-EXPLORATION -de I-EXPLORATION -1 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -región I-EXPLORATION -latero-cervical I-EXPLORATION -izquierda. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -los I-EXPLORATION -únicos I-EXPLORATION -datos I-EXPLORATION -reseñables I-EXPLORATION -eran I-EXPLORATION -una I-EXPLORATION -tasa I-EXPLORATION -de I-EXPLORATION -leucocitos I-EXPLORATION -de I-EXPLORATION -3.500 I-EXPLORATION -con I-EXPLORATION -40% I-EXPLORATION -linfocitos I-EXPLORATION -y I-EXPLORATION -LDH I-EXPLORATION -de I-EXPLORATION -626 I-EXPLORATION -U/L. I-EXPLORATION -La I-EXPLORATION -PPD I-EXPLORATION -5U I-EXPLORATION -fue I-EXPLORATION -negativa I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -hemocultivos, I-EXPLORATION -coprocultivo I-EXPLORATION -y I-EXPLORATION -pruebas I-EXPLORATION -serológicas I-EXPLORATION -frente I-EXPLORATION -a I-EXPLORATION -Brucella, I-EXPLORATION -Leptospira, I-EXPLORATION -Francisella I-EXPLORATION -tularensis, I-EXPLORATION -Bartonella, I-EXPLORATION -VEB, I-EXPLORATION -y I-EXPLORATION -CMV I-EXPLORATION -fueron I-EXPLORATION -negativas. I-EXPLORATION -La I-EXPLORATION -TAC I-EXPLORATION -cérvico-torácico I-EXPLORATION -puso I-EXPLORATION -de I-EXPLORATION -manifiesto I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -adenopatías I-EXPLORATION -cervicales I-EXPLORATION -bilaterales I-EXPLORATION -de I-EXPLORATION -hasta I-EXPLORATION -13 I-EXPLORATION -mm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -cadena I-EXPLORATION -yugulo-digástrica I-EXPLORATION -derecha I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -espacios I-EXPLORATION -cervicales I-EXPLORATION -posteriores I-EXPLORATION -de I-EXPLORATION -carácter I-EXPLORATION -inespecífico I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -adenopatías I-EXPLORATION -axilares I-EXPLORATION -bilaterales I-EXPLORATION -de I-EXPLORATION -hasta I-EXPLORATION -1 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -axila I-EXPLORATION -derecha. I-EXPLORATION -Practicada I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -adenopatía I-EXPLORATION -cervical I-EXPLORATION -se I-EXPLORATION -llegó I-EXPLORATION -al I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -linfadenitis I-EXPLORATION -necrotizante I-EXPLORATION -paracortical, I-EXPLORATION -con I-EXPLORATION -abundante I-EXPLORATION -cariorrexis, I-EXPLORATION -y I-EXPLORATION -células I-EXPLORATION -inflamatorias I-EXPLORATION -mononucleares. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT +mucosa I-TREATMENT +intestinal I-TREATMENT +y I-TREATMENT +realizar I-TREATMENT +las I-TREATMENT +biopsias I-TREATMENT +de I-TREATMENT +protocolo. I-TREATMENT +Al I-TREATMENT +girar I-TREATMENT +el I-TREATMENT +injerto I-TREATMENT +180º, I-TREATMENT +la I-TREATMENT +ileostomía I-TREATMENT +quedó I-TREATMENT +fijada I-TREATMENT +en I-TREATMENT +el I-TREATMENT +flanco I-TREATMENT +derecho I-TREATMENT +del I-TREATMENT +abdomen I-TREATMENT +en I-TREATMENT +lugar I-TREATMENT +del I-TREATMENT +izquierdo. I-TREATMENT +Además, I-TREATMENT +se I-TREATMENT +dejó I-TREATMENT +una I-TREATMENT +yeyunostomía I-TREATMENT +de I-TREATMENT +alimentación I-TREATMENT +y I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +una I-TREATMENT +colecistectomía I-TREATMENT +por I-TREATMENT +barro I-TREATMENT +biliar, I-TREATMENT +muy I-TREATMENT +frecuente I-TREATMENT +en I-TREATMENT +este I-TREATMENT +tipo I-TREATMENT +de I-TREATMENT +pacientes. I-TREATMENT + I-TREATMENT +El I-TREATMENT +paciente I-TREATMENT +recibió I-TREATMENT +tratamiento I-TREATMENT +de I-TREATMENT +inducción I-TREATMENT +con I-TREATMENT +timoglobulina I-TREATMENT +1, I-TREATMENT +5 I-TREATMENT +mg/kg I-TREATMENT +y I-TREATMENT +profilaxis I-TREATMENT +antibiótica I-TREATMENT +con I-TREATMENT +vancomicina, I-TREATMENT +aztreonam I-TREATMENT +y I-TREATMENT +anfotericina I-TREATMENT +B I-TREATMENT +lioposomal. I-TREATMENT +Durante I-TREATMENT +el I-TREATMENT +postoperatorio I-TREATMENT +inmediato I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +siguió I-TREATMENT tratamiento I-TREATMENT +inmunosupresor I-TREATMENT con I-TREATMENT -antiinflamatorios I-TREATMENT -no I-TREATMENT -esteroideos I-TREATMENT -desapareciendo I-TREATMENT +triple I-TREATMENT +terapia: I-TREATMENT +timoglobulina I-TREATMENT +1, I-TREATMENT +5 I-TREATMENT +mg/kg/día I-TREATMENT +(durante I-TREATMENT +5 I-TREATMENT +días), I-TREATMENT +tacrolimus I-TREATMENT +0, I-TREATMENT +15 I-TREATMENT +mg/kg/día I-TREATMENT +(administrado I-TREATMENT +en I-TREATMENT +dos I-TREATMENT +dosis) I-TREATMENT +por I-TREATMENT +sonda I-TREATMENT +nasogástrica, I-TREATMENT +modificando I-TREATMENT la I-TREATMENT -fiebre I-TREATMENT +dosis I-TREATMENT +hasta I-TREATMENT +alcanzar I-TREATMENT +niveles I-TREATMENT +sanguíneos I-TREATMENT +entre I-TREATMENT +15-20 I-TREATMENT +ng/dl, I-TREATMENT y I-TREATMENT -encontrándose I-TREATMENT -asintomático. I-TREATMENT -En B-EVOLUTION +prednisolona I-TREATMENT +200 I-TREATMENT +mg/día I-TREATMENT +en I-TREATMENT +pauta I-TREATMENT +descendente I-TREATMENT +hasta I-TREATMENT +llegar I-TREATMENT +a I-TREATMENT +20 I-TREATMENT +mg I-TREATMENT +el I-TREATMENT +6º I-TREATMENT +día. I-TREATMENT +Al I-TREATMENT +no I-TREATMENT +alcanzar I-TREATMENT +niveles I-TREATMENT +sanguíneos I-TREATMENT +de I-TREATMENT +tacrolimus I-TREATMENT +adecuados I-TREATMENT +al I-TREATMENT +3er I-TREATMENT +día I-TREATMENT +postoperatorio, I-TREATMENT +se I-TREATMENT +pasó I-TREATMENT +a I-TREATMENT +la I-TREATMENT +administración I-TREATMENT +intravenosa I-TREATMENT +durante I-TREATMENT +4 I-TREATMENT +días I-TREATMENT +hasta I-TREATMENT +que I-TREATMENT +los I-TREATMENT +niveles I-TREATMENT +fueron I-TREATMENT +correctos, I-TREATMENT +volviendo I-TREATMENT +de I-TREATMENT +nuevo I-TREATMENT +a I-TREATMENT +la I-TREATMENT +vía I-TREATMENT +enteral. I-TREATMENT +Además I-TREATMENT +se I-TREATMENT +administró I-TREATMENT +PGE1 I-TREATMENT +(Alprostadil®) I-TREATMENT +en I-TREATMENT +el I-TREATMENT +postoperatorio I-TREATMENT +inmediato I-TREATMENT +con I-TREATMENT +el I-TREATMENT +fin I-TREATMENT +de I-TREATMENT +mejorar I-TREATMENT +la I-TREATMENT +lesión I-TREATMENT +de I-TREATMENT +reperfusión I-TREATMENT +(4). I-TREATMENT + I-TREATMENT +A I-TREATMENT +las I-TREATMENT +72 I-TREATMENT +horas I-TREATMENT +del I-TREATMENT +trasplante I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +presentó I-TREATMENT +una I-TREATMENT +hemorragia I-TREATMENT +digestiva I-TREATMENT +secundaria I-TREATMENT +a I-TREATMENT +una I-TREATMENT +úlcera I-TREATMENT +cardial I-TREATMENT +que I-TREATMENT +fue I-TREATMENT +tratada I-TREATMENT +mediante I-TREATMENT +"clip" I-TREATMENT +por I-TREATMENT +vía I-TREATMENT +endoscópica. I-TREATMENT +A B-EVOLUTION +los I-EVOLUTION +10 I-EVOLUTION +días I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +fue I-EVOLUTION +dado I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +de I-EVOLUTION la I-EVOLUTION -actualidad I-EVOLUTION -lleva I-EVOLUTION -diez I-EVOLUTION -meses I-EVOLUTION -sin I-EVOLUTION -recidivar. I-EVOLUTION +UCI I-EVOLUTION +y I-EVOLUTION +trasladado I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +planta I-EVOLUTION +de I-EVOLUTION +hospitalización. I-EVOLUTION +Dentro I-EVOLUTION +del I-EVOLUTION +protocolo I-EVOLUTION +para I-EVOLUTION +el I-EVOLUTION +control I-EVOLUTION +del I-EVOLUTION +rechazo, I-EVOLUTION +se I-EVOLUTION +realizaron I-EVOLUTION +biopsias I-EVOLUTION +2 I-EVOLUTION +veces I-EVOLUTION +por I-EVOLUTION +semana I-EVOLUTION +a I-EVOLUTION +través I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +ileostomía I-EVOLUTION +durante I-EVOLUTION +el I-EVOLUTION +primer I-EVOLUTION +mes, I-EVOLUTION +y I-EVOLUTION +1 I-EVOLUTION +vez I-EVOLUTION +por I-EVOLUTION +semana I-EVOLUTION +durante I-EVOLUTION +el I-EVOLUTION +segundo I-EVOLUTION +mes. I-EVOLUTION +Durante I-EVOLUTION +las I-EVOLUTION +seis I-EVOLUTION +semanas I-EVOLUTION +de I-EVOLUTION +ingreso I-EVOLUTION +sólo I-EVOLUTION +una I-EVOLUTION +biopsia I-EVOLUTION +mostró I-EVOLUTION +rechazo I-EVOLUTION +indeterminado I-EVOLUTION +y I-EVOLUTION +otra I-EVOLUTION +rechazo I-EVOLUTION +leve, I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +trató I-EVOLUTION +con I-EVOLUTION +3 I-EVOLUTION +bolus I-EVOLUTION +de I-EVOLUTION +500 I-EVOLUTION +mg I-EVOLUTION +de I-EVOLUTION +metil-prednisolona. I-EVOLUTION I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -32 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -presentaba I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -hace I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -agrandamiento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -glandula I-PRESENT_ILLNESS -tiroides I-PRESENT_ILLNESS -acompañado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -síntomas I-PRESENT_ILLNESS -compresivos. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Exploración B-EXPLORATION -clínica: I-EXPLORATION -bocio I-EXPLORATION -multinodular I-EXPLORATION -intratorácico I-EXPLORATION -con I-EXPLORATION -nódulo I-EXPLORATION -en I-EXPLORATION -lóbulo I-EXPLORATION -tiroideo I-EXPLORATION -derecho I-EXPLORATION -e I-EXPLORATION -istmo. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -apeciaban I-EXPLORATION -adenopatías I-EXPLORATION -laterocervicales. I-EXPLORATION - I-EXPLORATION -Pruebas I-EXPLORATION -complementarias: I-EXPLORATION -analítica I-EXPLORATION -general, I-EXPLORATION -anticuerpos I-EXPLORATION -y I-EXPLORATION -hormonas I-EXPLORATION -tiroideas I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -normalidad. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -en I-EXPLORATION +Desde I-EVOLUTION +el I-EVOLUTION +punto I-EVOLUTION +de I-EVOLUTION +vista I-EVOLUTION +nutricional, I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +7 I-EVOLUTION +días I-EVOLUTION +post-trasplante I-EVOLUTION +se I-EVOLUTION +inició I-EVOLUTION +la I-EVOLUTION +administración I-EVOLUTION +de I-EVOLUTION +agua I-EVOLUTION +y I-EVOLUTION +posteriormente I-EVOLUTION +de I-EVOLUTION +nutrición I-EVOLUTION +enteral I-EVOLUTION +por I-EVOLUTION +la I-EVOLUTION +sonda I-EVOLUTION +de I-EVOLUTION +yeyunostomía. I-EVOLUTION +A I-EVOLUTION +las I-EVOLUTION +tres I-EVOLUTION +semanas I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +inició I-EVOLUTION +la I-EVOLUTION +ingesta I-EVOLUTION +oral I-EVOLUTION +de I-EVOLUTION +forma I-EVOLUTION +progresiva I-EVOLUTION +hasta I-EVOLUTION +ingerir I-EVOLUTION +2.100 I-EVOLUTION +kcal I-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +permitió I-EVOLUTION +suspender I-EVOLUTION +la I-EVOLUTION +nutrición I-EVOLUTION +parenteral. I-EVOLUTION +El I-EVOLUTION +paciente I-EVOLUTION +aumentó I-EVOLUTION +10 I-EVOLUTION +kg I-EVOLUTION +de I-EVOLUTION +peso I-EVOLUTION +en I-EVOLUTION +las I-EVOLUTION +6 I-EVOLUTION +semanas I-EVOLUTION +de I-EVOLUTION +ingreso I-EVOLUTION +y I-EVOLUTION +fue I-EVOLUTION +dado I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +hospitalaria I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +séptima I-EVOLUTION +semana I-EVOLUTION +del I-EVOLUTION +trasplante, I-EVOLUTION +sin I-EVOLUTION +requerir I-EVOLUTION +nutrición I-EVOLUTION +parenteral. I-EVOLUTION +La I-EVOLUTION +evolución I-EVOLUTION +hasta I-EVOLUTION +la I-EVOLUTION +actualidad I-EVOLUTION +ha I-EVOLUTION +sido I-EVOLUTION +excelente I-EVOLUTION +con I-EVOLUTION +un I-EVOLUTION +aumento I-EVOLUTION +ponderal, I-EVOLUTION +que I-EVOLUTION +indica I-EVOLUTION +la I-EVOLUTION +viabilidad I-EVOLUTION +y I-EVOLUTION +buena I-EVOLUTION +función I-EVOLUTION +del I-EVOLUTION +injerto I-EVOLUTION +intestinal. I-EVOLUTION + I-EVOLUTION + +Hombre B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +56 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que, B-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +unos I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +años, I-PAST_MEDICAL_HISTORY +presenta I-PAST_MEDICAL_HISTORY +molestias I-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +parestesias I-PAST_MEDICAL_HISTORY +(no I-PAST_MEDICAL_HISTORY +dolor) I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +espalda I-PAST_MEDICAL_HISTORY +(región I-PAST_MEDICAL_HISTORY +dorsal I-PAST_MEDICAL_HISTORY +alta I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +lado I-PAST_MEDICAL_HISTORY +izquierdo) I-PAST_MEDICAL_HISTORY +junto I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +mayor I-PAST_MEDICAL_HISTORY +sensibilidad I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +roce I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +ropa I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +esa I-PAST_MEDICAL_HISTORY +zona I-PAST_MEDICAL_HISTORY +(hiperestesia I-PAST_MEDICAL_HISTORY +mecánica). I-PAST_MEDICAL_HISTORY +En B-EXPLORATION la I-EXPLORATION -que I-EXPLORATION +exploración I-EXPLORATION se I-EXPLORATION -apreciaron I-EXPLORATION -múltiples I-EXPLORATION -nódulos I-EXPLORATION +objetivaba I-EXPLORATION +una I-EXPLORATION +zona I-EXPLORATION +de I-EXPLORATION +hiperestesia I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -glándula I-EXPLORATION -tiroides I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -localizaban I-EXPLORATION -sobre I-EXPLORATION -todo I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -lóbulo I-EXPLORATION -tiroideo I-EXPLORATION -derecho I-EXPLORATION -e I-EXPLORATION -istmo. I-EXPLORATION -La I-EXPLORATION -lesión I-EXPLORATION -presentaba I-EXPLORATION -áreas I-EXPLORATION -quísticas I-EXPLORATION -multiseptadas, I-EXPLORATION +región I-EXPLORATION +escapular I-EXPLORATION +izquierda, I-EXPLORATION con I-EXPLORATION -calcificaciones I-EXPLORATION -groseras I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -interior. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -lóbulo I-EXPLORATION -tiroideo I-EXPLORATION -izquierdo I-EXPLORATION -se I-EXPLORATION -observaba I-EXPLORATION -algún I-EXPLORATION -nódulo I-EXPLORATION -aislado I-EXPLORATION -de I-EXPLORATION -pequeño I-EXPLORATION -tamaño I-EXPLORATION +hiperestesia I-EXPLORATION +cutánea I-EXPLORATION y I-EXPLORATION -con I-EXPLORATION -características I-EXPLORATION -similares I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -anteriormente I-EXPLORATION -descritos. I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -bocio I-EXPLORATION -multinodular. I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION +dinámica, I-EXPLORATION una I-EXPLORATION -punción I-EXPLORATION -aspiración I-EXPLORATION -con I-EXPLORATION -aguja I-EXPLORATION -fina I-EXPLORATION -(PAAF) I-EXPLORATION +zona I-EXPLORATION +circular I-EXPLORATION +delimitada I-EXPLORATION que I-EXPLORATION -se I-EXPLORATION -informó I-EXPLORATION -como I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -atípicas. I-EXPLORATION -Debido B-TREATMENT -a I-TREATMENT -la I-TREATMENT -persistencia I-TREATMENT -de I-TREATMENT -los I-TREATMENT -síntomas I-TREATMENT -compresivos, I-TREATMENT -fundamentalmente I-TREATMENT -disfagia, I-TREATMENT -se I-TREATMENT -le I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -tiroidectomía I-TREATMENT -total I-TREATMENT -siendo I-TREATMENT -remitida I-TREATMENT -la I-TREATMENT -pieza I-TREATMENT -al I-TREATMENT -servicio I-TREATMENT -de I-TREATMENT -anatomía I-TREATMENT -patológica. I-TREATMENT - I-TREATMENT -Macroscópicamente B-EXPLORATION -se I-EXPLORATION -recibió I-EXPLORATION -una I-EXPLORATION -pieza I-EXPLORATION +no I-EXPLORATION +correspondía I-EXPLORATION +con I-EXPLORATION +la I-EXPLORATION +zona I-EXPLORATION de I-EXPLORATION -tiroidectomía I-EXPLORATION -total I-EXPLORATION -que I-EXPLORATION -medía I-EXPLORATION -8x6x4 I-EXPLORATION -cm I-EXPLORATION -y I-EXPLORATION -pesaba I-EXPLORATION -38 I-EXPLORATION -g. I-EXPLORATION -A I-EXPLORATION -los I-EXPLORATION -cortes I-EXPLORATION -seriados I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -múltiples I-EXPLORATION -espacios I-EXPLORATION -quísticos I-EXPLORATION -multiloculados I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -localizaban I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -lóbulo I-EXPLORATION -tiroideo I-EXPLORATION -derecho I-EXPLORATION -e I-EXPLORATION -istmo. I-EXPLORATION +hiperpigmentación. I-EXPLORATION La I-EXPLORATION -pared I-EXPLORATION -era I-EXPLORATION -lisa I-EXPLORATION +RMN I-EXPLORATION de I-EXPLORATION -color I-EXPLORATION -rosado I-EXPLORATION +columna I-EXPLORATION +cervical I-EXPLORATION y I-EXPLORATION -no I-EXPLORATION -contenía I-EXPLORATION -zonas I-EXPLORATION -sólidas. I-EXPLORATION -La I-EXPLORATION -lesión I-EXPLORATION -quística I-EXPLORATION -tenía I-EXPLORATION -unas I-EXPLORATION -dimensiones I-EXPLORATION -máximas I-EXPLORATION +dorsal I-EXPLORATION +mostraba I-EXPLORATION +protrusiones I-EXPLORATION +discales I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +zona I-EXPLORATION de I-EXPLORATION -4 I-EXPLORATION -cm I-EXPLORATION +C4, I-EXPLORATION +C5, I-EXPLORATION +C6 I-EXPLORATION y I-EXPLORATION -no I-EXPLORATION -tenía I-EXPLORATION -contenido I-EXPLORATION -aparente. I-EXPLORATION -Histológicamente I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -grandes I-EXPLORATION -cavidades I-EXPLORATION -quísticas I-EXPLORATION -tapizadas I-EXPLORATION -por I-EXPLORATION -epitelio I-EXPLORATION -escamoso I-EXPLORATION -o I-EXPLORATION -respiratorio I-EXPLORATION +D1, I-EXPLORATION sin I-EXPLORATION -atipia I-EXPLORATION +afectación I-EXPLORATION +radicular, I-EXPLORATION +sin I-EXPLORATION +compromiso I-EXPLORATION +medular I-EXPLORATION y I-EXPLORATION -subyacentemente I-EXPLORATION -mostraba I-EXPLORATION -un I-EXPLORATION -intenso I-EXPLORATION -infiltrado I-EXPLORATION -inflamatorio I-EXPLORATION -linfocitario I-EXPLORATION con I-EXPLORATION -patrón I-EXPLORATION -folicular. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -tejido I-EXPLORATION -tiroideo I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -apreciaron I-EXPLORATION -alteraciones I-EXPLORATION -histológicas I-EXPLORATION -significativas, I-EXPLORATION -excepto I-EXPLORATION un I-EXPLORATION -moderado I-EXPLORATION -infiltrado I-EXPLORATION -inflamatorio I-EXPLORATION -linfoide I-EXPLORATION -inespecífico. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -definitivo I-EXPLORATION -del I-EXPLORATION estudio I-EXPLORATION -histológico I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -quiste I-EXPLORATION -linfoepitelial I-EXPLORATION -intratiroideo. I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -presentó I-EVOLUTION -complicaciones I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -cirugía I-EVOLUTION -y I-EVOLUTION -está I-EVOLUTION -sano I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -momento I-EVOLUTION -actual. I-EVOLUTION - I-EVOLUTION +neurofisiológico I-EXPLORATION +normal. I-EXPLORATION +Se B-TREATMENT +decidió I-TREATMENT +no I-TREATMENT +iniciar I-TREATMENT +tratamiento, I-TREATMENT +ya I-TREATMENT +que I-TREATMENT +al I-TREATMENT +paciente I-TREATMENT +no I-TREATMENT +le I-TREATMENT +molestaban I-TREATMENT +dichos I-TREATMENT +síntomas I-TREATMENT +y I-TREATMENT +tampoco I-TREATMENT +era I-TREATMENT +partidario I-TREATMENT +de I-TREATMENT +ello. I-TREATMENT + I-TREATMENT -Paciente B-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -57 I-PRESENT_ILLNESS +60 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -enfermedades I-PAST_MEDICAL_HISTORY -previas I-PAST_MEDICAL_HISTORY +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +EPOC I-PAST_MEDICAL_HISTORY +moderado, I-PAST_MEDICAL_HISTORY que B-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -disartria I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -paralisis I-PRESENT_ILLNESS -facial I-PRESENT_ILLNESS -derecha. I-PRESENT_ILLNESS -Se B-EXPLORATION -realiza I-EXPLORATION -una I-EXPLORATION -TAC I-EXPLORATION -craneal I-EXPLORATION +incremento I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +perímetro I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +durante I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +previos I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +otra I-PRESENT_ILLNESS +sintomatología I-PRESENT_ILLNESS +acompañante. I-PRESENT_ILLNESS +En B-EXPLORATION +las I-EXPLORATION +pruebas I-EXPLORATION +complementarias I-EXPLORATION +solicitadas I-EXPLORATION +el I-EXPLORATION +hemograma I-EXPLORATION y I-EXPLORATION -posteriormente I-EXPLORATION -RNM I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -muestra I-EXPLORATION +coagulación I-EXPLORATION +son I-EXPLORATION +normales. I-EXPLORATION +Glucosa, I-EXPLORATION +urea, I-EXPLORATION +ácido I-EXPLORATION +úrico, I-EXPLORATION +creatinina, I-EXPLORATION +calcio I-EXPLORATION +total, I-EXPLORATION +fósforo, I-EXPLORATION +triglicéridos, I-EXPLORATION +colesterol I-EXPLORATION +LDL, I-EXPLORATION +bilirrubina I-EXPLORATION +total, I-EXPLORATION +GOT, I-EXPLORATION +GPT, I-EXPLORATION +GGT, I-EXPLORATION +LDH, I-EXPLORATION +fosfatasa I-EXPLORATION +alcalina, I-EXPLORATION +amilasa, I-EXPLORATION +proteínas I-EXPLORATION +totales, I-EXPLORATION +albúmina, I-EXPLORATION +sodio, I-EXPLORATION +potasio, I-EXPLORATION +cloro, I-EXPLORATION +ferritina, I-EXPLORATION +transferrina, I-EXPLORATION +vitamina I-EXPLORATION +B12 I-EXPLORATION +y I-EXPLORATION +folato I-EXPLORATION +normales. I-EXPLORATION +Colesterol I-EXPLORATION +total I-EXPLORATION +243 I-EXPLORATION +mg/dl I-EXPLORATION +(110-200), I-EXPLORATION +colesterol I-EXPLORATION +HDL I-EXPLORATION +120 I-EXPLORATION +mg/dl I-EXPLORATION +(42-68), I-EXPLORATION +hierro I-EXPLORATION +44 I-EXPLORATION +microg/dl I-EXPLORATION +(65-165); I-EXPLORATION +Ca I-EXPLORATION +19, I-EXPLORATION +9, I-EXPLORATION +82, I-EXPLORATION +03 I-EXPLORATION +U/l I-EXPLORATION +(< I-EXPLORATION +40). I-EXPLORATION +CEA, I-EXPLORATION +PSA I-EXPLORATION +y I-EXPLORATION +alfa-fetoproteína I-EXPLORATION +normales. I-EXPLORATION +Velocidad I-EXPLORATION +de I-EXPLORATION +sedimentación I-EXPLORATION +globular I-EXPLORATION +41 I-EXPLORATION +mm I-EXPLORATION +(< I-EXPLORATION +14). I-EXPLORATION +En I-EXPLORATION una I-EXPLORATION -lesión I-EXPLORATION -ocupante I-EXPLORATION +segunda I-EXPLORATION +determinación I-EXPLORATION de I-EXPLORATION -espacio I-EXPLORATION -parieto-temporal I-EXPLORATION -izquierda I-EXPLORATION -con I-EXPLORATION -gran I-EXPLORATION -edema I-EXPLORATION -perilesional I-EXPLORATION -que I-EXPLORATION -sugiere I-EXPLORATION -un I-EXPLORATION -proceso I-EXPLORATION -neoplásico. I-EXPLORATION -El I-EXPLORATION +marcadores I-EXPLORATION +tumorales I-EXPLORATION +Ca I-EXPLORATION +19, I-EXPLORATION +9, I-EXPLORATION +91, I-EXPLORATION +23 I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION resto I-EXPLORATION +normales. I-EXPLORATION +Resonancia I-EXPLORATION +magnética I-EXPLORATION +(RM) I-EXPLORATION +abdomino-pelvica: I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +gran I-EXPLORATION +masa I-EXPLORATION +multilobulada I-EXPLORATION +abdomino I-EXPLORATION +pelvica, I-EXPLORATION +cuya I-EXPLORATION +señal I-EXPLORATION +a I-EXPLORATION +excepción I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +tabiques I-EXPLORATION +es I-EXPLORATION +preferentemente I-EXPLORATION +grasa. I-EXPLORATION +Las I-EXPLORATION +dimensiones I-EXPLORATION +máximas I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -y I-EXPLORATION -pruebas I-EXPLORATION -complementarias I-EXPLORATION -iniciales I-EXPLORATION +masa I-EXPLORATION son I-EXPLORATION -normales, I-EXPLORATION -incluyendo I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION de I-EXPLORATION -tórax. I-EXPLORATION -En B-TREATMENT -el I-TREATMENT -servicio I-TREATMENT -de I-TREATMENT -neurocirugía I-TREATMENT -presenta I-TREATMENT -súbitamente I-TREATMENT -disnea I-TREATMENT -acompañada I-TREATMENT -de I-TREATMENT -desaturación, I-TREATMENT -motivos I-TREATMENT -por I-TREATMENT -los I-TREATMENT -que I-TREATMENT -es I-TREATMENT -ingresado I-TREATMENT -en I-TREATMENT -UCI I-TREATMENT -donde I-TREATMENT -precisa I-TREATMENT -ventilación I-TREATMENT -mecánica. I-TREATMENT -Bajo B-EXPLORATION -sospecha I-EXPLORATION +26 I-EXPLORATION +cm I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +eje I-EXPLORATION +cráneo I-EXPLORATION +caudal, I-EXPLORATION +24, I-EXPLORATION +5 I-EXPLORATION +cm I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +eje I-EXPLORATION +transverso I-EXPLORATION +y I-EXPLORATION de I-EXPLORATION -tromboembolismo I-EXPLORATION -pulmonar I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -una I-EXPLORATION -TAC I-EXPLORATION -torácica I-EXPLORATION -urgente I-EXPLORATION -existiendo I-EXPLORATION -una I-EXPLORATION -consolidación I-EXPLORATION -parenquimatosa I-EXPLORATION -pulmonar I-EXPLORATION -basal I-EXPLORATION -posterior I-EXPLORATION -bilateral I-EXPLORATION +21 I-EXPLORATION +cm I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +eje I-EXPLORATION +anteroposterior. I-EXPLORATION +Cruza I-EXPLORATION +la I-EXPLORATION +línea I-EXPLORATION +media I-EXPLORATION y I-EXPLORATION -múltiples I-EXPLORATION -nódulos I-EXPLORATION -pulmonares, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -un I-EXPLORATION -infiltrado I-EXPLORATION -alveolar I-EXPLORATION -e I-EXPLORATION -intersticial I-EXPLORATION -bilateral, I-EXPLORATION -todos I-EXPLORATION -ellos I-EXPLORATION +produce I-EXPLORATION +importante I-EXPLORATION +efecto I-EXPLORATION +de I-EXPLORATION +masa I-EXPLORATION +sobre I-EXPLORATION +el I-EXPLORATION +riñón I-EXPLORATION +izquierdo, I-EXPLORATION +al I-EXPLORATION +que I-EXPLORATION +rota I-EXPLORATION +y I-EXPLORATION +desplaza I-EXPLORATION +cranealmente, I-EXPLORATION +sin I-EXPLORATION +observarse I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +uropatía I-EXPLORATION +obstructiva. I-EXPLORATION +También I-EXPLORATION +ejerce I-EXPLORATION +efecto I-EXPLORATION +de I-EXPLORATION +masa I-EXPLORATION +sobre I-EXPLORATION +el I-EXPLORATION +colon I-EXPLORATION +transverso I-EXPLORATION +izquierdo, I-EXPLORATION +desplazándolo I-EXPLORATION +contra I-EXPLORATION +la I-EXPLORATION +pared I-EXPLORATION +abdominal. I-EXPLORATION +Los I-EXPLORATION hallazgos I-EXPLORATION -compatibles I-EXPLORATION +son I-EXPLORATION +muy I-EXPLORATION +sugerentes I-EXPLORATION +de I-EXPLORATION +liposarcoma. I-EXPLORATION +Se B-TREATMENT +realizó I-TREATMENT +intervención I-TREATMENT +quirúrgica I-TREATMENT +mediante I-TREATMENT +laparotomía I-TREATMENT +media I-TREATMENT +suprainfraumbilical I-TREATMENT +donde I-TREATMENT +se I-TREATMENT +encontró I-TREATMENT +una I-TREATMENT +gran I-TREATMENT +masa I-TREATMENT +de I-TREATMENT +aspecto I-TREATMENT +lipomatoso I-TREATMENT +desde I-TREATMENT +la I-TREATMENT +celda I-TREATMENT +renal I-TREATMENT +izquierda I-TREATMENT +hasta I-TREATMENT +espacio I-TREATMENT +retrovesical. I-TREATMENT +Se I-TREATMENT +intentó I-TREATMENT +extirpación I-TREATMENT +en I-TREATMENT +bloque I-TREATMENT +con I-TREATMENT +resección I-TREATMENT +de I-TREATMENT +fibras I-TREATMENT +del I-TREATMENT +psoas I-TREATMENT +izquierdo I-TREATMENT +infiltrado. I-TREATMENT + I-TREATMENT +El B-EXPLORATION +informe I-EXPLORATION +anatomopatológico I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +pieza I-EXPLORATION +extraída I-EXPLORATION +fue I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +descripción I-EXPLORATION +macroscópica: I-EXPLORATION +Pieza I-EXPLORATION +de I-EXPLORATION +45 I-EXPLORATION +x I-EXPLORATION +40 I-EXPLORATION +x I-EXPLORATION +15 I-EXPLORATION +cm. I-EXPLORATION con I-EXPLORATION un I-EXPLORATION -proceso I-EXPLORATION -infeccioso. I-EXPLORATION -Se I-EXPLORATION -procede I-EXPLORATION +peso I-EXPLORATION +de I-EXPLORATION +6.300 I-EXPLORATION +gr. I-EXPLORATION +A I-EXPLORATION +la I-EXPLORATION +superficie I-EXPLORATION +presenta I-EXPLORATION +una I-EXPLORATION +coloración I-EXPLORATION +amarillenta, I-EXPLORATION +y I-EXPLORATION a I-EXPLORATION la I-EXPLORATION -extracción I-EXPLORATION +sección I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +que I-EXPLORATION +mantiene I-EXPLORATION +esta I-EXPLORATION +coloración I-EXPLORATION +con I-EXPLORATION +finos I-EXPLORATION +tractos I-EXPLORATION +conectivos, I-EXPLORATION +sin I-EXPLORATION +apreciarse I-EXPLORATION de I-EXPLORATION -cultivo I-EXPLORATION -bronquial I-EXPLORATION -mediante I-EXPLORATION -lavado I-EXPLORATION -broncoalveolar. I-EXPLORATION -Debido B-EVOLUTION -a I-EVOLUTION -empeoramiento I-EVOLUTION -del I-EVOLUTION -paciente I-EVOLUTION -a B-TREATMENT -pesar I-TREATMENT -de I-TREATMENT -antibioterapia I-TREATMENT -de I-TREATMENT -amplio I-TREATMENT -espectro, I-TREATMENT -se B-EXPLORATION -practica I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -esteroatáxica I-EXPLORATION +manera I-EXPLORATION +clara I-EXPLORATION +áreas I-EXPLORATION de I-EXPLORATION +necrosis I-EXPLORATION +y I-EXPLORATION +sí I-EXPLORATION +una I-EXPLORATION +distribución I-EXPLORATION +en I-EXPLORATION +lóbulos. I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -lesión I-EXPLORATION -cerebral I-EXPLORATION +descripción I-EXPLORATION +microscópica I-EXPLORATION +las I-EXPLORATION +secciones I-EXPLORATION +histológicas I-EXPLORATION +muestran I-EXPLORATION +todas I-EXPLORATION +ellas I-EXPLORATION +un I-EXPLORATION +mismo I-EXPLORATION +aspecto: I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +mayor I-EXPLORATION +parte I-EXPLORATION +están I-EXPLORATION +constituidas I-EXPLORATION +por I-EXPLORATION +tejido I-EXPLORATION +adiposo I-EXPLORATION con I-EXPLORATION -cultivo I-EXPLORATION +células I-EXPLORATION +adiposas I-EXPLORATION +con I-EXPLORATION +tamaño I-EXPLORATION +grande I-EXPLORATION de I-EXPLORATION +vacuola I-EXPLORATION +grande I-EXPLORATION +y I-EXPLORATION +aspecto I-EXPLORATION +maduro. I-EXPLORATION +Se I-EXPLORATION +observa I-EXPLORATION +también I-EXPLORATION la I-EXPLORATION -misma. I-EXPLORATION -En I-EXPLORATION -ambos I-EXPLORATION -cultivos I-EXPLORATION -se I-EXPLORATION -aisla I-EXPLORATION -rhodococcus I-EXPLORATION -equi. I-EXPLORATION -La I-EXPLORATION -serología I-EXPLORATION -del I-EXPLORATION -virus I-EXPLORATION -VIH I-EXPLORATION -es I-EXPLORATION -negativa. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -inmunitario I-EXPLORATION -normal I-EXPLORATION -(CD3 I-EXPLORATION -65%, I-EXPLORATION -CD4 I-EXPLORATION -40%). I-EXPLORATION -A B-TREATMENT -pesar I-TREATMENT -de I-TREATMENT -realizar I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -vancomicina, I-TREATMENT -sulfametoxazol I-TREATMENT -y I-TREATMENT -rifampicina, I-TREATMENT -el B-EVOLUTION -paciente I-EVOLUTION -falleció I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -10 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -evolución. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -68 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -epilepsia I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -polimialgia I-PAST_MEDICAL_HISTORY -reumática, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -mg/día I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -prednisona. I-PAST_MEDICAL_HISTORY -Presenta B-PRESENT_ILLNESS -dolor, I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tamaño I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -impotencia I-PRESENT_ILLNESS -funcional I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -aquíleo I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -siete I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -iniciar I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -levofloxacino I-PRESENT_ILLNESS -(500 I-PRESENT_ILLNESS -mg/día) I-PRESENT_ILLNESS -indicado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -infección I-PRESENT_ILLNESS -urinaria. I-PRESENT_ILLNESS -Mediante B-EXPLORATION -Ecografía I-EXPLORATION -se I-EXPLORATION -demuestra I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -rotura I-EXPLORATION -parcial I-EXPLORATION -del I-EXPLORATION -tendón. I-EXPLORATION -Tras B-TREATMENT -retirar I-TREATMENT -el I-TREATMENT -fármaco I-TREATMENT -y I-TREATMENT -tratamiento I-TREATMENT -conservador I-TREATMENT -con I-TREATMENT -reposo I-TREATMENT -y I-TREATMENT -ortesis I-TREATMENT -el I-TREATMENT -cuadro I-TREATMENT -se I-TREATMENT -resuelve I-TREATMENT -en I-TREATMENT -dos I-TREATMENT -meses. I-TREATMENT - I-TREATMENT - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -72 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ulcus I-PAST_MEDICAL_HISTORY -gástrico, I-PAST_MEDICAL_HISTORY -diabetes I-PAST_MEDICAL_HISTORY -mellitus I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -insulinizada, I-PAST_MEDICAL_HISTORY -angina I-PAST_MEDICAL_HISTORY -estable, I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial, I-PAST_MEDICAL_HISTORY -dislipemia I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -accidente I-PAST_MEDICAL_HISTORY -cerebrovascular I-PAST_MEDICAL_HISTORY -isquémico I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -secuela I-PAST_MEDICAL_HISTORY -residual I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -mano I-PAST_MEDICAL_HISTORY -derecha. I-PAST_MEDICAL_HISTORY -Tratamiento I-PAST_MEDICAL_HISTORY -habitual I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -clopidogrel, I-PAST_MEDICAL_HISTORY -carvedilol, I-PAST_MEDICAL_HISTORY -nitroglicerina I-PAST_MEDICAL_HISTORY -transdérmica, I-PAST_MEDICAL_HISTORY -atorvastatina I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -omeprazol. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Consulta B-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -febrero I-PRESENT_ILLNESS -2005 I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -masa I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nivel I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -fosa I-PRESENT_ILLNESS -iliaca I-PRESENT_ILLNESS -derecha. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -exploración B-EXPLORATION -ginecológica, I-EXPLORATION -presenta I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -que I-EXPLORATION -parece I-EXPLORATION -depender I-EXPLORATION +núcleos I-EXPLORATION +atípicos I-EXPLORATION de I-EXPLORATION -útero. I-EXPLORATION -En B-TREATMENT -marzo I-TREATMENT -2005, I-TREATMENT -se I-TREATMENT -le I-TREATMENT -practica I-TREATMENT -histerectomía I-TREATMENT -y I-TREATMENT -doble I-TREATMENT -anexectomía, I-TREATMENT -junto I-TREATMENT -con I-TREATMENT -resección I-TREATMENT -del I-TREATMENT -tercio I-TREATMENT -final I-TREATMENT -de I-TREATMENT -íleon, I-TREATMENT -al I-TREATMENT -identificarse I-TREATMENT -una I-TREATMENT -masa I-TREATMENT -fibrosada I-TREATMENT -adherida I-TREATMENT -a I-TREATMENT -éste. I-TREATMENT -Anatomía B-EXPLORATION -patológica: I-EXPLORATION -endometrio I-EXPLORATION -atrófico, I-EXPLORATION -cervicitis I-EXPLORATION -crónica I-EXPLORATION -folicular; I-EXPLORATION -tumor I-EXPLORATION -gastrointestinal I-EXPLORATION -del I-EXPLORATION -estroma I-EXPLORATION -(GIST) I-EXPLORATION -ileal I-EXPLORATION +manera I-EXPLORATION +focal, I-EXPLORATION +con I-EXPLORATION +citoplasma I-EXPLORATION +vacuolado. I-EXPLORATION +Estas I-EXPLORATION +zonas I-EXPLORATION de I-EXPLORATION -8 I-EXPLORATION -cm I-EXPLORATION +tejido I-EXPLORATION +maduro I-EXPLORATION +están I-EXPLORATION +distribuidas I-EXPLORATION de I-EXPLORATION -tamaño, I-EXPLORATION -con I-EXPLORATION -2-3 I-EXPLORATION -metástasis I-EXPLORATION +manera I-EXPLORATION +difusa I-EXPLORATION por I-EXPLORATION -cada I-EXPLORATION -50 I-EXPLORATION -campos I-EXPLORATION -de I-EXPLORATION -gran I-EXPLORATION -aumento, I-EXPLORATION -hipercelularidad, I-EXPLORATION -celularidad I-EXPLORATION -epitelioide, I-EXPLORATION -pleomorfismo I-EXPLORATION -celular, I-EXPLORATION -necrosis I-EXPLORATION -focal; I-EXPLORATION -c-kit I-EXPLORATION -positivo. I-EXPLORATION -Valorada I-EXPLORATION +toda I-EXPLORATION +la I-EXPLORATION +neoplasia, I-EXPLORATION +y I-EXPLORATION +los I-EXPLORATION +focos I-EXPLORATION +con I-EXPLORATION +núcleos I-EXPLORATION +atípicos, I-EXPLORATION en I-EXPLORATION -consultas I-EXPLORATION -externas I-EXPLORATION -de I-EXPLORATION -Oncología I-EXPLORATION -Médica, I-EXPLORATION +ocasiones I-EXPLORATION +hipercromáticos I-EXPLORATION se I-EXPLORATION -solicita I-EXPLORATION -como I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -extensión: I-EXPLORATION -analítica I-EXPLORATION -completa: I-EXPLORATION -hemoglobina I-EXPLORATION -11, I-EXPLORATION -7 I-EXPLORATION -mg/dl, I-EXPLORATION -con I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -parámetros I-EXPLORATION -normales; I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computerizada I-EXPLORATION -(TAC) I-EXPLORATION -toraco-abdomino-pélvica: I-EXPLORATION -colelitiasis, I-EXPLORATION -pequeño I-EXPLORATION -nódulo I-EXPLORATION -suprarrenal I-EXPLORATION -derecho I-EXPLORATION +muestran I-EXPLORATION de I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION +manera I-EXPLORATION +aislada. I-EXPLORATION +Diagnóstico: I-EXPLORATION +Liposarcoma I-EXPLORATION +bien I-EXPLORATION +diferenciado. I-EXPLORATION +Una I-EXPLORATION +nueva I-EXPLORATION +determinación I-EXPLORATION de I-EXPLORATION -características I-EXPLORATION -benignas; I-EXPLORATION -gammagrafía I-EXPLORATION -ósea: I-EXPLORATION -negativa I-EXPLORATION -para I-EXPLORATION -metástasis I-EXPLORATION -óseas. I-EXPLORATION -En I-EXPLORATION -octubre I-EXPLORATION -se I-EXPLORATION -solicitó I-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -por I-EXPLORATION -emisión I-EXPLORATION +Ca I-EXPLORATION +19, I-EXPLORATION +9, I-EXPLORATION +posterior I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +intervención I-EXPLORATION +quirúrgica I-EXPLORATION +presenta I-EXPLORATION +normalización I-EXPLORATION de I-EXPLORATION -positrones I-EXPLORATION -(PET), I-EXPLORATION -que I-EXPLORATION -reflejó I-EXPLORATION la I-EXPLORATION -presencia I-EXPLORATION +misma I-EXPLORATION +(24, I-EXPLORATION +17 I-EXPLORATION +U/l), I-EXPLORATION +manteniéndose I-EXPLORATION +el I-EXPLORATION +resto I-EXPLORATION de I-EXPLORATION -un I-EXPLORATION -depósito I-EXPLORATION -patológico I-EXPLORATION +marcadores I-EXPLORATION +tumorales I-EXPLORATION +normales. I-EXPLORATION +Posteriormente B-TREATMENT +se I-TREATMENT +realiza I-TREATMENT +radioterapia I-TREATMENT +complementaria, I-TREATMENT +presentando I-TREATMENT +una I-TREATMENT +evolución I-TREATMENT +favorable I-TREATMENT +y I-TREATMENT +permaneciendo I-TREATMENT +asintomático. I-TREATMENT +La B-EXPLORATION +RM I-EXPLORATION +abdominopélvica I-EXPLORATION de I-EXPLORATION -fluorodeoxiglucosa I-EXPLORATION -(FDG) I-EXPLORATION +control I-EXPLORATION +realizada I-EXPLORATION a I-EXPLORATION -nivel I-EXPLORATION +los I-EXPLORATION +cinco I-EXPLORATION +meses I-EXPLORATION de I-EXPLORATION -fosa I-EXPLORATION -iliaca I-EXPLORATION -derecha, I-EXPLORATION -localizado I-EXPLORATION -sobre I-EXPLORATION -asas I-EXPLORATION -intestinales, I-EXPLORATION -con I-EXPLORATION +la I-EXPLORATION +intervención I-EXPLORATION +quirurgica I-EXPLORATION +presenta I-EXPLORATION un I-EXPLORATION -SUV I-EXPLORATION -máximo I-EXPLORATION +estado I-EXPLORATION +postoperatorio I-EXPLORATION +del I-EXPLORATION +liposarcoma I-EXPLORATION +retroperitoneal, I-EXPLORATION +sin I-EXPLORATION +evidencia I-EXPLORATION +macroscópica I-EXPLORATION de I-EXPLORATION -8, I-EXPLORATION -12. I-EXPLORATION -Ante B-TREATMENT -estos I-TREATMENT -hallazgos, I-TREATMENT -se I-TREATMENT -inicia I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -imatinib I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -400 I-TREATMENT -mg/día. I-TREATMENT -La B-EVOLUTION -tolerancia I-EVOLUTION -a I-EVOLUTION -dicho I-EVOLUTION -tratamiento I-EVOLUTION -ha I-EVOLUTION -sido I-EVOLUTION -adecuada. I-EVOLUTION -En I-EVOLUTION -el I-EVOLUTION -nuevo I-EVOLUTION -estudio I-EVOLUTION -de I-EVOLUTION -reevaluación, I-EVOLUTION -tres I-EVOLUTION -meses I-EVOLUTION -tras I-EVOLUTION -el I-EVOLUTION -inicio I-EVOLUTION -del I-EVOLUTION -tratamiento, I-EVOLUTION -persiste I-EVOLUTION -el I-EVOLUTION -nódulo I-EVOLUTION -suprarrenal I-EVOLUTION -derecho, I-EVOLUTION -sin I-EVOLUTION -cambios I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -tamaño I-EVOLUTION -ni I-EVOLUTION +lesión. I-EXPLORATION +Así B-EVOLUTION +este I-EVOLUTION +paciente I-EVOLUTION +presentó I-EVOLUTION +una I-EVOLUTION +evolución I-EVOLUTION +favorable, I-EVOLUTION +permaneciendo I-EVOLUTION +asintomático I-EVOLUTION en I-EVOLUTION -el I-EVOLUTION -aspecto, I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -PET I-EVOLUTION -no I-EVOLUTION -revela I-EVOLUTION la I-EVOLUTION -presencia I-EVOLUTION +actualidad I-EVOLUTION +transcurriendo I-EVOLUTION +más I-EVOLUTION de I-EVOLUTION -ninguna I-EVOLUTION -lesión I-EVOLUTION -residual. I-EVOLUTION +un I-EVOLUTION +año I-EVOLUTION +desde I-EVOLUTION +la I-EVOLUTION +intervención I-EVOLUTION +quirúrgica. I-EVOLUTION I-EVOLUTION -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS mujer I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -45 I-PRESENT_ILLNESS +36 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -haber I-PRESENT_ILLNESS -presentado I-PRESENT_ILLNESS -hace I-PRESENT_ILLNESS -18 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -forma I-PRESENT_ILLNESS -brusca I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -intenso I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nivel I-PRESENT_ILLNESS -cervical I-PRESENT_ILLNESS -irradiado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -zona I-PRESENT_ILLNESS -frontotemporal, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -acentuaba I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -movimientos I-PRESENT_ILLNESS -cervicales I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -bipedestación, I-PRESENT_ILLNESS que I-PRESENT_ILLNESS -aumentaba I-PRESENT_ILLNESS -progresivamente I-PRESENT_ILLNESS +acudió I-PRESENT_ILLNESS a I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -largo I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -día, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -nauseas, I-PRESENT_ILLNESS -mareos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -fotofobia. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -presentado I-PRESENT_ILLNESS -mejoría I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +Unidad I-PRESENT_ILLNESS +Dental I-PRESENT_ILLNESS del I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -analgésico I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -antiinflamatorio, I-PRESENT_ILLNESS -pautado I-PRESENT_ILLNESS +Centro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Referencia I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Salud I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Peñalolén, I-PRESENT_ILLNESS +Cordillera I-PRESENT_ILLNESS +Oriente, I-PRESENT_ILLNESS +Santiago, I-PRESENT_ILLNESS +Chile. I-PRESENT_ILLNESS +Consultó I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -médico I-PRESENT_ILLNESS +aumento I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -cabecera. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION +volumen I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +labio I-PRESENT_ILLNESS +superior I-PRESENT_ILLNESS +lado I-PRESENT_ILLNESS +izquierdo. I-PRESENT_ILLNESS +La I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +señaló I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +lesión I-PRESENT_ILLNESS +había I-PRESENT_ILLNESS +crecido I-PRESENT_ILLNESS +lentamente I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +aproximadamente I-PRESENT_ILLNESS +1 I-PRESENT_ILLNESS +año I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +ella I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +detectó. I-PRESENT_ILLNESS +A B-EXPLORATION la I-EXPLORATION -paciente I-EXPLORATION -presentaba I-EXPLORATION -dolor I-EXPLORATION +inspección I-EXPLORATION +clínica I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +el I-EXPLORATION +labio I-EXPLORATION +con I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION +volumen I-EXPLORATION +nodular, I-EXPLORATION +irregular, I-EXPLORATION +globuloso I-EXPLORATION +(como I-EXPLORATION +racimo), I-EXPLORATION +de I-EXPLORATION +aproximadamente I-EXPLORATION +2 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +diámetro I-EXPLORATION +mayor, I-EXPLORATION +indoloro, I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +consistencia I-EXPLORATION +firme I-EXPLORATION a I-EXPLORATION la I-EXPLORATION -flexión I-EXPLORATION +palpación, I-EXPLORATION +de I-EXPLORATION +límites I-EXPLORATION +más I-EXPLORATION +o I-EXPLORATION +menos I-EXPLORATION +difusos I-EXPLORATION y I-EXPLORATION -movilización I-EXPLORATION -con I-EXPLORATION -contractura I-EXPLORATION -voluntaria I-EXPLORATION -cervical. I-EXPLORATION -No I-EXPLORATION -existían I-EXPLORATION -signos I-EXPLORATION -meníngeos I-EXPLORATION -claros I-EXPLORATION -ni I-EXPLORATION -focalidad I-EXPLORATION -neurológica I-EXPLORATION -evidente. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -Tomografía I-EXPLORATION -Axial I-EXPLORATION -Computerizada I-EXPLORATION -cerebral I-EXPLORATION -donde I-EXPLORATION +recubierto I-EXPLORATION +por I-EXPLORATION +mucosa I-EXPLORATION +de I-EXPLORATION +aspecto I-EXPLORATION +normal. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +anamnesis I-EXPLORATION no I-EXPLORATION se I-EXPLORATION -apreciaron I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -sangrado. I-EXPLORATION +pesquisaron I-EXPLORATION +otros I-EXPLORATION +procesos I-EXPLORATION +ni I-EXPLORATION +antecedentes I-EXPLORATION +mórbidos I-EXPLORATION +relevantes. I-EXPLORATION I-EXPLORATION -Con I-EXPLORATION +Con B-TREATMENT +la I-TREATMENT +hipótesis I-TREATMENT +diagnóstica I-TREATMENT +de I-TREATMENT +adenoma I-TREATMENT +pleomorfo, I-TREATMENT +se I-TREATMENT +procedió I-TREATMENT +a I-TREATMENT +realizar I-TREATMENT +la I-TREATMENT +biopsia I-TREATMENT +excisional I-TREATMENT +bajo I-TREATMENT +anestesia I-TREATMENT +local. I-TREATMENT +Se I-TREATMENT +logró I-TREATMENT +extraer I-TREATMENT +toda I-TREATMENT +la I-TREATMENT +tumoración I-TREATMENT +además I-TREATMENT +de I-TREATMENT +tejido I-TREATMENT +adyacente, I-TREATMENT +ya I-TREATMENT +que I-TREATMENT +si I-TREATMENT +bien I-TREATMENT +se I-TREATMENT +observaba I-TREATMENT +algo I-TREATMENT +de I-TREATMENT +fibrosis I-TREATMENT +periférica, I-TREATMENT +ésta I-TREATMENT +se I-TREATMENT +entremezclaba I-TREATMENT +con I-TREATMENT +el I-TREATMENT +tejido I-TREATMENT +conjuntivo I-TREATMENT +y I-TREATMENT +capa I-TREATMENT +muscular I-TREATMENT +de I-TREATMENT +los I-TREATMENT +labios. I-TREATMENT +La B-EXPLORATION +muestra I-EXPLORATION +fue I-EXPLORATION +enviada I-EXPLORATION +a I-EXPLORATION +análisis I-EXPLORATION +histopatológico. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +informe I-EXPLORATION +histopatológico I-EXPLORATION +reveló I-EXPLORATION la I-EXPLORATION -sospecha I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -hemorragia I-EXPLORATION -subaracnoidea I-EXPLORATION +proliferación I-EXPLORATION +bien I-EXPLORATION +delimitada, I-EXPLORATION +pero I-EXPLORATION +no I-EXPLORATION +capsulada, I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +tejido I-EXPLORATION +compuesto I-EXPLORATION +por I-EXPLORATION +vasos I-EXPLORATION +sanguíneos I-EXPLORATION +de I-EXPLORATION +paredes I-EXPLORATION +engrosadas, I-EXPLORATION +entremezclados I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +infiltrado I-EXPLORATION +linfocitario I-EXPLORATION +que I-EXPLORATION se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -punción I-EXPLORATION -lumbar, I-EXPLORATION +disponía I-EXPLORATION +a I-EXPLORATION +manera I-EXPLORATION +de I-EXPLORATION + I-EXPLORATION +folículos I-EXPLORATION con I-EXPLORATION -el I-EXPLORATION -resultado I-EXPLORATION +centros I-EXPLORATION +germinativos, I-EXPLORATION +además I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -bioquímica I-EXPLORATION -urgente I-EXPLORATION +presencia I-EXPLORATION +destacada I-EXPLORATION de I-EXPLORATION -303 I-EXPLORATION -hematíes I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -primer I-EXPLORATION -tubo I-EXPLORATION -y I-EXPLORATION -301 I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -tercero. I-EXPLORATION -Se I-EXPLORATION -solicitó I-EXPLORATION -una I-EXPLORATION -centrifugado I-EXPLORATION +eosinófilos. I-EXPLORATION +El I-EXPLORATION +tejido I-EXPLORATION +presentaba I-EXPLORATION +múltiples I-EXPLORATION +tabicaciones I-EXPLORATION +por I-EXPLORATION +haces I-EXPLORATION +de I-EXPLORATION +fibras I-EXPLORATION +colágenas. I-EXPLORATION +El I-EXPLORATION +diagnóstico I-EXPLORATION +histopatológico I-EXPLORATION +correspondió I-EXPLORATION +a I-EXPLORATION +hiperplasia I-EXPLORATION +angiolinfoidea I-EXPLORATION +con I-EXPLORATION +eosinofilia. I-EXPLORATION +Los I-EXPLORATION +valores I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +distintos I-EXPLORATION +parámetros I-EXPLORATION del I-EXPLORATION -líquido I-EXPLORATION -cefalorraquídeo, I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -demostró I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION +hemograma I-EXPLORATION +estaban I-EXPLORATION +dentro I-EXPLORATION de I-EXPLORATION -xantocromía I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -sobrenadante. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -Resonancia I-EXPLORATION -Nuclear I-EXPLORATION -Magnética I-EXPLORATION -cerebral I-EXPLORATION -confirmó I-EXPLORATION -posteriormente I-EXPLORATION -el I-EXPLORATION -diagnóstico. I-EXPLORATION +los I-EXPLORATION +rangos I-EXPLORATION +normales. I-EXPLORATION I-EXPLORATION +La B-EVOLUTION +paciente I-EVOLUTION +fue I-EVOLUTION +controlada I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +10 I-EVOLUTION +días I-EVOLUTION +y I-EVOLUTION +se I-EVOLUTION +procedió I-EVOLUTION +al I-EVOLUTION +retiro I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +sutura. I-EVOLUTION +Luego I-EVOLUTION +se I-EVOLUTION +volvió I-EVOLUTION +a I-EVOLUTION +controlar I-EVOLUTION +al I-EVOLUTION +mes I-EVOLUTION +y I-EVOLUTION +6 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +realizada I-EVOLUTION +la I-EVOLUTION +cirugía, I-EVOLUTION +sin I-EVOLUTION +observarse I-EVOLUTION +recidiva. I-EVOLUTION + I-EVOLUTION -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -17 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -soltera, B-PAST_MEDICAL_HISTORY -mestiza, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS +Niña B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -Cirugía I-PRESENT_ILLNESS -Maxilofacial I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -HUSVF I-PRESENT_ILLNESS +diez I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +Urgencias I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -“aumento I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -pómulo I-PRESENT_ILLNESS -izquierdo” I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +alta, I-PRESENT_ILLNESS +cefalea I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +odinofagia I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS de I-PRESENT_ILLNESS evolución I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -ha I-PRESENT_ILLNESS -ido I-PRESENT_ILLNESS -aumentando I-PRESENT_ILLNESS -rápidamente I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +azitromicina I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +últimas I-PRESENT_ILLNESS +24 I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +aparición I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -tamaño I-PRESENT_ILLNESS -; I-PRESENT_ILLNESS -a B-EXPLORATION +lesiones I-PRESENT_ILLNESS +genitales I-PRESENT_ILLNESS +muy I-PRESENT_ILLNESS +dolorosas. I-PRESENT_ILLNESS +Ausencia B-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +menarquia, I-PAST_MEDICAL_HISTORY +contacto I-PAST_MEDICAL_HISTORY +sexual I-PAST_MEDICAL_HISTORY +o I-PAST_MEDICAL_HISTORY +traumatismos I-PAST_MEDICAL_HISTORY +genitales I-PAST_MEDICAL_HISTORY +previos. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +A B-EXPLORATION la I-EXPLORATION -inspección I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -tumefacción I-EXPLORATION -en I-EXPLORATION -maxilar I-EXPLORATION -izquierdo I-EXPLORATION -sin I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -ningún I-EXPLORATION -tipo I-EXPLORATION +exploración I-EXPLORATION +genital I-EXPLORATION +presenta I-EXPLORATION +eritema I-EXPLORATION +y I-EXPLORATION +edema I-EXPLORATION de I-EXPLORATION -sintomatología. I-EXPLORATION -Clínicamente I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -asimetría I-EXPLORATION -facial I-EXPLORATION -en I-EXPLORATION -maxilar I-EXPLORATION -izquierdo I-EXPLORATION +ambos I-EXPLORATION +labios I-EXPLORATION +mayores, I-EXPLORATION con I-EXPLORATION -borramiento I-EXPLORATION -de I-EXPLORATION -surco I-EXPLORATION -nasogeniano I-EXPLORATION -izquierdo I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -inflamatorios. I-EXPLORATION -A I-EXPLORATION +úlceras I-EXPLORATION +profundas, I-EXPLORATION +simétricas, I-EXPLORATION +negruzcas, I-EXPLORATION la I-EXPLORATION -palpación, I-EXPLORATION -masa I-EXPLORATION +mayor I-EXPLORATION de I-EXPLORATION -consistencia I-EXPLORATION -sólida I-EXPLORATION +ellas I-EXPLORATION de I-EXPLORATION -bordes I-EXPLORATION -bien I-EXPLORATION -definidos I-EXPLORATION -que I-EXPLORATION -altera I-EXPLORATION -la I-EXPLORATION -forma I-EXPLORATION +3 I-EXPLORATION +cm I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -apertura I-EXPLORATION -piriforme I-EXPLORATION -ipsilateral I-EXPLORATION +diámetro I-EXPLORATION +longitudinal I-EXPLORATION +en I-EXPLORATION +ambos I-EXPLORATION +labios I-EXPLORATION +menores I-EXPLORATION y I-EXPLORATION -produce I-EXPLORATION -abombamiento I-EXPLORATION -de I-EXPLORATION -piso I-EXPLORATION -nasal I-EXPLORATION +varias I-EXPLORATION +lesiones I-EXPLORATION +satélites I-EXPLORATION +menores I-EXPLORATION +perivulvares, I-EXPLORATION +recubiertas I-EXPLORATION +algunas I-EXPLORATION de I-EXPLORATION +material I-EXPLORATION +fibrinoide I-EXPLORATION +y I-EXPLORATION +muy I-EXPLORATION +dolorosa I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -fosa I-EXPLORATION -nasal I-EXPLORATION -izquierda, I-EXPLORATION -pero I-EXPLORATION -se I-EXPLORATION -conserva I-EXPLORATION -la I-EXPLORATION -permeabilidad I-EXPLORATION +manipulación. I-EXPLORATION +Resto I-EXPLORATION de I-EXPLORATION -dicha I-EXPLORATION -fosa. I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +sin I-EXPLORATION +hallazgos I-EXPLORATION +relevantes. I-EXPLORATION + I-EXPLORATION En I-EXPLORATION -radiografía I-EXPLORATION -panorámica I-EXPLORATION -(Fg. I-EXPLORATION -1b), I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -zona I-EXPLORATION -radiolúcida I-EXPLORATION -circunscrita I-EXPLORATION -de I-EXPLORATION -bordes I-EXPLORATION -bien I-EXPLORATION -delimitados I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -extiende I-EXPLORATION +las I-EXPLORATION +pruebas I-EXPLORATION +complementarias I-EXPLORATION +destaca I-EXPLORATION +leucocitosis I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -dientes I-EXPLORATION -22 I-EXPLORATION -al I-EXPLORATION -26 I-EXPLORATION -haciendo I-EXPLORATION -desplazamiento I-EXPLORATION -radicular I-EXPLORATION -distal I-EXPLORATION +22, I-EXPLORATION +38/µl I-EXPLORATION +y I-EXPLORATION +proteína I-EXPLORATION +C I-EXPLORATION +reactiva I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -raíces I-EXPLORATION +138, I-EXPLORATION +9 I-EXPLORATION +mg/l, I-EXPLORATION +con I-EXPLORATION +función I-EXPLORATION +renal, I-EXPLORATION +hepática I-EXPLORATION +y I-EXPLORATION +sedimento I-EXPLORATION +urinario I-EXPLORATION +normales. I-EXPLORATION + I-EXPLORATION +Ante I-EXPLORATION +una I-EXPLORATION +úlcera I-EXPLORATION +genital I-EXPLORATION +aguda, I-EXPLORATION +planteamos I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +diferencial I-EXPLORATION +entre I-EXPLORATION +el I-EXPLORATION +origen I-EXPLORATION +infeccioso, I-EXPLORATION +ya I-EXPLORATION +sea I-EXPLORATION +venéreo I-EXPLORATION +(sífilis, I-EXPLORATION +virus I-EXPLORATION +herpes I-EXPLORATION +simple, I-EXPLORATION +linfogranuloma I-EXPLORATION +venéreo, I-EXPLORATION +chancroide) I-EXPLORATION +o I-EXPLORATION +no I-EXPLORATION +venéreo I-EXPLORATION +(virus I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -bicúspides, I-EXPLORATION -rechaza I-EXPLORATION +Epstein-Barr I-EXPLORATION +[VEB], I-EXPLORATION +citomegalovirus I-EXPLORATION +[CMV], I-EXPLORATION +Brucella), I-EXPLORATION +y I-EXPLORATION el I-EXPLORATION -seno I-EXPLORATION -maxilar I-EXPLORATION -e I-EXPLORATION -involucra I-EXPLORATION -la I-EXPLORATION -totalidad I-EXPLORATION -del I-EXPLORATION -diente I-EXPLORATION -23 I-EXPLORATION -con I-EXPLORATION -presencia I-EXPLORATION +origen I-EXPLORATION +no I-EXPLORATION +infeccioso I-EXPLORATION +(enfermedad I-EXPLORATION de I-EXPLORATION -imágenes I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -calcificaciones I-EXPLORATION -internas. I-EXPLORATION +Crohn, I-EXPLORATION +síndrome I-EXPLORATION +de I-EXPLORATION +Behçet, I-EXPLORATION +pénfigo I-EXPLORATION +vulgar, I-EXPLORATION +liquen I-EXPLORATION +escleroso, I-EXPLORATION +aftosis I-EXPLORATION +idiopática, I-EXPLORATION +eritema I-EXPLORATION +fijo I-EXPLORATION +medicamentoso, I-EXPLORATION +eritema I-EXPLORATION +multiforme) I-EXPLORATION +1-3. I-EXPLORATION I-EXPLORATION -Al B-TREATMENT -momento I-TREATMENT -de I-TREATMENT +Se B-TREATMENT +ingresa I-TREATMENT +a I-TREATMENT la I-TREATMENT -resección I-TREATMENT -de I-TREATMENT +paciente I-TREATMENT +con I-TREATMENT +analgesia, I-TREATMENT +lubricante I-TREATMENT +cicratizante I-TREATMENT +y I-TREATMENT +fomentos I-TREATMENT +con I-TREATMENT +suero I-TREATMENT +fisiológico. I-TREATMENT +Ante I-TREATMENT la I-TREATMENT -lesión, I-TREATMENT +evolución I-TREATMENT +tórpida, I-TREATMENT se I-TREATMENT -encuentra I-TREATMENT -una I-TREATMENT -masa I-TREATMENT -de I-TREATMENT -consistencia I-TREATMENT -sólida I-TREATMENT -de I-TREATMENT -aproximadamente I-TREATMENT -5 I-TREATMENT -centímetros I-TREATMENT +añaden I-TREATMENT +al I-TREATMENT +tratamiento I-TREATMENT +antibióticos I-TREATMENT de I-TREATMENT -diámetro, I-TREATMENT -recubierta I-TREATMENT -por I-TREATMENT -una I-TREATMENT -membrana I-TREATMENT -gruesa I-TREATMENT +amplio I-TREATMENT +espectro, I-TREATMENT +aciclovir I-TREATMENT +IV I-TREATMENT y I-TREATMENT -de I-TREATMENT -aspecto I-TREATMENT -fibroso. I-TREATMENT -Posterior I-TREATMENT -a I-TREATMENT -la I-TREATMENT -enucleación I-TREATMENT -de I-TREATMENT -la I-TREATMENT -lesión I-TREATMENT -queda I-TREATMENT -un I-TREATMENT -defecto I-TREATMENT -óseo I-TREATMENT +corticoterapia I-TREATMENT +oral, I-TREATMENT en I-TREATMENT -el I-TREATMENT -maxilar I-TREATMENT -superior I-TREATMENT -de I-TREATMENT -aproximadamente I-TREATMENT -5 I-TREATMENT -centímetros I-TREATMENT +espera I-TREATMENT de I-TREATMENT -diámetro I-TREATMENT -donde I-TREATMENT -estaba I-TREATMENT -respetado I-TREATMENT -el I-TREATMENT -seno I-TREATMENT -maxilar. I-TREATMENT -En I-TREATMENT -la I-TREATMENT -periferia I-TREATMENT +los I-TREATMENT +resultados I-TREATMENT de I-TREATMENT -la I-TREATMENT -lesión I-TREATMENT -se I-TREATMENT -palpa I-TREATMENT -la I-TREATMENT -presencia I-TREATMENT -del I-TREATMENT -diente I-TREATMENT -involucrado. I-TREATMENT - I-TREATMENT +los I-TREATMENT +cultivos. I-TREATMENT El B-EXPLORATION -estudio I-EXPLORATION -histopatológico I-EXPLORATION -describe I-EXPLORATION -tejido I-EXPLORATION -que I-EXPLORATION -incluye I-EXPLORATION -diente I-EXPLORATION -dentro I-EXPLORATION -del I-EXPLORATION -tumor. I-EXPLORATION -Muestra I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION +urocultivo, I-EXPLORATION +el I-EXPLORATION +hemocultivo I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +cultivo I-EXPLORATION de I-EXPLORATION -una I-EXPLORATION -porción I-EXPLORATION -quística I-EXPLORATION -delimitada I-EXPLORATION -por I-EXPLORATION -tejido I-EXPLORATION -fibroconectivo I-EXPLORATION -con I-EXPLORATION -células I-EXPLORATION +exudado I-EXPLORATION +vaginal I-EXPLORATION +y I-EXPLORATION +cervical I-EXPLORATION +(para I-EXPLORATION +C. I-EXPLORATION +trachomatis), I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +los I-EXPLORATION +frotis I-EXPLORATION de I-EXPLORATION -disposición I-EXPLORATION -paralela. I-EXPLORATION -Hay I-EXPLORATION -neoformación I-EXPLORATION -ósea I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -adyacente I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -pared. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -central I-EXPLORATION +las I-EXPLORATION +úlceras I-EXPLORATION +genitales, I-EXPLORATION +fueron I-EXPLORATION +negativos. I-EXPLORATION +Las I-EXPLORATION +serologías I-EXPLORATION +para I-EXPLORATION +VEB, I-EXPLORATION +CMV, I-EXPLORATION +Brucella, I-EXPLORATION +Rosa I-EXPLORATION +de I-EXPLORATION +Bengala, I-EXPLORATION +virus I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -cavidad I-EXPLORATION -hay I-EXPLORATION -una I-EXPLORATION -proliferación I-EXPLORATION +inmunodeficiencia I-EXPLORATION +humana I-EXPLORATION +y I-EXPLORATION +lúes I-EXPLORATION +fueron I-EXPLORATION +negativas. I-EXPLORATION +Se I-EXPLORATION +solicita I-EXPLORATION +determinación I-EXPLORATION de I-EXPLORATION -células I-EXPLORATION -epiteliales I-EXPLORATION -cilíndricas I-EXPLORATION +ADN I-EXPLORATION +del I-EXPLORATION +virus I-EXPLORATION +herpes I-EXPLORATION +simple I-EXPLORATION +tipos I-EXPLORATION +I I-EXPLORATION y I-EXPLORATION -algunas I-EXPLORATION -fusocelulares I-EXPLORATION -que I-EXPLORATION -forman I-EXPLORATION -varios I-EXPLORATION -nódulos I-EXPLORATION -intercalados I-EXPLORATION -con I-EXPLORATION -bandas I-EXPLORATION +II, I-EXPLORATION +mediante I-EXPLORATION +reacción I-EXPLORATION +en I-EXPLORATION +cadena I-EXPLORATION de I-EXPLORATION -tejido I-EXPLORATION -eosinófilo I-EXPLORATION -hialinizado I-EXPLORATION -a I-EXPLORATION -manera I-EXPLORATION +la I-EXPLORATION +polimerasa I-EXPLORATION de I-EXPLORATION -membrana. I-EXPLORATION -En I-EXPLORATION la I-EXPLORATION -proliferación I-EXPLORATION -celular I-EXPLORATION -hay I-EXPLORATION -múltiples I-EXPLORATION -calcificaciones I-EXPLORATION +muestra I-EXPLORATION de I-EXPLORATION -forma I-EXPLORATION -irregular. I-EXPLORATION -Además I-EXPLORATION -hay I-EXPLORATION -pequeñas I-EXPLORATION -estructuras I-EXPLORATION -tubulares I-EXPLORATION -revestidas I-EXPLORATION -por I-EXPLORATION -epitelio I-EXPLORATION -cilíndrico I-EXPLORATION +la I-EXPLORATION +úlcera I-EXPLORATION +genital, I-EXPLORATION +que I-EXPLORATION +resultó I-EXPLORATION +finalmente I-EXPLORATION +negativa. I-EXPLORATION + I-EXPLORATION +Se B-EVOLUTION +establece I-EVOLUTION +el I-EVOLUTION +diagnóstico, I-EVOLUTION +por I-EVOLUTION +exclusión, I-EVOLUTION +de I-EVOLUTION +úlcera I-EVOLUTION +de I-EVOLUTION +Lipschütz I-EVOLUTION +en I-EVOLUTION +su I-EVOLUTION +forma I-EVOLUTION +gangrenosa I-EVOLUTION +y I-EVOLUTION +se I-EVOLUTION +decide I-EVOLUTION +el I-EVOLUTION +alta I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +siete I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +ingreso, I-EVOLUTION +persistiendo I-EVOLUTION +las I-EVOLUTION +ulceraciones I-EVOLUTION +múltiples I-EVOLUTION +con I-EVOLUTION +pérdida I-EVOLUTION +de I-EVOLUTION +tejido, I-EVOLUTION +sin I-EVOLUTION +aspecto I-EVOLUTION +inflamatorio I-EVOLUTION +y I-EVOLUTION +con I-EVOLUTION +inicio I-EVOLUTION +de I-EVOLUTION +cicatrización, I-EVOLUTION +en I-EVOLUTION +las I-EVOLUTION +más I-EVOLUTION +externas, I-EVOLUTION +sin I-EVOLUTION +apreciarse I-EVOLUTION +retracción I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +mucosas I-EVOLUTION +genitales I-EVOLUTION +ni I-EVOLUTION +secreciones I-EVOLUTION +vaginales. I-EVOLUTION + I-EVOLUTION +El I-EVOLUTION +cuadro I-EVOLUTION +estaba I-EVOLUTION +casi I-EVOLUTION +totalmente I-EVOLUTION +resuelto I-EVOLUTION +a I-EVOLUTION +las I-EVOLUTION +siete I-EVOLUTION +semanas I-EVOLUTION +del I-EVOLUTION +diagnóstico. I-EVOLUTION + I-EVOLUTION + +Paciente B-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +73 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +diabético B-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +hipertenso I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +sigue I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +farmacológico. I-PAST_MEDICAL_HISTORY +Dos I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +antes, I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +ingresado I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +cuadro I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +hepatitis I-PAST_MEDICAL_HISTORY +tóxica I-PAST_MEDICAL_HISTORY +secundaria I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +consumo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +amoxicilina-clavulánico. I-PAST_MEDICAL_HISTORY +Desde I-PAST_MEDICAL_HISTORY +entonces I-PAST_MEDICAL_HISTORY +estaba I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +seguimiento I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +especialista I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Aparato I-PAST_MEDICAL_HISTORY +Digestivo. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +varios I-PAST_MEDICAL_HISTORY +controles I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +presentado I-PAST_MEDICAL_HISTORY +cifras I-PAST_MEDICAL_HISTORY +discretamente I-PAST_MEDICAL_HISTORY +elevadas I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +calcio I-PAST_MEDICAL_HISTORY +plasmático, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +hubiera I-PAST_MEDICAL_HISTORY +llegado I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +filiar I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +origen I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +dicha I-PAST_MEDICAL_HISTORY +alteración I-PAST_MEDICAL_HISTORY +analítica. I-PAST_MEDICAL_HISTORY +No I-PAST_MEDICAL_HISTORY +seguía I-PAST_MEDICAL_HISTORY +tratamientos I-PAST_MEDICAL_HISTORY +crónicos I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +refería I-PAST_MEDICAL_HISTORY +hábitos I-PAST_MEDICAL_HISTORY +tóxicos. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Ingresa B-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +pancreatitis I-PRESENT_ILLNESS +aguda, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +epigástrico, I-PRESENT_ILLNESS +intolerancia I-PRESENT_ILLNESS +oral, I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +elevación I-PRESENT_ILLNESS +significativa I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +cifras I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +amilasa I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +lipasa, I-PRESENT_ILLNESS +siendo I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +resto I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +datos I-PRESENT_ILLNESS +analíticos I-PRESENT_ILLNESS +anodinos. I-PRESENT_ILLNESS +La B-EVOLUTION +evolución I-EVOLUTION +es I-EVOLUTION +favorable I-EVOLUTION +en I-EVOLUTION +los I-EVOLUTION +primeros I-EVOLUTION +días, I-EVOLUTION +con I-EVOLUTION +mejoría I-EVOLUTION +del I-EVOLUTION +dolor I-EVOLUTION +y I-EVOLUTION +reinstauración I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +dieta I-EVOLUTION +oral. I-EVOLUTION +No I-EVOLUTION +obstante, I-EVOLUTION +sufre I-EVOLUTION +de I-EVOLUTION +forma I-EVOLUTION +súbita I-EVOLUTION +un I-EVOLUTION +empeoramiento I-EVOLUTION +de I-EVOLUTION +su I-EVOLUTION +situación I-EVOLUTION +clínica, I-EVOLUTION +con I-EVOLUTION +aparición I-EVOLUTION +nuevamente I-EVOLUTION +del I-EVOLUTION +dolor I-EVOLUTION +abdominal I-EVOLUTION +y I-EVOLUTION +deterioro I-EVOLUTION +progresivo I-EVOLUTION +del I-EVOLUTION +nivel I-EVOLUTION +de I-EVOLUTION +conciencia, I-EVOLUTION +con I-EVOLUTION +episodios I-EVOLUTION +fluctuantes I-EVOLUTION +de I-EVOLUTION +desconexión I-EVOLUTION +del I-EVOLUTION +medio, I-EVOLUTION +objetivándose I-EVOLUTION +además, I-EVOLUTION +en I-EVOLUTION +los I-EVOLUTION +controles I-EVOLUTION +analíticos I-EVOLUTION +llevados I-EVOLUTION +a I-EVOLUTION +cabo I-EVOLUTION +esos I-EVOLUTION +días, I-EVOLUTION +elevación I-EVOLUTION +progresiva I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +cifras I-EVOLUTION +de I-EVOLUTION +calcio I-EVOLUTION +total, I-EVOLUTION +alcanzándose I-EVOLUTION +niveles I-EVOLUTION +de I-EVOLUTION +15, I-EVOLUTION +5 I-EVOLUTION +mg/dl I-EVOLUTION +(rangos I-EVOLUTION +de I-EVOLUTION +normalidad I-EVOLUTION +del I-EVOLUTION +calcio I-EVOLUTION +sérico I-EVOLUTION +entre I-EVOLUTION +8, I-EVOLUTION +4-10, I-EVOLUTION +4 I-EVOLUTION +mg/dl). I-EVOLUTION +Se B-EXPLORATION +determinaron I-EXPLORATION +los I-EXPLORATION +niveles I-EXPLORATION +de I-EXPLORATION +paratohormona I-EXPLORATION +intacta I-EXPLORATION +(PTHi): I-EXPLORATION +311, I-EXPLORATION +2 I-EXPLORATION +pg/ml I-EXPLORATION +(valores I-EXPLORATION +de I-EXPLORATION +normalidad I-EXPLORATION +< I-EXPLORATION +9 I-EXPLORATION +pg/ml) I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +ecografía I-EXPLORATION +cervical I-EXPLORATION que I-EXPLORATION -contienen I-EXPLORATION -material I-EXPLORATION -eosinó- I-EXPLORATION -filo I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -lumen. I-EXPLORATION +informaba I-EXPLORATION +de I-EXPLORATION +masa I-EXPLORATION +de I-EXPLORATION +aspecto I-EXPLORATION +quístico I-EXPLORATION +junto I-EXPLORATION +a I-EXPLORATION +lóbulo I-EXPLORATION +tiroideo I-EXPLORATION +izquierdo. I-EXPLORATION I-EXPLORATION +El B-EVOLUTION +paciente I-EVOLUTION +requirió I-EVOLUTION +ingreso I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +Unidad I-EVOLUTION +de I-EVOLUTION +Cuidados I-EVOLUTION +Intensivos, I-EVOLUTION +con I-EVOLUTION +mala I-EVOLUTION +evolución I-EVOLUTION +en I-EVOLUTION +los I-EVOLUTION +días I-EVOLUTION +posteriores. I-EVOLUTION +No I-EVOLUTION +se I-EVOLUTION +pudo I-EVOLUTION +corregir I-EVOLUTION +la I-EVOLUTION +hipercalcemia I-EVOLUTION +a I-EVOLUTION +pesar I-EVOLUTION +de I-EVOLUTION +tratamiento I-EVOLUTION +médico I-EVOLUTION +intensivo I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +PTHi I-EVOLUTION +alcanzó I-EVOLUTION +cifras I-EVOLUTION +de I-EVOLUTION +1.900 I-EVOLUTION +pg/ml. I-EVOLUTION +Se B-TREATMENT +intervino I-TREATMENT +quirúrgicamente, I-TREATMENT +extirpándose I-TREATMENT +un I-TREATMENT +nódulo I-TREATMENT +paratiroideo I-TREATMENT +dependiente I-TREATMENT +de I-TREATMENT +la I-TREATMENT +glándula I-TREATMENT +superior I-TREATMENT +izquierda, I-TREATMENT +tras I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +la I-TREATMENT +PTHi I-TREATMENT +descendió I-TREATMENT +a I-TREATMENT +324, I-TREATMENT +7 I-TREATMENT +pg/ml, I-TREATMENT +llegando I-TREATMENT +a I-TREATMENT +normalizarse I-TREATMENT +en I-TREATMENT +las I-TREATMENT +horas I-TREATMENT +siguientes. I-TREATMENT +El B-EVOLUTION +calcio I-EVOLUTION +plasmático I-EVOLUTION +ionizado I-EVOLUTION +disminuyó I-EVOLUTION +igualmente, I-EVOLUTION +consiguiéndose I-EVOLUTION +valores I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +límite I-EVOLUTION +alto I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +normalidad. I-EVOLUTION +No I-EVOLUTION +obstante, I-EVOLUTION +y I-EVOLUTION +a I-EVOLUTION +pesar I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +medidas I-EVOLUTION +de I-EVOLUTION +soporte, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +no I-EVOLUTION +pudo I-EVOLUTION +superar I-EVOLUTION +un I-EVOLUTION +shock I-EVOLUTION +refractario I-EVOLUTION +con I-EVOLUTION +intensa I-EVOLUTION +acidosis I-EVOLUTION +metabólica I-EVOLUTION +láctica, I-EVOLUTION +falleciendo I-EVOLUTION +por I-EVOLUTION +asistolia I-EVOLUTION +sin I-EVOLUTION +respuesta I-EVOLUTION +a I-EVOLUTION +las I-EVOLUTION +maniobras I-EVOLUTION +de I-EVOLUTION +reanimación. I-EVOLUTION + I-EVOLUTION -Neonato B-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -indeterminado I-PRESENT_ILLNESS -llevado I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS +78 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +es I-PRESENT_ILLNESS +ingresado I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -alteraciones I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +Servicio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -miembros I-PRESENT_ILLNESS -inferiores I-PRESENT_ILLNESS +Urgencias I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +hipocondrio I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS +acompañado I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -pared I-PRESENT_ILLNESS -abdominopélvica. I-PRESENT_ILLNESS -Los B-PAST_MEDICAL_HISTORY -datos I-PAST_MEDICAL_HISTORY -administrados I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -familia I-PAST_MEDICAL_HISTORY -sobre I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -evolución I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -embarazo, I-PAST_MEDICAL_HISTORY -controles I-PAST_MEDICAL_HISTORY -prenatales I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -parto I-PAST_MEDICAL_HISTORY -son I-PAST_MEDICAL_HISTORY -contradictorios. I-PAST_MEDICAL_HISTORY -El B-EXPLORATION -abdomen I-EXPLORATION -presenta I-EXPLORATION -un I-EXPLORATION -defecto I-EXPLORATION -infraumbilical I-EXPLORATION -con I-EXPLORATION -eventración I-EXPLORATION +subictericia I-PRESENT_ILLNESS +cutánea-mucosa. I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +analítica I-EXPLORATION +destaca I-EXPLORATION +elevación I-EXPLORATION de I-EXPLORATION -colon I-EXPLORATION -y I-EXPLORATION -recto. I-EXPLORATION -A I-EXPLORATION -nivel I-EXPLORATION -lumbar I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -lipomeningocele. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -observan I-EXPLORATION -genitales I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -ano I-EXPLORATION -se I-EXPLORATION -encuentra I-EXPLORATION -imperforado. I-EXPLORATION -Las I-EXPLORATION -extremidades I-EXPLORATION -superiores I-EXPLORATION -son I-EXPLORATION -simétricas, I-EXPLORATION -con I-EXPLORATION -pliegue I-EXPLORATION -único I-EXPLORATION -palmar. I-EXPLORATION -Las I-EXPLORATION -extremidades I-EXPLORATION -inferiores I-EXPLORATION -son I-EXPLORATION -asimétricas I-EXPLORATION +GGT I-EXPLORATION y I-EXPLORATION -dismórficas; I-EXPLORATION -el I-EXPLORATION -muslo I-EXPLORATION -derecho I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -longitud I-EXPLORATION -de I-EXPLORATION -8, I-EXPLORATION -5 I-EXPLORATION -centímetros I-EXPLORATION -a I-EXPLORATION -partir I-EXPLORATION +discreta I-EXPLORATION de I-EXPLORATION -cuyo I-EXPLORATION -tercio I-EXPLORATION -medio I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION +bilirrubina I-EXPLORATION +total I-EXPLORATION +con I-EXPLORATION un I-EXPLORATION -segmento I-EXPLORATION +CA I-EXPLORATION +19.9 I-EXPLORATION de I-EXPLORATION -6, I-EXPLORATION -5 I-EXPLORATION -centímetros I-EXPLORATION +1.973 I-EXPLORATION +U/ml. I-EXPLORATION +Al I-EXPLORATION +igual I-EXPLORATION que I-EXPLORATION -termina I-EXPLORATION -en I-EXPLORATION -pie I-EXPLORATION -con I-EXPLORATION -ectrodactilia; I-EXPLORATION el I-EXPLORATION -muslo I-EXPLORATION -izquierdo I-EXPLORATION -con I-EXPLORATION +primer I-EXPLORATION +caso, I-EXPLORATION +la I-EXPLORATION +ecografía I-EXPLORATION +demuestra I-EXPLORATION una I-EXPLORATION -longitud I-EXPLORATION +dilatación I-EXPLORATION de I-EXPLORATION -8, I-EXPLORATION -5 I-EXPLORATION -centímetros, I-EXPLORATION +la I-EXPLORATION +vía I-EXPLORATION +biliar I-EXPLORATION +izquierda. I-EXPLORATION +En I-EXPLORATION +este I-EXPLORATION +caso, I-EXPLORATION en I-EXPLORATION -cuyo I-EXPLORATION -segmento I-EXPLORATION -distal I-EXPLORATION +la I-EXPLORATION +colangio-RMN I-EXPLORATION se I-EXPLORATION -observa I-EXPLORATION -protuberancia I-EXPLORATION -de I-EXPLORATION -2 I-EXPLORATION -centímetros I-EXPLORATION -y I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION +puede I-EXPLORATION +ver I-EXPLORATION +gran I-EXPLORATION +dilatación I-EXPLORATION del I-EXPLORATION -tercio I-EXPLORATION -medio I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -un I-EXPLORATION -pie I-EXPLORATION +árbol I-EXPLORATION +biliar I-EXPLORATION +izquierdo I-EXPLORATION con I-EXPLORATION -ectrodactilia. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION -del I-EXPLORATION -miembro I-EXPLORATION -inferior I-EXPLORATION -derecho I-EXPLORATION -muestra I-EXPLORATION -un I-EXPLORATION -fémur I-EXPLORATION +ocupación I-EXPLORATION +por I-EXPLORATION +material I-EXPLORATION +velloso I-EXPLORATION y I-EXPLORATION -agenesia I-EXPLORATION -de I-EXPLORATION -tibia. I-EXPLORATION -El I-EXPLORATION -miembro I-EXPLORATION -inferior I-EXPLORATION -izquierdo I-EXPLORATION -mostró I-EXPLORATION -bifurcación I-EXPLORATION +mucina. I-EXPLORATION +La I-EXPLORATION +CPRE I-EXPLORATION +demuestra I-EXPLORATION +la I-EXPLORATION +salida I-EXPLORATION +de I-EXPLORATION +mucina I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +ocupación I-EXPLORATION +vellosa I-EXPLORATION del I-EXPLORATION -fémur I-EXPLORATION +árbol I-EXPLORATION +biliar I-EXPLORATION +izquierdo, I-EXPLORATION +del I-EXPLORATION +cual I-EXPLORATION +se I-EXPLORATION +toma I-EXPLORATION +una I-EXPLORATION +biopsia, I-EXPLORATION y I-EXPLORATION -agenesia I-EXPLORATION -tibial. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION +se I-EXPLORATION +coloca I-EXPLORATION una I-EXPLORATION -cirugía I-EXPLORATION -reconstructiva. I-EXPLORATION -Los I-EXPLORATION -hallazgos I-EXPLORATION -incluyeron I-EXPLORATION -alteraciones I-EXPLORATION +prótesis I-EXPLORATION +plástica. I-EXPLORATION +La I-EXPLORATION +histología I-EXPLORATION +es I-EXPLORATION +de I-EXPLORATION +neoplasia I-EXPLORATION +papilar I-EXPLORATION +intraductal I-EXPLORATION +con I-EXPLORATION +displasia I-EXPLORATION +de I-EXPLORATION +alto I-EXPLORATION +grado. I-EXPLORATION +También B-TREATMENT +se I-TREATMENT +le I-TREATMENT +plantea I-TREATMENT +tratamiento I-TREATMENT +quirúrgico, I-TREATMENT +practicando I-TREATMENT +hepatectomía I-TREATMENT +izquierda I-TREATMENT +con I-TREATMENT +resección I-TREATMENT +del I-TREATMENT +segmento I-TREATMENT +I I-TREATMENT +y I-TREATMENT +del I-TREATMENT +árbol I-TREATMENT +biliar I-TREATMENT +izquierdo, I-TREATMENT +colecistectomía I-TREATMENT +y I-TREATMENT +linfadenectomía I-TREATMENT +del I-TREATMENT +hilio I-TREATMENT +hepático. I-TREATMENT +La B-EXPLORATION +biopsia I-EXPLORATION +intraoperatoria I-EXPLORATION +demuestra I-EXPLORATION +la I-EXPLORATION +ausencia I-EXPLORATION +de I-EXPLORATION +afectación I-EXPLORATION del I-EXPLORATION -aparato I-EXPLORATION -urogenital, I-EXPLORATION -como I-EXPLORATION -ectopia I-EXPLORATION -renal I-EXPLORATION -derecha I-EXPLORATION -en I-EXPLORATION -fosa I-EXPLORATION -ilíaca, I-EXPLORATION -extrofia I-EXPLORATION -vesical, I-EXPLORATION -agenesia I-EXPLORATION +borde I-EXPLORATION de I-EXPLORATION -uretra, I-EXPLORATION -estenosis I-EXPLORATION +resección I-EXPLORATION +biliar. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +histológico I-EXPLORATION +definitivo I-EXPLORATION +confirma I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION de I-EXPLORATION -uréter I-EXPLORATION -izquierdo I-EXPLORATION +colangiocarcinoma I-EXPLORATION con I-EXPLORATION -dilatación I-EXPLORATION -proximal I-EXPLORATION +componente I-EXPLORATION +microinfiltrante I-EXPLORATION +aislado I-EXPLORATION y I-EXPLORATION -uraco I-EXPLORATION -persistente. I-EXPLORATION -Se I-EXPLORATION -encontraron I-EXPLORATION -alteraciones I-EXPLORATION +focal I-EXPLORATION +en I-EXPLORATION +rama I-EXPLORATION +distal I-EXPLORATION del I-EXPLORATION -aparato I-EXPLORATION -reproductor, I-EXPLORATION -como I-EXPLORATION -clítoris I-EXPLORATION -bífido, I-EXPLORATION -agenesia I-EXPLORATION -de I-EXPLORATION -vagina I-EXPLORATION -y I-EXPLORATION -útero I-EXPLORATION -doble, I-EXPLORATION -cuyo I-EXPLORATION segmento I-EXPLORATION -derecho I-EXPLORATION -se I-EXPLORATION -continuaba I-EXPLORATION +III I-EXPLORATION +hepático I-EXPLORATION con I-EXPLORATION +producción I-EXPLORATION +de I-EXPLORATION +moco. I-EXPLORATION +Tampoco B-TREATMENT +se I-TREATMENT +realiza I-TREATMENT +tratamiento I-TREATMENT +adyuvante I-TREATMENT +y B-EVOLUTION +el I-EVOLUTION +paciente, I-EVOLUTION +tras I-EVOLUTION +cuatro I-EVOLUTION +años I-EVOLUTION +de I-EVOLUTION +seguimiento, I-EVOLUTION +no I-EVOLUTION +presenta I-EVOLUTION +recidiva I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +enfermedad. I-EVOLUTION + I-EVOLUTION + +Un B-PRESENT_ILLNESS +soldado I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +25 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +y B-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés I-PAST_MEDICAL_HISTORY +fue B-PRESENT_ILLNESS +evacuado I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +ROLE I-PRESENT_ILLNESS +1 I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +base I-PRESENT_ILLNESS +Miguel I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Cervantes I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +posición I-PRESENT_ILLNESS +cercana I-PRESENT_ILLNESS +tras I-PRESENT_ILLNESS +sufrir I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +picaduras I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +escorpión, I-PRESENT_ILLNESS +localizadas I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +pierna I-PRESENT_ILLNESS +derecha, I-PRESENT_ILLNESS +menos I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +antes I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +llegada. I-PRESENT_ILLNESS +La I-PRESENT_ILLNESS +primera I-PRESENT_ILLNESS +estaba I-PRESENT_ILLNESS +localizada I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +región I-PRESENT_ILLNESS +anterior I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +tercio I-PRESENT_ILLNESS +medio I-PRESENT_ILLNESS +tibial. I-PRESENT_ILLNESS +La I-PRESENT_ILLNESS +segunda, I-PRESENT_ILLNESS +prácticamente I-PRESENT_ILLNESS +indetectable, I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +hallaba I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +misma I-PRESENT_ILLNESS +altura I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +región I-PRESENT_ILLNESS +posterior. I-PRESENT_ILLNESS +El I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +refirió I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +como I-PRESENT_ILLNESS +única I-PRESENT_ILLNESS +manifestación, I-PRESENT_ILLNESS +más I-PRESENT_ILLNESS +acentuado I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +segunda I-PRESENT_ILLNESS +picadura. I-PRESENT_ILLNESS +Durante B-EXPLORATION +la I-EXPLORATION +asistencia I-EXPLORATION +inicial, I-EXPLORATION el I-EXPLORATION -cérvix I-EXPLORATION -y I-EXPLORATION -al I-EXPLORATION -izquierdo I-EXPLORATION -desembocaba I-EXPLORATION -el I-EXPLORATION -uréter I-EXPLORATION -izquierdo, I-EXPLORATION -cada I-EXPLORATION -uno I-EXPLORATION -presentaba I-EXPLORATION -trompa I-EXPLORATION -y I-EXPLORATION -ovario. I-EXPLORATION -Se I-EXPLORATION -hallaron I-EXPLORATION -alteraciones I-EXPLORATION +paciente I-EXPLORATION +presentó I-EXPLORATION +valores I-EXPLORATION +de I-EXPLORATION +presión I-EXPLORATION +arterial I-EXPLORATION +(PA) I-EXPLORATION +de I-EXPLORATION +130/ I-EXPLORATION +60, I-EXPLORATION +una I-EXPLORATION +frecuencia I-EXPLORATION +cardíaca I-EXPLORATION +de I-EXPLORATION +62 I-EXPLORATION +latidos I-EXPLORATION +por I-EXPLORATION +minuto, I-EXPLORATION +una I-EXPLORATION +saturación I-EXPLORATION +de I-EXPLORATION +oxígeno I-EXPLORATION +inicial I-EXPLORATION del I-EXPLORATION -aparato I-EXPLORATION -gastrointestinal, I-EXPLORATION -como I-EXPLORATION -ano I-EXPLORATION -imperforado I-EXPLORATION +96% I-EXPLORATION y I-EXPLORATION -fístula I-EXPLORATION -cecal. I-EXPLORATION +una I-EXPLORATION +temperatura I-EXPLORATION +de I-EXPLORATION +36oC. I-EXPLORATION +El I-EXPLORATION +electrocardiograma I-EXPLORATION +era I-EXPLORATION +normal I-EXPLORATION +y I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +objetivaron I-EXPLORATION +otras I-EXPLORATION +manifestaciones I-EXPLORATION +sistémicas. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +inició I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +2 I-TREATMENT +gramos I-TREATMENT +de I-TREATMENT +dipirona I-TREATMENT +intravenosa I-TREATMENT +y I-TREATMENT +la I-TREATMENT +vacuna I-TREATMENT +antitetánica. I-TREATMENT +El I-TREATMENT +tratamiento I-TREATMENT +local I-TREATMENT +incluyó I-TREATMENT +una I-TREATMENT +exhaustiva I-TREATMENT +irrigación I-TREATMENT +con I-TREATMENT +povidona I-TREATMENT +diluida I-TREATMENT +para I-TREATMENT +su I-TREATMENT +limpieza. I-TREATMENT +Tras I-TREATMENT +la I-TREATMENT +aparición I-TREATMENT +de I-TREATMENT +una I-TREATMENT +reacción I-TREATMENT +edematosa I-TREATMENT +localizada I-TREATMENT +en I-TREATMENT +la I-TREATMENT +pierna I-TREATMENT +derecha I-TREATMENT +se I-TREATMENT +administró I-TREATMENT +una I-TREATMENT +dosis I-TREATMENT +única I-TREATMENT +de I-TREATMENT +corticoterapia I-TREATMENT +intravenosa. I-TREATMENT Durante B-EVOLUTION +el I-EVOLUTION +ingreso I-EVOLUTION +la I-EVOLUTION +PA I-EVOLUTION +se I-EVOLUTION +mantuvo I-EVOLUTION +entre I-EVOLUTION +100 I-EVOLUTION +y I-EVOLUTION +130 I-EVOLUTION +(sistólica) I-EVOLUTION +y I-EVOLUTION +55 I-EVOLUTION +y I-EVOLUTION +70 I-EVOLUTION +(diastólica). I-EVOLUTION +La I-EVOLUTION +temperatura I-EVOLUTION +corporal I-EVOLUTION +nunca I-EVOLUTION +superó I-EVOLUTION +los I-EVOLUTION +36´5oC. I-EVOLUTION + I-EVOLUTION +El I-EVOLUTION +paciente I-EVOLUTION +abandonó I-EVOLUTION +el I-EVOLUTION +ROLE I-EVOLUTION +1 I-EVOLUTION +24 I-EVOLUTION +horas I-EVOLUTION +después I-EVOLUTION +de I-EVOLUTION su I-EVOLUTION -estadía I-EVOLUTION -hospitalaria I-EVOLUTION -desarrolla I-EVOLUTION -sepsis, I-EVOLUTION -insuficiencia I-EVOLUTION -hepática, I-EVOLUTION -acidosis I-EVOLUTION -metabólica I-EVOLUTION -e I-EVOLUTION -hiponatremia; I-EVOLUTION -fallece I-EVOLUTION +ingreso I-EVOLUTION +sin I-EVOLUTION +requerir I-EVOLUTION +ningún I-EVOLUTION +tipo I-EVOLUTION +de I-EVOLUTION +medicación I-EVOLUTION +(sólo I-EVOLUTION +analgesia I-EVOLUTION +convencional I-EVOLUTION a I-EVOLUTION -las I-EVOLUTION -siete I-EVOLUTION -semanas I-EVOLUTION +demanda). I-EVOLUTION +Las I-EVOLUTION +heridas I-EVOLUTION +cicatrizaron I-EVOLUTION +sin I-EVOLUTION +incidencias. I-EVOLUTION + I-EVOLUTION +El I-EVOLUTION +ejemplar I-EVOLUTION +fue I-EVOLUTION +capturado I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +mismo I-EVOLUTION +lugar I-EVOLUTION +donde I-EVOLUTION +se I-EVOLUTION +produjo I-EVOLUTION +la I-EVOLUTION +picadura. I-EVOLUTION +Se I-EVOLUTION +trataba I-EVOLUTION de I-EVOLUTION -edad. I-EVOLUTION +un I-EVOLUTION +escorpión I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +familia I-EVOLUTION +Buthidae, I-EVOLUTION +muy I-EVOLUTION +común I-EVOLUTION +en I-EVOLUTION +Líbano, I-EVOLUTION +aunque I-EVOLUTION +no I-EVOLUTION +se I-EVOLUTION +pudo I-EVOLUTION +precisar I-EVOLUTION +la I-EVOLUTION +especie. I-EVOLUTION I-EVOLUTION -Paciente B-PRESENT_ILLNESS -femenina I-PRESENT_ILLNESS +El B-PRESENT_ILLNESS +23 I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +agosto I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -referida B-DERIVED_FROM/TO +2011 I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +médico I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Role I-PRESENT_ILLNESS +1 I-PRESENT_ILLNESS +informa I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +Medical I-PRESENT_ILLNESS +Advisor I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +Operación I-PRESENT_ILLNESS +European I-PRESENT_ILLNESS +Union I-PRESENT_ILLNESS +Training I-PRESENT_ILLNESS +Mission I-PRESENT_ILLNESS +(EUTM) I-PRESENT_ILLNESS +Somalia I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +prueba I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +"quick I-PRESENT_ILLNESS +test" I-PRESENT_ILLNESS +realizada I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +enfermeras I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +Role I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS +ha I-PRESENT_ILLNESS +resultado I-PRESENT_ILLNESS +positiva. I-PRESENT_ILLNESS +Por B-DERIVED_FROM/TO +lo I-DERIVED_FROM/TO +que I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +va I-DERIVED_FROM/TO a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -consulta I-DERIVED_FROM/TO -externa I-DERIVED_FROM/TO +proceder I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +su I-DERIVED_FROM/TO +traslado I-DERIVED_FROM/TO de I-DERIVED_FROM/TO -dermatología I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO +forma I-DERIVED_FROM/TO +urgente I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO Hospital I-DERIVED_FROM/TO -Nacional I-DERIVED_FROM/TO +Nakasero I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +Kampala I-DERIVED_FROM/TO +situado I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +400 I-DERIVED_FROM/TO +km I-DERIVED_FROM/TO +aproximadamente I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +carreteras I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +muy I-DERIVED_FROM/TO +malas I-DERIVED_FROM/TO +condiciones. I-DERIVED_FROM/TO +La I-DERIVED_FROM/TO +decisión I-DERIVED_FROM/TO de I-DERIVED_FROM/TO -Niños I-DERIVED_FROM/TO -Benjamín I-DERIVED_FROM/TO -Bloom I-DERIVED_FROM/TO +cómo I-DERIVED_FROM/TO +realizar I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +traslado I-DERIVED_FROM/TO +no I-DERIVED_FROM/TO +depende I-DERIVED_FROM/TO de I-DERIVED_FROM/TO -San I-DERIVED_FROM/TO -Salvador, I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -presentar I-DERIVED_FROM/TO -engrosamiento I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -cambios I-DERIVED_FROM/TO +EUTM-Somalia, I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +Role I-DERIVED_FROM/TO +2 I-DERIVED_FROM/TO +puede I-DERIVED_FROM/TO +decidir I-DERIVED_FROM/TO de I-DERIVED_FROM/TO -coloración I-DERIVED_FROM/TO +forma I-DERIVED_FROM/TO +independiente I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +estar I-DERIVED_FROM/TO +éste I-DERIVED_FROM/TO +contratado I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +EUTM-Somalia. I-DERIVED_FROM/TO +El I-DERIVED_FROM/TO +personal I-DERIVED_FROM/TO +del I-DERIVED_FROM/TO +Role-2 I-DERIVED_FROM/TO +tiene I-DERIVED_FROM/TO +su I-DERIVED_FROM/TO +propio I-DERIVED_FROM/TO +seguro I-DERIVED_FROM/TO +sanitario. I-DERIVED_FROM/TO +Quiere I-DERIVED_FROM/TO +decir I-DERIVED_FROM/TO +que, I-DERIVED_FROM/TO +pueden I-DERIVED_FROM/TO +gestionarse I-DERIVED_FROM/TO +sus I-DERIVED_FROM/TO +propias I-DERIVED_FROM/TO +evacuaciones I-DERIVED_FROM/TO +e I-DERIVED_FROM/TO +ingresos I-DERIVED_FROM/TO en I-DERIVED_FROM/TO +hospitales. I-DERIVED_FROM/TO +Al I-DERIVED_FROM/TO +igual I-DERIVED_FROM/TO +que I-DERIVED_FROM/TO +cuentan I-DERIVED_FROM/TO +siempre I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO la I-DERIVED_FROM/TO -uña I-DERIVED_FROM/TO +ayuda I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +colaboración I-DERIVED_FROM/TO del I-DERIVED_FROM/TO -pulgar I-DERIVED_FROM/TO -derecho. I-DERIVED_FROM/TO -Al B-EXPLORATION -examen I-EXPLORATION -físico, I-EXPLORATION -en I-EXPLORATION -cuero I-EXPLORATION -cabelludo, I-EXPLORATION -se I-EXPLORATION -observan I-EXPLORATION -tres I-EXPLORATION -placas I-EXPLORATION -alopécicas, I-EXPLORATION -con I-EXPLORATION -cicatrización I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -periferia I-EXPLORATION -y I-EXPLORATION -escasas I-EXPLORATION -costras I-EXPLORATION -serosanguinolentas I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -centro, I-EXPLORATION -dos I-EXPLORATION -de I-EXPLORATION -estas I-EXPLORATION -placas I-EXPLORATION -se I-EXPLORATION -localizan I-EXPLORATION -alrededor I-EXPLORATION -del I-EXPLORATION -ápice I-EXPLORATION -del I-EXPLORATION -cráneo I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -tercera I-EXPLORATION -en I-EXPLORATION -región I-EXPLORATION -parietal I-EXPLORATION -derecha. I-EXPLORATION -En I-EXPLORATION -cavidad I-EXPLORATION -oral I-EXPLORATION -y I-EXPLORATION -labios I-EXPLORATION -se I-EXPLORATION -observan I-EXPLORATION -placas I-EXPLORATION -blanquecinas I-EXPLORATION -que I-EXPLORATION -cubren I-EXPLORATION -el I-EXPLORATION -centro I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -bordes I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lengua, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -ambas I-EXPLORATION -comisuras I-EXPLORATION -labiales; I-EXPLORATION -al I-EXPLORATION -remover I-EXPLORATION -estas I-EXPLORATION -placas I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -eritema I-EXPLORATION -y I-EXPLORATION -fisuras I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -mucosa. I-EXPLORATION -La I-EXPLORATION -uña I-EXPLORATION -del I-EXPLORATION -pulgar I-EXPLORATION -derecho I-EXPLORATION -está I-EXPLORATION -engrosada, I-EXPLORATION -amarillenta, I-EXPLORATION -distrófica I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -eritema I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -pliegues I-EXPLORATION -periungueales; I-EXPLORATION -la I-EXPLORATION -uña I-EXPLORATION -del I-EXPLORATION -dedo I-EXPLORATION -medio I-EXPLORATION -de I-EXPLORATION -mano I-EXPLORATION -izquierda I-EXPLORATION -presenta I-EXPLORATION -coloración I-EXPLORATION -amarillenta I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -bordes I-EXPLORATION -laterales. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -encuentran I-EXPLORATION -signos I-EXPLORATION -clínicos I-EXPLORATION -de I-EXPLORATION -hipoparatiroidismo I-EXPLORATION -o I-EXPLORATION -enfermedad I-EXPLORATION -de I-EXPLORATION -Addison. I-EXPLORATION - I-EXPLORATION -Desde B-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -edad I-PAST_MEDICAL_HISTORY -ha I-PAST_MEDICAL_HISTORY -requerido I-PAST_MEDICAL_HISTORY -atención I-PAST_MEDICAL_HISTORY -hospitalaria I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -diarrea, I-PAST_MEDICAL_HISTORY -gastroenteritis I-PAST_MEDICAL_HISTORY -aguda, I-PAST_MEDICAL_HISTORY -neumonía I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -desnutrición I-PAST_MEDICAL_HISTORY -moderada, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -múltiples I-PAST_MEDICAL_HISTORY -hospitalizaciones; I-PAST_MEDICAL_HISTORY -sufre I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -candidiasis I-PAST_MEDICAL_HISTORY -oral I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY +Cuartel I-DERIVED_FROM/TO +General I-DERIVED_FROM/TO +EUTM-Somalia. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +Los B-PRESENT_ILLNESS +síntomas I-PRESENT_ILLNESS +alarmantes I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +llevan I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +sus I-PRESENT_ILLNESS +compañeros I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +realizar I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +Quik I-PRESENT_ILLNESS +test I-PRESENT_ILLNESS +es I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +síndrome I-PRESENT_ILLNESS +agudo I-PRESENT_ILLNESS +pseudo-confusional, I-PRESENT_ILLNESS +asociado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +cansancio, I-PRESENT_ILLNESS +cefalea, I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +más I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +38oC. I-PRESENT_ILLNESS +Al I-PRESENT_ILLNESS +parecer, I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +posteriores I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +confirmación I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +diagnóstico I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +suman I-PRESENT_ILLNESS +antecedentes I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +había I-PRESENT_ILLNESS +revelado I-PRESENT_ILLNESS +hasta I-PRESENT_ILLNESS +ese I-PRESENT_ILLNESS +momento: I-PRESENT_ILLNESS +astenia I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +últimos I-PRESENT_ILLNESS +quince I-PRESENT_ILLNESS +días, I-PRESENT_ILLNESS +cefaleas, I-PRESENT_ILLNESS +diarrea I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +aparentemente I-PRESENT_ILLNESS +infeccioso I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +había I-PRESENT_ILLNESS +comenzado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +automedicarse I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +antibiótico I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +tipo I-PRESENT_ILLNESS +amoxicilina I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +ácido I-PRESENT_ILLNESS +clavulánico. I-PRESENT_ILLNESS +Como B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +médicos I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +sufría I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -edad. I-PAST_MEDICAL_HISTORY -Los I-PAST_MEDICAL_HISTORY -análisis I-PAST_MEDICAL_HISTORY +migrañas. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +El I-PAST_MEDICAL_HISTORY +personal I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -laboratorio I-PAST_MEDICAL_HISTORY -archivados I-PAST_MEDICAL_HISTORY +este I-PAST_MEDICAL_HISTORY +Role I-PAST_MEDICAL_HISTORY +2 I-PAST_MEDICAL_HISTORY +permanecía I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -expediente I-PAST_MEDICAL_HISTORY -clínico I-PAST_MEDICAL_HISTORY -informan I-PAST_MEDICAL_HISTORY -anemia I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -parasitismo I-PAST_MEDICAL_HISTORY -intestinal; I-PAST_MEDICAL_HISTORY -tres I-PAST_MEDICAL_HISTORY -exámenes I-PAST_MEDICAL_HISTORY -ELISA I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -virus I-PAST_MEDICAL_HISTORY +zona I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +periodos I-PAST_MEDICAL_HISTORY +largos I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -inmunodeficiencia I-PAST_MEDICAL_HISTORY -humana, I-PAST_MEDICAL_HISTORY -tomados I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -segundo I-PAST_MEDICAL_HISTORY +más I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY año I-PAST_MEDICAL_HISTORY +(con I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +mes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -vida, I-PAST_MEDICAL_HISTORY -resultaron I-PAST_MEDICAL_HISTORY -negativos, I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY +descanso I-PAST_MEDICAL_HISTORY +cada I-PAST_MEDICAL_HISTORY +seis I-PAST_MEDICAL_HISTORY +meses I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +estancia I-PAST_MEDICAL_HISTORY +aproximadamente), I-PAST_MEDICAL_HISTORY lo I-PAST_MEDICAL_HISTORY que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -descarta I-PAST_MEDICAL_HISTORY -esta I-PAST_MEDICAL_HISTORY -infección. I-PAST_MEDICAL_HISTORY -La B-FAMILY_HISTORY -paciente I-FAMILY_HISTORY -es I-FAMILY_HISTORY -la I-FAMILY_HISTORY -segunda I-FAMILY_HISTORY -de I-FAMILY_HISTORY -tres I-FAMILY_HISTORY -hermanas I-FAMILY_HISTORY -y I-FAMILY_HISTORY -tiene I-FAMILY_HISTORY -dos I-FAMILY_HISTORY -hermanos I-FAMILY_HISTORY -mayores I-FAMILY_HISTORY -con I-FAMILY_HISTORY -los I-FAMILY_HISTORY -que I-FAMILY_HISTORY -sólo I-FAMILY_HISTORY -comparte I-FAMILY_HISTORY -padre; I-FAMILY_HISTORY -padres I-FAMILY_HISTORY -y I-FAMILY_HISTORY -hermanos I-FAMILY_HISTORY -son I-FAMILY_HISTORY -sanos. I-FAMILY_HISTORY -No I-FAMILY_HISTORY -se I-FAMILY_HISTORY -encontró I-FAMILY_HISTORY -evidencia I-FAMILY_HISTORY -de I-FAMILY_HISTORY -infecciones I-FAMILY_HISTORY -cutáneas I-FAMILY_HISTORY -a I-FAMILY_HISTORY -repetición I-FAMILY_HISTORY -o I-FAMILY_HISTORY -endocrinopatías I-FAMILY_HISTORY -en I-FAMILY_HISTORY -abuelos I-FAMILY_HISTORY -y I-FAMILY_HISTORY -tíos I-FAMILY_HISTORY -de I-FAMILY_HISTORY -la I-FAMILY_HISTORY -paciente. I-FAMILY_HISTORY -Ante B-EXPLORATION -una I-EXPLORATION -posible I-EXPLORATION -inmunodeficiencia I-EXPLORATION -primaria, I-EXPLORATION -específicamente I-EXPLORATION -una I-EXPLORATION -CMC, I-EXPLORATION -se I-EXPLORATION -indican I-EXPLORATION -estudios I-EXPLORATION -inmunológicos. I-EXPLORATION -La I-EXPLORATION -citometría I-EXPLORATION -de I-EXPLORATION -flujo I-EXPLORATION -informa I-EXPLORATION -niveles I-EXPLORATION -séricos I-EXPLORATION -bajos I-EXPLORATION -de I-EXPLORATION -linfocitos I-EXPLORATION -T I-EXPLORATION -y I-EXPLORATION -células I-EXPLORATION -NK, I-EXPLORATION -que I-EXPLORATION -repercuten I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -número I-EXPLORATION -total I-EXPLORATION -de I-EXPLORATION -linfocitos; I-EXPLORATION -las I-EXPLORATION -concentraciones I-EXPLORATION -séricas I-EXPLORATION -de I-EXPLORATION -linfocitos I-EXPLORATION -B I-EXPLORATION -son I-EXPLORATION -normales. I-EXPLORATION -El I-EXPLORATION -déficit I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -inmunidad I-EXPLORATION -mediada I-EXPLORATION -por I-EXPLORATION -células I-EXPLORATION -se I-EXPLORATION -constata I-EXPLORATION -también I-EXPLORATION -a I-EXPLORATION -través I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -prueba I-EXPLORATION -de I-EXPLORATION -candidina, I-EXPLORATION -que I-EXPLORATION -denota I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -induración I-EXPLORATION -tanto I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -48 I-EXPLORATION -h, I-EXPLORATION -como I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -semana I-EXPLORATION -de I-EXPLORATION -haberse I-EXPLORATION -aplicado; I-EXPLORATION -iguales I-EXPLORATION -resultados I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -prueba I-EXPLORATION -de I-EXPLORATION -tuberculina I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -48 I-EXPLORATION -h I-EXPLORATION -de I-EXPLORATION -aplicación. I-EXPLORATION -Los I-EXPLORATION -niveles I-EXPLORATION -séricos I-EXPLORATION -de I-EXPLORATION -inmunoglobulinas I-EXPLORATION -A, I-EXPLORATION -E I-EXPLORATION -y I-EXPLORATION -M I-EXPLORATION -son I-EXPLORATION -normales, I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -de I-EXPLORATION -IgG I-EXPLORATION -altos. I-EXPLORATION -El I-EXPLORATION -cultivo I-EXPLORATION -micológico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -uña I-EXPLORATION -del I-EXPLORATION -pulgar I-EXPLORATION -derecho I-EXPLORATION -arroja I-EXPLORATION -crecimiento I-EXPLORATION -de I-EXPLORATION -Tricophyton I-EXPLORATION -mentagrophytes; I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -de I-EXPLORATION -cuero I-EXPLORATION -cabelludo I-EXPLORATION -se I-EXPLORATION -detecta I-EXPLORATION -crecimiento I-EXPLORATION -de I-EXPLORATION -Candida I-EXPLORATION -albicans. I-EXPLORATION -Las I-EXPLORATION -concentraciones I-EXPLORATION -séricas I-EXPLORATION -de I-EXPLORATION -electrólitos: I-EXPLORATION -sodio, I-EXPLORATION -potasio, I-EXPLORATION -cloro, I-EXPLORATION -calcio, I-EXPLORATION -fósforo, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -función I-EXPLORATION -renal I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -transaminasa I-EXPLORATION -glutámicopirúvica I-EXPLORATION -son I-EXPLORATION -normales; I-EXPLORATION -se I-EXPLORATION -halló I-EXPLORATION -una I-EXPLORATION -discreta I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -transaminasa I-EXPLORATION -glutámico-oxalacética. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -estudios I-EXPLORATION -clínicos I-EXPLORATION -confirman I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION -diagnóstica I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -CMC, I-EXPLORATION -específicamente I-EXPLORATION -por I-EXPLORATION -déficit I-EXPLORATION -de I-EXPLORATION -linfocitos I-EXPLORATION -T I-EXPLORATION -y I-EXPLORATION -células I-EXPLORATION -NK. I-EXPLORATION -Se B-TREATMENT -indica I-TREATMENT -itraconazol I-TREATMENT -100 I-TREATMENT -mg I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -oral, I-TREATMENT -una I-TREATMENT -vez I-TREATMENT -al I-TREATMENT -día, I-TREATMENT +ha I-PAST_MEDICAL_HISTORY +llevado I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +muchos I-PAST_MEDICAL_HISTORY +casos I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +abandono I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +forma I-PAST_MEDICAL_HISTORY +voluntaria I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +quimioprofilaxis I-PAST_MEDICAL_HISTORY +(Lariam®, I-PAST_MEDICAL_HISTORY +Malarone® I-PAST_MEDICAL_HISTORY +o I-PAST_MEDICAL_HISTORY +Doxiciclina). I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Se B-EVOLUTION +decide I-EVOLUTION +realizar I-EVOLUTION +el I-EVOLUTION +traslado I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +por I-EVOLUTION +carretera I-EVOLUTION +con I-EVOLUTION +ambulancia I-EVOLUTION +procedente I-EVOLUTION +de I-EVOLUTION +Kampala I-EVOLUTION +y I-EVOLUTION +se I-EVOLUTION +informa I-EVOLUTION +al I-EVOLUTION +Medical I-EVOLUTION +Advisor I-EVOLUTION +que I-EVOLUTION +el I-EVOLUTION +ingreso I-EVOLUTION +será I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +hospital I-EVOLUTION +Nakasero I-EVOLUTION +de I-EVOLUTION +Kampala. I-EVOLUTION +A I-EVOLUTION +las I-EVOLUTION +12 I-EVOLUTION +horas I-EVOLUTION +aproximadamente I-EVOLUTION +del I-EVOLUTION +diagnóstico I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +ingresa I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +citado I-EVOLUTION +Hospital I-EVOLUTION +y I-EVOLUTION +pocas I-EVOLUTION +horas I-EVOLUTION +más I-EVOLUTION +tarde I-EVOLUTION +entra I-EVOLUTION +en I-EVOLUTION +coma. I-EVOLUTION +Ya I-EVOLUTION +entonces I-EVOLUTION +se I-EVOLUTION +estaba I-EVOLUTION +gestionando I-EVOLUTION +la I-EVOLUTION +aeroevacuación I-EVOLUTION +a I-EVOLUTION +Italia. I-EVOLUTION +Dado I-EVOLUTION +el I-EVOLUTION +estado I-EVOLUTION +avanzado I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +enfermedad I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +es I-EVOLUTION +aeroevacuada I-EVOLUTION +por I-EVOLUTION +la I-EVOLUTION +compañía I-EVOLUTION +de I-EVOLUTION +"Flying I-EVOLUTION +Doctors" I-EVOLUTION +a I-EVOLUTION +Nairobi I-EVOLUTION +dos I-EVOLUTION +días I-EVOLUTION +más I-EVOLUTION +tarde. I-EVOLUTION +Tras I-EVOLUTION +su I-EVOLUTION +ingreso I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +hospital I-EVOLUTION +de I-EVOLUTION +Nairobi I-EVOLUTION +su I-EVOLUTION +evolución I-EVOLUTION +persiste I-EVOLUTION +muy I-EVOLUTION +desfavorablemente I-EVOLUTION +falleciendo I-EVOLUTION +pocas I-EVOLUTION +horas I-EVOLUTION +después I-EVOLUTION +al I-EVOLUTION +cuarto I-EVOLUTION +día I-EVOLUTION +de I-EVOLUTION +su I-EVOLUTION +diagnóstico I-EVOLUTION +inicial. I-EVOLUTION + I-EVOLUTION +Se I-EVOLUTION +puede I-EVOLUTION +pensar I-EVOLUTION +que I-EVOLUTION +una I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +causas I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +rápida I-EVOLUTION +y I-EVOLUTION +mala I-EVOLUTION +evolución I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +enfermedad I-EVOLUTION +de I-EVOLUTION +nuestra I-EVOLUTION +compañera I-EVOLUTION +fue I-EVOLUTION +debido I-EVOLUTION +a I-EVOLUTION +un I-EVOLUTION +diagnóstico I-EVOLUTION +e I-EVOLUTION +inicio I-EVOLUTION +del I-EVOLUTION +tratamiento I-EVOLUTION +tardíos, I-EVOLUTION +la I-EVOLUTION +falta I-EVOLUTION +de I-EVOLUTION +inmunidad I-EVOLUTION +adquirida I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +y I-EVOLUTION +el I-EVOLUTION +abandono I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +quimioprofilaxis I-EVOLUTION +que I-EVOLUTION +pudo I-EVOLUTION +ayudar I-EVOLUTION +al I-EVOLUTION +plasmodium I-EVOLUTION +a I-EVOLUTION +una I-EVOLUTION +reproducción I-EVOLUTION +e I-EVOLUTION +invasión I-EVOLUTION +rápida. I-EVOLUTION + I-EVOLUTION +El I-EVOLUTION +Medical I-EVOLUTION +Advisor I-EVOLUTION + I-EVOLUTION +Durante I-EVOLUTION +todo I-EVOLUTION +este I-EVOLUTION +proceso I-EVOLUTION +y I-EVOLUTION +como I-EVOLUTION +es I-EVOLUTION +habitual, I-EVOLUTION +el I-EVOLUTION +Medical I-EVOLUTION +Advisor I-EVOLUTION +informa I-EVOLUTION +en I-EVOLUTION +cada I-EVOLUTION +momento I-EVOLUTION +al I-EVOLUTION +Jefe I-EVOLUTION +de I-EVOLUTION +Estado I-EVOLUTION +Mayor I-EVOLUTION +y I-EVOLUTION +éste I-EVOLUTION +mantiene I-EVOLUTION +informado I-EVOLUTION +al I-EVOLUTION +Jefe I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +Mision, I-EVOLUTION +quien I-EVOLUTION +a I-EVOLUTION +su I-EVOLUTION +vez I-EVOLUTION +transmite I-EVOLUTION +todo I-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +acontece I-EVOLUTION +en I-EVOLUTION +nuestra I-EVOLUTION +Misión I-EVOLUTION +en I-EVOLUTION +Uganda I-EVOLUTION +al I-EVOLUTION +Cuartel I-EVOLUTION +General I-EVOLUTION +en I-EVOLUTION +Bruselas. I-EVOLUTION +La I-EVOLUTION +preocupación I-EVOLUTION +de I-EVOLUTION +Bruselas I-EVOLUTION +se I-EVOLUTION +hace I-EVOLUTION +evidente. I-EVOLUTION +Asimismo I-EVOLUTION +el I-EVOLUTION +Medical I-EVOLUTION +Advisor I-EVOLUTION +informa I-EVOLUTION +al I-EVOLUTION +Mando I-EVOLUTION +de I-EVOLUTION +Operaciones I-EVOLUTION +(CMOPS) I-EVOLUTION +y I-EVOLUTION +al I-EVOLUTION +Instituto I-EVOLUTION +de I-EVOLUTION +Medicina I-EVOLUTION +Preventiva I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +Defensa I-EVOLUTION +(IMPDEF) I-EVOLUTION +para I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +informe I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +mayor I-EVOLUTION +brevedad I-EVOLUTION +posible I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +Inspección I-EVOLUTION +General I-EVOLUTION +de I-EVOLUTION +Sanidad. I-EVOLUTION + I-EVOLUTION +Tras I-EVOLUTION +esta I-EVOLUTION +amarga I-EVOLUTION +experiencia, I-EVOLUTION +cobra I-EVOLUTION +mayor I-EVOLUTION +relieve I-EVOLUTION +la I-EVOLUTION +figura I-EVOLUTION +del I-EVOLUTION +Medical I-EVOLUTION +Advisor I-EVOLUTION +en I-EVOLUTION +Uganda, I-EVOLUTION +una I-EVOLUTION +de I-EVOLUTION +cuyas I-EVOLUTION +funciones I-EVOLUTION +es I-EVOLUTION +la I-EVOLUTION +de I-EVOLUTION +recordar I-EVOLUTION +a I-EVOLUTION +todo I-EVOLUTION +el I-EVOLUTION +contingente I-EVOLUTION +desplegado I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +misión I-EVOLUTION +las I-EVOLUTION +enfermedades I-EVOLUTION +de I-EVOLUTION +riesgo I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +zona, I-EVOLUTION +les I-EVOLUTION +aconseja I-EVOLUTION +e I-EVOLUTION +instruye I-EVOLUTION +sobre I-EVOLUTION +la I-EVOLUTION +prevención I-EVOLUTION +de I-EVOLUTION +dichas I-EVOLUTION +enfermedades I-EVOLUTION +y I-EVOLUTION +sobre I-EVOLUTION +las I-EVOLUTION +medidas I-EVOLUTION +higiénico-sanitarias I-EVOLUTION +a I-EVOLUTION +tomar I-EVOLUTION +para I-EVOLUTION +prevenirlas. I-EVOLUTION +En B-TREATMENT +relación I-TREATMENT +a I-TREATMENT +la I-TREATMENT +Malaria I-TREATMENT +se I-TREATMENT +remarca I-TREATMENT +lo I-TREATMENT +importante I-TREATMENT +que I-TREATMENT +es I-TREATMENT +tomar I-TREATMENT +la I-TREATMENT +quimioprofilaxis, I-TREATMENT +además I-TREATMENT +de I-TREATMENT +llevar I-TREATMENT +a I-TREATMENT +cabo I-TREATMENT +medidas I-TREATMENT +defensivas I-TREATMENT +que I-TREATMENT +todos I-TREATMENT +conocemos I-TREATMENT +para I-TREATMENT +evitar I-TREATMENT +la I-TREATMENT +picadura I-TREATMENT +del I-TREATMENT +mosquito I-TREATMENT +como: I-TREATMENT + I-TREATMENT +1. I-TREATMENT +Utilizar I-TREATMENT +repelente I-TREATMENT +de I-TREATMENT +insectos I-TREATMENT +de I-TREATMENT +tipo I-TREATMENT +dietiltoluamida, I-TREATMENT +de I-TREATMENT +aplicación I-TREATMENT +en I-TREATMENT +zonas I-TREATMENT +expuestas I-TREATMENT +sobre I-TREATMENT +todo I-TREATMENT +desde I-TREATMENT +las I-TREATMENT +18 I-TREATMENT +p.m. I-TREATMENT +a I-TREATMENT +las I-TREATMENT +05 I-TREATMENT +a.m. I-TREATMENT + I-TREATMENT +2. I-TREATMENT +En I-TREATMENT +el I-TREATMENT +exterior I-TREATMENT +utilizar I-TREATMENT +ropa I-TREATMENT +de I-TREATMENT +manga I-TREATMENT +larga I-TREATMENT +y I-TREATMENT +pantalón I-TREATMENT +largo. I-TREATMENT +Incluso I-TREATMENT +impregnar I-TREATMENT +el I-TREATMENT +uniforme I-TREATMENT +con I-TREATMENT +permetrina. I-TREATMENT + I-TREATMENT +3. I-TREATMENT +Disponer I-TREATMENT +de I-TREATMENT +mosquiteras I-TREATMENT +en I-TREATMENT +las I-TREATMENT +ventanas I-TREATMENT +de I-TREATMENT +las I-TREATMENT +habitaciones. I-TREATMENT +Malla I-TREATMENT +mosquitera I-TREATMENT +impregnada I-TREATMENT +en I-TREATMENT +permetrina I-TREATMENT +en I-TREATMENT +la I-TREATMENT +cama, I-TREATMENT +que I-TREATMENT +se I-TREATMENT +mantenga I-TREATMENT +bien I-TREATMENT +tensada I-TREATMENT +y I-TREATMENT +metida I-TREATMENT por I-TREATMENT -dos I-TREATMENT -meses, I-TREATMENT +debajo I-TREATMENT +del I-TREATMENT +colchón, I-TREATMENT +y I-TREATMENT +que I-TREATMENT +nunca I-TREATMENT +se I-TREATMENT +apoye I-TREATMENT +en I-TREATMENT +el I-TREATMENT +suelo. I-TREATMENT + I-TREATMENT +4. I-TREATMENT +En I-TREATMENT +el I-TREATMENT +interior I-TREATMENT +de I-TREATMENT +la I-TREATMENT +habitación I-TREATMENT +utilizar I-TREATMENT +insecticidas I-TREATMENT +para I-TREATMENT +el I-TREATMENT +cuarto. I-TREATMENT + I-TREATMENT +Se I-TREATMENT +les I-TREATMENT +informa I-TREATMENT y I-TREATMENT -nistatina I-TREATMENT +recuerda I-TREATMENT +continuamente I-TREATMENT +que I-TREATMENT +para I-TREATMENT +evitar I-TREATMENT +un I-TREATMENT +desenlace I-TREATMENT +fatal I-TREATMENT +con I-TREATMENT +la I-TREATMENT +malaria I-TREATMENT +es I-TREATMENT +fundamental I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +precoz I-TREATMENT +y, I-TREATMENT +para I-TREATMENT +ello I-TREATMENT +es I-TREATMENT +fundamental I-TREATMENT +que I-TREATMENT +adviertan I-TREATMENT +al I-TREATMENT +médico I-TREATMENT +del I-TREATMENT +Role I-TREATMENT 1 I-TREATMENT -000 I-TREATMENT -000 I-TREATMENT -U/ml I-TREATMENT -vía I-TREATMENT -oral, I-TREATMENT -4 I-TREATMENT -veces I-TREATMENT -día, I-TREATMENT -resolviéndose I-TREATMENT -las I-TREATMENT -lesiones I-TREATMENT -cutáneas I-TREATMENT +(en I-TREATMENT +Bihanga I-TREATMENT +o I-TREATMENT +Kampala) I-TREATMENT +de I-TREATMENT +cualquier I-TREATMENT +síntoma I-TREATMENT +que I-TREATMENT +se I-TREATMENT +presente, I-TREATMENT +en I-TREATMENT +general I-TREATMENT +"cuando I-TREATMENT +uno I-TREATMENT +se I-TREATMENT +encuentre I-TREATMENT +mal". I-TREATMENT +Se I-TREATMENT +dice I-TREATMENT +que I-TREATMENT +cuando I-TREATMENT +aparece I-TREATMENT +fiebre I-TREATMENT +en I-TREATMENT +zona I-TREATMENT +endémica I-TREATMENT +de I-TREATMENT +malaria I-TREATMENT +"hay I-TREATMENT +que I-TREATMENT +pensar I-TREATMENT +como I-TREATMENT +primera I-TREATMENT +opción I-TREATMENT +en I-TREATMENT +esta I-TREATMENT +enfermedad". I-TREATMENT +Es I-TREATMENT +muy I-TREATMENT +importante I-TREATMENT +tener I-TREATMENT +en I-TREATMENT +cuenta I-TREATMENT +este I-TREATMENT +principio I-TREATMENT +pero, I-TREATMENT +no I-TREATMENT +hay I-TREATMENT +que I-TREATMENT +olvidar I-TREATMENT +además, I-TREATMENT +todos I-TREATMENT +los I-TREATMENT +síntomas I-TREATMENT +que I-TREATMENT +pueden I-TREATMENT +aparecer I-TREATMENT +en I-TREATMENT +la I-TREATMENT +malaria: I-TREATMENT +cefalea, I-TREATMENT +dolor I-TREATMENT +de I-TREATMENT +garganta, I-TREATMENT +astenia I-TREATMENT +intensa, I-TREATMENT +escalofríos, I-TREATMENT +sudoración, I-TREATMENT +náuseas, I-TREATMENT +diarrea I-TREATMENT y I-TREATMENT -orales, I-TREATMENT +vómitos. I-TREATMENT +Estos, I-TREATMENT +son I-TREATMENT +síntomas I-TREATMENT +comunes I-TREATMENT +a I-TREATMENT +otras I-TREATMENT +afecciones I-TREATMENT +frecuentes I-TREATMENT +en I-TREATMENT +la I-TREATMENT +zona I-TREATMENT +como I-TREATMENT +es I-TREATMENT +el I-TREATMENT +caso I-TREATMENT +de I-TREATMENT +la I-TREATMENT +gastroenteritis, I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +puede I-TREATMENT no I-TREATMENT -así I-TREATMENT +darles I-TREATMENT +importancia. I-TREATMENT +Se I-TREATMENT +debe I-TREATMENT +insistir I-TREATMENT +en I-TREATMENT la I-TREATMENT -onicomicosis. I-TREATMENT -Aproximadamente B-EVOLUTION -un I-EVOLUTION -mes I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -terminado I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -con I-EVOLUTION -itraconazol I-EVOLUTION -reapareció I-EVOLUTION -la I-EVOLUTION -candidiasis I-EVOLUTION -oral. I-EVOLUTION - I-EVOLUTION - -Niña B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -eutrófica, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -importancia. I-PAST_MEDICAL_HISTORY -Consulta B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -erupción I-PRESENT_ILLNESS -eritematosa, I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -descamativa, I-PRESENT_ILLNESS -generalizada, I-PRESENT_ILLNESS -pruriginosa, I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -compromete I-PRESENT_ILLNESS -más I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -90% I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -superficie I-PRESENT_ILLNESS -corporal I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -secundarias I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -despegamiento I-PRESENT_ILLNESS -ampollar, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -comprometen I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -axilas I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -ingles. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -cara I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -cuello I-PRESENT_ILLNESS -exhibe I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -ampollares I-PRESENT_ILLNESS -pequeñas, I-PRESENT_ILLNESS -menores I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -1 I-PRESENT_ILLNESS -cm I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -edema I-PRESENT_ILLNESS -bipalpebral I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -secreción I-PRESENT_ILLNESS -purulenta I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -impide I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -apertura I-PRESENT_ILLNESS -ocular. I-PRESENT_ILLNESS -Su I-PRESENT_ILLNESS -madre I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -refiere I-PRESENT_ILLNESS -que, I-PRESENT_ILLNESS -48 I-PRESENT_ILLNESS -h I-PRESENT_ILLNESS -previas I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -consulta, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -niña I-PRESENT_ILLNESS -ingiere, I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -mientras I-PRESENT_ILLNESS -jugaba I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -hacer I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -comida, I-PRESENT_ILLNESS -parte I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -planta I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hojas I-PRESENT_ILLNESS -verdes I-PRESENT_ILLNESS -teñidas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -rojo I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -jugo I-PRESENT_ILLNESS -lechoso, I-PRESENT_ILLNESS -conocida I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -"lechero I-PRESENT_ILLNESS -africano". I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Inmediatamente, I-PRESENT_ILLNESS -comienza I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -ardor I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -inflamación I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -boca. I-PRESENT_ILLNESS -La B-EXPLORATION -paciente I-EXPLORATION -es I-EXPLORATION -internada, I-EXPLORATION -se I-EXPLORATION -solicitan I-EXPLORATION - I-EXPLORATION -estudios I-EXPLORATION -de I-EXPLORATION -laboratorio, I-EXPLORATION -evidenciando I-EXPLORATION -sólo I-EXPLORATION - I-EXPLORATION -leucocitosis I-EXPLORATION -(glóbulos I-EXPLORATION -blancos: I-EXPLORATION -14 I-EXPLORATION -300 I-EXPLORATION -mm). I-EXPLORATION -Por I-EXPLORATION - I-EXPLORATION -el I-EXPLORATION -antecedente I-EXPLORATION -del I-EXPLORATION -contacto I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -ingesta, I-EXPLORATION -es I-EXPLORATION -evaluada I-EXPLORATION - I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -Servicio I-EXPLORATION -de I-EXPLORATION -Toxicología. I-EXPLORATION -La I-EXPLORATION -madre I-EXPLORATION -trae I-EXPLORATION - I-EXPLORATION -la I-EXPLORATION -hoja I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -planta, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -identifica I-EXPLORATION -como I-EXPLORATION -perteneciente I-EXPLORATION - I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -familia I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -Euforbiáceas I-EXPLORATION -(especie I-EXPLORATION - I-EXPLORATION -Synadenium I-EXPLORATION -grantii). I-EXPLORATION -Recibe B-TREATMENT -hidratación I-TREATMENT -parenteral, I-TREATMENT +necesidad I-TREATMENT +de I-TREATMENT +consultar I-TREATMENT +con I-TREATMENT +el I-TREATMENT +médico I-TREATMENT +de I-TREATMENT +la I-TREATMENT +presencia I-TREATMENT +de I-TREATMENT +cualquiera I-TREATMENT +de I-TREATMENT +ellos. I-TREATMENT I-TREATMENT -antihistamínicos, I-TREATMENT -analgésicos I-TREATMENT -endovenosos, I-TREATMENT +Durante I-TREATMENT +la I-TREATMENT +misión, I-TREATMENT +el I-TREATMENT +Medical I-TREATMENT +Advisor I-TREATMENT +viaja I-TREATMENT +a I-TREATMENT +la I-TREATMENT +capital I-TREATMENT +de I-TREATMENT +Kenya I-TREATMENT +para I-TREATMENT +informarse I-TREATMENT +de I-TREATMENT +las I-TREATMENT +prestaciones I-TREATMENT +y I-TREATMENT +servicios I-TREATMENT +de I-TREATMENT +los I-TREATMENT +hospitales I-TREATMENT +que I-TREATMENT +allí I-TREATMENT +se I-TREATMENT +encuentran. I-TREATMENT +Así I-TREATMENT +mismo I-TREATMENT +se I-TREATMENT +informa I-TREATMENT +sobre I-TREATMENT +el I-TREATMENT +protocolo I-TREATMENT +que I-TREATMENT +siguen I-TREATMENT +para I-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT +y I-TREATMENT +tratamiento I-TREATMENT +de I-TREATMENT +la I-TREATMENT +malaria. I-TREATMENT +Todos I-TREATMENT +ellos I-TREATMENT +coinciden I-TREATMENT +en I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +precoz I-TREATMENT +de I-TREATMENT +la I-TREATMENT +enfermedad, I-TREATMENT +siendo I-TREATMENT +suficiente I-TREATMENT +la I-TREATMENT +presencia I-TREATMENT +de I-TREATMENT +síntomas I-TREATMENT +clínicos I-TREATMENT +aunque I-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT +microscópico I-TREATMENT +sea I-TREATMENT +negativo. I-TREATMENT +En I-TREATMENT +la I-TREATMENT +mayoría I-TREATMENT +de I-TREATMENT +los I-TREATMENT +casos I-TREATMENT +se I-TREATMENT +utiliza I-TREATMENT +Artemether I-TREATMENT +20mg/Lumefantrine I-TREATMENT +120mg I-TREATMENT +cuatro I-TREATMENT +unidades I-TREATMENT +cada I-TREATMENT +12 I-TREATMENT +horas I-TREATMENT +durante I-TREATMENT +3 I-TREATMENT +días. I-TREATMENT +En I-TREATMENT +el I-TREATMENT +Cuartel I-TREATMENT +General I-TREATMENT +de I-TREATMENT +Kampala, I-TREATMENT +se I-TREATMENT +trataron I-TREATMENT +dos I-TREATMENT +casos I-TREATMENT +sospechosos I-TREATMENT +de I-TREATMENT +malaria, I-TREATMENT +sin I-TREATMENT +diagnóstico I-TREATMENT +evidente I-TREATMENT +al I-TREATMENT +microscopio. I-TREATMENT +La I-TREATMENT +evolución I-TREATMENT +fue I-TREATMENT +muy I-TREATMENT +buena. I-TREATMENT I-TREATMENT -gotas I-TREATMENT -oftálmicas I-TREATMENT -con I-TREATMENT -eritromicina, I-TREATMENT -curaciones I-TREATMENT +Otra I-TREATMENT +medida I-TREATMENT +de I-TREATMENT +prevención I-TREATMENT +que I-TREATMENT +se I-TREATMENT +tuvo I-TREATMENT +en I-TREATMENT +cuenta, I-TREATMENT +fue I-TREATMENT +luchar I-TREATMENT +contra I-TREATMENT +el I-TREATMENT +vector. I-TREATMENT +Se I-TREATMENT +visitaron I-TREATMENT +varias I-TREATMENT +compañías I-TREATMENT +expertas I-TREATMENT +en I-TREATMENT +la I-TREATMENT +lucha I-TREATMENT +contra I-TREATMENT +el I-TREATMENT +vector I-TREATMENT +de I-TREATMENT +la I-TREATMENT +malaria I-TREATMENT +y I-TREATMENT +se I-TREATMENT +pidió I-TREATMENT +estudio I-TREATMENT +para I-TREATMENT +la I-TREATMENT +desinfección I-TREATMENT +del I-TREATMENT +Campamento I-TREATMENT de I-TREATMENT +Bihanga. I-TREATMENT +En I-TREATMENT +el I-TREATMENT +Cuartel I-TREATMENT +General I-TREATMENT +de I-TREATMENT +Kampala I-TREATMENT +se I-TREATMENT +desinfecta I-TREATMENT +una I-TREATMENT +vez I-TREATMENT +al I-TREATMENT +mes I-TREATMENT +dentro I-TREATMENT +de I-TREATMENT +las I-TREATMENT +habitaciones I-TREATMENT +y I-TREATMENT +en I-TREATMENT +el I-TREATMENT +exterior I-TREATMENT +más I-TREATMENT +próximo, I-TREATMENT +incluyendo I-TREATMENT +toda I-TREATMENT +la I-TREATMENT +vegetación I-TREATMENT +que I-TREATMENT +allí I-TREATMENT +se I-TREATMENT +encuentra. I-TREATMENT I-TREATMENT +La I-TREATMENT +desinfección I-TREATMENT +completa I-TREATMENT +del I-TREATMENT +Campamento I-TREATMENT +de I-TREATMENT +Bihanga I-TREATMENT +es I-TREATMENT +más I-TREATMENT +complicada, I-TREATMENT +al I-TREATMENT +estar I-TREATMENT +rodeado I-TREATMENT +de I-TREATMENT +zonas I-TREATMENT +verdes I-TREATMENT +muy I-TREATMENT +extensas I-TREATMENT +y I-TREATMENT +de I-TREATMENT +una I-TREATMENT +zona I-TREATMENT +de I-TREATMENT +vida I-TREATMENT +de I-TREATMENT +los I-TREATMENT +militares I-TREATMENT +de I-TREATMENT +Uganda I-TREATMENT +y I-TREATMENT +sus I-TREATMENT +familias I-TREATMENT +que I-TREATMENT +no I-TREATMENT +reúnen I-TREATMENT las I-TREATMENT -lesiones I-TREATMENT -cutáneas I-TREATMENT -con I-TREATMENT -crema I-TREATMENT -con I-TREATMENT -vitamina I-TREATMENT -A I-TREATMENT +condiciones I-TREATMENT +higiénico I-TREATMENT +sanitarias I-TREATMENT +suficientes I-TREATMENT +para I-TREATMENT +la I-TREATMENT +lucha I-TREATMENT +contra I-TREATMENT +el I-TREATMENT +vector, I-TREATMENT y I-TREATMENT +el I-TREATMENT +plan I-TREATMENT +de I-TREATMENT +desinfección I-TREATMENT +implicarían I-TREATMENT +medidas I-TREATMENT +que I-TREATMENT +precisaría I-TREATMENT +de I-TREATMENT +la I-TREATMENT +autorización I-TREATMENT +de I-TREATMENT +los I-TREATMENT +militares I-TREATMENT +Ugandeses. I-TREATMENT I-TREATMENT -anestésicos I-TREATMENT -locales. I-TREATMENT +Se I-TREATMENT +realizó I-TREATMENT +un I-TREATMENT +estudio I-TREATMENT +por I-TREATMENT +parte I-TREATMENT +de I-TREATMENT +la I-TREATMENT +compañía I-TREATMENT +experta I-TREATMENT +para I-TREATMENT +la I-TREATMENT +desinfección I-TREATMENT +dentro I-TREATMENT +de I-TREATMENT +las I-TREATMENT +viviendas, I-TREATMENT +medidas I-TREATMENT +para I-TREATMENT +evitar I-TREATMENT +que I-TREATMENT +entren I-TREATMENT +mosquitos I-TREATMENT +en I-TREATMENT +el I-TREATMENT +interior, I-TREATMENT +drenaje I-TREATMENT +de I-TREATMENT +charcas I-TREATMENT +y I-TREATMENT +desecación I-TREATMENT +de I-TREATMENT +colecciones I-TREATMENT +de I-TREATMENT +agua I-TREATMENT +estancada, I-TREATMENT +además I-TREATMENT +de I-TREATMENT +eliminación I-TREATMENT +de I-TREATMENT +vegetación I-TREATMENT +que I-TREATMENT +pueda I-TREATMENT +favorecer I-TREATMENT +el I-TREATMENT +desarrollo I-TREATMENT +de I-TREATMENT +larvas. I-TREATMENT +Todo I-TREATMENT +ello I-TREATMENT +en I-TREATMENT +un I-TREATMENT +radio I-TREATMENT +mínimo I-TREATMENT +de I-TREATMENT +un I-TREATMENT +kilómetro. I-TREATMENT I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -evoluciona I-EVOLUTION -con I-EVOLUTION -resolución I-EVOLUTION -paulatina I-EVOLUTION - I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -síntomas. I-EVOLUTION -Persiste I-EVOLUTION -con I-EVOLUTION -exantema I-EVOLUTION -descamativo I-EVOLUTION - I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -7 I-EVOLUTION -días I-EVOLUTION -con I-EVOLUTION -controles I-EVOLUTION -ambulatorios. I-EVOLUTION -Remisión I-EVOLUTION - I-EVOLUTION -completa I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -15 I-EVOLUTION -días I-EVOLUTION -del I-EVOLUTION -accidente. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -16 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -piel I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -No B-PAST_MEDICAL_HISTORY -refería I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -o B-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -de I-FAMILY_HISTORY -importancia. I-FAMILY_HISTORY -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -se I-EXPLORATION -evidenciaron I-EXPLORATION -pápulas I-EXPLORATION -poligonales I-EXPLORATION -rugosas I-EXPLORATION -cubiertas I-EXPLORATION -por I-EXPLORATION -escamocostras I-EXPLORATION -amarillento-parduscas, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -agrupaban I-EXPLORATION -formando I-EXPLORATION -placas I-EXPLORATION -localizadas I-EXPLORATION -en I-EXPLORATION -frente, I-EXPLORATION -cuero I-EXPLORATION -cabelludo, I-EXPLORATION -zona I-EXPLORATION -retroauricular, I-EXPLORATION -caras I-EXPLORATION -laterales I-EXPLORATION -de I-EXPLORATION -cuello, I-EXPLORATION -nuca I-EXPLORATION -y I-EXPLORATION -"V" I-EXPLORATION -del I-EXPLORATION -escote. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -mucosa I-EXPLORATION -oral, I-EXPLORATION -presentaba I-EXPLORATION -pápulas I-EXPLORATION -blanquecinas I-EXPLORATION -con I-EXPLORATION -umbilicación I-EXPLORATION -central I-EXPLORATION -en I-EXPLORATION -encías I-EXPLORATION -superiores. I-EXPLORATION -A I-EXPLORATION -nivel I-EXPLORATION -ungueal I-EXPLORATION -presentaba I-EXPLORATION -indentación I-EXPLORATION -en I-EXPLORATION -"V I-EXPLORATION -"en I-EXPLORATION -el I-EXPLORATION -borde I-EXPLORATION -libre I-EXPLORATION -del I-EXPLORATION -pulgar I-EXPLORATION -derecho, I-EXPLORATION -surcos I-EXPLORATION -longitudinales I-EXPLORATION -y I-EXPLORATION -líneas I-EXPLORATION -blancas I-EXPLORATION -y I-EXPLORATION -rojas, I-EXPLORATION -paralelas I-EXPLORATION -al I-EXPLORATION -eje I-EXPLORATION -mayor I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -uña I-EXPLORATION -del I-EXPLORATION -dedo I-EXPLORATION -medio I-EXPLORATION -izquierdo. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -piel I-EXPLORATION -que I-EXPLORATION -evidenció I-EXPLORATION -paraqueratosis I-EXPLORATION -focal, I-EXPLORATION -células I-EXPLORATION -disqueratósicas I-EXPLORATION -y I-EXPLORATION -sectores I-EXPLORATION -de I-EXPLORATION -acantólisis I-EXPLORATION -suprabasal. I-EXPLORATION -Cuerpos I-EXPLORATION -redondos, I-EXPLORATION -granos I-EXPLORATION -y I-EXPLORATION -leves I-EXPLORATION -infiltrados I-EXPLORATION -perivasculares I-EXPLORATION -en I-EXPLORATION -dermis I-EXPLORATION -superficial. I-EXPLORATION -Previamente, B-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -recibido I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -adapalene I-PAST_MEDICAL_HISTORY -tópico I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -emolientes, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -escasa I-PAST_MEDICAL_HISTORY -respuesta. I-PAST_MEDICAL_HISTORY -Dada B-TREATMENT +La I-TREATMENT +misión I-TREATMENT +del I-TREATMENT +Medical I-TREATMENT +Advisor I-TREATMENT +en I-TREATMENT +Uganda I-TREATMENT +terminó I-TREATMENT +sin I-TREATMENT +haberse I-TREATMENT +decidido I-TREATMENT +sobre I-TREATMENT +muchas I-TREATMENT +de I-TREATMENT +las I-TREATMENT +medidas I-TREATMENT +anteriores. I-TREATMENT +Al I-TREATMENT +no I-TREATMENT +poner I-TREATMENT +ningún I-TREATMENT +país I-TREATMENT +Europeo I-TREATMENT +un I-TREATMENT +Medical I-TREATMENT +Advisor I-TREATMENT +que I-TREATMENT +reemplace I-TREATMENT +al I-TREATMENT +anterior, I-TREATMENT +todos I-TREATMENT +estos I-TREATMENT +temas I-TREATMENT +quedan I-TREATMENT +abiertos I-TREATMENT +y I-TREATMENT +pendientes I-TREATMENT +de I-TREATMENT +que I-TREATMENT +se I-TREATMENT +tome I-TREATMENT +una I-TREATMENT +decisión I-TREATMENT +por I-TREATMENT +el I-TREATMENT +nuevo I-TREATMENT +Jefe I-TREATMENT +de I-TREATMENT la I-TREATMENT -magnitud I-TREATMENT +Mision, I-TREATMENT +asesorado I-TREATMENT +por I-TREATMENT +el I-TREATMENT +Jefe I-TREATMENT +de I-TREATMENT +Estado I-TREATMENT +Mayor I-TREATMENT +y I-TREATMENT +los I-TREATMENT +estudios I-TREATMENT +realizados. I-TREATMENT + I-TREATMENT +En I-TREATMENT +las I-TREATMENT +Figuras I-TREATMENT +1 I-TREATMENT +y I-TREATMENT +2 I-TREATMENT +se I-TREATMENT +observan I-TREATMENT +las I-TREATMENT +condiciones I-TREATMENT de I-TREATMENT las I-TREATMENT -manifestaciones I-TREATMENT -cutáneas, I-TREATMENT -y I-TREATMENT -teniendo I-TREATMENT -en I-TREATMENT -cuenta I-TREATMENT -el I-TREATMENT -deterioro I-TREATMENT -en I-TREATMENT -su I-TREATMENT -calidad I-TREATMENT +viviendas I-TREATMENT de I-TREATMENT -vida, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -realizar I-TREATMENT -tratamiento I-TREATMENT -sistémico I-TREATMENT -con I-TREATMENT -isotretinoína. I-TREATMENT -Se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -oral I-TREATMENT -por I-TREATMENT -6 I-TREATMENT -meses. I-TREATMENT -Inicialmente I-TREATMENT -con I-TREATMENT -una I-TREATMENT -dosis I-TREATMENT +las I-TREATMENT +familias I-TREATMENT de I-TREATMENT -20 I-TREATMENT -mg/d I-TREATMENT -(0, I-TREATMENT -4 I-TREATMENT -mg/kg/d), I-TREATMENT -que I-TREATMENT -rápidamente I-TREATMENT -se I-TREATMENT -aumentó I-TREATMENT -hasta I-TREATMENT -40 I-TREATMENT -mg/d I-TREATMENT -(0, I-TREATMENT -7 I-TREATMENT -mg/ I-TREATMENT -kg/d). I-TREATMENT -Se B-EVOLUTION -realizaron I-EVOLUTION -los I-EVOLUTION -controles I-EVOLUTION -clínicos I-EVOLUTION -y I-EVOLUTION -de I-EVOLUTION -laboratorio I-EVOLUTION -correspondientes, I-EVOLUTION -con I-EVOLUTION -buena I-EVOLUTION -tolerancia I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -complicaciones. I-EVOLUTION -Evolucionó I-EVOLUTION -favorablemente I-EVOLUTION -con I-EVOLUTION -mejoría I-EVOLUTION -sintomatológica I-EVOLUTION -y I-EVOLUTION -disminución I-EVOLUTION -del I-EVOLUTION -tamaño I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -lesiones I-EVOLUTION -cutáneas. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -oriunda B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -provincia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Misiones, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Dermatología I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -múltiples I-PRESENT_ILLNESS -placas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -aspecto I-PRESENT_ILLNESS -verrugoso I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -numerosas I-PRESENT_ILLNESS -pápulas I-PRESENT_ILLNESS -negruzcas I-PRESENT_ILLNESS -sobre I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -superficie, I-PRESENT_ILLNESS -localizadas I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -sitios I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -apoyo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -ambos I-PRESENT_ILLNESS -pies I-PRESENT_ILLNESS -(punta I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dedos, I-PRESENT_ILLNESS -metatarso I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -talones), I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -reciente I-PRESENT_ILLNESS -aparición. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Las I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -ocasionaban I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dificultaban I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -deambulación. I-PRESENT_ILLNESS -Realizada B-TREATMENT +militares I-TREATMENT +Ugandeses I-TREATMENT +muy I-TREATMENT +próximas I-TREATMENT +a I-TREATMENT la I-TREATMENT -extracción I-TREATMENT -quirúrgica, I-TREATMENT -se B-EXPLORATION -obtuvieron I-EXPLORATION -alrededor I-EXPLORATION -de I-EXPLORATION -20 I-EXPLORATION -tungas I-EXPLORATION -y I-EXPLORATION -las I-EXPLORATION -muestras I-EXPLORATION -extraídas I-EXPLORATION -se I-EXPLORATION -enviaron I-EXPLORATION -al I-EXPLORATION -servicio I-EXPLORATION -de I-EXPLORATION -anatomopatología, I-EXPLORATION -que I-EXPLORATION -confirmó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -tungiasis. I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -tratada I-TREATMENT +zona I-TREATMENT +de I-TREATMENT +vida I-TREATMENT +de I-TREATMENT +los I-TREATMENT +europeos. I-TREATMENT +Debieran I-TREATMENT +tratarse I-TREATMENT +y I-TREATMENT +cerrar I-TREATMENT +ventanas I-TREATMENT +y I-TREATMENT +puertas I-TREATMENT con I-TREATMENT -ivermecti-na I-TREATMENT -vía I-TREATMENT -oral I-TREATMENT -200 I-TREATMENT -µg/kg I-TREATMENT -como I-TREATMENT -terapia I-TREATMENT -coadyuvante, I-TREATMENT -debido I-TREATMENT -al I-TREATMENT -gran I-TREATMENT -compromiso I-TREATMENT -cutáneo I-TREATMENT +mosquiteras I-TREATMENT +para I-TREATMENT +una I-TREATMENT +correcta I-TREATMENT +desinfección I-TREATMENT y I-TREATMENT +eliminación I-TREATMENT +del I-TREATMENT +vector. I-TREATMENT + I-TREATMENT +La I-TREATMENT +Figura I-TREATMENT +3, I-TREATMENT +nos I-TREATMENT +da I-TREATMENT +clara I-TREATMENT +idea I-TREATMENT +de I-TREATMENT la I-TREATMENT -multiplicidad I-TREATMENT +cercanía I-TREATMENT de I-TREATMENT -lesiones. I-TREATMENT -Las B-EVOLUTION -lesiones I-EVOLUTION -evolucionaron I-EVOLUTION -favorablemente I-EVOLUTION -con I-EVOLUTION -resolución I-EVOLUTION -completa. I-EVOLUTION - I-EVOLUTION +las I-TREATMENT +viviendas I-TREATMENT +de I-TREATMENT +militares I-TREATMENT +europeos I-TREATMENT +(con I-TREATMENT +tejados I-TREATMENT +azules) I-TREATMENT +y I-TREATMENT +las I-TREATMENT +viviendas I-TREATMENT +de I-TREATMENT +militares I-TREATMENT +ugandeses I-TREATMENT +(construcciones I-TREATMENT +propias I-TREATMENT +de I-TREATMENT +la I-TREATMENT +zona). I-TREATMENT + I-TREATMENT -Paciente B-PRESENT_ILLNESS +Embarazada B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino I-PRESENT_ILLNESS -internada I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -cuatro I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS +28 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -vida I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +procedente B-FAMILY_HISTORY +de I-FAMILY_HISTORY +Embarcación I-FAMILY_HISTORY +(Salta), I-FAMILY_HISTORY +que I-FAMILY_HISTORY +cursaba I-FAMILY_HISTORY +su I-FAMILY_HISTORY +segunda I-FAMILY_HISTORY +gesta I-FAMILY_HISTORY +en I-FAMILY_HISTORY +semana I-FAMILY_HISTORY +38 I-FAMILY_HISTORY +sin I-FAMILY_HISTORY +antecedentes I-FAMILY_HISTORY +patológicos. I-FAMILY_HISTORY +Consultó B-PRESENT_ILLNESS por I-PRESENT_ILLNESS fiebre I-PRESENT_ILLNESS +(39,4°C), I-PRESENT_ILLNESS +mialgias I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -depresión I-PRESENT_ILLNESS +cefalea I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -sensorio. I-PRESENT_ILLNESS -Antecedentes: B-PAST_MEDICAL_HISTORY -recién I-PAST_MEDICAL_HISTORY -nacida I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -término, I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -peso I-PAST_MEDICAL_HISTORY -adecuado I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -edad I-PAST_MEDICAL_HISTORY -gestacional, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ictericia I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -incompatibilidad I-PAST_MEDICAL_HISTORY -ABO, I-PAST_MEDICAL_HISTORY -tratada I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -luminoterapia I-PAST_MEDICAL_HISTORY -dentro I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -primeras I-PAST_MEDICAL_HISTORY -24 I-PAST_MEDICAL_HISTORY -h I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -vida. I-PAST_MEDICAL_HISTORY -Al I-PAST_MEDICAL_HISTORY -momento I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -egreso I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -valores I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -bilirrubina I-PAST_MEDICAL_HISTORY -total I-PAST_MEDICAL_HISTORY -eran I-PAST_MEDICAL_HISTORY -9, I-PAST_MEDICAL_HISTORY -9 I-PAST_MEDICAL_HISTORY -mg/dl I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -directa I-PAST_MEDICAL_HISTORY -0, I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -mg/dl. I-PAST_MEDICAL_HISTORY -Reingresó I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -Neonatología I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -mes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -vida I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -ictericia I-PAST_MEDICAL_HISTORY -prolongada. I-PAST_MEDICAL_HISTORY -Durante I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -internación I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -realizó I-PAST_MEDICAL_HISTORY -ecografía I-PAST_MEDICAL_HISTORY -abdominal I-PAST_MEDICAL_HISTORY -cuyo I-PAST_MEDICAL_HISTORY -informe I-PAST_MEDICAL_HISTORY -mencionaba I-PAST_MEDICAL_HISTORY -presencia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -vías I-PAST_MEDICAL_HISTORY -biliares I-PAST_MEDICAL_HISTORY -intrahepática I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -extrahepáticas, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -dilatación. I-PAST_MEDICAL_HISTORY -Laboratorio: I-PAST_MEDICAL_HISTORY -bilirrubinemia I-PAST_MEDICAL_HISTORY -total I-PAST_MEDICAL_HISTORY -11, I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -mg/dl I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -directa I-PAST_MEDICAL_HISTORY -1, I-PAST_MEDICAL_HISTORY -7 I-PAST_MEDICAL_HISTORY -mg/dl, I-PAST_MEDICAL_HISTORY -FAL I-PAST_MEDICAL_HISTORY -257 I-PAST_MEDICAL_HISTORY -UI/L, I-PAST_MEDICAL_HISTORY -TGP I-PAST_MEDICAL_HISTORY -55 I-PAST_MEDICAL_HISTORY -UI/L, I-PAST_MEDICAL_HISTORY -TGO I-PAST_MEDICAL_HISTORY -69 I-PAST_MEDICAL_HISTORY -UI/L. I-PAST_MEDICAL_HISTORY -Fue I-PAST_MEDICAL_HISTORY -dada I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -alta I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -continuó I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -seguimiento I-PAST_MEDICAL_HISTORY -ambulatorio I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -gastroenterólogo I-PAST_MEDICAL_HISTORY -pediatra, I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -internación I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -hemorragia I-PAST_MEDICAL_HISTORY -intracraneal. I-PAST_MEDICAL_HISTORY -Evolución: B-EXPLORATION -al I-EXPLORATION -ingreso I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -ictericia I-EXPLORATION -generalizada, I-EXPLORATION -hepatomegalia I-EXPLORATION -y I-EXPLORATION -sopor. I-EXPLORATION -Dentro B-EVOLUTION +48 I-PRESENT_ILLNESS +h I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +internó I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +estudio I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +tratamiento. I-PRESENT_ILLNESS +Al B-EVOLUTION +tercer I-EVOLUTION +día I-EVOLUTION +comenzó I-EVOLUTION +con I-EVOLUTION +sangrado I-EVOLUTION +de I-EVOLUTION +mucosas, I-EVOLUTION +en I-EVOLUTION +zonas I-EVOLUTION +de I-EVOLUTION +venopuntura I-EVOLUTION +y I-EVOLUTION +deterioro I-EVOLUTION +progresivo I-EVOLUTION +del I-EVOLUTION +estado I-EVOLUTION +general. I-EVOLUTION +Veinticuatro B-TREATMENT +horas I-TREATMENT +más I-TREATMENT +tarde I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +una I-TREATMENT +cesárea I-TREATMENT +de I-TREATMENT +urgencia I-TREATMENT +por I-TREATMENT +sufrimiento I-TREATMENT +fetal I-TREATMENT +agudo, I-TREATMENT +con I-TREATMENT +una I-TREATMENT +grave I-TREATMENT +metrorragia I-TREATMENT +posparto. I-TREATMENT +La B-EVOLUTION +madre I-EVOLUTION +recibió I-EVOLUTION +tratamiento I-EVOLUTION de I-EVOLUTION +sostén I-EVOLUTION +que I-EVOLUTION +requirió I-EVOLUTION +múltiples I-EVOLUTION +transfusiones I-EVOLUTION +sanguíneas. I-EVOLUTION +Se I-EVOLUTION +recuperó I-EVOLUTION +favorablemente I-EVOLUTION +a I-EVOLUTION las I-EVOLUTION -primeras I-EVOLUTION -24 I-EVOLUTION +72 I-EVOLUTION h I-EVOLUTION +posparto. I-EVOLUTION +El I-EVOLUTION +niño I-EVOLUTION +nació I-EVOLUTION +a I-EVOLUTION +las I-EVOLUTION +38 I-EVOLUTION +semanas I-EVOLUTION +de I-EVOLUTION +edad I-EVOLUTION +gestacional, I-EVOLUTION +con I-EVOLUTION +un I-EVOLUTION +peso I-EVOLUTION +de I-EVOLUTION +3900 I-EVOLUTION +g I-EVOLUTION +y I-EVOLUTION +puntaje I-EVOLUTION de I-EVOLUTION +Apgar I-EVOLUTION +4/4. I-EVOLUTION +Durante I-EVOLUTION +la I-EVOLUTION internación I-EVOLUTION -presentó I-EVOLUTION -episodio I-EVOLUTION -convulsivo I-EVOLUTION -focal I-EVOLUTION en I-EVOLUTION -hemicuerpo I-EVOLUTION -derecho; I-EVOLUTION -en B-TREATMENT -la I-TREATMENT -tomografía I-TREATMENT -computada I-TREATMENT -cerebral I-TREATMENT -(TC) I-TREATMENT -se I-TREATMENT -constató I-TREATMENT -hematoma I-TREATMENT -subdural I-TREATMENT -que I-TREATMENT -requirió I-TREATMENT -drenaje I-TREATMENT -quirúrgico I-TREATMENT -y I-TREATMENT -asistencia I-TREATMENT -respiratoria I-TREATMENT -mecánica I-TREATMENT -hasta I-TREATMENT -48 I-TREATMENT -h I-TREATMENT -del I-TREATMENT -postoperatorio. I-TREATMENT -Laboratorio B-EXPLORATION -de I-EXPLORATION -ingreso: I-EXPLORATION -GOT I-EXPLORATION -120 I-EXPLORATION -UI/L, I-EXPLORATION -GPT I-EXPLORATION -180 I-EXPLORATION -UI/L, I-EXPLORATION -FAL I-EXPLORATION -1053 I-EXPLORATION -UI/L, I-EXPLORATION -gammaglutamiltranspeptidasa I-EXPLORATION -1119 I-EXPLORATION -UI/L, I-EXPLORATION -LDH I-EXPLORATION -1262 I-EXPLORATION -UI/L, I-EXPLORATION -bilirrubinemia I-EXPLORATION -total I-EXPLORATION -6 I-EXPLORATION -mg/dl I-EXPLORATION +la I-EVOLUTION +Unidad I-EVOLUTION +de I-EVOLUTION +cuidado I-EVOLUTION +intensivo I-EVOLUTION +neonatal I-EVOLUTION +requirió I-EVOLUTION +asistencia I-EVOLUTION +respiratoria I-EVOLUTION +mecánica I-EVOLUTION +por I-EVOLUTION +un I-EVOLUTION +síndrome I-EVOLUTION +de I-EVOLUTION +aspiración I-EVOLUTION +meconial I-EVOLUTION +e I-EVOLUTION +hipertensión I-EVOLUTION +pulmonar I-EVOLUTION +y I-EVOLUTION +luminoterapia I-EVOLUTION +por I-EVOLUTION +su I-EVOLUTION +ictericia. I-EVOLUTION +Al I-EVOLUTION +5to I-EVOLUTION +día I-EVOLUTION +de I-EVOLUTION +vida, I-EVOLUTION +el I-EVOLUTION +niño I-EVOLUTION +comenzó I-EVOLUTION +con I-EVOLUTION +fiebre I-EVOLUTION +(39°C), I-EVOLUTION +hepatomegalia I-EVOLUTION +y I-EVOLUTION +un I-EVOLUTION +exantema I-EVOLUTION +evanescente I-EVOLUTION +generalizado. I-EVOLUTION +Pasadas I-EVOLUTION +24 I-EVOLUTION +h I-EVOLUTION +se I-EVOLUTION +agregaron I-EVOLUTION +hemorragias I-EVOLUTION +por I-EVOLUTION +sonda I-EVOLUTION +nasogástrica I-EVOLUTION +y I-EVOLUTION +en I-EVOLUTION +las I-EVOLUTION +venopunturas. I-EVOLUTION +El B-EXPLORATION +hemograma I-EXPLORATION +presentó I-EXPLORATION +5800 I-EXPLORATION +glóbulos I-EXPLORATION +blancos I-EXPLORATION +(linfocitos I-EXPLORATION +43%, I-EXPLORATION +neutrófilos I-EXPLORATION +segmentados I-EXPLORATION +47%, I-EXPLORATION +monocitos I-EXPLORATION +6%, I-EXPLORATION +basófilos I-EXPLORATION +4%), I-EXPLORATION +hematócrito I-EXPLORATION +34%, I-EXPLORATION +hemoglobina I-EXPLORATION +11, I-EXPLORATION +2 I-EXPLORATION +mg% I-EXPLORATION y I-EXPLORATION -directa I-EXPLORATION -3, I-EXPLORATION -9 I-EXPLORATION -mg/ I-EXPLORATION -dl, I-EXPLORATION -amonio I-EXPLORATION -51, I-EXPLORATION -8 I-EXPLORATION -mcg/dl, I-EXPLORATION -lactacidemia I-EXPLORATION -7 I-EXPLORATION -mmol/L, I-EXPLORATION -tiempo I-EXPLORATION +recuento I-EXPLORATION de I-EXPLORATION -protrombina I-EXPLORATION -59%, I-EXPLORATION -KPTT I-EXPLORATION -100 I-EXPLORATION -segundos I-EXPLORATION -(no I-EXPLORATION +plaquetas I-EXPLORATION +de I-EXPLORATION +13 I-EXPLORATION +000/mm³. I-EXPLORATION +Con I-EXPLORATION +diagnóstico I-EXPLORATION +presuntivo I-EXPLORATION +de I-EXPLORATION +sepsis I-EXPLORATION se I-EXPLORATION le I-EXPLORATION -administró I-EXPLORATION -vitamina I-EXPLORATION -K I-EXPLORATION -ni I-EXPLORATION -plasma I-EXPLORATION -frasco I-EXPLORATION -congelado I-EXPLORATION -previo I-EXPLORATION -a I-EXPLORATION +realizaron I-EXPLORATION +hemocultivos, I-EXPLORATION +urocultivo I-EXPLORATION +y I-EXPLORATION +punción I-EXPLORATION +lumbar. I-EXPLORATION +También I-EXPLORATION +se I-EXPLORATION +le I-EXPLORATION +solicitó I-EXPLORATION +detección I-EXPLORATION +de I-EXPLORATION +anticuerpos I-EXPLORATION +IgM I-EXPLORATION +para I-EXPLORATION +virus I-EXPLORATION +dengue. I-EXPLORATION +Se I-EXPLORATION +le I-EXPLORATION +indicaron I-EXPLORATION +antibióticos I-EXPLORATION +y I-EXPLORATION +transfusiones I-EXPLORATION +de I-EXPLORATION +sangre I-EXPLORATION +y I-EXPLORATION +plaquetas. I-EXPLORATION +Los I-EXPLORATION +cultivos I-EXPLORATION +para I-EXPLORATION +gérmenes I-EXPLORATION +comunes I-EXPLORATION +y I-EXPLORATION +hongos I-EXPLORATION +fueron I-EXPLORATION +negativos. I-EXPLORATION +El I-EXPLORATION +laboratorio I-EXPLORATION +informó I-EXPLORATION +IgM I-EXPLORATION +por I-EXPLORATION +técnica I-EXPLORATION +de I-EXPLORATION +ELISA I-EXPLORATION +positiva I-EXPLORATION +para I-EXPLORATION +dengue. I-EXPLORATION +Para I-EXPLORATION la I-EXPLORATION -toma I-EXPLORATION +confirmación I-EXPLORATION +del I-EXPLORATION +resultado I-EXPLORATION +se I-EXPLORATION +envió I-EXPLORATION +la I-EXPLORATION +muestra I-EXPLORATION +al I-EXPLORATION +Instituto I-EXPLORATION +Nacional I-EXPLORATION +de I-EXPLORATION +Enfermedades I-EXPLORATION +Virales I-EXPLORATION +Humanas I-EXPLORATION +de I-EXPLORATION +Pergamino, I-EXPLORATION +quienes I-EXPLORATION +certificaron I-EXPLORATION +por I-EXPLORATION +pruebas I-EXPLORATION +serológicas I-EXPLORATION +de I-EXPLORATION +ELISA, I-EXPLORATION +neutralización I-EXPLORATION +y I-EXPLORATION +detección I-EXPLORATION +molecular I-EXPLORATION +del I-EXPLORATION +genoma I-EXPLORATION +viral I-EXPLORATION +(RT-PCR), I-EXPLORATION +la I-EXPLORATION +infección I-EXPLORATION +por I-EXPLORATION +serotipo I-EXPLORATION +DEN-1. I-EXPLORATION +Se B-EVOLUTION +administró I-EVOLUTION +oxígeno I-EVOLUTION +hasta I-EVOLUTION +los I-EVOLUTION +26 I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +vida. I-EVOLUTION +A I-EVOLUTION +los I-EVOLUTION +7 I-EVOLUTION +días I-EVOLUTION +del I-EVOLUTION +comienzo I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +síntomas I-EVOLUTION +se I-EVOLUTION +normalizó I-EVOLUTION +el I-EVOLUTION +recuento I-EVOLUTION +de I-EVOLUTION +plaquetas. I-EVOLUTION +La I-EVOLUTION +evolución I-EVOLUTION +clínica I-EVOLUTION +fue I-EVOLUTION +favorable I-EVOLUTION +y I-EVOLUTION +se I-EVOLUTION +dio I-EVOLUTION +el I-EVOLUTION +alta I-EVOLUTION +al I-EVOLUTION +mes I-EVOLUTION +de I-EVOLUTION +vida. I-EVOLUTION +Como I-EVOLUTION +consecuencia I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +asfixia I-EVOLUTION +perinatal I-EVOLUTION +relacionada I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +forma I-EVOLUTION +de I-EVOLUTION +dengue I-EVOLUTION +grave I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +madre, I-EVOLUTION +el I-EVOLUTION +niño I-EVOLUTION +presentó I-EVOLUTION +encefalopatía I-EVOLUTION +hipóxico-isquémica I-EVOLUTION +y I-EVOLUTION +compromiso I-EVOLUTION +respiratorio I-EVOLUTION +secuelar. I-EVOLUTION +Se I-EVOLUTION +le I-EVOLUTION +realizaron I-EVOLUTION +controles I-EVOLUTION +clínicos I-EVOLUTION +y I-EVOLUTION +serológicos I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +8 I-EVOLUTION +y I-EVOLUTION +13 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +vida, I-EVOLUTION +con I-EVOLUTION +persistencia I-EVOLUTION +de I-EVOLUTION +títulos I-EVOLUTION +de I-EVOLUTION +anticuerpos I-EVOLUTION +IgG I-EVOLUTION +antidengue, I-EVOLUTION +por I-EVOLUTION +lo I-EVOLUTION +cual I-EVOLUTION +se I-EVOLUTION +confirmó I-EVOLUTION +el I-EVOLUTION +diagnóstico I-EVOLUTION +de I-EVOLUTION +infección I-EVOLUTION +congénita. I-EVOLUTION +Los B-EXPLORATION +resultados I-EXPLORATION +serológicos I-EXPLORATION +mediante I-EXPLORATION +técnica I-EXPLORATION de I-EXPLORATION -muestra). I-EXPLORATION -Serologías I-EXPLORATION -para I-EXPLORATION -VIH, I-EXPLORATION -sífilis, I-EXPLORATION -toxoplasmosis, I-EXPLORATION -hepatitis I-EXPLORATION -B, I-EXPLORATION -hepatitis I-EXPLORATION -A I-EXPLORATION -y I-EXPLORATION -citomegalovirus I-EXPLORATION -negativas. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -centellograma I-EXPLORATION +ELISA I-EXPLORATION +mostraron I-EXPLORATION +títulos I-EXPLORATION +positivos I-EXPLORATION +elevados, I-EXPLORATION con I-EXPLORATION -HIDA I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -falta I-EXPLORATION -de I-EXPLORATION -captación I-EXPLORATION -de I-EXPLORATION -contraste I-EXPLORATION -intrahepático I-EXPLORATION +una I-EXPLORATION +RP I-EXPLORATION +1, I-EXPLORATION +92 I-EXPLORATION y I-EXPLORATION -extrahepático, I-EXPLORATION -sin I-EXPLORATION -pasaje I-EXPLORATION de I-EXPLORATION -contraste I-EXPLORATION -al I-EXPLORATION -intestino. I-EXPLORATION -Se B-TREATMENT -decidió I-TREATMENT -realizar I-TREATMENT -portoenteroanastomosis I-TREATMENT -por I-TREATMENT -laparoscopia, I-TREATMENT -después I-TREATMENT -de I-TREATMENT -confirmar I-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -atresia I-TREATMENT -de I-TREATMENT -vías I-TREATMENT -biliares I-TREATMENT -durante I-TREATMENT -la I-TREATMENT -cirugía. I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -vida I-EVOLUTION -presentaba I-EVOLUTION -maduración I-EVOLUTION +1, I-EXPLORATION +37 I-EXPLORATION +para I-EXPLORATION +dengue I-EXPLORATION +a I-EXPLORATION +los I-EXPLORATION +8 I-EXPLORATION +y I-EXPLORATION +13 I-EXPLORATION +meses, I-EXPLORATION +respectivamente. I-EXPLORATION +Actualmente, B-EVOLUTION +el I-EVOLUTION +niño I-EVOLUTION +realiza I-EVOLUTION +estimulación I-EVOLUTION neurológica I-EVOLUTION -adecuada I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -edad. I-EVOLUTION -Requirió B-TREATMENT -trasplante I-TREATMENT -hepático I-TREATMENT -cerca I-TREATMENT -del I-TREATMENT -año I-TREATMENT -de I-TREATMENT -edad. I-TREATMENT - I-TREATMENT +y I-EVOLUTION +tratamiento I-EVOLUTION +preventivo I-EVOLUTION +respiratorio I-EVOLUTION +con I-EVOLUTION +corticoides I-EVOLUTION +inhalatorios, I-EVOLUTION +con I-EVOLUTION +buena I-EVOLUTION +evolución. I-EVOLUTION + I-EVOLUTION -Niño B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -30 I-PRESENT_ILLNESS -meses, I-PRESENT_ILLNESS -nacido B-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -término, I-PAST_MEDICAL_HISTORY -cesárea I-PAST_MEDICAL_HISTORY -programada, I-PAST_MEDICAL_HISTORY -embarazo I-PAST_MEDICAL_HISTORY -controlado, I-PAST_MEDICAL_HISTORY -peso I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -talla I-PAST_MEDICAL_HISTORY -acordes I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -edad I-PAST_MEDICAL_HISTORY -gestacional. I-PAST_MEDICAL_HISTORY -Antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -episodios I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -otitis I-PAST_MEDICAL_HISTORY -media, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -cirugías, I-PAST_MEDICAL_HISTORY -internaciones I-PAST_MEDICAL_HISTORY -previas I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -alergias. I-PAST_MEDICAL_HISTORY -Inmunizaciones I-PAST_MEDICAL_HISTORY -completas I-PAST_MEDICAL_HISTORY -según I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -calendario I-PAST_MEDICAL_HISTORY -oficial. I-PAST_MEDICAL_HISTORY -Crecimiento I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -desarrollo I-PAST_MEDICAL_HISTORY -normales. I-PAST_MEDICAL_HISTORY -Historia B-FAMILY_HISTORY -familiar I-FAMILY_HISTORY -con I-FAMILY_HISTORY -ambos I-FAMILY_HISTORY -padres I-FAMILY_HISTORY -obesos I-FAMILY_HISTORY -con I-FAMILY_HISTORY -cirugía I-FAMILY_HISTORY -bariátrica I-FAMILY_HISTORY -realizada, I-FAMILY_HISTORY -y I-FAMILY_HISTORY -dos I-FAMILY_HISTORY -hermanas I-FAMILY_HISTORY -mayores I-FAMILY_HISTORY -con I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -de I-FAMILY_HISTORY -asma I-FAMILY_HISTORY -e I-FAMILY_HISTORY -hipotiroidismo, I-FAMILY_HISTORY -respectivamente. I-FAMILY_HISTORY - I-FAMILY_HISTORY -Es B-DERIVED_FROM/TO -derivado I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -hospital I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -diagnóstico I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -síndrome I-DERIVED_FROM/TO -ascítico I-DERIVED_FROM/TO -edematoso. I-DERIVED_FROM/TO -Comenzó B-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -edema I-PRESENT_ILLNESS -palpebral I-PRESENT_ILLNESS -bilateral I-PRESENT_ILLNESS -leve. I-PRESENT_ILLNESS -Dos I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -después, I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -exantema I-PRESENT_ILLNESS -urticariante I-PRESENT_ILLNESS -generalizado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -todo I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -cuerpo, I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -pruriginoso, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -revirtió I-PRESENT_ILLNESS -espontáneamente I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -menos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -horas. I-PRESENT_ILLNESS -A I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -48 I-PRESENT_ILLNESS -horas, I-PRESENT_ILLNESS -apareció I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -edema I-PRESENT_ILLNESS -bipalpebral I-PRESENT_ILLNESS -más I-PRESENT_ILLNESS -pronunciado, I-PRESENT_ILLNESS -distensión I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -irritabilidad. I-PRESENT_ILLNESS -Se I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -pediatra, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -constató I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS +Niña B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -kg I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -respecto I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -previo I-PRESENT_ILLNESS -(2 I-PRESENT_ILLNESS +diez I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +previamente B-PAST_MEDICAL_HISTORY +sana, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +inicia, I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS meses I-PRESENT_ILLNESS -antes). I-PRESENT_ILLNESS -No B-PAST_MEDICAL_HISTORY -tenía I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -infecciones. I-PAST_MEDICAL_HISTORY -Fue B-DERIVED_FROM/TO -derivado I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -médico I-DERIVED_FROM/TO -nefrólogo, I-DERIVED_FROM/TO -quien I-DERIVED_FROM/TO -solicitó I-DERIVED_FROM/TO -estudios I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -laboratorio I-DERIVED_FROM/TO -cuyos I-DERIVED_FROM/TO -resultados I-DERIVED_FROM/TO -mostraron I-DERIVED_FROM/TO -marcada I-DERIVED_FROM/TO -hipoproteinemia I-DERIVED_FROM/TO -e I-DERIVED_FROM/TO -hipoalbuminemia, I-DERIVED_FROM/TO -hipertrigliceridemia, I-DERIVED_FROM/TO -hipocalcemia I-DERIVED_FROM/TO -leve I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -orina I-DERIVED_FROM/TO -normal. I-DERIVED_FROM/TO -Se I-DERIVED_FROM/TO -trasladó I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -niño I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -hospital I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -diagnóstico I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -tratamiento. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -Examen B-EXPLORATION -físico: I-EXPLORATION -niño I-EXPLORATION -lúcido, I-EXPLORATION -vigil, I-EXPLORATION -orientado, I-EXPLORATION -irritable. I-EXPLORATION -TA I-EXPLORATION -109/78 I-EXPLORATION -mm I-EXPLORATION -Hg, I-EXPLORATION -TAM I-EXPLORATION -92 I-EXPLORATION -mm I-EXPLORATION -Hg, I-EXPLORATION -FC I-EXPLORATION -130 I-EXPLORATION -lpm, I-EXPLORATION -FR I-EXPLORATION -32 I-EXPLORATION -rpm, I-EXPLORATION -temperatura I-EXPLORATION -36, I-EXPLORATION -7°C, I-EXPLORATION -saturación I-EXPLORATION -de I-EXPLORATION -O2 I-EXPLORATION -96% I-EXPLORATION -respirando I-EXPLORATION -aire I-EXPLORATION -ambiente. I-EXPLORATION -Peso I-EXPLORATION -14, I-EXPLORATION -600 I-EXPLORATION -kg, I-EXPLORATION -palidez I-EXPLORATION -generalizada, I-EXPLORATION -facies I-EXPLORATION -abotagada. I-EXPLORATION -Edema I-EXPLORATION -palpebral I-EXPLORATION -bilateral. I-EXPLORATION -Algunos I-EXPLORATION -crepitantes I-EXPLORATION -basales I-EXPLORATION +antes I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +ingreso, I-PRESENT_ILLNESS +lesiones I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +cuero I-PRESENT_ILLNESS +cabelludo, I-PRESENT_ILLNESS +posteriormente I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +nariz, I-PRESENT_ILLNESS +luego I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +cara I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +después I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +boca. I-PRESENT_ILLNESS +Es B-TREATMENT +valorada I-TREATMENT +por I-TREATMENT +el I-TREATMENT +dermatólogo, I-TREATMENT +el I-TREATMENT +odontólogo I-TREATMENT +y I-TREATMENT +el I-TREATMENT +otorrinolaringólogo; I-TREATMENT +se I-TREATMENT +realiza I-TREATMENT +tratamiento I-TREATMENT +por I-TREATMENT +sospecha I-TREATMENT +de I-TREATMENT +impétigo. I-TREATMENT +No B-EVOLUTION +se I-EVOLUTION +observa I-EVOLUTION +mejoría; I-EVOLUTION +en I-EVOLUTION +las I-EVOLUTION +dos I-EVOLUTION +semanas I-EVOLUTION +siguientes, I-EVOLUTION +presenta I-EVOLUTION +lesiones I-EVOLUTION +eritematosas I-EVOLUTION +en I-EVOLUTION +los I-EVOLUTION +dedos I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +manos I-EVOLUTION +y I-EVOLUTION +se I-EVOLUTION +diagnostica I-EVOLUTION +de I-EVOLUTION +viriasis. I-EVOLUTION +Sigue I-EVOLUTION +sin I-EVOLUTION +presentar I-EVOLUTION +mejoría, I-EVOLUTION +se I-EVOLUTION +observan I-EVOLUTION +también I-EVOLUTION +dichas I-EVOLUTION +lesiones I-EVOLUTION +en I-EVOLUTION +los I-EVOLUTION +dedos I-EVOLUTION +de I-EVOLUTION +ambos I-EVOLUTION +pies, I-EVOLUTION +asociando I-EVOLUTION +abdominalgias I-EVOLUTION +y I-EVOLUTION +vómitos I-EVOLUTION +ocasionales. I-EVOLUTION +Siempre I-EVOLUTION +afebril, I-EVOLUTION +la I-EVOLUTION +madre I-EVOLUTION +refiere I-EVOLUTION +observar I-EVOLUTION +"caída I-EVOLUTION +del I-EVOLUTION +cabello", I-EVOLUTION +sin I-EVOLUTION +otros I-EVOLUTION +signos I-EVOLUTION +clínicos I-EVOLUTION +asociados. I-EVOLUTION +Antecedentes B-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +interés. I-PAST_MEDICAL_HISTORY +Antecedentes B-FAMILY_HISTORY +familiares: I-FAMILY_HISTORY +padre I-FAMILY_HISTORY +diagnosticado I-FAMILY_HISTORY +de I-FAMILY_HISTORY +colon I-FAMILY_HISTORY +irritable, I-FAMILY_HISTORY +sin I-FAMILY_HISTORY +casos I-FAMILY_HISTORY +reumatológicos I-FAMILY_HISTORY +ni I-FAMILY_HISTORY +clínica I-FAMILY_HISTORY +similar I-FAMILY_HISTORY +a I-FAMILY_HISTORY +la I-FAMILY_HISTORY +de I-FAMILY_HISTORY +la I-FAMILY_HISTORY +niña; I-FAMILY_HISTORY +una I-FAMILY_HISTORY +prima I-FAMILY_HISTORY +hermana I-FAMILY_HISTORY +materna I-FAMILY_HISTORY +diagnosticada I-FAMILY_HISTORY +hace I-FAMILY_HISTORY +un I-FAMILY_HISTORY +año I-FAMILY_HISTORY +de I-FAMILY_HISTORY +púrpura I-FAMILY_HISTORY +de I-FAMILY_HISTORY +Schonlein-Henoch. I-FAMILY_HISTORY + I-FAMILY_HISTORY +Cuando B-EXPLORATION +ingresa I-EXPLORATION en I-EXPLORATION -ambos I-EXPLORATION -campos I-EXPLORATION -pulmonares. I-EXPLORATION -Edema I-EXPLORATION -pretibial I-EXPLORATION -bilateral. I-EXPLORATION -Abdomen I-EXPLORATION -globuloso, I-EXPLORATION -distendido, I-EXPLORATION -onda I-EXPLORATION -ascítica I-EXPLORATION -positiva, I-EXPLORATION -sin I-EXPLORATION -hepatoesplenomegalia. I-EXPLORATION -Edema I-EXPLORATION -escrotal I-EXPLORATION +el I-EXPLORATION +hospital I-EXPLORATION +está I-EXPLORATION +febril I-EXPLORATION +(38 I-EXPLORATION +oC), I-EXPLORATION +con I-EXPLORATION +buen I-EXPLORATION +aspecto I-EXPLORATION +general. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +eritema I-EXPLORATION +malar I-EXPLORATION +derecho I-EXPLORATION +que I-EXPLORATION +respeta I-EXPLORATION +el I-EXPLORATION +pliegue I-EXPLORATION +nasolabial; I-EXPLORATION +eritema I-EXPLORATION y I-EXPLORATION -suprapúbico. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION +leve I-EXPLORATION +tumefacción I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +área I-EXPLORATION del I-EXPLORATION -examen I-EXPLORATION -no I-EXPLORATION -presentó I-EXPLORATION -particularidades. I-EXPLORATION - I-EXPLORATION -Laboratorio I-EXPLORATION -inicial: I-EXPLORATION -leucocitos: I-EXPLORATION -17 I-EXPLORATION -700/mm3, I-EXPLORATION -fórmula: I-EXPLORATION -27% I-EXPLORATION -neutrófilos, I-EXPLORATION -14% I-EXPLORATION -eosinófilos, I-EXPLORATION -49% I-EXPLORATION -linfocitos, I-EXPLORATION -6% I-EXPLORATION -monocitos I-EXPLORATION +lacrimal I-EXPLORATION +izquierdo. I-EXPLORATION +Lesiones I-EXPLORATION +purpúricas I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +pulpejos I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +manos, I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +pies I-EXPLORATION y I-EXPLORATION -4% I-EXPLORATION -linfocitos I-EXPLORATION -atípicos. I-EXPLORATION -Calcio I-EXPLORATION -total I-EXPLORATION -7, I-EXPLORATION -4 I-EXPLORATION -mmol/L I-EXPLORATION -(VN I-EXPLORATION -8, I-EXPLORATION -5-10), I-EXPLORATION -proteínas I-EXPLORATION -totales I-EXPLORATION -3 I-EXPLORATION -g/dl I-EXPLORATION -(VN I-EXPLORATION -6, I-EXPLORATION -6-8, I-EXPLORATION -7), I-EXPLORATION -albúmina I-EXPLORATION -1, I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +talones. I-EXPLORATION +Presenta I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +orofaringe I-EXPLORATION +aftas, I-EXPLORATION +estomatitis I-EXPLORATION +y I-EXPLORATION +enantema. I-EXPLORATION +No I-EXPLORATION +tiene I-EXPLORATION +adenopatías. I-EXPLORATION +Las I-EXPLORATION +exploraciones I-EXPLORATION +osteoarticular I-EXPLORATION +y I-EXPLORATION +neurológica, I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +auscultación I-EXPLORATION +cardiopulmonar, I-EXPLORATION +fueron I-EXPLORATION +normales. I-EXPLORATION + I-EXPLORATION +Estudios I-EXPLORATION +complementarios I-EXPLORATION +solicitados: I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +hemograma, I-EXPLORATION +Hb I-EXPLORATION +10, I-EXPLORATION 6 I-EXPLORATION -g/dl I-EXPLORATION -(VN I-EXPLORATION -3, I-EXPLORATION -5-3), I-EXPLORATION +g/dl, I-EXPLORATION +leucocitos I-EXPLORATION +3500/μl I-EXPLORATION +con I-EXPLORATION +fórmula I-EXPLORATION +normal, I-EXPLORATION +plaquetas I-EXPLORATION +126 I-EXPLORATION +000/ I-EXPLORATION +μl I-EXPLORATION +(un I-EXPLORATION +mes I-EXPLORATION +antes I-EXPLORATION +solo I-EXPLORATION +destacar I-EXPLORATION +4400 I-EXPLORATION +leucocitos/ I-EXPLORATION +μl). I-EXPLORATION +Frotis I-EXPLORATION +sanguíneo I-EXPLORATION +sin I-EXPLORATION +alteraciones I-EXPLORATION +morfológicas. I-EXPLORATION +Velocidad I-EXPLORATION +de I-EXPLORATION +sedimentación I-EXPLORATION +44 I-EXPLORATION +mm/hora. I-EXPLORATION +Reactantes I-EXPLORATION +fase I-EXPLORATION +aguda: I-EXPLORATION +proteína I-EXPLORATION +C I-EXPLORATION +reactiva I-EXPLORATION +0, I-EXPLORATION +18 I-EXPLORATION +mg/dl, I-EXPLORATION +procalcitonina I-EXPLORATION +0, I-EXPLORATION +06 I-EXPLORATION +ng/ml. I-EXPLORATION +Estudio I-EXPLORATION +de I-EXPLORATION +coagulación, I-EXPLORATION +pruebas I-EXPLORATION +reumáticas I-EXPLORATION +y I-EXPLORATION +proteinograma I-EXPLORATION +normales. I-EXPLORATION +Inmunoglobulinas I-EXPLORATION +con I-EXPLORATION IgG I-EXPLORATION -136 I-EXPLORATION -mg/dl I-EXPLORATION -(VN I-EXPLORATION -490-1450), I-EXPLORATION -IgE I-EXPLORATION -140 I-EXPLORATION -UI/ I-EXPLORATION -ml I-EXPLORATION -(VN I-EXPLORATION -hasta I-EXPLORATION -75), I-EXPLORATION -triglicéridos I-EXPLORATION -196 I-EXPLORATION +1830 I-EXPLORATION mg/dl I-EXPLORATION -(N I-EXPLORATION -< I-EXPLORATION -150), I-EXPLORATION -TGO I-EXPLORATION -62 I-EXPLORATION -U/L I-EXPLORATION -(VN I-EXPLORATION -< I-EXPLORATION -37), I-EXPLORATION -TGP I-EXPLORATION -43 I-EXPLORATION -U/L I-EXPLORATION -(VN I-EXPLORATION -< I-EXPLORATION -41), I-EXPLORATION - I-EXPLORATION -colesterol I-EXPLORATION -total I-EXPLORATION -129 I-EXPLORATION +e I-EXPLORATION +IgA I-EXPLORATION +271 I-EXPLORATION +mg/dl. I-EXPLORATION +Complementos I-EXPLORATION +C3 I-EXPLORATION +23, I-EXPLORATION +7 I-EXPLORATION mg/dl I-EXPLORATION -(VN I-EXPLORATION -< I-EXPLORATION -200), I-EXPLORATION -HDL I-EXPLORATION -25 I-EXPLORATION -mg/ I-EXPLORATION -dl I-EXPLORATION -(VN I-EXPLORATION -> I-EXPLORATION -35). I-EXPLORATION -PCR I-EXPLORATION -1, I-EXPLORATION -3mg/dl I-EXPLORATION -(VN I-EXPLORATION -< I-EXPLORATION -0, I-EXPLORATION -06). I-EXPLORATION -Orina I-EXPLORATION -normal I-EXPLORATION -sin I-EXPLORATION -proteinuria. I-EXPLORATION -Relación I-EXPLORATION -Prot/Cr I-EXPLORATION -0, I-EXPLORATION -26. I-EXPLORATION -Hormonas I-EXPLORATION -tiroideas I-EXPLORATION -normales I-EXPLORATION y I-EXPLORATION -anticuerpos I-EXPLORATION -para I-EXPLORATION -enfermedad I-EXPLORATION -celíaca I-EXPLORATION +C4 I-EXPLORATION +4, I-EXPLORATION +2 I-EXPLORATION +mg/dl. I-EXPLORATION +Autoinmunidad: I-EXPLORATION +anticuerpos I-EXPLORATION +antinucleares I-EXPLORATION +(ANA) I-EXPLORATION ++ I-EXPLORATION +1/1280, I-EXPLORATION +anti-SM I-EXPLORATION +positivo, I-EXPLORATION +anti-ADN I-EXPLORATION +fuertemente I-EXPLORATION +positivo. I-EXPLORATION +Sistemático I-EXPLORATION +de I-EXPLORATION +orina I-EXPLORATION +150-250 I-EXPLORATION +eritrocitos/campo. I-EXPLORATION +Serologías I-EXPLORATION +bacteriana I-EXPLORATION +a I-EXPLORATION +Mycoplasma, I-EXPLORATION +parasitaria I-EXPLORATION +a I-EXPLORATION +toxoplasma I-EXPLORATION +y I-EXPLORATION +vírica I-EXPLORATION +a I-EXPLORATION +virus I-EXPLORATION +de I-EXPLORATION +Epstein-Barr, I-EXPLORATION +parvovirus I-EXPLORATION +B19, I-EXPLORATION +adenovirus, I-EXPLORATION +echovirus I-EXPLORATION +y I-EXPLORATION +coxsakie I-EXPLORATION +negativas. I-EXPLORATION +Destacar I-EXPLORATION +una I-EXPLORATION +IgM I-EXPLORATION +a I-EXPLORATION +citomegalovirus I-EXPLORATION +positiva. I-EXPLORATION +Hemocultivo I-EXPLORATION +y I-EXPLORATION +frotis I-EXPLORATION +faríngeo, I-EXPLORATION +bucal, I-EXPLORATION +conjuntiva I-EXPLORATION +y I-EXPLORATION +punción I-EXPLORATION +púrpura, I-EXPLORATION negativos. I-EXPLORATION -Prueba I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -tuberculina I-EXPLORATION -negativa. I-EXPLORATION - I-EXPLORATION -Al B-EVOLUTION -segundo I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -internación, I-EVOLUTION -el I-EVOLUTION -niño I-EVOLUTION -presentó I-EVOLUTION -dos I-EVOLUTION -picos I-EVOLUTION -febriles, I-EVOLUTION -fauces I-EVOLUTION -congestivas, I-EVOLUTION -subcrepitantes I-EVOLUTION -pulmonares I-EVOLUTION -bibasales I-EVOLUTION -leves. I-EVOLUTION -Radiografía B-EXPLORATION +Radiografía I-EXPLORATION de I-EXPLORATION tórax I-EXPLORATION y I-EXPLORATION ecografía I-EXPLORATION -renal I-EXPLORATION -sin I-EXPLORATION -particularidades. I-EXPLORATION -Ecografía I-EXPLORATION -abdominal I-EXPLORATION -sin I-EXPLORATION -visceromegalia, I-EXPLORATION -con I-EXPLORATION -líquido I-EXPLORATION -ascítico I-EXPLORATION -moderado, I-EXPLORATION -mucosa I-EXPLORATION -gástrica I-EXPLORATION +abdominal, I-EXPLORATION sin I-EXPLORATION -agrandamiento I-EXPLORATION -ni I-EXPLORATION -hipertrofia I-EXPLORATION -de I-EXPLORATION -pliegues. I-EXPLORATION +hallazgos I-EXPLORATION +patológicos. I-EXPLORATION I-EXPLORATION -Se I-EXPLORATION -descartó I-EXPLORATION -la I-EXPLORATION -etiología I-EXPLORATION -cardiovascular, I-EXPLORATION -renal I-EXPLORATION -o I-EXPLORATION -hepática I-EXPLORATION -por I-EXPLORATION +Con I-EXPLORATION la I-EXPLORATION clínica I-EXPLORATION y I-EXPLORATION los I-EXPLORATION -estudios I-EXPLORATION -realizados. I-EXPLORATION - I-EXPLORATION -Ante I-EXPLORATION +datos I-EXPLORATION +complementarios I-EXPLORATION +referidos, I-EXPLORATION +ante I-EXPLORATION la I-EXPLORATION sospecha I-EXPLORATION de I-EXPLORATION -gastroenteropatía I-EXPLORATION -perdedora I-EXPLORATION -de I-EXPLORATION -proteínas, I-EXPLORATION +lupus I-EXPLORATION +eritematoso I-EXPLORATION +sistémico I-EXPLORATION +(LES), I-EXPLORATION se I-EXPLORATION -realizó I-EXPLORATION +solicitan I-EXPLORATION +anticuerpos I-EXPLORATION +antifosfolípidos I-EXPLORATION +(AAF), I-EXPLORATION +antilúpicos I-EXPLORATION +positivos I-EXPLORATION +y I-EXPLORATION +anticardiolipina I-EXPLORATION +positiva I-EXPLORATION +(IgG, I-EXPLORATION +IgM), I-EXPLORATION una I-EXPLORATION -endoscopia I-EXPLORATION -esofagogastroduodenal I-EXPLORATION -con I-EXPLORATION -biopsia, I-EXPLORATION -cuyo I-EXPLORATION -informe I-EXPLORATION -reveló: I-EXPLORATION -esófago I-EXPLORATION -con I-EXPLORATION -cambio I-EXPLORATION -mucoso I-EXPLORATION -a I-EXPLORATION -23 I-EXPLORATION -cm, I-EXPLORATION -mucosa I-EXPLORATION -pálida I-EXPLORATION +ecocardiografía I-EXPLORATION +(función I-EXPLORATION y I-EXPLORATION -muy I-EXPLORATION -edematosa; I-EXPLORATION -estómago I-EXPLORATION -con I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -pliegues I-EXPLORATION -engrosados, I-EXPLORATION -seudopólipos I-EXPLORATION +estructura I-EXPLORATION +cardiacas I-EXPLORATION +normales) I-EXPLORATION y I-EXPLORATION -erosiones I-EXPLORATION +opinión I-EXPLORATION +dermatológica. I-EXPLORATION + I-EXPLORATION +Al I-EXPLORATION +cumplir I-EXPLORATION +más I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -mucosa. I-EXPLORATION -Duodeno I-EXPLORATION -con I-EXPLORATION -pliegues I-EXPLORATION -engrosados I-EXPLORATION -y I-EXPLORATION -mucosa I-EXPLORATION -edematosa. I-EXPLORATION -El I-EXPLORATION -informe I-EXPLORATION +cuatro I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -correspondió I-EXPLORATION -a I-EXPLORATION -esofagitis, I-EXPLORATION -gastritis I-EXPLORATION -y I-EXPLORATION -duodenitis I-EXPLORATION -crónica I-EXPLORATION -leve I-EXPLORATION -a I-EXPLORATION -moderada I-EXPLORATION -con I-EXPLORATION -frecuentes I-EXPLORATION -eosinófilos. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -depuración I-EXPLORATION +los I-EXPLORATION +criterios I-EXPLORATION de I-EXPLORATION -α1-antitripsina I-EXPLORATION -por I-EXPLORATION la I-EXPLORATION -falta I-EXPLORATION +Asociación I-EXPLORATION +Americana I-EXPLORATION de I-EXPLORATION -accesibilidad I-EXPLORATION -al I-EXPLORATION -método. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -solicitó I-EXPLORATION -en I-EXPLORATION -sangre, I-EXPLORATION -IgM-IgG I-EXPLORATION -para I-EXPLORATION -CMV: I-EXPLORATION -positivo; I-EXPLORATION -antígeno I-EXPLORATION -temprano: I-EXPLORATION -reactivo; I-EXPLORATION -PCR: I-EXPLORATION -2075 I-EXPLORATION -copias I-EXPLORATION -(no I-EXPLORATION -reactivo I-EXPLORATION -< I-EXPLORATION -750 I-EXPLORATION -copias). I-EXPLORATION -No I-EXPLORATION +Reumatología, I-EXPLORATION se I-EXPLORATION -analizó I-EXPLORATION -material I-EXPLORATION +confirma I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION de I-EXPLORATION -biopsia I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -detección I-EXPLORATION -del I-EXPLORATION -virus. I-EXPLORATION - I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -sometido I-TREATMENT -a I-TREATMENT -una I-TREATMENT -dieta I-TREATMENT -hiperproteica I-TREATMENT -y I-TREATMENT -gastroprotectora. I-TREATMENT -Recibió I-TREATMENT -una I-TREATMENT -infusión I-TREATMENT -intravenosa I-TREATMENT -de I-TREATMENT -albúmina I-TREATMENT -(25% I-TREATMENT -1 I-TREATMENT -g/ I-TREATMENT -kg, I-TREATMENT -una I-TREATMENT -dosis), I-TREATMENT -omeprazol I-TREATMENT -20 I-TREATMENT -mg/día I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -intravenosa I-TREATMENT -y I-TREATMENT -espironolactona I-TREATMENT -3 I-TREATMENT -mg/kg/día I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -oral. I-TREATMENT -Al I-TREATMENT -no I-TREATMENT -mejorar I-TREATMENT -clínicamente, I-TREATMENT -a I-TREATMENT -los I-TREATMENT -6 I-TREATMENT -días I-TREATMENT -se I-TREATMENT -comenzó I-TREATMENT -la I-TREATMENT -administración I-TREATMENT -de I-TREATMENT -ganciclovir I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -intravenosa I-TREATMENT -(5 I-TREATMENT -mg/kg I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -horas). I-TREATMENT -A I-TREATMENT -las I-TREATMENT -48 I-TREATMENT -horas I-TREATMENT -se I-TREATMENT -rotó I-TREATMENT -a I-TREATMENT -valganciclovir I-TREATMENT -oral I-TREATMENT -(400 I-TREATMENT -mg/día) I-TREATMENT -por I-TREATMENT -la I-TREATMENT -imposibilidad I-TREATMENT -de I-TREATMENT -mantener I-TREATMENT -la I-TREATMENT -venoclisis. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -10 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -internación, I-EVOLUTION -dada I-EVOLUTION -la I-EVOLUTION -buena I-EVOLUTION -evolución, I-EVOLUTION -se I-EVOLUTION -le I-EVOLUTION -otorgó I-EVOLUTION -el I-EVOLUTION -alta I-EVOLUTION -hospitalaria. I-EVOLUTION -Laboratorio B-EXPLORATION -al I-EXPLORATION -alta: I-EXPLORATION -proteínas I-EXPLORATION -totales I-EXPLORATION -4, I-EXPLORATION -6 I-EXPLORATION -g/ I-EXPLORATION -dl I-EXPLORATION -(VN I-EXPLORATION -6, I-EXPLORATION -6-8, I-EXPLORATION -7), I-EXPLORATION -albúmina I-EXPLORATION -2, I-EXPLORATION -6 I-EXPLORATION -g/dl I-EXPLORATION -(VN I-EXPLORATION -3, I-EXPLORATION -5-5), I-EXPLORATION -triglicéridos I-EXPLORATION -254 I-EXPLORATION -mg/dl I-EXPLORATION -(VN I-EXPLORATION -< I-EXPLORATION -150). I-EXPLORATION -Carga I-EXPLORATION -viral I-EXPLORATION -para I-EXPLORATION -CMV I-EXPLORATION -< I-EXPLORATION -750 I-EXPLORATION -copias. I-EXPLORATION -Se B-TREATMENT -indicó I-TREATMENT -continuar I-TREATMENT -con I-TREATMENT -dieta I-TREATMENT -hiperproteica, I-TREATMENT -protectores I-TREATMENT -gástricos I-TREATMENT -y I-TREATMENT -valganciclovir I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -oral I-TREATMENT -hasta I-TREATMENT -completar I-TREATMENT -6 I-TREATMENT -semanas I-TREATMENT -de I-TREATMENT -tratamiento. I-TREATMENT -Cuatro B-EXPLORATION -meses I-EXPLORATION -después, I-EXPLORATION -se I-EXPLORATION -repitió I-EXPLORATION -la I-EXPLORATION -endoscopia I-EXPLORATION -esofagogastroduodenal, I-EXPLORATION -cuyo I-EXPLORATION -resultado I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION +LES I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +solicita I-EXPLORATION +la I-EXPLORATION +valoración I-EXPLORATION +nefrológica I-EXPLORATION +y I-EXPLORATION +reumatológica. I-EXPLORATION +Se B-TREATMENT +pauta I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +medidas I-TREATMENT +generales, I-TREATMENT +antipalúdicos I-TREATMENT +(hidroxicloroquina) I-TREATMENT +y I-TREATMENT +corticoides I-TREATMENT +(prednisona) I-TREATMENT +orales, I-TREATMENT +manteniéndose I-TREATMENT +revisiones I-TREATMENT +correspondientes I-TREATMENT +en I-TREATMENT +su I-TREATMENT +seguimiento I-TREATMENT +multidisciplinar. I-TREATMENT + I-TREATMENT -Niña B-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS +63 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +ingresa I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +clínica I-PRESENT_ILLNESS +compatible I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -lesión I-PRESENT_ILLNESS -eritematosa I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -antifaz, I-PRESENT_ILLNESS -pequeñas I-PRESENT_ILLNESS -placas I-PRESENT_ILLNESS -redondeadas, I-PRESENT_ILLNESS -ligeramente I-PRESENT_ILLNESS -atróficas I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -temporooccipital I-PRESENT_ILLNESS -bilateral I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -cuello I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -finas I-PRESENT_ILLNESS -telangiectasias I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -superficie. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -genital, I-PRESENT_ILLNESS -lesión I-PRESENT_ILLNESS -eritematosa, I-PRESENT_ILLNESS -atrófica, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -bordes I-PRESENT_ILLNESS -definidos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Madre B-FAMILY_HISTORY -con I-FAMILY_HISTORY -alopecia I-FAMILY_HISTORY -cicatrizal, I-FAMILY_HISTORY -ojo I-FAMILY_HISTORY -seco, I-FAMILY_HISTORY -boca I-FAMILY_HISTORY -seca I-FAMILY_HISTORY -y I-FAMILY_HISTORY -anemia, I-FAMILY_HISTORY -sin I-FAMILY_HISTORY -diagnóstico I-FAMILY_HISTORY -de I-FAMILY_HISTORY -su I-FAMILY_HISTORY -enfermedad I-FAMILY_HISTORY -al I-FAMILY_HISTORY -momento I-FAMILY_HISTORY -de I-FAMILY_HISTORY -la I-FAMILY_HISTORY -consulta. I-FAMILY_HISTORY - I-FAMILY_HISTORY -Exámenes B-EXPLORATION -complementarios: I-EXPLORATION -Hb I-EXPLORATION -11, I-EXPLORATION -2g/dl, I-EXPLORATION -Hto I-EXPLORATION -33%, I-EXPLORATION -TGO I-EXPLORATION -265 I-EXPLORATION -UI/L, I-EXPLORATION -TGP I-EXPLORATION -212 I-EXPLORATION -UI/L, I-EXPLORATION -FAL I-EXPLORATION -927 I-EXPLORATION -UI/L, I-EXPLORATION -C3 I-EXPLORATION -54 I-EXPLORATION -mg/dl, I-EXPLORATION -C4 I-EXPLORATION -2 I-EXPLORATION -mg/dl, I-EXPLORATION -FAN I-EXPLORATION -+ I-EXPLORATION -1/1000 I-EXPLORATION -patrón I-EXPLORATION -moteado I-EXPLORATION -grueso I-EXPLORATION +Pielonefritis I-PRESENT_ILLNESS +aguda I-PRESENT_ILLNESS +izquierda. I-PRESENT_ILLNESS +Antecedentes B-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +cólicos I-PAST_MEDICAL_HISTORY +nefríticos I-PAST_MEDICAL_HISTORY +izquierdos I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +estudiados I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +hepatitis I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +juventud. I-PAST_MEDICAL_HISTORY +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +destaca I-EXPLORATION +una I-EXPLORATION +puñopercusión I-EXPLORATION +renal I-EXPLORATION +izquierda I-EXPLORATION +positiva I-EXPLORATION y I-EXPLORATION -anti I-EXPLORATION -La I-EXPLORATION -positivo I-EXPLORATION -(paciente), I-EXPLORATION -FAN I-EXPLORATION -+ I-EXPLORATION -1/2000 I-EXPLORATION -patrón I-EXPLORATION -homogéneo I-EXPLORATION +un I-EXPLORATION +tacto I-EXPLORATION +rectal I-EXPLORATION +con I-EXPLORATION +hipertrofia I-EXPLORATION +prostática I-EXPLORATION +volumen I-EXPLORATION +III/IV, I-EXPLORATION +fibroadenomatosa I-EXPLORATION y I-EXPLORATION -anti I-EXPLORATION -La I-EXPLORATION +sin I-EXPLORATION +nódulos. I-EXPLORATION +Analítica I-EXPLORATION +sanguínea I-EXPLORATION +con I-EXPLORATION +bioquímica I-EXPLORATION +dentro I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +normalidad, I-EXPLORATION +PSA I-EXPLORATION +de I-EXPLORATION +3, I-EXPLORATION +4 I-EXPLORATION +ng/ml I-EXPLORATION y I-EXPLORATION -anti I-EXPLORATION -Ro I-EXPLORATION +formula I-EXPLORATION +sanguínea I-EXPLORATION +con I-EXPLORATION +leucocitosis I-EXPLORATION +y I-EXPLORATION +desviación I-EXPLORATION +izquierda. I-EXPLORATION +Analítica I-EXPLORATION +de I-EXPLORATION +orina I-EXPLORATION +con I-EXPLORATION +nitritos I-EXPLORATION positivos I-EXPLORATION -(madre) I-EXPLORATION - I-EXPLORATION -Estudio I-EXPLORATION -histopatológico: I-EXPLORATION -capa I-EXPLORATION -córnea I-EXPLORATION -engrosada, I-EXPLORATION -epidermis I-EXPLORATION -adelgazada, I-EXPLORATION -intensa I-EXPLORATION -vacuolización I-EXPLORATION +y I-EXPLORATION +leucocituria. I-EXPLORATION +Urocultivos I-EXPLORATION +y I-EXPLORATION +Hemocultivos I-EXPLORATION +positivos I-EXPLORATION +a I-EXPLORATION +E. I-EXPLORATION +Coli. I-EXPLORATION +Rx I-EXPLORATION +simple I-EXPLORATION +de I-EXPLORATION +aparato I-EXPLORATION +urinario I-EXPLORATION +sin I-EXPLORATION +hallazgos I-EXPLORATION +patológicos I-EXPLORATION +significativos. I-EXPLORATION +Ecografía I-EXPLORATION +con I-EXPLORATION +ectasia I-EXPLORATION +renal I-EXPLORATION +izquierda I-EXPLORATION +grado I-EXPLORATION +II-III. I-EXPLORATION +La I-EXPLORATION +UIV I-EXPLORATION +realizada I-EXPLORATION +muestra I-EXPLORATION +vía I-EXPLORATION +urinaria I-EXPLORATION +alta I-EXPLORATION +derecha I-EXPLORATION +dentro I-EXPLORATION de I-EXPLORATION -queratinocitos I-EXPLORATION -basales, I-EXPLORATION +la I-EXPLORATION +normalidad I-EXPLORATION +y I-EXPLORATION +retraso I-EXPLORATION en I-EXPLORATION -dermis I-EXPLORATION -infiltrado I-EXPLORATION -mononuclear I-EXPLORATION -difuso. I-EXPLORATION -Membrana I-EXPLORATION -basal I-EXPLORATION -engrosada. I-EXPLORATION -IFD I-EXPLORATION -negativa. I-EXPLORATION - I-EXPLORATION -Valoración I-EXPLORATION -cardiológica I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Tratamiento: B-TREATMENT -Hidrocortisona I-TREATMENT -1% I-TREATMENT -tópico, I-TREATMENT -Pimecrolimus I-TREATMENT -1%. I-TREATMENT -Desaparición B-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -lesiones I-EVOLUTION -eritematosas I-EVOLUTION -a I-EVOLUTION +la I-EXPLORATION +captación I-EXPLORATION +y I-EXPLORATION +eliminación I-EXPLORATION +de I-EXPLORATION +contraste I-EXPLORATION +del I-EXPLORATION +riñón I-EXPLORATION +izquierdo I-EXPLORATION +que I-EXPLORATION +persiste I-EXPLORATION +a I-EXPLORATION +las I-EXPLORATION +dos I-EXPLORATION +horas. I-EXPLORATION +Se I-EXPLORATION +procede I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +realización I-EXPLORATION +de I-EXPLORATION +nefrostomía I-EXPLORATION +derivativa I-EXPLORATION +izquierda I-EXPLORATION +y I-EXPLORATION +posterior I-EXPLORATION +pielografía I-EXPLORATION +anterógrada, I-EXPLORATION +la I-EXPLORATION +cual I-EXPLORATION +demuestra I-EXPLORATION +defecto I-EXPLORATION +de I-EXPLORATION +repleción I-EXPLORATION +en I-EXPLORATION +uréter I-EXPLORATION +iliaco I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +tumoración I-EXPLORATION +ureteral I-EXPLORATION +de I-EXPLORATION +3-4 I-EXPLORATION +cm I-EXPLORATION +y I-EXPLORATION +uréter I-EXPLORATION +en I-EXPLORATION +anzuelo. I-EXPLORATION +Citología I-EXPLORATION +a I-EXPLORATION +través I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +nefrostomía I-EXPLORATION +negativa I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +extensión I-EXPLORATION +con I-EXPLORATION +TAC I-EXPLORATION +objetivaba I-EXPLORATION +dicha I-EXPLORATION +lesión I-EXPLORATION +como I-EXPLORATION +confinada I-EXPLORATION +al I-EXPLORATION +órgano I-EXPLORATION +origen. I-EXPLORATION +Se B-TREATMENT +realizó I-TREATMENT +Nefroureterectomía I-TREATMENT +izquierda I-TREATMENT +previa I-TREATMENT +desinserción I-TREATMENT +endoscópica, I-TREATMENT +siendo I-TREATMENT +el I-TREATMENT +resultado I-TREATMENT +anatomopatológico I-TREATMENT +de I-TREATMENT +Papiloma I-TREATMENT +invertido I-TREATMENT +de I-TREATMENT +uréter I-TREATMENT +y I-TREATMENT +riñón I-TREATMENT +izquierdo I-TREATMENT +con I-TREATMENT +pielonefritis I-TREATMENT +crónica. I-TREATMENT +A B-EVOLUTION los I-EVOLUTION -15 I-EVOLUTION -días I-EVOLUTION -y I-EVOLUTION -persistencia I-EVOLUTION +dos I-EVOLUTION +años I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +sufre I-EVOLUTION +una I-EVOLUTION +RAO I-EVOLUTION +que I-EVOLUTION +aconseja I-EVOLUTION +la I-EVOLUTION +realización I-EVOLUTION de I-EVOLUTION -lesiones I-EVOLUTION -atróficas I-EVOLUTION -con I-EVOLUTION -puntillado I-EVOLUTION -petequial I-EVOLUTION -en I-EVOLUTION -cuero I-EVOLUTION -cabelludo, I-EVOLUTION -normalizando I-EVOLUTION -las I-EVOLUTION -enzimas I-EVOLUTION -hepáticas I-EVOLUTION +Adenomectomía I-EVOLUTION +Retropúbica I-EVOLUTION +y I-EVOLUTION +posteriormente I-EVOLUTION a I-EVOLUTION los I-EVOLUTION -10 I-EVOLUTION -meses I-EVOLUTION +4 I-EVOLUTION +y I-EVOLUTION +5 I-EVOLUTION +años I-EVOLUTION +presenta I-EVOLUTION +sendas I-EVOLUTION +recidivas I-EVOLUTION +vesicales I-EVOLUTION de I-EVOLUTION -vida. I-EVOLUTION - I-EVOLUTION -Luego, I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -madre I-EVOLUTION +Carcinoma I-EVOLUTION +transicional I-EVOLUTION de I-EVOLUTION -la I-EVOLUTION +vejiga I-EVOLUTION +T1GII. I-EVOLUTION +El I-EVOLUTION paciente I-EVOLUTION -se I-EVOLUTION -le I-EVOLUTION -realizó I-EVOLUTION -diagnóstico I-EVOLUTION +sigue I-EVOLUTION +vivo I-EVOLUTION +libre I-EVOLUTION de I-EVOLUTION -Síndrome I-EVOLUTION -(Sme.) I-EVOLUTION +enfermedad I-EVOLUTION +urotelial I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +6 I-EVOLUTION +años I-EVOLUTION +del I-EVOLUTION +diagnóstico I-EVOLUTION de I-EVOLUTION -Sjögren. I-EVOLUTION +PI. I-EVOLUTION I-EVOLUTION -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -77 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -ambos I-PRESENT_ILLNESS -ojos I-PRESENT_ILLNESS -(AO), I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS +Recién B-PRESENT_ILLNESS +nacido I-PRESENT_ILLNESS +masculino I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -agudeza I-PRESENT_ILLNESS -visual I-PRESENT_ILLNESS -(AV). I-PRESENT_ILLNESS -Asimismo, I-PRESENT_ILLNESS -comenta I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -lleva I-PRESENT_ILLNESS -unos I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -notando I-PRESENT_ILLNESS -molestias I-PRESENT_ILLNESS +33 I-PRESENT_ILLNESS +semanas I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -manera I-PRESENT_ILLNESS -alterna I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -uno I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -otro I-PRESENT_ILLNESS -ojo. I-PRESENT_ILLNESS - B-FAMILY_HISTORY -No I-FAMILY_HISTORY -presenta I-FAMILY_HISTORY +edad I-PRESENT_ILLNESS +gestacional, I-PRESENT_ILLNESS +nacido B-PAST_MEDICAL_HISTORY +vía I-PAST_MEDICAL_HISTORY +cesárea I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +sepsis I-PAST_MEDICAL_HISTORY +materna. I-PAST_MEDICAL_HISTORY +Madre B-FAMILY_HISTORY +de I-FAMILY_HISTORY +19 I-FAMILY_HISTORY +años I-FAMILY_HISTORY +de I-FAMILY_HISTORY +edad I-FAMILY_HISTORY +falleció I-FAMILY_HISTORY +en I-FAMILY_HISTORY +el I-FAMILY_HISTORY +puerperio I-FAMILY_HISTORY +inme I-FAMILY_HISTORY +diato I-FAMILY_HISTORY +por I-FAMILY_HISTORY +sepsis I-FAMILY_HISTORY +grave, I-FAMILY_HISTORY +sin I-FAMILY_HISTORY antecedentes I-FAMILY_HISTORY -familiares I-FAMILY_HISTORY de I-FAMILY_HISTORY -interés I-FAMILY_HISTORY -y B-PAST_MEDICAL_HISTORY -entre I-PAST_MEDICAL_HISTORY +consanguinidad, I-FAMILY_HISTORY +el B-PAST_MEDICAL_HISTORY +embarazo I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +controlado, I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +reporte I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +tres I-PAST_MEDICAL_HISTORY +ultrasonidos I-PAST_MEDICAL_HISTORY +durante I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +gestación I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +mostró I-PAST_MEDICAL_HISTORY +signos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +hidrops I-PAST_MEDICAL_HISTORY +(derrame I-PAST_MEDICAL_HISTORY +pleural, I-PAST_MEDICAL_HISTORY +derrame I-PAST_MEDICAL_HISTORY +pericárdico I-PAST_MEDICAL_HISTORY +o I-PAST_MEDICAL_HISTORY +asci I-PAST_MEDICAL_HISTORY +tis). I-PAST_MEDICAL_HISTORY +El I-PAST_MEDICAL_HISTORY +peso I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +nacimiento I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +2090g, I-PAST_MEDICAL_HISTORY +APGAR I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +6 I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +minuto I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +6 I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY los I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -destaca I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -cardiopatía I-PAST_MEDICAL_HISTORY -isquémica I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con: I-PAST_MEDICAL_HISTORY -Pravastatina I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -mg/24 I-PAST_MEDICAL_HISTORY -horas, I-PAST_MEDICAL_HISTORY -Atenolol I-PAST_MEDICAL_HISTORY -50 I-PAST_MEDICAL_HISTORY -mg/12 I-PAST_MEDICAL_HISTORY -horas, I-PAST_MEDICAL_HISTORY -Ranipril I-PAST_MEDICAL_HISTORY -2, I-PAST_MEDICAL_HISTORY 5 I-PAST_MEDICAL_HISTORY -mg/12 I-PAST_MEDICAL_HISTORY -horas, I-PAST_MEDICAL_HISTORY -Acido I-PAST_MEDICAL_HISTORY -acetilsalicílico I-PAST_MEDICAL_HISTORY -100 I-PAST_MEDICAL_HISTORY -mg/24 I-PAST_MEDICAL_HISTORY -horas I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -Lorazepam I-PAST_MEDICAL_HISTORY -1 I-PAST_MEDICAL_HISTORY -mg/24 I-PAST_MEDICAL_HISTORY -horas. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Como B-PRESENT_ILLNESS -antecedente I-PRESENT_ILLNESS -personal I-PRESENT_ILLNESS -más I-PRESENT_ILLNESS -próximo, I-PRESENT_ILLNESS -señalar I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -empezar I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -problemas I-PRESENT_ILLNESS -oculares I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -sido I-PRESENT_ILLNESS -ingresada I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -medicina I-PRESENT_ILLNESS -interna I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -diagnóstico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Neumonía I-PRESENT_ILLNESS -neumocócica I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -lóbulo I-PRESENT_ILLNESS -superior I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -tratada I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -Moxifloxacino I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -dosis I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -400 I-PRESENT_ILLNESS -mg/24 I-PRESENT_ILLNESS +minutos. I-PAST_MEDICAL_HISTORY +El I-PAST_MEDICAL_HISTORY +examen I-PAST_MEDICAL_HISTORY +clínico I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +mostró I-PAST_MEDICAL_HISTORY +fenotipo I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +sugiera I-PAST_MEDICAL_HISTORY +síndrome I-PAST_MEDICAL_HISTORY +genético. I-PAST_MEDICAL_HISTORY +Dos B-PRESENT_ILLNESS horas I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -días, I-PRESENT_ILLNESS +después I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +nacimiento I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +taquipnea I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +cianosis I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -buena I-PRESENT_ILLNESS -respuesta. I-PRESENT_ILLNESS -Tras I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -alta I-PRESENT_ILLNESS -hospitalaria, I-PRESENT_ILLNESS -ya I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -antibiótico, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -comienza I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -referir I-PRESENT_ILLNESS -molestias I-PRESENT_ILLNESS -oculares I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -manera I-PRESENT_ILLNESS -alterna I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -AO. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -oftalmológica I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -una I-EXPLORATION -AV I-EXPLORATION -en I-EXPLORATION -ojo I-EXPLORATION -derecho I-EXPLORATION -(OD) I-EXPLORATION -de I-EXPLORATION -0, I-EXPLORATION -6 I-EXPLORATION -que I-EXPLORATION -mejora I-EXPLORATION -a I-EXPLORATION -0, I-EXPLORATION -8 I-EXPLORATION -con I-EXPLORATION -corrección I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -ojo I-EXPLORATION -izquierdo I-EXPLORATION -(OI) I-EXPLORATION -de I-EXPLORATION -0, I-EXPLORATION -3 I-EXPLORATION -que I-EXPLORATION -mejora I-EXPLORATION -a I-EXPLORATION -0, I-EXPLORATION -6 I-EXPLORATION -con I-EXPLORATION -corrección. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -segmento I-EXPLORATION -anterior I-EXPLORATION -destaca I-EXPLORATION -una I-EXPLORATION -reacción I-EXPLORATION -inflamatoria I-EXPLORATION -en I-EXPLORATION -cámara I-EXPLORATION -anterior I-EXPLORATION -de I-EXPLORATION -AO I-EXPLORATION -(Fenómeno I-EXPLORATION -de I-EXPLORATION -tyndall I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -+1 I-EXPLORATION -y I-EXPLORATION -proteínas I-EXPLORATION -+1), I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -fuerte I-EXPLORATION -dispersión I-EXPLORATION +dificultad I-PRESENT_ILLNESS +respiratoria I-PRESENT_ILLNESS +grave. I-PRESENT_ILLNESS +Fue B-TREATMENT +tratado I-TREATMENT +con I-TREATMENT +surfactante I-TREATMENT +exógeno I-TREATMENT +de I-TREATMENT +rescate I-TREATMENT +por I-TREATMENT +la I-TREATMENT +presencia I-TREATMENT +de I-TREATMENT +signos I-TREATMENT +y I-TREATMENT +síntomas I-TREATMENT +de I-TREATMENT +síndrome I-TREATMENT +de I-TREATMENT +dificultad I-TREATMENT +respiratoria, I-TREATMENT +catecolaminas, I-TREATMENT +antibióticos I-TREATMENT +y I-TREATMENT +ventilación I-TREATMENT +mecánica I-TREATMENT +por I-TREATMENT +22 I-TREATMENT +días; I-TREATMENT +la I-TREATMENT +ventilación I-TREATMENT +convencional I-TREATMENT +con I-TREATMENT +presión I-TREATMENT +media I-TREATMENT +de I-TREATMENT +la I-TREATMENT +vía I-TREATMENT +aérea I-TREATMENT +máxima I-TREATMENT +de I-TREATMENT +16 I-TREATMENT +cm I-TREATMENT +H2O, I-TREATMENT +seguida I-TREATMENT +de I-TREATMENT +VAFO I-TREATMENT +por I-TREATMENT +acidosis I-TREATMENT +respiratoria I-TREATMENT +e I-TREATMENT +hipoxemia I-TREATMENT +refrac I-TREATMENT +taria I-TREATMENT +(pCO2 I-TREATMENT +75 I-TREATMENT +mmHg I-TREATMENT +y I-TREATMENT +pO2 I-TREATMENT +45 I-TREATMENT +mmHg). I-TREATMENT + I-TREATMENT +La B-EXPLORATION +radiografía I-EXPLORATION de I-EXPLORATION -pigmento I-EXPLORATION -(+/++) I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -deposita I-EXPLORATION -en I-EXPLORATION -todas I-EXPLORATION -las I-EXPLORATION -estructuras: I-EXPLORATION +tórax I-EXPLORATION +mostró I-EXPLORATION +infiltración I-EXPLORATION +reticular I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -endotelio I-EXPLORATION -corneal I-EXPLORATION -de I-EXPLORATION -forma I-EXPLORATION -difusa, I-EXPLORATION -sobre I-EXPLORATION -el I-EXPLORATION -iris, I-EXPLORATION -sinequias I-EXPLORATION -posteriores I-EXPLORATION +ambos I-EXPLORATION +pulmones I-EXPLORATION y I-EXPLORATION -malla I-EXPLORATION -trabecular. I-EXPLORATION - I-EXPLORATION +sobre I-EXPLORATION +distención I-EXPLORATION +pulmonar I-EXPLORATION +sin I-EXPLORATION +consolidaciones. I-EXPLORATION La I-EXPLORATION -tensión I-EXPLORATION -ocular I-EXPLORATION -era I-EXPLORATION +TAC I-EXPLORATION de I-EXPLORATION -9 I-EXPLORATION -mm I-EXPLORATION -Hg I-EXPLORATION +tórax I-EXPLORATION +describió I-EXPLORATION +cambios I-EXPLORATION +reticulares I-EXPLORATION en I-EXPLORATION -OD I-EXPLORATION +todas I-EXPLORATION +las I-EXPLORATION +zonas, I-EXPLORATION +engrosamiento I-EXPLORATION +intersticial, I-EXPLORATION +múltiples I-EXPLORATION +bullas I-EXPLORATION y I-EXPLORATION -8 I-EXPLORATION -mmHg I-EXPLORATION -en I-EXPLORATION -OI. I-EXPLORATION -El I-EXPLORATION -fondo I-EXPLORATION +atrapamiento I-EXPLORATION de I-EXPLORATION -ojo, I-EXPLORATION -bajo I-EXPLORATION -midriasis I-EXPLORATION -farmacológica, I-EXPLORATION -era I-EXPLORATION -normal, I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -apreció I-EXPLORATION -reacción I-EXPLORATION -inflamatoria I-EXPLORATION +aire I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -cámara I-EXPLORATION -vítrea. I-EXPLORATION - I-EXPLORATION +pulmón I-EXPLORATION +izquierdo, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +neumonía I-EXPLORATION +derecha I-EXPLORATION +(Fi I-EXPLORATION +gura I-EXPLORATION +2). I-EXPLORATION Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -historia I-EXPLORATION -clínica, I-EXPLORATION -dentro I-EXPLORATION -del I-EXPLORATION -protocolo I-EXPLORATION +descartó I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -uveítis I-EXPLORATION -seguido I-EXPLORATION +linfangiectasia I-EXPLORATION en I-EXPLORATION -nuestro I-EXPLORATION -departamento, I-EXPLORATION -que I-EXPLORATION -incluyó I-EXPLORATION -una I-EXPLORATION -anamnesis I-EXPLORATION +otros I-EXPLORATION +órganos I-EXPLORATION por I-EXPLORATION -aparatos I-EXPLORATION +TAC I-EXPLORATION +abdominal. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +biopsia I-EXPLORATION +pulmonar I-EXPLORATION y I-EXPLORATION -la I-EXPLORATION -solicitud I-EXPLORATION +por I-EXPLORATION +indicación I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -exploraciones I-EXPLORATION -complementarias I-EXPLORATION -dirigidas, I-EXPLORATION -sistemático I-EXPLORATION +cirugía I-EXPLORATION +pediátrica I-EXPLORATION +lobectomía I-EXPLORATION +inferior I-EXPLORATION +izquierda. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +histopatológico I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +dilatación I-EXPLORATION +quística I-EXPLORATION de I-EXPLORATION -sangre, I-EXPLORATION -bioquímica, I-EXPLORATION -VDRL, I-EXPLORATION -FTA-abs I-EXPLORATION +los I-EXPLORATION +canales I-EXPLORATION +linfáti I-EXPLORATION +cos I-EXPLORATION +broncovasculares,. I-EXPLORATION +Por I-EXPLORATION +ecocardiografía I-EXPLORATION +se I-EXPLORATION +diagnosticó I-EXPLORATION +comunicación I-EXPLORATION +interauricular I-EXPLORATION +(CIA) I-EXPLORATION y I-EXPLORATION -placa I-EXPLORATION -de I-EXPLORATION -tórax. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -midriáticos I-TREATMENT -y I-TREATMENT -corticoides I-TREATMENT -tópicos I-TREATMENT -cediendo B-EXPLORATION -el I-EXPLORATION -cuadro I-EXPLORATION -en I-EXPLORATION -pocos I-EXPLORATION -días, I-EXPLORATION -manteniéndose, I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -sucesivas I-EXPLORATION -revisiones, I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION +persistencia I-EXPLORATION de I-EXPLORATION -pigmento I-EXPLORATION -en I-EXPLORATION -numerosas I-EXPLORATION -estructuras I-EXPLORATION -del I-EXPLORATION -segmento I-EXPLORATION -anterior I-EXPLORATION +conducto I-EXPLORATION +arterioso I-EXPLORATION +(PCA) I-EXPLORATION y I-EXPLORATION -manteniendo I-EXPLORATION -una I-EXPLORATION -presión I-EXPLORATION -intraocular I-EXPLORATION +fueron I-EXPLORATION +corregidas I-EXPLORATION +quirúrgicamente I-EXPLORATION +a I-EXPLORATION +los I-EXPLORATION +30 I-EXPLORATION +días I-EXPLORATION de I-EXPLORATION -14 I-EXPLORATION -mmHg I-EXPLORATION -en I-EXPLORATION -AO. I-EXPLORATION - I-EXPLORATION -Las I-EXPLORATION -exploraciones I-EXPLORATION -complementarias I-EXPLORATION -realizadas I-EXPLORATION -no I-EXPLORATION -detectaron I-EXPLORATION -ninguna I-EXPLORATION -alteración I-EXPLORATION -significativa. I-EXPLORATION - I-EXPLORATION +vida I-EXPLORATION +extra I-EXPLORATION +uterina. I-EXPLORATION +La B-EVOLUTION +evolución I-EVOLUTION +fue I-EVOLUTION +satisfactoria, I-EVOLUTION +el I-EVOLUTION +seguimiento I-EVOLUTION +pediátrico I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +19 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +edad I-EVOLUTION +reportó I-EVOLUTION +peso I-EVOLUTION +y I-EVOLUTION +talla I-EVOLUTION +adecuados I-EVOLUTION +para I-EVOLUTION +su I-EVOLUTION +edad, I-EVOLUTION +desarrollo I-EVOLUTION +psicomotor I-EVOLUTION +nor I-EVOLUTION +mal, I-EVOLUTION +sin I-EVOLUTION +cuadros I-EVOLUTION +infecciosos I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +vía I-EVOLUTION +respiratoria I-EVOLUTION +in I-EVOLUTION +ferior, I-EVOLUTION +no I-EVOLUTION +requirió I-EVOLUTION +oxigeno I-EVOLUTION +suplementario; I-EVOLUTION +la I-EVOLUTION +TAC I-EVOLUTION +de I-EVOLUTION +tórax I-EVOLUTION +de I-EVOLUTION +control I-EVOLUTION +informó I-EVOLUTION +con I-EVOLUTION +engrosamiento I-EVOLUTION +intersti I-EVOLUTION +cial, I-EVOLUTION +bullas I-EVOLUTION +enfisematosas I-EVOLUTION +difusas I-EVOLUTION +pequeñas I-EVOLUTION +y I-EVOLUTION +mejoría I-EVOLUTION +con I-EVOLUTION +respecto I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +TAC I-EVOLUTION +inicial,. I-EVOLUTION + I-EVOLUTION -Mujer B-PRESENT_ILLNESS +Presentamos B-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -18 I-PRESENT_ILLNESS +83 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY +de B-PAST_MEDICAL_HISTORY +edad, I-PAST_MEDICAL_HISTORY +hipertensa, I-PAST_MEDICAL_HISTORY +dislipémica, I-PAST_MEDICAL_HISTORY +apendicectomizada, I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +le I-PAST_MEDICAL_HISTORY +practicó I-PAST_MEDICAL_HISTORY +antrectomía I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +reconstrucción I-PAST_MEDICAL_HISTORY +Billroth-II I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +50 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cefalea I-PRESENT_ILLNESS -holocraneal I-PRESENT_ILLNESS +la I-PAST_MEDICAL_HISTORY +enfermedad I-PAST_MEDICAL_HISTORY +ulcerosa I-PAST_MEDICAL_HISTORY +péptica. I-PAST_MEDICAL_HISTORY +Acudió B-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +hospital I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +hipocondrio I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -vómitos. I-PRESENT_ILLNESS +vómitos I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +5 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION +Durante B-EXPLORATION +su I-EXPLORATION exploración I-EXPLORATION -neurológica I-EXPLORATION +no I-EXPLORATION presentaba I-EXPLORATION -hipoestesia I-EXPLORATION +ni I-EXPLORATION +ictericia I-EXPLORATION +ni I-EXPLORATION +fiebre. I-EXPLORATION +Las I-EXPLORATION +pruebas I-EXPLORATION de I-EXPLORATION -miembro I-EXPLORATION -superior I-EXPLORATION -derecho I-EXPLORATION +laboratorio I-EXPLORATION +mostraron I-EXPLORATION +cambios I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +función I-EXPLORATION +hepática I-EXPLORATION +(GGT I-EXPLORATION +386 I-EXPLORATION +IU/L, I-EXPLORATION +AP I-EXPLORATION +337 I-EXPLORATION +IU/L, I-EXPLORATION +AST I-EXPLORATION +245 I-EXPLORATION +U/L, I-EXPLORATION +ALT I-EXPLORATION +342 I-EXPLORATION +U/L, I-EXPLORATION y I-EXPLORATION -dudosa I-EXPLORATION -rigidez I-EXPLORATION -de I-EXPLORATION -nuca, I-EXPLORATION -sin I-EXPLORATION -otros I-EXPLORATION -signos I-EXPLORATION -meníngeos. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computarizada I-EXPLORATION -(TAC) I-EXPLORATION -cerebral I-EXPLORATION -era I-EXPLORATION -normal, I-EXPLORATION -el I-EXPLORATION -análisis I-EXPLORATION -del I-EXPLORATION -líquido I-EXPLORATION -cefalorraquídeo I-EXPLORATION -(LCR) I-EXPLORATION -mostró I-EXPLORATION -hiperproteinorraquia, I-EXPLORATION -hipoglucorraquia I-EXPLORATION +bilirrubina I-EXPLORATION +total I-EXPLORATION +0, I-EXPLORATION +03 I-EXPLORATION +g/l). I-EXPLORATION +Se I-EXPLORATION +detectaron I-EXPLORATION +también I-EXPLORATION +hiperamilasemia I-EXPLORATION y I-EXPLORATION -pleocitosis I-EXPLORATION -(98% I-EXPLORATION -linfocitos). I-EXPLORATION -Ante B-TREATMENT -la I-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -meningitis I-TREATMENT -vírica I-TREATMENT -o I-TREATMENT -bacteriana I-TREATMENT -decapitada, I-TREATMENT -se I-TREATMENT -instauró I-TREATMENT -tratamiento I-TREATMENT -intravenoso I-TREATMENT -con I-TREATMENT -aciclovir, I-TREATMENT -ceftriaxona I-TREATMENT -y I-TREATMENT -ampicilina. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -3 I-EVOLUTION -días I-EVOLUTION -presentó I-EVOLUTION -disminución I-EVOLUTION -de I-EVOLUTION -conciencia, I-EVOLUTION -midriasis I-EVOLUTION -arreactiva I-EVOLUTION -bilateral I-EVOLUTION -y I-EVOLUTION -parálisis I-EVOLUTION -bilateral I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -pares I-EVOLUTION -craneales I-EVOLUTION -III, I-EVOLUTION -IV, I-EVOLUTION -VI, I-EVOLUTION -VII, I-EVOLUTION -IX I-EVOLUTION -y I-EVOLUTION -X. I-EVOLUTION -La B-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -nuclear I-EXPLORATION -(RMN) I-EXPLORATION +elevación I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +proteína I-EXPLORATION +C I-EXPLORATION +reactiva; I-EXPLORATION +además, I-EXPLORATION +la I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION mostró I-EXPLORATION -realce I-EXPLORATION -lepto I-EXPLORATION -y I-EXPLORATION -paquimeníngeo I-EXPLORATION -e I-EXPLORATION -hidrocefalia I-EXPLORATION -tetraventricular. I-EXPLORATION -A B-TREATMENT -pesar I-TREATMENT -de I-TREATMENT -los I-TREATMENT -resultados I-TREATMENT -microbiológicos I-TREATMENT -no I-TREATMENT -concluyentes I-TREATMENT -(hemocultivos, I-TREATMENT -Mantoux, I-TREATMENT -Tinción I-TREATMENT -tinta I-TREATMENT -china I-TREATMENT -y I-TREATMENT -Ziehl I-TREATMENT -de I-TREATMENT -LCR: I-TREATMENT -todos I-TREATMENT -negativos), I-TREATMENT -y I-TREATMENT -ante I-TREATMENT -la I-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -leptomeningitis I-TREATMENT -tuberculosa I-TREATMENT -se I-TREATMENT -modificó I-TREATMENT -el I-TREATMENT -tratamiento, I-TREATMENT -pautándose I-TREATMENT -inicialmente I-TREATMENT -isoniacida I-TREATMENT -600 I-TREATMENT -mg/día I-TREATMENT -(más I-TREATMENT -vitamina I-TREATMENT -B6), I-TREATMENT -etambutol I-TREATMENT -22 I-TREATMENT -mg/kg/día I-TREATMENT -y I-TREATMENT -rifampicina I-TREATMENT -600 I-TREATMENT -mg/día; I-TREATMENT -a I-TREATMENT -las I-TREATMENT -48 I-TREATMENT -horas I-TREATMENT -se I-TREATMENT -suspendió I-TREATMENT -el I-TREATMENT -etambutol I-TREATMENT -y I-TREATMENT -se I-TREATMENT -añadió I-TREATMENT -pirazinamida I-TREATMENT -1, I-TREATMENT -5 I-TREATMENT -g/día, I-TREATMENT -estreptomicina I-TREATMENT -1g/día I-TREATMENT -y I-TREATMENT -dexametasona I-TREATMENT -24 I-TREATMENT -mg/día I-TREATMENT -sustituyendo I-TREATMENT -la I-TREATMENT -ampicilina I-TREATMENT -por I-TREATMENT -cotrimoxazol. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -12 I-EVOLUTION -días I-EVOLUTION -la I-EVOLUTION -agudeza I-EVOLUTION -visual I-EVOLUTION -(AV) I-EVOLUTION -bajó I-EVOLUTION -a I-EVOLUTION -amaurosis I-EVOLUTION -bilateral I-EVOLUTION -con I-EVOLUTION -alucinaciones I-EVOLUTION -visuales. I-EVOLUTION -La B-EXPLORATION -funduscopia I-EXPLORATION -era I-EXPLORATION -normal. I-EXPLORATION -Los I-EXPLORATION -potenciales I-EXPLORATION -visuales I-EXPLORATION -evocados I-EXPLORATION -(PEV) I-EXPLORATION -mostraron I-EXPLORATION -una I-EXPLORATION -onda I-EXPLORATION -P100 I-EXPLORATION -muy I-EXPLORATION -degradada I-EXPLORATION -con I-EXPLORATION -latencia I-EXPLORATION -muy I-EXPLORATION -aumentada, I-EXPLORATION -en I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +colecistitis, I-EXPLORATION +colelitiasis, I-EXPLORATION +dilatación I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -estimulación I-EXPLORATION -mono I-EXPLORATION +vesícula I-EXPLORATION +biliar I-EXPLORATION y I-EXPLORATION -binocular. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION de I-EXPLORATION -meningitis I-EXPLORATION -tuberculosa I-EXPLORATION -se I-EXPLORATION -confirmó I-EXPLORATION -mediante I-EXPLORATION -cultivo I-EXPLORATION -del I-EXPLORATION -LCR I-EXPLORATION +la I-EXPLORATION +vía I-EXPLORATION +biliar I-EXPLORATION +extrahepática. I-EXPLORATION +Basándose I-EXPLORATION en I-EXPLORATION -medio I-EXPLORATION -Lowestein. I-EXPLORATION +todos I-EXPLORATION +estos, I-EXPLORATION +se I-EXPLORATION +sospechó I-EXPLORATION +colecistopancreatitis I-EXPLORATION +aguda I-EXPLORATION +litiásica. I-EXPLORATION I-EXPLORATION -Durante B-TREATMENT -6 I-TREATMENT -meses I-TREATMENT -se I-TREATMENT -mantuvo I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -tuberculostático I-TREATMENT -(rifampicina I-TREATMENT -y I-TREATMENT -piridoxina) I-TREATMENT -y I-TREATMENT -dexametasona. I-TREATMENT - I-TREATMENT -La B-EVOLUTION -AV I-EVOLUTION -mejoró I-EVOLUTION -lentamente I-EVOLUTION -y B-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +por I-EXPLORATION +contraste I-EXPLORATION +oral I-EXPLORATION +se I-EXPLORATION +apreció I-EXPLORATION +drenaje I-EXPLORATION +biliar I-EXPLORATION al I-EXPLORATION -año I-EXPLORATION -presenta I-EXPLORATION -la I-EXPLORATION -siguiente I-EXPLORATION -exploración: I-EXPLORATION -AV I-EXPLORATION -bilateral: I-EXPLORATION -1/1, I-EXPLORATION -leve I-EXPLORATION -midriasis I-EXPLORATION -reactiva, I-EXPLORATION -sin I-EXPLORATION -restricciones I-EXPLORATION -en I-EXPLORATION +asa I-EXPLORATION +eferente. I-EXPLORATION +Por I-EXPLORATION +otra I-EXPLORATION +parte, I-EXPLORATION +los I-EXPLORATION +hallazgos I-EXPLORATION +endoscópicos I-EXPLORATION +no I-EXPLORATION +aportaron I-EXPLORATION +nuevos I-EXPLORATION +datos. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +tomografía I-EXPLORATION +computerizada I-EXPLORATION +(CT) I-EXPLORATION +reveló I-EXPLORATION +marcada I-EXPLORATION +dilatación I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -motilidad I-EXPLORATION -ocular I-EXPLORATION -extrínseca I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -nervio I-EXPLORATION -óptico I-EXPLORATION -presenta I-EXPLORATION -una I-EXPLORATION -leve I-EXPLORATION -palidez I-EXPLORATION -papilar I-EXPLORATION -sin I-EXPLORATION -aumento I-EXPLORATION +vía I-EXPLORATION +biliar I-EXPLORATION +extrahepática, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -excavación. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -perimetría I-EXPLORATION -computarizada I-EXPLORATION -en I-EXPLORATION -ojo I-EXPLORATION -derecho I-EXPLORATION -muestra I-EXPLORATION -una I-EXPLORATION -reducción I-EXPLORATION -concéntrica I-EXPLORATION -con I-EXPLORATION -respeto I-EXPLORATION +vesícula I-EXPLORATION +biliar I-EXPLORATION +y I-EXPLORATION +del I-EXPLORATION +asa I-EXPLORATION +yeyunal; I-EXPLORATION +también I-EXPLORATION +se I-EXPLORATION +apreció I-EXPLORATION +incremento I-EXPLORATION de I-EXPLORATION los I-EXPLORATION -10º I-EXPLORATION -centrales, I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -ojo I-EXPLORATION -izquierdo I-EXPLORATION -una I-EXPLORATION -reducción I-EXPLORATION -concéntrica I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +colecistitis I-EXPLORATION +mostrados I-EXPLORATION en I-EXPLORATION -hemicampo I-EXPLORATION -temporal I-EXPLORATION -y I-EXPLORATION -parte I-EXPLORATION -del I-EXPLORATION -nasal. I-EXPLORATION -Los I-EXPLORATION -PVE I-EXPLORATION -demuestran I-EXPLORATION -una I-EXPLORATION -notable I-EXPLORATION -mejoría I-EXPLORATION +la I-EXPLORATION +ecografía I-EXPLORATION +inicial, I-EXPLORATION +pero I-EXPLORATION +no I-EXPLORATION +reveló I-EXPLORATION +la I-EXPLORATION +causa I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -onda I-EXPLORATION -P100 I-EXPLORATION -en I-EXPLORATION -voltaje, I-EXPLORATION -latencia I-EXPLORATION -y I-EXPLORATION -morfología. I-EXPLORATION +ictericia I-EXPLORATION +obstructiva. I-EXPLORATION I-EXPLORATION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -78 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -afáquica B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ambos I-PAST_MEDICAL_HISTORY -ojos I-PAST_MEDICAL_HISTORY -tras I-PAST_MEDICAL_HISTORY -haber I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -intervenida I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cataratas I-PAST_MEDICAL_HISTORY -veinte I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -desarrolló I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -glaucoma I-PRESENT_ILLNESS -secundario I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -ojo I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -(OD). I-PRESENT_ILLNESS -Ante B-TREATMENT -la I-TREATMENT -falta I-TREATMENT +Por I-EXPLORATION +otro I-EXPLORATION +lado, I-EXPLORATION +se I-EXPLORATION +fueron I-EXPLORATION +incrementando I-EXPLORATION +los I-EXPLORATION +niveles I-EXPLORATION +de I-EXPLORATION +hiperbilirrubinemia I-EXPLORATION +(0, I-EXPLORATION +097 I-EXPLORATION +g/l) I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +las I-EXPLORATION +pruebas I-EXPLORATION +de I-EXPLORATION +función I-EXPLORATION +hepáticas I-EXPLORATION +(AST I-EXPLORATION +600 I-EXPLORATION +U/L) I-EXPLORATION +tras I-EXPLORATION +quince I-EXPLORATION +días I-EXPLORATION +de I-EXPLORATION +hospitalización. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +indicó I-TREATMENT +laparotomía I-TREATMENT +en I-TREATMENT +base I-TREATMENT +al I-TREATMENT +diagnóstico I-TREATMENT de I-TREATMENT -control I-TREATMENT +colecistitis I-TREATMENT +aguda I-TREATMENT +litiásica I-TREATMENT +e I-TREATMENT +ictericia I-TREATMENT +obstructiva I-TREATMENT +progresiva I-TREATMENT +que I-TREATMENT +involucraba I-TREATMENT +al I-TREATMENT +asa I-TREATMENT +aferente I-TREATMENT de I-TREATMENT -su I-TREATMENT -presión I-TREATMENT -intraocular I-TREATMENT -con I-TREATMENT +la I-TREATMENT +reconstrucción I-TREATMENT +Billroth-II. I-TREATMENT +Se B-EXPLORATION +encontró I-EXPLORATION +una I-EXPLORATION +vesícula I-EXPLORATION +biliar I-EXPLORATION +dilatada I-EXPLORATION +y I-EXPLORATION +necrótica, I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +estenosis I-EXPLORATION +del I-EXPLORATION +asa I-EXPLORATION +aferente I-EXPLORATION +volvulada I-EXPLORATION +sobre I-EXPLORATION +el I-EXPLORATION +asa I-EXPLORATION +eferente I-EXPLORATION +provocando I-EXPLORATION +la I-EXPLORATION +ictericia I-EXPLORATION +obstructiva. I-EXPLORATION +Se B-TREATMENT +resecó I-TREATMENT el I-TREATMENT -tratamiento I-TREATMENT -médico, I-TREATMENT +asa I-TREATMENT +aferente I-TREATMENT +estenótica, I-TREATMENT se I-TREATMENT -decidió I-TREATMENT +drenó I-TREATMENT +el I-TREATMENT +éstasis I-TREATMENT +biliar I-TREATMENT +y I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +una I-TREATMENT +reconstrucción I-TREATMENT +mediante I-TREATMENT +Y-Roux I-TREATMENT +yeyuno-yeyunal. I-TREATMENT +Así I-TREATMENT +mismo I-TREATMENT +se I-TREATMENT +practicó I-TREATMENT +colecistectomía, I-TREATMENT +y I-TREATMENT +colangiografía I-TREATMENT +intraoperatoria, I-TREATMENT +obtenida I-TREATMENT +a I-TREATMENT la I-TREATMENT -implantación I-TREATMENT -de I-TREATMENT +finalización I-TREATMENT +del I-TREATMENT +procedimiento, I-TREATMENT +mostrando I-TREATMENT un I-TREATMENT -dispositivo I-TREATMENT -de I-TREATMENT drenaje I-TREATMENT -valvulado I-TREATMENT +satisfactorio I-TREATMENT +a I-TREATMENT +través I-TREATMENT de I-TREATMENT -Ahmed, I-TREATMENT -con I-TREATMENT -parche I-TREATMENT +la I-TREATMENT +papila I-TREATMENT de I-TREATMENT -esclera I-TREATMENT -recubriendo I-TREATMENT +Vater I-TREATMENT +hacia I-TREATMENT el I-TREATMENT -trayecto I-TREATMENT -extraocular I-TREATMENT -del I-TREATMENT -tubo I-TREATMENT +duodeno I-TREATMENT y I-TREATMENT -el I-TREATMENT -extremo I-TREATMENT +posteriormente I-TREATMENT +transanastomótico I-TREATMENT +y I-TREATMENT +a I-TREATMENT +lo I-TREATMENT +largo I-TREATMENT del I-TREATMENT -mismo I-TREATMENT -localizado I-TREATMENT -en I-TREATMENT -cámara I-TREATMENT -anterior. I-TREATMENT -El B-EVOLUTION +yeyuno. I-TREATMENT + I-TREATMENT +Al B-EVOLUTION +sexto I-EVOLUTION +día I-EVOLUTION postoperatorio I-EVOLUTION -evolucionó I-EVOLUTION -favorablemente. I-EVOLUTION -La I-EVOLUTION -agudeza I-EVOLUTION -visual I-EVOLUTION -(AV) I-EVOLUTION -postoperatoria I-EVOLUTION -era I-EVOLUTION +los I-EVOLUTION +niveles I-EVOLUTION de I-EVOLUTION -0, I-EVOLUTION -5 I-EVOLUTION -en I-EVOLUTION -OD I-EVOLUTION +amilasemia I-EVOLUTION +y I-EVOLUTION +bilirrubina I-EVOLUTION +se I-EVOLUTION +normalizaron I-EVOLUTION y I-EVOLUTION -0, I-EVOLUTION -2 I-EVOLUTION -en I-EVOLUTION -ojo I-EVOLUTION -izquierdo I-EVOLUTION -(OI). I-EVOLUTION -La B-TREATMENT -presión I-TREATMENT -intraocular I-TREATMENT -en I-TREATMENT -OD I-TREATMENT -era I-TREATMENT -de I-TREATMENT -12 I-TREATMENT -mmHg I-TREATMENT -en I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -tartrato I-TREATMENT -de I-TREATMENT -brimonidina I-TREATMENT -0, I-TREATMENT -2%. I-TREATMENT -El I-TREATMENT -cuerpo I-TREATMENT -valvular I-TREATMENT -estaba I-TREATMENT -situado I-TREATMENT -en I-TREATMENT -el I-TREATMENT -cuadrante I-TREATMENT -temporal I-TREATMENT -superior I-TREATMENT -y I-TREATMENT -la I-TREATMENT -ampolla I-TREATMENT -era I-TREATMENT -amplia I-TREATMENT -y I-TREATMENT -de I-TREATMENT -paredes I-TREATMENT -finas. I-TREATMENT -El I-TREATMENT -tubo I-TREATMENT -quedaba I-TREATMENT -situado I-TREATMENT -en I-TREATMENT -cámara I-TREATMENT -anterior I-TREATMENT -y I-TREATMENT -libre I-TREATMENT -de I-TREATMENT -vítreo. I-TREATMENT -Acudió B-EVOLUTION -a I-EVOLUTION -urgencias I-EVOLUTION -nueve I-EVOLUTION -meses I-EVOLUTION -tras I-EVOLUTION la I-EVOLUTION -cirugía I-EVOLUTION -siendo I-EVOLUTION -diagnosticada I-EVOLUTION +paciente I-EVOLUTION +presentó I-EVOLUTION +normalización I-EVOLUTION de I-EVOLUTION -conjuntivitis I-EVOLUTION -aguda I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -OD, I-EVOLUTION -se B-TREATMENT -instauró I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -medidas I-TREATMENT -higiénicas I-TREATMENT -y I-TREATMENT -colirio I-TREATMENT -de I-TREATMENT -tobramicina I-TREATMENT -1 I-TREATMENT -gota/8 I-TREATMENT -horas I-TREATMENT -(Tobrex I-TREATMENT -solución I-TREATMENT -Gotas I-TREATMENT -oft. I-TREATMENT -0, I-TREATMENT -3%; I-TREATMENT -Alcon I-TREATMENT -Cusi; I-TREATMENT -Barcelona; I-TREATMENT -España) I-TREATMENT -y I-TREATMENT -lágrimas I-TREATMENT -artificiales I-TREATMENT -a I-TREATMENT -demanda. I-TREATMENT -Cuatro B-EVOLUTION -días I-EVOLUTION -más I-EVOLUTION -tarde I-EVOLUTION -acudió I-EVOLUTION -a I-EVOLUTION -revisión I-EVOLUTION -presentando I-EVOLUTION -una I-EVOLUTION -AV I-EVOLUTION +la I-EVOLUTION +exploración I-EVOLUTION +clínica I-EVOLUTION +y I-EVOLUTION de I-EVOLUTION -movimiento I-EVOLUTION +la I-EVOLUTION +sintomatología. I-EVOLUTION +La I-EVOLUTION +ictericia I-EVOLUTION +desapareció I-EVOLUTION +completamente I-EVOLUTION +antes I-EVOLUTION +del I-EVOLUTION +alta I-EVOLUTION +hospitalaria. I-EVOLUTION + I-EVOLUTION +El I-EVOLUTION +estudio I-EVOLUTION +histopatológico I-EVOLUTION +del I-EVOLUTION +espécimen I-EVOLUTION +reveló I-EVOLUTION +colecistitis I-EVOLUTION +crónica, I-EVOLUTION +colelitiasis, I-EVOLUTION +y I-EVOLUTION +el I-EVOLUTION +asa I-EVOLUTION +intestinal I-EVOLUTION +presentó I-EVOLUTION +signos I-EVOLUTION +inespecíficos I-EVOLUTION +inflamatorios I-EVOLUTION +y I-EVOLUTION +atrofia I-EVOLUTION de I-EVOLUTION -manos. I-EVOLUTION +la I-EVOLUTION +mucosa. I-EVOLUTION + I-EVOLUTION + +FGR. B-PRESENT_ILLNESS +Mujer I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +35 I-PRESENT_ILLNESS +años. I-PRESENT_ILLNESS +Sobrina. B-PAST_MEDICAL_HISTORY +Hija I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +JoRB I-PAST_MEDICAL_HISTORY +(caso I-PAST_MEDICAL_HISTORY +4). I-PAST_MEDICAL_HISTORY +Soltera. I-PAST_MEDICAL_HISTORY +Nacida I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +8 I-PAST_MEDICAL_HISTORY +meses, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +vuelta I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +cordón I-PAST_MEDICAL_HISTORY +umbilical I-PAST_MEDICAL_HISTORY +alrededor I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +cuello I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +parto I-PAST_MEDICAL_HISTORY +distócico. I-PAST_MEDICAL_HISTORY +Como I-PAST_MEDICAL_HISTORY +consecuencia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +ello, I-PAST_MEDICAL_HISTORY +padece I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +parálisis I-PAST_MEDICAL_HISTORY +cerebral I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +importante I-PAST_MEDICAL_HISTORY +retraso I-PAST_MEDICAL_HISTORY +mental I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +psicomotriz, I-PAST_MEDICAL_HISTORY +camina I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +dificultad I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +muletas I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +utiliza I-PAST_MEDICAL_HISTORY +parcialmente I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +silla I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +ruedas. I-PAST_MEDICAL_HISTORY +Se I-PAST_MEDICAL_HISTORY +encuentra I-PAST_MEDICAL_HISTORY +muy I-PAST_MEDICAL_HISTORY +hinchada I-PAST_MEDICAL_HISTORY +habitualmente I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +le I-PAST_MEDICAL_HISTORY +sientan I-PAST_MEDICAL_HISTORY +muy I-PAST_MEDICAL_HISTORY +mal I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +comidas. I-PAST_MEDICAL_HISTORY +Ardores I-PAST_MEDICAL_HISTORY +epigástricos I-PAST_MEDICAL_HISTORY +frecuentes, I-PAST_MEDICAL_HISTORY +acompañados I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +reflujo. I-PAST_MEDICAL_HISTORY +Hábito I-PAST_MEDICAL_HISTORY +intestinal I-PAST_MEDICAL_HISTORY +muy I-PAST_MEDICAL_HISTORY +estreñido, I-PAST_MEDICAL_HISTORY +precisando I-PAST_MEDICAL_HISTORY +empleo I-PAST_MEDICAL_HISTORY +habitual I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +laxantes. I-PAST_MEDICAL_HISTORY En B-EXPLORATION la I-EXPLORATION -biomicroscopía I-EXPLORATION -presentaba I-EXPLORATION -hiperemia I-EXPLORATION -3-4 I-EXPLORATION -+, I-EXPLORATION -blebitis, I-EXPLORATION -no I-EXPLORATION -seidel, I-EXPLORATION -edema I-EXPLORATION -corneal I-EXPLORATION -difuso I-EXPLORATION -de I-EXPLORATION -3+, I-EXPLORATION -tyndall I-EXPLORATION -4+, I-EXPLORATION -plastrón I-EXPLORATION +analítica I-EXPLORATION +existe I-EXPLORATION +un I-EXPLORATION +descenso I-EXPLORATION +persistente I-EXPLORATION de I-EXPLORATION -fibrina I-EXPLORATION -en I-EXPLORATION -cámara I-EXPLORATION -anterior, I-EXPLORATION -no I-EXPLORATION -hipopion I-EXPLORATION +ferritina I-EXPLORATION +(6 I-EXPLORATION +ng/ml) I-EXPLORATION y I-EXPLORATION -PIO I-EXPLORATION -de I-EXPLORATION -35 I-EXPLORATION -mm I-EXPLORATION -Hg. I-EXPLORATION +del I-EXPLORATION +IST I-EXPLORATION +(13,4%) I-EXPLORATION +sin I-EXPLORATION +anemia I-EXPLORATION +acompañante. I-EXPLORATION +Presenta I-EXPLORATION +anticuerpos I-EXPLORATION +anti-tiroideos I-EXPLORATION +ligeramente I-EXPLORATION +positivos I-EXPLORATION +(163 I-EXPLORATION +U/ml), I-EXPLORATION +con I-EXPLORATION +normofunción I-EXPLORATION +tiroidea. I-EXPLORATION La I-EXPLORATION -conjuntiva I-EXPLORATION -que I-EXPLORATION -recubría I-EXPLORATION +TTG I-EXPLORATION +es I-EXPLORATION +ligeramente I-EXPLORATION +positiva I-EXPLORATION +(1,9), I-EXPLORATION el I-EXPLORATION -tubo I-EXPLORATION +DQ2 I-EXPLORATION +es I-EXPLORATION +negativo, I-EXPLORATION +siendo I-EXPLORATION +DQ8 I-EXPLORATION +(+) I-EXPLORATION y I-EXPLORATION -la I-EXPLORATION -cápsula I-EXPLORATION -filtrante I-EXPLORATION -parecía I-EXPLORATION -íntegra. I-EXPLORATION -El I-EXPLORATION -fondo I-EXPLORATION -de I-EXPLORATION -ojo I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -visualizaba I-EXPLORATION -por I-EXPLORATION -opacidad I-EXPLORATION +las I-EXPLORATION +biopsias I-EXPLORATION +duodenales I-EXPLORATION +mostraron I-EXPLORATION +un I-EXPLORATION +claro I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION -medios. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -aparecían I-EXPLORATION -ecos I-EXPLORATION +los I-EXPLORATION +linfocitos I-EXPLORATION +intraepiteliales I-EXPLORATION +(estadio I-EXPLORATION +1 I-EXPLORATION de I-EXPLORATION -baja I-EXPLORATION -densidad, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION +Marsh). I-EXPLORATION + I-EXPLORATION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +ingresa I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +nuestro I-PRESENT_ILLNESS +centro I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +estenosis I-PRESENT_ILLNESS +esofágica I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tres I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +secundaria I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +ingesta I-PRESENT_ILLNESS +accidental I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cáustico. I-PRESENT_ILLNESS +El B-DERIVED_FROM/TO +paciente I-DERIVED_FROM/TO +es I-DERIVED_FROM/TO +derivado I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +nuestra I-DERIVED_FROM/TO +institución I-DERIVED_FROM/TO +siendo I-DERIVED_FROM/TO +portador I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +gastrostomía I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +una I-DERIVED_FROM/TO +sutura I-DERIVED_FROM/TO +nasogástrica I-DERIVED_FROM/TO +(stringing) I-DERIVED_FROM/TO +que I-DERIVED_FROM/TO +permitía I-DERIVED_FROM/TO +dilataciones I-DERIVED_FROM/TO +retrógradas. I-DERIVED_FROM/TO +El B-EXPLORATION +esofagograma I-EXPLORATION de I-EXPLORATION -desprendimiento I-EXPLORATION +bario I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +estenosis I-EXPLORATION de I-EXPLORATION -retina. I-EXPLORATION -Ante B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -una I-TREATMENT -endoftalmitis I-TREATMENT -aguda I-TREATMENT -tardía, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -iniciar I-TREATMENT -el I-TREATMENT -protocolo I-TREATMENT -existente I-TREATMENT -en I-TREATMENT -el I-TREATMENT -hospital, I-TREATMENT -con I-TREATMENT -la I-TREATMENT -obtención I-TREATMENT -de I-TREATMENT -muestras I-TREATMENT -de I-TREATMENT -humor I-TREATMENT -acuoso I-TREATMENT -y I-TREATMENT -vítreo, I-TREATMENT -y I-TREATMENT -tratamiento I-TREATMENT -intravenoso I-TREATMENT +gran I-EXPLORATION +longitud I-EXPLORATION +desde I-EXPLORATION +el I-EXPLORATION +nivel I-EXPLORATION +cricotraqueal I-EXPLORATION +hasta I-EXPLORATION +el I-EXPLORATION +tercio I-EXPLORATION +inferior I-EXPLORATION +del I-EXPLORATION +esófago. I-EXPLORATION +Se B-TREATMENT +llevó I-TREATMENT a I-TREATMENT -base I-TREATMENT -de I-TREATMENT -ceftazidima I-TREATMENT -1 I-TREATMENT -gramo/8 I-TREATMENT -horas I-TREATMENT -y I-TREATMENT -vancomicina I-TREATMENT -1 I-TREATMENT -gramo/12 I-TREATMENT -horas, I-TREATMENT -inyección I-TREATMENT -intravítrea I-TREATMENT -de I-TREATMENT -ceftazidima I-TREATMENT -2, I-TREATMENT -25 I-TREATMENT -mg/0, I-TREATMENT -1 I-TREATMENT -ml I-TREATMENT -y I-TREATMENT -vancomicina I-TREATMENT -1 I-TREATMENT -mg/0, I-TREATMENT -1 I-TREATMENT -ml I-TREATMENT -y I-TREATMENT -colirio I-TREATMENT -tópico I-TREATMENT -reforzado I-TREATMENT -50 I-TREATMENT -mg/ml I-TREATMENT +cabo I-TREATMENT +un I-TREATMENT +programa I-TREATMENT de I-TREATMENT -vancomicina I-TREATMENT -y I-TREATMENT -ceftazidima I-TREATMENT +dilataciones I-TREATMENT +esofágicas I-TREATMENT +retrógradas I-TREATMENT cada I-TREATMENT -hora. I-TREATMENT -A B-EXPLORATION -las I-EXPLORATION -48 I-EXPLORATION -horas I-EXPLORATION -el I-EXPLORATION -resultado I-EXPLORATION -del I-EXPLORATION -cultivo I-EXPLORATION -fue I-EXPLORATION -Haemophilus I-EXPLORATION -influenzae I-EXPLORATION -resistente I-EXPLORATION -a I-EXPLORATION -vancomicina I-EXPLORATION -y I-EXPLORATION -sensible I-EXPLORATION -a I-EXPLORATION -betalactámicos, I-EXPLORATION -quinolonas, I-EXPLORATION -rifamicina, I-EXPLORATION -aminoglicósidos I-EXPLORATION -y I-EXPLORATION -tetraciclinas I-EXPLORATION -por B-TREATMENT +dos I-TREATMENT +semanas I-TREATMENT +sin I-TREATMENT +ninguna I-TREATMENT +mejora, I-TREATMENT +por I-TREATMENT lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -suspendió I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -vancomicina I-TREATMENT -y I-TREATMENT +que, I-TREATMENT +a I-TREATMENT +los I-TREATMENT +cinco I-TREATMENT +meses I-TREATMENT +postingesta I-TREATMENT +del I-TREATMENT +agente I-TREATMENT +corrosivo, I-TREATMENT se I-TREATMENT -añadió I-TREATMENT -una I-TREATMENT -quinolona I-TREATMENT -intravenosa I-TREATMENT +colocaron I-TREATMENT +del I-TREATMENT +mismo I-TREATMENT +modo I-TREATMENT +tres I-TREATMENT +stents I-TREATMENT +autoexpandibles I-TREATMENT +de I-TREATMENT +nitinol I-TREATMENT +cubiertos I-TREATMENT +de I-TREATMENT +silicona I-TREATMENT +internamente I-TREATMENT +(Stents I-TREATMENT +MI I-TREATMENT +Tech, I-TREATMENT +Izasa); I-TREATMENT +dos I-TREATMENT +de I-TREATMENT +16 I-TREATMENT +x I-TREATMENT +60 I-TREATMENT +mm I-TREATMENT y I-TREATMENT -tópica, I-TREATMENT -además I-TREATMENT +uno I-TREATMENT de I-TREATMENT +16 I-TREATMENT +x I-TREATMENT +40 I-TREATMENT +mm. I-TREATMENT +El I-TREATMENT +más I-TREATMENT +craneal I-TREATMENT +se I-TREATMENT +colocó I-TREATMENT +primero, I-TREATMENT +introduciendo I-TREATMENT +los I-TREATMENT +otros I-TREATMENT +en I-TREATMENT +dirección I-TREATMENT +caudal I-TREATMENT +y I-TREATMENT +manteniendo I-TREATMENT una I-TREATMENT -nueva I-TREATMENT -inyección I-TREATMENT -intravítrea I-TREATMENT +distancia I-TREATMENT de I-TREATMENT -ceftazidima I-TREATMENT +superposición I-TREATMENT +de I-TREATMENT +1-2 I-TREATMENT +cm I-TREATMENT +para I-TREATMENT +evitar I-TREATMENT +el I-TREATMENT +desplazamiento I-TREATMENT +de I-TREATMENT +los I-TREATMENT +mismos. I-TREATMENT +Este B-EVOLUTION +procedimiento I-EVOLUTION +logró I-EVOLUTION +una I-EVOLUTION +dilatación I-EVOLUTION +completa I-EVOLUTION +durante I-EVOLUTION +un I-EVOLUTION +mes. I-EVOLUTION + I-EVOLUTION +El I-EVOLUTION +niño I-EVOLUTION +refirió I-EVOLUTION +dolor I-EVOLUTION +como I-EVOLUTION +único I-EVOLUTION +síntoma I-EVOLUTION +postoperatorio I-EVOLUTION +que I-EVOLUTION +remitió I-EVOLUTION +espontáneamente I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +cuatro I-EVOLUTION +días. I-EVOLUTION +No B-EXPLORATION +se I-EXPLORATION +observaron I-EXPLORATION +ni I-EXPLORATION +migración I-EXPLORATION +ni I-EXPLORATION +otras I-EXPLORATION +complicaciones I-EXPLORATION +a I-EXPLORATION +corto I-EXPLORATION +plazo. I-EXPLORATION +Tolerando B-TREATMENT +su I-TREATMENT +alimentación I-TREATMENT +habitual I-TREATMENT +vía I-TREATMENT +oral I-TREATMENT +de I-TREATMENT +manera I-TREATMENT +adecuada, I-TREATMENT +fue I-TREATMENT +dado I-TREATMENT +de I-TREATMENT +alta I-TREATMENT +con I-TREATMENT +omeprazol I-TREATMENT +pautado I-TREATMENT +(15 I-TREATMENT +mg/24 I-TREATMENT +horas I-TREATMENT +vía I-TREATMENT +oral) I-TREATMENT y I-TREATMENT -decadrán. I-TREATMENT -A I-TREATMENT +seguimiento I-TREATMENT +en I-TREATMENT +consultas I-TREATMENT +externas. I-TREATMENT + I-TREATMENT +Los I-TREATMENT +stents I-TREATMENT +se I-TREATMENT +retiraron I-TREATMENT +a I-TREATMENT las I-TREATMENT -72 I-TREATMENT -horas, I-TREATMENT +cuatro I-TREATMENT +semanas I-TREATMENT y I-TREATMENT -ante I-TREATMENT -la I-TREATMENT -mala I-TREATMENT -evolución, I-TREATMENT +en I-TREATMENT +el I-TREATMENT +mismo I-TREATMENT +procedimiento I-TREATMENT se I-TREATMENT -decidió I-TREATMENT -la I-TREATMENT -retirada I-TREATMENT -del I-TREATMENT -dispositivo I-TREATMENT -de I-TREATMENT -drenaje, I-TREATMENT -lavado I-TREATMENT +pulverizó I-TREATMENT +una I-TREATMENT +dosis I-TREATMENT de I-TREATMENT +mitomicina I-TREATMENT +(0, I-TREATMENT +4 I-TREATMENT +ml/kg) I-TREATMENT +sobre I-TREATMENT +el I-TREATMENT +área I-TREATMENT +dilatada I-TREATMENT +a I-TREATMENT +través I-TREATMENT +del I-TREATMENT +irrigador I-TREATMENT +del I-TREATMENT +endoscopio. I-TREATMENT +Se B-EXPLORATION +identificaron I-EXPLORATION +dos I-EXPLORATION +estenosis I-EXPLORATION +residuales I-EXPLORATION +de I-EXPLORATION +1 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +largo I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +del I-EXPLORATION +esfínter I-EXPLORATION +cricofaríngeo I-EXPLORATION +y I-EXPLORATION +3 I-EXPLORATION +cm I-EXPLORATION +por I-EXPLORATION +encima I-EXPLORATION +del I-EXPLORATION +cardias I-EXPLORATION +respectivamente. I-EXPLORATION +La I-EXPLORATION +primera I-EXPLORATION +ya I-EXPLORATION +había I-EXPLORATION +sido I-EXPLORATION +visualizada I-EXPLORATION +durante I-EXPLORATION +la I-EXPLORATION +intervención I-EXPLORATION +endoscópica I-EXPLORATION +previa, I-EXPLORATION +cuando I-EXPLORATION +fue I-EXPLORATION +imposible I-EXPLORATION +la I-EXPLORATION +colocación I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +stent I-EXPLORATION +en I-EXPLORATION +dicha I-EXPLORATION +región I-EXPLORATION +debido I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +compresión I-EXPLORATION +traqueal. I-EXPLORATION +La B-TREATMENT +estenosis I-TREATMENT +esofágica I-TREATMENT +distal I-TREATMENT +requirió I-TREATMENT +otro I-TREATMENT +stent I-TREATMENT +(16 I-TREATMENT +x I-TREATMENT +40 I-TREATMENT +mm), I-TREATMENT +obteniendo I-TREATMENT la I-TREATMENT -cámara I-TREATMENT -anterior, I-TREATMENT -e I-TREATMENT -inyección I-TREATMENT +dilatación I-TREATMENT +completa I-TREATMENT de I-TREATMENT -ceftazidima I-TREATMENT -subconjuntival I-TREATMENT -e I-TREATMENT -intravítrea. I-TREATMENT -La I-TREATMENT -mala I-TREATMENT -visualización I-TREATMENT -desestimó I-TREATMENT la I-TREATMENT -práctica I-TREATMENT +misma I-TREATMENT +después I-TREATMENT de I-TREATMENT -vitrectomía. I-TREATMENT -A I-TREATMENT -los I-TREATMENT -cuatro I-TREATMENT -días, I-TREATMENT -la I-TREATMENT -AV I-TREATMENT -era I-TREATMENT +un I-TREATMENT +mes I-TREATMENT +desde I-TREATMENT +su I-TREATMENT +colocación. I-TREATMENT +Las I-TREATMENT +dilataciones I-TREATMENT +con I-TREATMENT +balón I-TREATMENT +posteriores I-TREATMENT +se I-TREATMENT +realizaron I-TREATMENT +a I-TREATMENT +intervalos I-TREATMENT de I-TREATMENT -no I-TREATMENT -percepción I-TREATMENT +cuatro I-TREATMENT +semanas, I-TREATMENT +consiguiéndose I-TREATMENT +un I-TREATMENT +esófago I-TREATMENT +elástico I-TREATMENT +con I-TREATMENT +aspecto I-TREATMENT +normal I-TREATMENT de I-TREATMENT -luz I-TREATMENT +su I-TREATMENT +mucosa. I-TREATMENT +Sin I-TREATMENT +embargo, I-TREATMENT +la I-TREATMENT +estenosis I-TREATMENT +del I-TREATMENT +esófago I-TREATMENT +proximal I-TREATMENT +mencionada I-TREATMENT +con I-TREATMENT +anterioridad I-TREATMENT +tuvo I-TREATMENT +una I-TREATMENT +respuesta I-TREATMENT +pobre, I-TREATMENT por I-TREATMENT lo I-TREATMENT que I-TREATMENT se I-TREATMENT -decidió I-TREATMENT -eviscerar. I-TREATMENT +optó I-TREATMENT +por I-TREATMENT +resección I-TREATMENT +quirúrgica I-TREATMENT +y I-TREATMENT +anastomosis I-TREATMENT +mediante I-TREATMENT +un I-TREATMENT +abordaje I-TREATMENT +laterocervical I-TREATMENT +inferior I-TREATMENT +izquierdo I-TREATMENT +seguida I-TREATMENT +de I-TREATMENT +dilataciones I-TREATMENT +neumáticas I-TREATMENT +dos I-TREATMENT +veces I-TREATMENT +al I-TREATMENT +mes I-TREATMENT +con I-TREATMENT +intervalos I-TREATMENT +progresivamente I-TREATMENT +más I-TREATMENT +largos I-TREATMENT +durante I-TREATMENT +cinco I-TREATMENT +meses. I-TREATMENT I-TREATMENT +Después B-EVOLUTION +de I-EVOLUTION +dos I-EVOLUTION +años I-EVOLUTION +de I-EVOLUTION +seguimiento, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +fue I-EVOLUTION +dado I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +totalmente I-EVOLUTION +asintomático I-EVOLUTION +y I-EVOLUTION +con I-EVOLUTION +un I-EVOLUTION +excelente I-EVOLUTION +aspecto I-EVOLUTION +macroscópico I-EVOLUTION +del I-EVOLUTION +esófago I-EVOLUTION +valorado I-EVOLUTION +endoscópicamente I-EVOLUTION +y I-EVOLUTION +mediante I-EVOLUTION +un I-EVOLUTION +esofagograma I-EVOLUTION +baritado I-EVOLUTION +de I-EVOLUTION +control. I-EVOLUTION + I-EVOLUTION Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -36 I-PRESENT_ILLNESS +55 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ser I-PAST_MEDICAL_HISTORY -bebedor I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -350 I-PAST_MEDICAL_HISTORY -gr/alcohol/día, I-PAST_MEDICAL_HISTORY -fumador I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -1 I-PAST_MEDICAL_HISTORY -cajetilla/día, I-PAST_MEDICAL_HISTORY -ExUDVP I-PAST_MEDICAL_HISTORY -(heroína I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -cocaína), I-PAST_MEDICAL_HISTORY -VHB I-PAST_MEDICAL_HISTORY -+, I-PAST_MEDICAL_HISTORY -VHC I-PAST_MEDICAL_HISTORY -+, I-PAST_MEDICAL_HISTORY -VIH I-PAST_MEDICAL_HISTORY --, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -hepatitis I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -multifactorial I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -estadio I-PAST_MEDICAL_HISTORY -A I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Child I-PAST_MEDICAL_HISTORY +y B-PAST_MEDICAL_HISTORY sin I-PAST_MEDICAL_HISTORY -datos I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +previos I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -portal. I-PAST_MEDICAL_HISTORY -Acude B-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS +interés. I-PAST_MEDICAL_HISTORY +Diez B-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +antes I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -brusca I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -importante I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +comenzó I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +inflamación I-PRESENT_ILLNESS +progresiva I-PRESENT_ILLNESS +pero I-PRESENT_ILLNESS +indolora I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +cuarto I-PRESENT_ILLNESS +dedo I-PRESENT_ILLNESS de I-PRESENT_ILLNESS la I-PRESENT_ILLNESS -AV I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -varias I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS +mano I-PRESENT_ILLNESS +derecha. I-PRESENT_ILLNESS +La I-PRESENT_ILLNESS +inflamación I-PRESENT_ILLNESS +dio I-PRESENT_ILLNESS +lugar I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +déficit I-PRESENT_ILLNESS +funcional, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +imposibilidad I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +realizar I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +flexoextensión I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +dedo I-PRESENT_ILLNESS +afectado. I-PRESENT_ILLNESS El B-EXPLORATION estudio I-EXPLORATION -oftalmológico I-EXPLORATION -mostraba I-EXPLORATION +radiográfico I-EXPLORATION +mostró I-EXPLORATION una I-EXPLORATION -AV I-EXPLORATION +pérdida I-EXPLORATION de I-EXPLORATION -movimiento I-EXPLORATION +definición I-EXPLORATION de I-EXPLORATION -manos I-EXPLORATION +la I-EXPLORATION +cortical I-EXPLORATION +anterior I-EXPLORATION en I-EXPLORATION -ambos I-EXPLORATION -ojos I-EXPLORATION -(AO), I-EXPLORATION +la I-EXPLORATION +base I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +falange I-EXPLORATION +proximal I-EXPLORATION +del I-EXPLORATION +cuarto I-EXPLORATION +dedo, I-EXPLORATION +junto I-EXPLORATION con I-EXPLORATION un I-EXPLORATION -fondo I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION -ojo I-EXPLORATION +partes I-EXPLORATION +blandas I-EXPLORATION +que I-EXPLORATION +parecía I-EXPLORATION +presentar I-EXPLORATION +una I-EXPLORATION +incipiente I-EXPLORATION +calcificación I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +extendía I-EXPLORATION +distalmente I-EXPLORATION +por I-EXPLORATION +la I-EXPLORATION +cara I-EXPLORATION +palmar I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +falange; I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +vio I-EXPLORATION +lesión I-EXPLORATION +intramedular. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +practicó I-EXPLORATION +biopsia I-EXPLORATION +incisional, I-EXPLORATION +cuyo I-EXPLORATION +diagnóstico I-EXPLORATION +anatomopatológico I-EXPLORATION +fue I-EXPLORATION +de I-EXPLORATION +periostitis I-EXPLORATION +reactiva I-EXPLORATION +florida. I-EXPLORATION + I-EXPLORATION +El B-DERIVED_FROM/TO +paciente I-DERIVED_FROM/TO +fue I-DERIVED_FROM/TO +remitido I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +nuestro I-DERIVED_FROM/TO +Servicio I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +donde I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +comprobó I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +existencia I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +una I-DERIVED_FROM/TO +masa I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +falange I-DERIVED_FROM/TO +proximal I-DERIVED_FROM/TO +del I-DERIVED_FROM/TO +cuarto I-DERIVED_FROM/TO +dedo I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +inflamación I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +tumefacción. I-DERIVED_FROM/TO +No B-EXPLORATION +se I-EXPLORATION +encontraron I-EXPLORATION +signos I-EXPLORATION +locorregionales I-EXPLORATION +de I-EXPLORATION +infección. I-EXPLORATION +La I-EXPLORATION +movilidad I-EXPLORATION +en I-EXPLORATION +todas I-EXPLORATION +las I-EXPLORATION +articulaciones I-EXPLORATION +del I-EXPLORATION +dedo I-EXPLORATION +estaba I-EXPLORATION +afectada, I-EXPLORATION +existiendo I-EXPLORATION +una I-EXPLORATION +impotencia I-EXPLORATION +funcional I-EXPLORATION +absoluta. I-EXPLORATION +El I-EXPLORATION +paciente I-EXPLORATION +refería I-EXPLORATION +dolor I-EXPLORATION con I-EXPLORATION -infiltrados I-EXPLORATION +parestesias I-EXPLORATION en I-EXPLORATION -polo I-EXPLORATION -posterior I-EXPLORATION -y I-EXPLORATION -desprendimiento I-EXPLORATION -seroso I-EXPLORATION -macular. I-EXPLORATION +el I-EXPLORATION +territorio I-EXPLORATION +del I-EXPLORATION +nervio I-EXPLORATION +colateral I-EXPLORATION +cubital. I-EXPLORATION + I-EXPLORATION El I-EXPLORATION -resto I-EXPLORATION +estudio I-EXPLORATION +radiográfico I-EXPLORATION +mostró I-EXPLORATION +un I-EXPLORATION +estadio I-EXPLORATION +evolutivo I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -oftalmológica I-EXPLORATION -era I-EXPLORATION -normal. I-EXPLORATION -Además I-EXPLORATION -presentaba I-EXPLORATION -fiebre I-EXPLORATION +lesión I-EXPLORATION +con I-EXPLORATION +respecto I-EXPLORATION +al I-EXPLORATION +primer I-EXPLORATION +estudio, I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +que I-EXPLORATION +la I-EXPLORATION +calcificación I-EXPLORATION de I-EXPLORATION -38, I-EXPLORATION -4ºC I-EXPLORATION -y I-EXPLORATION -discreto I-EXPLORATION -dolor I-EXPLORATION -abdominal I-EXPLORATION +las I-EXPLORATION +partes I-EXPLORATION +blandas I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +zona I-EXPLORATION +palmar I-EXPLORATION +de I-EXPLORATION +falange I-EXPLORATION +proximal I-EXPLORATION +se I-EXPLORATION +había I-EXPLORATION +hecho I-EXPLORATION +más I-EXPLORATION +ostensible, I-EXPLORATION +extendiéndose I-EXPLORATION a I-EXPLORATION +lo I-EXPLORATION +largo I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -palpación I-EXPLORATION +falange. I-EXPLORATION +Aparecía I-EXPLORATION +una I-EXPLORATION +clara I-EXPLORATION +reacción I-EXPLORATION +perióstica I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +base I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +falange I-EXPLORATION +que I-EXPLORATION +parecía I-EXPLORATION +conectar I-EXPLORATION con I-EXPLORATION -hepatomegalia I-EXPLORATION +la I-EXPLORATION +calcificación I-EXPLORATION +pero I-EXPLORATION +que I-EXPLORATION +además, I-EXPLORATION +se I-EXPLORATION +extendía I-EXPLORATION +al I-EXPLORATION +lado I-EXPLORATION +opuesto. I-EXPLORATION +Es I-EXPLORATION +interesante I-EXPLORATION +señalar I-EXPLORATION +también I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +apreciaba I-EXPLORATION +una I-EXPLORATION +reacción I-EXPLORATION +perióstica I-EXPLORATION +sólida I-EXPLORATION de I-EXPLORATION -dos I-EXPLORATION -traveses I-EXPLORATION +borde I-EXPLORATION +irregular I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +falange I-EXPLORATION +media. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +radiográfico I-EXPLORATION +preoperatorio I-EXPLORATION +la I-EXPLORATION +calcificación I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +base I-EXPLORATION de I-EXPLORATION -dedo. I-EXPLORATION +la I-EXPLORATION +falange I-EXPLORATION +media I-EXPLORATION +se I-EXPLORATION +volvió I-EXPLORATION +más I-EXPLORATION +definida I-EXPLORATION +y I-EXPLORATION +grande, I-EXPLORATION +abarcando I-EXPLORATION +toda I-EXPLORATION +la I-EXPLORATION +extensión I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +falange. I-EXPLORATION I-EXPLORATION -Ante B-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -sospecha I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -pancreatitis I-DERIVED_FROM/TO -aguda I-DERIVED_FROM/TO -es I-DERIVED_FROM/TO -derivado I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -Servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Medicina I-DERIVED_FROM/TO -Interna, I-DERIVED_FROM/TO -que B-EXPLORATION -confirmada I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +mediante I-EXPLORATION +Resonancia I-EXPLORATION +Magnética I-EXPLORATION +(RM) I-EXPLORATION +permitió I-EXPLORATION +apreciar I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +de I-EXPLORATION +partes I-EXPLORATION +blandas I-EXPLORATION +que I-EXPLORATION +englobaba I-EXPLORATION +los I-EXPLORATION +tendones I-EXPLORATION +flexores I-EXPLORATION +y I-EXPLORATION +contactaba I-EXPLORATION +con I-EXPLORATION el I-EXPLORATION -diagnóstico I-EXPLORATION -tras I-EXPLORATION +periostio I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +falange I-EXPLORATION +proximal. I-EXPLORATION +Era I-EXPLORATION +hipointensa I-EXPLORATION +en I-EXPLORATION +T1, I-EXPLORATION +hiperintensa I-EXPLORATION +en I-EXPLORATION +T2 I-EXPLORATION +y I-EXPLORATION +realzaba I-EXPLORATION +de I-EXPLORATION +forma I-EXPLORATION +homogénea I-EXPLORATION +con I-EXPLORATION +Gadolinio. I-EXPLORATION +En I-EXPLORATION +su I-EXPLORATION +margen I-EXPLORATION +palmar I-EXPLORATION +presentaba I-EXPLORATION +un I-EXPLORATION +reborde I-EXPLORATION +hipointenso I-EXPLORATION +que I-EXPLORATION +pudiera I-EXPLORATION +representar I-EXPLORATION +calcificación. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +apreciaron I-EXPLORATION +vacíos I-EXPLORATION +de I-EXPLORATION +señal I-EXPLORATION +internos, I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +el I-EXPLORATION +patrón I-EXPLORATION +de I-EXPLORATION +calcificación I-EXPLORATION +debería I-EXPLORATION +ir I-EXPLORATION +unido I-EXPLORATION +a I-EXPLORATION +una I-EXPLORATION +matriz I-EXPLORATION +celular I-EXPLORATION +(lo I-EXPLORATION +que I-EXPLORATION +sugiere I-EXPLORATION +tumor I-EXPLORATION +o I-EXPLORATION +psedotumor). I-EXPLORATION +En I-EXPLORATION los I-EXPLORATION -estudios I-EXPLORATION +márgenes I-EXPLORATION +laterales I-EXPLORATION de I-EXPLORATION -laboratorio: I-EXPLORATION -Leucocitos I-EXPLORATION -12, I-EXPLORATION -4 I-EXPLORATION -(4, I-EXPLORATION -8-10, I-EXPLORATION -8 I-EXPLORATION -x103 I-EXPLORATION -ul); I-EXPLORATION -Neutrófilos I-EXPLORATION -88% I-EXPLORATION -(42,2-75,2); I-EXPLORATION -Volumen I-EXPLORATION -Corpuscular I-EXPLORATION -Medio I-EXPLORATION -111 I-EXPLORATION -fl I-EXPLORATION -(85,9-95,9); I-EXPLORATION -Bilirrubina I-EXPLORATION -total I-EXPLORATION -8, I-EXPLORATION -23 I-EXPLORATION -mg/dl I-EXPLORATION -(0,2-1,0); I-EXPLORATION -Amilasa I-EXPLORATION -1.523 I-EXPLORATION -u/l I-EXPLORATION -(55-201); I-EXPLORATION -GOT I-EXPLORATION -200 I-EXPLORATION -u/l I-EXPLORATION -(5-45); I-EXPLORATION -GPT I-EXPLORATION -227 I-EXPLORATION -u/l I-EXPLORATION -(5-45); I-EXPLORATION -GGT I-EXPLORATION -1.346 I-EXPLORATION -u/l I-EXPLORATION -(3-52); I-EXPLORATION -Fosfatasa I-EXPLORATION -Alcalina I-EXPLORATION -1.159 I-EXPLORATION -u/l I-EXPLORATION -(98-295); I-EXPLORATION -Fibrinógeno I-EXPLORATION -157 I-EXPLORATION -mg/dl I-EXPLORATION -(200-400) I-EXPLORATION -y I-EXPLORATION +la I-EXPLORATION +falange I-EXPLORATION +se I-EXPLORATION +visualizaron I-EXPLORATION +levantamientos I-EXPLORATION +periostios, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +un I-EXPLORATION +componente I-EXPLORATION de I-EXPLORATION -imagen I-EXPLORATION -[tomografía I-EXPLORATION -axial I-EXPLORATION -computerizada I-EXPLORATION -(TAC) I-EXPLORATION -y I-EXPLORATION -ecografía I-EXPLORATION -abdominales I-EXPLORATION +partes I-EXPLORATION +blandas I-EXPLORATION que I-EXPLORATION -muestran I-EXPLORATION -hepatopatía I-EXPLORATION -grasa I-EXPLORATION +desplazaba I-EXPLORATION +al I-EXPLORATION +tendón I-EXPLORATION +extensor. I-EXPLORATION +En I-EXPLORATION +los I-EXPLORATION +cortes I-EXPLORATION +sagitales I-EXPLORATION +se I-EXPLORATION +evidenció I-EXPLORATION +que I-EXPLORATION +la I-EXPLORATION +medular I-EXPLORATION +ósea I-EXPLORATION +estaba I-EXPLORATION +respetada I-EXPLORATION y I-EXPLORATION -infiltración I-EXPLORATION -del I-EXPLORATION -tejido I-EXPLORATION -peripancreático, I-EXPLORATION -especialmente I-EXPLORATION -a I-EXPLORATION +que I-EXPLORATION la I-EXPLORATION -altura I-EXPLORATION +cortical I-EXPLORATION +anterior I-EXPLORATION +no I-EXPLORATION +estaba I-EXPLORATION +infiltrada I-EXPLORATION +pero I-EXPLORATION +si I-EXPLORATION +mostraba I-EXPLORATION +un I-EXPLORATION +ligero I-EXPLORATION +festoneado I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +superficie I-EXPLORATION +externa. I-EXPLORATION + I-EXPLORATION +La B-TREATMENT +lesión I-TREATMENT +fue I-TREATMENT +extirpada I-TREATMENT +realizando I-TREATMENT +una I-TREATMENT +amputación I-TREATMENT +estética I-TREATMENT +del I-TREATMENT +4º I-TREATMENT +radio I-TREATMENT +de I-TREATMENT +la I-TREATMENT +mano I-TREATMENT +derecha I-TREATMENT +por I-TREATMENT +el I-TREATMENT +déficit I-TREATMENT +funcional I-TREATMENT +del I-TREATMENT +dedo. I-TREATMENT + I-TREATMENT +El B-EXPLORATION +estudio I-EXPLORATION +anatomopatológico I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -cola I-EXPLORATION -del I-EXPLORATION -páncreas, I-EXPLORATION -donde I-EXPLORATION +pieza I-EXPLORATION +de I-EXPLORATION +amputación I-EXPLORATION +señaló I-EXPLORATION la I-EXPLORATION -infiltración I-EXPLORATION -continúa I-EXPLORATION -por I-EXPLORATION +existencia I-EXPLORATION +entre I-EXPLORATION el I-EXPLORATION -espacio I-EXPLORATION -pararrenal I-EXPLORATION -anterior I-EXPLORATION -izquierdo]. I-EXPLORATION -La I-EXPLORATION -angiografía I-EXPLORATION -fluoresceínica I-EXPLORATION -mostraba I-EXPLORATION -inicialmente I-EXPLORATION -áreas I-EXPLORATION +tendón I-EXPLORATION +flexor I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +superficie I-EXPLORATION de I-EXPLORATION -no I-EXPLORATION -perfusión I-EXPLORATION -capilar, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -correspondían I-EXPLORATION -con I-EXPLORATION la I-EXPLORATION -presencia I-EXPLORATION +primera I-EXPLORATION +falange, I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -exudados, I-EXPLORATION -seguidas I-EXPLORATION +hueso I-EXPLORATION +maduro I-EXPLORATION +con I-EXPLORATION +intensos I-EXPLORATION +fenómenos I-EXPLORATION de I-EXPLORATION -difusión I-EXPLORATION -en I-EXPLORATION -tiempos I-EXPLORATION -tardíos I-EXPLORATION -y I-EXPLORATION -efectos I-EXPLORATION -pantalla I-EXPLORATION -provocados I-EXPLORATION -por I-EXPLORATION -las I-EXPLORATION -hemorragias I-EXPLORATION -retinianas. I-EXPLORATION -La B-TREATMENT -resolución I-TREATMENT -del I-TREATMENT -cuadro I-TREATMENT -digestivo I-TREATMENT -fue I-TREATMENT -favorable I-TREATMENT -con I-TREATMENT -tratamiento I-TREATMENT -médico I-TREATMENT -mediante I-TREATMENT -sueroterapia, I-TREATMENT -dieta I-TREATMENT -absoluta I-TREATMENT -y I-TREATMENT -antibioticoterapia, I-TREATMENT -con B-EVOLUTION -rápida I-EVOLUTION -mejoría I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -sintomatología I-EVOLUTION -clínica I-EVOLUTION -e I-EVOLUTION -importante I-EVOLUTION -mejoría I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -analítica I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -dos I-EVOLUTION -semanas, I-EVOLUTION -aunque B-EXPLORATION -un I-EXPLORATION -mes I-EXPLORATION -después I-EXPLORATION -presenta I-EXPLORATION +remodelación. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +centro I-EXPLORATION +del I-EXPLORATION +mencionado I-EXPLORATION +hueso I-EXPLORATION +existía I-EXPLORATION una I-EXPLORATION -encefalopatía I-EXPLORATION +proliferación I-EXPLORATION +fibroblástica I-EXPLORATION +con I-EXPLORATION +casi I-EXPLORATION +total I-EXPLORATION +ausencia I-EXPLORATION +de I-EXPLORATION +mitosis, I-EXPLORATION +que I-EXPLORATION +diferenciaba I-EXPLORATION +pequeñas I-EXPLORATION +cantidades I-EXPLORATION de I-EXPLORATION -Wernicke I-EXPLORATION +osteoide. I-EXPLORATION +Al I-EXPLORATION +comparar I-EXPLORATION +esta I-EXPLORATION +biopsia I-EXPLORATION con I-EXPLORATION +la I-EXPLORATION +previa I-EXPLORATION +o I-EXPLORATION +diagnóstica, I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION una I-EXPLORATION -TAC I-EXPLORATION -craneal I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -A B-EVOLUTION -los I-EVOLUTION -dos I-EVOLUTION -meses I-EVOLUTION -el I-EVOLUTION +mayor I-EXPLORATION +celularidad, I-EXPLORATION +con I-EXPLORATION +discreta I-EXPLORATION +atipia I-EXPLORATION +celular I-EXPLORATION +y I-EXPLORATION +mayor I-EXPLORATION +actividad I-EXPLORATION +mitótica. I-EXPLORATION + B-EVOLUTION +La I-EVOLUTION +evolución I-EVOLUTION +del I-EVOLUTION paciente I-EVOLUTION -había I-EVOLUTION -recuperado I-EVOLUTION -una I-EVOLUTION -AV I-EVOLUTION -de I-EVOLUTION -1 I-EVOLUTION -en I-EVOLUTION -AO I-EVOLUTION +fue I-EVOLUTION +satisfactoria I-EVOLUTION y I-EVOLUTION -el I-EVOLUTION -estudio I-EVOLUTION +la I-EVOLUTION +lesión I-EVOLUTION +no I-EVOLUTION +ha I-EVOLUTION +recidivado I-EVOLUTION +tras I-EVOLUTION +8 I-EVOLUTION +años I-EVOLUTION de I-EVOLUTION -fondo I-EVOLUTION +seguimiento, I-EVOLUTION +conservando I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +actualidad I-EVOLUTION +una I-EVOLUTION +buena I-EVOLUTION +función I-EVOLUTION de I-EVOLUTION -ojo I-EVOLUTION -solo I-EVOLUTION -mostraba I-EVOLUTION -algún I-EVOLUTION -pigmento I-EVOLUTION -residual. I-EVOLUTION +la I-EVOLUTION +mano. I-EVOLUTION I-EVOLUTION -Mujer B-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +37 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +que B-PAST_MEDICAL_HISTORY +acude I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +infiltración I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +material I-PAST_MEDICAL_HISTORY +desconocido I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +ambas I-PAST_MEDICAL_HISTORY +mamas I-PAST_MEDICAL_HISTORY +16 I-PAST_MEDICAL_HISTORY +meses I-PAST_MEDICAL_HISTORY +antes, I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +aproximadamente I-PAST_MEDICAL_HISTORY +200 I-PAST_MEDICAL_HISTORY +cc I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +cada I-PAST_MEDICAL_HISTORY +lado, I-PAST_MEDICAL_HISTORY +presentando B-PRESENT_ILLNESS +dolor, I-PRESENT_ILLNESS +deformidad I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +cambios I-PRESENT_ILLNESS +tróficos I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +piel I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +zona I-PRESENT_ILLNESS +afectada. I-PRESENT_ILLNESS +A B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +se I-EXPLORATION +palpa I-EXPLORATION +tejido I-EXPLORATION +de I-EXPLORATION +consistencia I-EXPLORATION +pétrea I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +retroareolar I-EXPLORATION +que I-EXPLORATION +involucra I-EXPLORATION +prácticamente I-EXPLORATION +al I-EXPLORATION +80 I-EXPLORATION +% I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +glándula I-EXPLORATION +mamaria. I-EXPLORATION +Se B-TREATMENT +decide I-TREATMENT +iniciar I-TREATMENT +tratamiento I-TREATMENT +médico I-TREATMENT +a I-TREATMENT +base I-TREATMENT +de I-TREATMENT +esteroides, I-TREATMENT +metrotexate I-TREATMENT +y I-TREATMENT +antiinflamatorios I-TREATMENT +no I-TREATMENT +esteroideos I-TREATMENT +por I-TREATMENT +parte I-TREATMENT +del I-TREATMENT +Servicio I-TREATMENT +de I-TREATMENT +Reumatología I-TREATMENT +de I-TREATMENT +nuestro I-TREATMENT +hospital I-TREATMENT +y I-TREATMENT +se I-TREATMENT +programa I-TREATMENT +para I-TREATMENT +mastectomía I-TREATMENT +y I-TREATMENT +reconstrucción I-TREATMENT +mediante I-TREATMENT +colgajo I-TREATMENT +TRAM I-TREATMENT +pediculado I-TREATMENT +bilateral, I-TREATMENT +procedimiento I-TREATMENT +que I-TREATMENT +se I-TREATMENT +realiza I-TREATMENT +sin I-TREATMENT +complicaciones I-TREATMENT +ni I-TREATMENT +incidentes. I-TREATMENT +Queda I-TREATMENT +pendiente I-TREATMENT +de I-TREATMENT +la I-TREATMENT +reconstrucción I-TREATMENT +bilateral I-TREATMENT +del I-TREATMENT +complejo I-TREATMENT +pezón-areola. I-TREATMENT + I-TREATMENT + +Hombre B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -58 I-PRESENT_ILLNESS +47 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +diabetes I-PAST_MEDICAL_HISTORY +mellitus I-PAST_MEDICAL_HISTORY +diagnosticada I-PAST_MEDICAL_HISTORY +cinco I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +antes, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +irregular I-PAST_MEDICAL_HISTORY +control I-PAST_MEDICAL_HISTORY +metabólico I-PAST_MEDICAL_HISTORY +(amaurosis I-PAST_MEDICAL_HISTORY +bilateral I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +hospitalizaciones I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +último I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +cetoacidosis I-PAST_MEDICAL_HISTORY +diabética), I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +inicialmente I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +glibenclamida I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +luego I-PAST_MEDICAL_HISTORY +insulina I-PAST_MEDICAL_HISTORY +NPH. I-PAST_MEDICAL_HISTORY +Consultó B-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -urgencia I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nuestras I-PRESENT_ILLNESS -consultas I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +semanas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +caracterizado I-PRESENT_ILLNESS por I-PRESENT_ILLNESS dolor I-PRESENT_ILLNESS -ocular I-PRESENT_ILLNESS -unilateral I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +aumento I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -unas I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS +volumen I-PRESENT_ILLNESS +progresivo I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -acompañado I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +pierna I-PRESENT_ILLNESS +izquierda I-PRESENT_ILLNESS +secundario I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +caída, I-PRESENT_ILLNESS +asociado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +somnolencia, I-PRESENT_ILLNESS +anorexia I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +dificultad I-PRESENT_ILLNESS +respiratoria, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +fiebre. I-PRESENT_ILLNESS +En I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +centro I-PRESENT_ILLNESS +primario I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -cierto I-PRESENT_ILLNESS -grado I-PRESENT_ILLNESS +salud I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +le I-PRESENT_ILLNESS +administró I-PRESENT_ILLNESS +4 I-PRESENT_ILLNESS +millones I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -disminución I-PRESENT_ILLNESS +UI I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -agudeza I-PRESENT_ILLNESS -visual. I-PRESENT_ILLNESS +penicilina I-PRESENT_ILLNESS +G I-PRESENT_ILLNESS +sódica. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -presenta I-EXPLORATION -inyección I-EXPLORATION -ciliar, I-EXPLORATION -midriasis I-EXPLORATION -media I-EXPLORATION -arreactiva I-EXPLORATION +su I-EXPLORATION +ingreso I-EXPLORATION +al I-EXPLORATION +servicio I-EXPLORATION +de I-EXPLORATION +urgencia I-EXPLORATION +se I-EXPLORATION +le I-EXPLORATION +constató I-EXPLORATION +en I-EXPLORATION +sopor, I-EXPLORATION +afebril, I-EXPLORATION +hipotenso I-EXPLORATION y I-EXPLORATION +deshidratado. I-EXPLORATION +Al I-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +extremidades I-EXPLORATION +inferiores I-EXPLORATION +destacaba I-EXPLORATION una I-EXPLORATION -presión I-EXPLORATION -intraocular I-EXPLORATION +lesión I-EXPLORATION +necrótica I-EXPLORATION +y I-EXPLORATION +flictenas I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +zona I-EXPLORATION +pretibial I-EXPLORATION +izquierda I-EXPLORATION de I-EXPLORATION -53 I-EXPLORATION -mm I-EXPLORATION -Hg. I-EXPLORATION -Ante B-EVOLUTION -este I-EVOLUTION -cuadro I-EVOLUTION -se I-EVOLUTION -establece I-EVOLUTION -el I-EVOLUTION -diagnóstico I-EVOLUTION -presuntivo I-EVOLUTION -de I-EVOLUTION -ataque I-EVOLUTION -agudo I-EVOLUTION -de I-EVOLUTION -glaucoma I-EVOLUTION -de I-EVOLUTION -ángulo I-EVOLUTION -estrecho I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -procede I-EVOLUTION -a I-EVOLUTION +30 I-EXPLORATION +x I-EXPLORATION +10 I-EXPLORATION +cm, I-EXPLORATION +ausencia I-EXPLORATION +de I-EXPLORATION +pulsos I-EXPLORATION +poplíteo I-EXPLORATION +y I-EXPLORATION +pedio I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación. I-EXPLORATION + I-EXPLORATION +Los I-EXPLORATION +exámenes I-EXPLORATION +mostraron I-EXPLORATION +leucocitosis I-EXPLORATION +(20.400/mm3), I-EXPLORATION +hiperglicemia I-EXPLORATION +(539 I-EXPLORATION +mg/dL), I-EXPLORATION +acidosis I-EXPLORATION +metabólica I-EXPLORATION +(pH I-EXPLORATION +6, I-EXPLORATION +9), I-EXPLORATION +proteína I-EXPLORATION +C I-EXPLORATION +reactiva I-EXPLORATION +elevada I-EXPLORATION +(189 I-EXPLORATION +mg/L) I-EXPLORATION +y I-EXPLORATION +disfunción I-EXPLORATION +renal I-EXPLORATION +(creatininemia: I-EXPLORATION +1, I-EXPLORATION +87 I-EXPLORATION +mg/dL, I-EXPLORATION +potasio: I-EXPLORATION +5, I-EXPLORATION +5 I-EXPLORATION +mmol/L). I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +le I-TREATMENT +efectuó I-TREATMENT +aseo I-TREATMENT +quirúrgico I-TREATMENT +encontrándose I-TREATMENT +una I-TREATMENT +necrosis I-TREATMENT +muscular I-TREATMENT +del I-TREATMENT +compartimiento I-TREATMENT +antero I-TREATMENT +lateral I-TREATMENT +de I-TREATMENT +la I-TREATMENT +pierna I-TREATMENT +izquierda; I-TREATMENT +se B-EXPLORATION +envió I-EXPLORATION +muestras I-EXPLORATION +para I-EXPLORATION +cultivo I-EXPLORATION +y I-EXPLORATION +biopsia. I-EXPLORATION +Ingresó B-TREATMENT +a I-TREATMENT +la I-TREATMENT +UCI I-TREATMENT +con I-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT +de I-TREATMENT +fascitis I-TREATMENT +necrosante I-TREATMENT +y I-TREATMENT +sepsis I-TREATMENT +grave, I-TREATMENT +iniciando I-TREATMENT +tratamiento I-TREATMENT +antimicrobiano I-TREATMENT +con I-TREATMENT +ceftriaxona I-TREATMENT +y I-TREATMENT +clindamicina, I-TREATMENT +analgesia I-TREATMENT +con I-TREATMENT +fentanilo I-TREATMENT +y I-TREATMENT +corrección I-TREATMENT +metabólica I-TREATMENT +con I-TREATMENT +bicarbonato I-TREATMENT +de I-TREATMENT +sodio, I-TREATMENT +gluconato I-TREATMENT +de I-TREATMENT +calcio, I-TREATMENT +aporte I-TREATMENT +de I-TREATMENT +volumen I-TREATMENT +e I-TREATMENT +insulina. I-TREATMENT + I-TREATMENT +Evolucionó B-EVOLUTION +hacia I-EVOLUTION la I-EVOLUTION -toma I-EVOLUTION +estabilidad, I-EVOLUTION +afebril, I-EVOLUTION +con I-EVOLUTION +mejoría I-EVOLUTION de I-EVOLUTION -imágenes I-EVOLUTION -mediante I-EVOLUTION -BMU I-EVOLUTION +sus I-EVOLUTION +parámetros I-EVOLUTION +metabólicos I-EVOLUTION +pero I-EVOLUTION +con I-EVOLUTION +persistencia I-EVOLUTION y I-EVOLUTION -OCT. I-EVOLUTION +progresión I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +lesión I-EVOLUTION +necrótica I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +pierna I-EVOLUTION +izquierda. I-EVOLUTION El B-EXPLORATION -OCT I-EXPLORATION -muestra I-EXPLORATION +estudio I-EXPLORATION +histopatológico I-EXPLORATION +informó I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION +de I-EXPLORATION un I-EXPLORATION -cierre I-EXPLORATION -angular I-EXPLORATION +tejido I-EXPLORATION +fibroconectivo I-EXPLORATION +denso I-EXPLORATION +y I-EXPLORATION +muscular I-EXPLORATION +esquelético I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +proceso I-EXPLORATION +inflamatorio I-EXPLORATION +agudo I-EXPLORATION +necrosante I-EXPLORATION +y I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +elementos I-EXPLORATION +micóticos I-EXPLORATION +de I-EXPLORATION +tipo I-EXPLORATION +hifas I-EXPLORATION +no I-EXPLORATION +septadas, I-EXPLORATION +compatibles I-EXPLORATION con I-EXPLORATION -contacto I-EXPLORATION -entre I-EXPLORATION -la I-EXPLORATION -malla I-EXPLORATION -trabecular I-EXPLORATION +mucor, I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +indicó I-EXPLORATION +anfotericina I-EXPLORATION +B I-EXPLORATION +desoxicolato. I-EXPLORATION +El I-EXPLORATION +cultivo I-EXPLORATION +resultó I-EXPLORATION +negativo I-EXPLORATION +para I-EXPLORATION +elementos I-EXPLORATION +micóticos. I-EXPLORATION + I-EXPLORATION +Luego I-EXPLORATION +de I-EXPLORATION +20 I-EXPLORATION +días I-EXPLORATION +de I-EXPLORATION +tratamiento I-EXPLORATION +antifúngico I-EXPLORATION y I-EXPLORATION +tres I-EXPLORATION +aseos I-EXPLORATION +quirúrgicos, I-EXPLORATION la I-EXPLORATION -zona I-EXPLORATION -más I-EXPLORATION -periférica I-EXPLORATION -del I-EXPLORATION -iris I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -cuatro I-EXPLORATION -cuadrantes. I-EXPLORATION -De I-EXPLORATION -igual I-EXPLORATION -forma I-EXPLORATION -la I-EXPLORATION -BMU I-EXPLORATION -muestra I-EXPLORATION -una I-EXPLORATION -disposición I-EXPLORATION -similar I-EXPLORATION -del I-EXPLORATION -ángulo I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -360º. I-EXPLORATION -Se B-TREATMENT -instaura I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -médico I-TREATMENT -correspondiente I-TREATMENT -para I-TREATMENT -posteriormente I-TREATMENT -realizar I-TREATMENT -unas I-TREATMENT -iridotomías I-TREATMENT -bilaterales I-TREATMENT -con I-TREATMENT -láser I-TREATMENT -YAG. I-TREATMENT -Tras B-EXPLORATION -las I-EXPLORATION -iridotomías I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION +RM I-EXPLORATION +evidenciaba I-EXPLORATION un I-EXPLORATION -OCT I-EXPLORATION +compromiso I-EXPLORATION +infeccioso I-EXPLORATION +necrosante I-EXPLORATION +hasta I-EXPLORATION +la I-EXPLORATION +tuberosidad I-EXPLORATION de I-EXPLORATION -cámara I-EXPLORATION -anterior I-EXPLORATION +la I-EXPLORATION +tibia I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION que I-EXPLORATION -nos I-EXPLORATION -muestra I-EXPLORATION -como I-EXPLORATION +se I-EXPLORATION +decidió I-EXPLORATION +realizar I-EXPLORATION +amputación I-EXPLORATION +suprapatelar I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -iridotomía I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -ojo I-EXPLORATION +pierna I-EXPLORATION +izquierda. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +con I-EXPLORATION +biopsia I-EXPLORATION +intra-operatoria I-EXPLORATION del I-EXPLORATION -ataque I-EXPLORATION -agudo I-EXPLORATION +margen I-EXPLORATION de I-EXPLORATION -glaucoma I-EXPLORATION +sección I-EXPLORATION +proximal I-EXPLORATION no I-EXPLORATION -es I-EXPLORATION -permeable, I-EXPLORATION -siendo B-TREATMENT -necesario I-TREATMENT -retratar I-TREATMENT -la I-TREATMENT -zona I-TREATMENT -con I-TREATMENT -nuevos I-TREATMENT -impactos. I-TREATMENT -Tras B-EVOLUTION -este I-EVOLUTION -segundo I-EVOLUTION +demostró I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +elementos I-EXPLORATION +micóticos I-EXPLORATION +de I-EXPLORATION +tipo I-EXPLORATION +mucor. I-EXPLORATION + I-EXPLORATION +El B-EVOLUTION +paciente I-EVOLUTION +evolucionó I-EVOLUTION +favorablemente I-EVOLUTION +desde I-EVOLUTION +el I-EVOLUTION +punto I-EVOLUTION +de I-EVOLUTION +vista I-EVOLUTION +quirúrgico I-EVOLUTION +e I-EVOLUTION +infeccioso I-EVOLUTION +completando I-EVOLUTION +30 I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION tratamiento I-EVOLUTION -se I-EVOLUTION -realiza I-EVOLUTION -un I-EVOLUTION -nuevo I-EVOLUTION -OCT I-EVOLUTION -que, I-EVOLUTION -esta I-EVOLUTION -vez I-EVOLUTION -sí, I-EVOLUTION -muestra I-EVOLUTION -permeabilidad I-EVOLUTION +con I-EVOLUTION +anfotericina I-EVOLUTION +B. I-EVOLUTION +Fue I-EVOLUTION +dado I-EVOLUTION de I-EVOLUTION -la I-EVOLUTION -iridotomía, I-EVOLUTION -apertura I-EVOLUTION -del I-EVOLUTION -ángulo I-EVOLUTION -y I-EVOLUTION -profundización I-EVOLUTION +alta I-EVOLUTION +encontrándose, I-EVOLUTION +al I-EVOLUTION +momento I-EVOLUTION de I-EVOLUTION -la I-EVOLUTION -cámara I-EVOLUTION -anterior. I-EVOLUTION +preparar I-EVOLUTION +este I-EVOLUTION +reporte, I-EVOLUTION +bajo I-EVOLUTION +controles I-EVOLUTION +con I-EVOLUTION +fisiatra I-EVOLUTION +y I-EVOLUTION +terapia I-EVOLUTION +ocupacional. I-EVOLUTION I-EVOLUTION -Una B-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -25 I-PRESENT_ILLNESS +43 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -fue B-DERIVED_FROM/TO -remitida I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -servicio I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -confirmar I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -presencia I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -síndrome I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Susac, I-DERIVED_FROM/TO -debido I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -pérdida I-DERIVED_FROM/TO -visual I-DERIVED_FROM/TO -bilateral. I-DERIVED_FROM/TO -La B-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -tenía I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -alteraciones I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -equilibrio, I-PAST_MEDICAL_HISTORY -ataxia, I-PAST_MEDICAL_HISTORY -incontinencia I-PAST_MEDICAL_HISTORY -fecal I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -urinaria, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -pérdida I-PAST_MEDICAL_HISTORY -auditiva I-PAST_MEDICAL_HISTORY -izquierda I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -hacía I-PAST_MEDICAL_HISTORY -cuatro I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY +cefaleas I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -estaba I-PAST_MEDICAL_HISTORY -recibiendo I-PAST_MEDICAL_HISTORY -corticoides, I-PAST_MEDICAL_HISTORY -nimodipino I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -anticoagulantes. I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -neurológico I-EXPLORATION -se I-EXPLORATION -apreciaba I-EXPLORATION -una I-EXPLORATION -paraparesia I-EXPLORATION -espástica, I-EXPLORATION -hiperreflexia I-EXPLORATION -tendinosa I-EXPLORATION -y I-EXPLORATION -disfunción I-EXPLORATION -genitourinaria. I-EXPLORATION -La I-EXPLORATION -analítica I-EXPLORATION -sanguínea I-EXPLORATION -que I-EXPLORATION -incluía I-EXPLORATION -hemograma, I-EXPLORATION -bioquímica I-EXPLORATION -general, I-EXPLORATION -velocidad I-EXPLORATION -de I-EXPLORATION -sedimentación I-EXPLORATION -globular, I-EXPLORATION -enzima I-EXPLORATION -conversor I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -angiotensina I-EXPLORATION -y I-EXPLORATION -coagulación I-EXPLORATION -resultaba I-EXPLORATION -sin I-EXPLORATION -alteraciones. I-EXPLORATION -La I-EXPLORATION -serología I-EXPLORATION -de I-EXPLORATION -lúes, I-EXPLORATION -virus I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -inmunodeficiencia I-EXPLORATION -humana, I-EXPLORATION -herpes I-EXPLORATION -simple, I-EXPLORATION -hepatitis I-EXPLORATION -B I-EXPLORATION -y I-EXPLORATION -C, I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva, I-EXPLORATION -factor I-EXPLORATION -reumatoide, I-EXPLORATION -anticoagulante I-EXPLORATION -lúpico, I-EXPLORATION -anticuerpos I-EXPLORATION -antinucleares, I-EXPLORATION -anticardiolipina, I-EXPLORATION -y I-EXPLORATION -antifosfolípido I-EXPLORATION -fue I-EXPLORATION -negativa. I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax, I-EXPLORATION -electrocardiograma, I-EXPLORATION -ecocardiografía I-EXPLORATION -y I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computerizada I-EXPLORATION +tabaquismo. I-PAST_MEDICAL_HISTORY +Desde B-PRESENT_ILLNESS +hace I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +año I-PRESENT_ILLNESS +presentaba I-PRESENT_ILLNESS +episodios I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +visión I-PRESENT_ILLNESS +borrosa, I-PRESENT_ILLNESS +notando I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +alguna I-PRESENT_ILLNESS +ocasión I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +visual I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +hemicampo I-PRESENT_ILLNESS +derecho, I-PRESENT_ILLNESS +acompañándose I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cefaleas I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +cedían I-PRESENT_ILLNESS +tras I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +analgésico. I-PRESENT_ILLNESS +Hace I-PRESENT_ILLNESS +nueve I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +episodio I-PRESENT_ILLNESS +ictal I-PRESENT_ILLNESS +transitorio I-PRESENT_ILLNESS +hemisférico I-PRESENT_ILLNESS +izquierdo, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +desapareció I-PRESENT_ILLNESS +pasados I-PRESENT_ILLNESS +30 I-PRESENT_ILLNESS +minutos. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +En I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +mañana I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +presente I-PRESENT_ILLNESS +ingreso I-PRESENT_ILLNESS +notó I-PRESENT_ILLNESS +torpeza I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +mano I-PRESENT_ILLNESS +derecha, I-PRESENT_ILLNESS +desviación I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +comisura I-PRESENT_ILLNESS +bucal I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +dificultad I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +articulación I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +palabra. I-PRESENT_ILLNESS +Por I-PRESENT_ILLNESS +este I-PRESENT_ILLNESS +motivo I-PRESENT_ILLNESS +acudió I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +urgencias, I-PRESENT_ILLNESS +siendo I-PRESENT_ILLNESS +valorada I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +neurólogo I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +objetivó I-PRESENT_ILLNESS +paresia I-PRESENT_ILLNESS +facial I-PRESENT_ILLNESS +supranuclear I-PRESENT_ILLNESS +derecha I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +leve I-PRESENT_ILLNESS +disartria, I-PRESENT_ILLNESS +inestabilidad I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +miembro I-PRESENT_ILLNESS +superior I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +torpeza I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +movimientos I-PRESENT_ILLNESS +finos I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +hipoestesia I-PRESENT_ILLNESS +táctil I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +algésica I-PRESENT_ILLNESS +facio-braquial I-PRESENT_ILLNESS +derecha. I-PRESENT_ILLNESS +En B-EXPLORATION +urgencias I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +ECG, I-EXPLORATION +en I-EXPLORATION +ritmo I-EXPLORATION +sinusal, I-EXPLORATION +TAC I-EXPLORATION craneal I-EXPLORATION +que I-EXPLORATION +inicialmente I-EXPLORATION no I-EXPLORATION -presentaban I-EXPLORATION -alteraciones. I-EXPLORATION -El I-EXPLORATION -líquido I-EXPLORATION -cefalorraquídeo I-EXPLORATION -(LCR) I-EXPLORATION -era I-EXPLORATION +mostró I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -aspecto I-EXPLORATION -claro I-EXPLORATION +infarto I-EXPLORATION y I-EXPLORATION -con I-EXPLORATION -presión I-EXPLORATION -de I-EXPLORATION -apertura I-EXPLORATION -normal, I-EXPLORATION -con I-EXPLORATION -ligero I-EXPLORATION -aumento I-EXPLORATION +Doppler I-EXPLORATION de I-EXPLORATION -proteínas, I-EXPLORATION +troncos I-EXPLORATION +supraaórticos I-EXPLORATION y I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -fórmula I-EXPLORATION -normal. I-EXPLORATION -La I-EXPLORATION -serología I-EXPLORATION +transcraneal I-EXPLORATION +que I-EXPLORATION +resultaron I-EXPLORATION +normales. I-EXPLORATION +Se I-EXPLORATION +decidió I-EXPLORATION +ingreso I-EXPLORATION en I-EXPLORATION -LCR I-EXPLORATION -para I-EXPLORATION -borrelia, I-EXPLORATION -virus I-EXPLORATION +planta, I-EXPLORATION +solicitándose I-EXPLORATION +perfiles I-EXPLORATION +analíticos I-EXPLORATION +completos I-EXPLORATION +incluyendo I-EXPLORATION +estudios I-EXPLORATION de I-EXPLORATION -Epstein-Barr, I-EXPLORATION -citomegalovirus I-EXPLORATION +hipercoagulabilidad, I-EXPLORATION +ANAS, I-EXPLORATION +c-ANCA, I-EXPLORATION +p-ANCA, I-EXPLORATION +DNA I-EXPLORATION +nativo I-EXPLORATION y I-EXPLORATION -lúes, I-EXPLORATION -además I-EXPLORATION +anticuerpos I-EXPLORATION +antimitocondriales. I-EXPLORATION +También I-EXPLORATION +pruebas I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -cultivos I-EXPLORATION -habituales I-EXPLORATION -resultaron I-EXPLORATION -negativos. I-EXPLORATION +imagen: I-EXPLORATION +RNM I-EXPLORATION +cerebral I-EXPLORATION +y I-EXPLORATION +ecocardiografía. I-EXPLORATION + I-EXPLORATION La I-EXPLORATION -detección I-EXPLORATION -de I-EXPLORATION -bandas I-EXPLORATION -oligoclonales I-EXPLORATION +RNM I-EXPLORATION +mostró I-EXPLORATION +infarto I-EXPLORATION +isquémico I-EXPLORATION +agudo I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -mismo I-EXPLORATION -también I-EXPLORATION -resultó I-EXPLORATION -negativa. I-EXPLORATION -La I-EXPLORATION -Resonancia I-EXPLORATION -Magnética I-EXPLORATION -Nuclear I-EXPLORATION -(RMN) I-EXPLORATION -cerebral I-EXPLORATION -mostraba I-EXPLORATION -múltiples I-EXPLORATION -áreas I-EXPLORATION -focales I-EXPLORATION +territorio I-EXPLORATION +silviano I-EXPLORATION +superior I-EXPLORATION de I-EXPLORATION -hiperintensidad I-EXPLORATION -en I-EXPLORATION la I-EXPLORATION -sustancia I-EXPLORATION -blanca I-EXPLORATION -periventricular I-EXPLORATION -y I-EXPLORATION -pericallosa, I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -regiones I-EXPLORATION -del I-EXPLORATION -centro I-EXPLORATION -semioval. I-EXPLORATION +arteria I-EXPLORATION +cerebral I-EXPLORATION +media I-EXPLORATION +izquierda. I-EXPLORATION Los I-EXPLORATION -tests I-EXPLORATION -audiométricos I-EXPLORATION -estándares I-EXPLORATION -revelaron I-EXPLORATION -pérdida I-EXPLORATION -auditiva I-EXPLORATION -neurosensorial, I-EXPLORATION -asimétrica, I-EXPLORATION +anticuerpos I-EXPLORATION +antineutrófilos, I-EXPLORATION +anticuerpos I-EXPLORATION +antinucleares, I-EXPLORATION +anticentrómero I-EXPLORATION +y I-EXPLORATION +antimitocondrias I-EXPLORATION +fueron I-EXPLORATION +negativos. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION de I-EXPLORATION -predominio I-EXPLORATION -izquierdo, I-EXPLORATION -para I-EXPLORATION -las I-EXPLORATION -bajas I-EXPLORATION -frecuencias. I-EXPLORATION -A I-EXPLORATION +trombofilia I-EXPLORATION +tan I-EXPLORATION +sólo I-EXPLORATION +detectó I-EXPLORATION +ligera I-EXPLORATION +hiperfibrinogenemia. I-EXPLORATION + I-EXPLORATION +Finalmente I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -oftalmológica, I-EXPLORATION -su I-EXPLORATION -agudeza I-EXPLORATION -visual I-EXPLORATION -era I-EXPLORATION +ecocardiografía, I-EXPLORATION +prueba I-EXPLORATION +que I-EXPLORATION +resultó I-EXPLORATION +crucial I-EXPLORATION +al I-EXPLORATION +proporcionar I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +definitivo, I-EXPLORATION +observándose I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +pedunculada I-EXPLORATION +en I-EXPLORATION +AI I-EXPLORATION +que I-EXPLORATION +prolapsaba I-EXPLORATION +a I-EXPLORATION +través I-EXPLORATION de I-EXPLORATION -20/25 I-EXPLORATION +la I-EXPLORATION +válvula I-EXPLORATION +mitral I-EXPLORATION en I-EXPLORATION -ambos I-EXPLORATION -ojos. I-EXPLORATION -La I-EXPLORATION -campimetría I-EXPLORATION +diástole, I-EXPLORATION +correspondiente I-EXPLORATION +a I-EXPLORATION +un I-EXPLORATION +mixoma I-EXPLORATION +(35 I-EXPLORATION +x I-EXPLORATION +26 I-EXPLORATION +mm), I-EXPLORATION +con I-EXPLORATION +pedículo I-EXPLORATION +en I-EXPLORATION +región I-EXPLORATION de I-EXPLORATION -Goldmann I-EXPLORATION -(Haag-Streit, I-EXPLORATION -Berna, I-EXPLORATION -Suiza) I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -cuadrantanopsia I-EXPLORATION -inferior I-EXPLORATION -bitemporal. I-EXPLORATION -En I-EXPLORATION la I-EXPLORATION -biomicroscopía I-EXPLORATION +fosa I-EXPLORATION +oval. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +programó I-TREATMENT +para I-TREATMENT +cirugía I-TREATMENT +realizándose I-TREATMENT +previamente I-TREATMENT +RNM I-TREATMENT +cardiaca I-TREATMENT +para I-TREATMENT +determinar I-TREATMENT +con I-TREATMENT +mayor I-TREATMENT +precisión I-TREATMENT +las I-TREATMENT +características I-TREATMENT +morfológicas I-TREATMENT +de I-TREATMENT +la I-TREATMENT +masa I-TREATMENT +auricular. I-TREATMENT +Se I-TREATMENT +realizó I-TREATMENT +atriotomía I-TREATMENT +izquierda, I-TREATMENT +extrayéndose I-TREATMENT +el I-TREATMENT +tumor I-TREATMENT +en I-TREATMENT +su I-TREATMENT +totalidad, I-TREATMENT +siendo I-TREATMENT +éste I-TREATMENT +de I-TREATMENT +aspecto I-TREATMENT +morulado. I-TREATMENT +Se I-TREATMENT +abrió I-TREATMENT +también I-TREATMENT +aurícula I-TREATMENT +derecha I-TREATMENT +y I-TREATMENT +se I-TREATMENT +resecó I-TREATMENT +la I-TREATMENT +zona I-TREATMENT +de I-TREATMENT +implantación, I-TREATMENT +cerrándose I-TREATMENT +posteriormente I-TREATMENT +la I-TREATMENT +comunicación I-TREATMENT +interauricular I-TREATMENT +creada. I-TREATMENT + I-TREATMENT +La B-EVOLUTION +evolución I-EVOLUTION +posquirúrgica I-EVOLUTION +resultó I-EVOLUTION +muy I-EVOLUTION +satisfactoria, I-EVOLUTION +siendo I-EVOLUTION +dada I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +sin I-EVOLUTION +déficit I-EVOLUTION +neurológico. I-EVOLUTION + I-EVOLUTION + +Niño B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +7 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +acudió I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +intenso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +20 I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +localizado I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +fosa I-PRESENT_ILLNESS +iliaca I-PRESENT_ILLNESS +derecha. I-PRESENT_ILLNESS +Febrícula I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +vómito I-PRESENT_ILLNESS +alimentario. I-PRESENT_ILLNESS +Deposiciones I-PRESENT_ILLNESS +normales. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +A B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +presentaba I-EXPLORATION +afectación I-EXPLORATION del I-EXPLORATION -segmento I-EXPLORATION -anterior I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -apreciaban I-EXPLORATION -hallazgos I-EXPLORATION -destacables. I-EXPLORATION -El I-EXPLORATION -examen I-EXPLORATION -funduscópico I-EXPLORATION -reveló I-EXPLORATION -una I-EXPLORATION -microangiopatía I-EXPLORATION -retiniana I-EXPLORATION -periférica, I-EXPLORATION -apreciándose I-EXPLORATION -amputación I-EXPLORATION -de I-EXPLORATION -vasos I-EXPLORATION -con I-EXPLORATION -cúmulos I-EXPLORATION -de I-EXPLORATION -microaneurismas I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -ojos. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -inflamación I-EXPLORATION -o I-EXPLORATION -células I-EXPLORATION +estado I-EXPLORATION +general. I-EXPLORATION +La I-EXPLORATION +palpación I-EXPLORATION +abdominal I-EXPLORATION +objetivó I-EXPLORATION +defensa I-EXPLORATION +voluntaria I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -vítreo, I-EXPLORATION -ni I-EXPLORATION -envainamiento I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -vasos I-EXPLORATION -retinianos. I-EXPLORATION +FID, I-EXPLORATION +Blumberg I-EXPLORATION +y I-EXPLORATION +psoas I-EXPLORATION +positivo. I-EXPLORATION + I-EXPLORATION La I-EXPLORATION -angiografía I-EXPLORATION -fluoresceínica I-EXPLORATION -(AGF) I-EXPLORATION -demostró I-EXPLORATION -signos I-EXPLORATION +analítica I-EXPLORATION +mostraba I-EXPLORATION +leucocitosis I-EXPLORATION +con I-EXPLORATION +neutrofilia I-EXPLORATION +y I-EXPLORATION +eosinofilia. I-EXPLORATION +La I-EXPLORATION +ecografía I-EXPLORATION +visualizó I-EXPLORATION +apéndice I-EXPLORATION de I-EXPLORATION -isquemia I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -áreas I-EXPLORATION -correspondientes I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -oclusiones I-EXPLORATION -arteriolares. I-EXPLORATION +6 I-EXPLORATION +mm I-EXPLORATION +retrocecal. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +realizó I-TREATMENT +apendicectomía I-TREATMENT +laparotómica I-TREATMENT +urgente, I-TREATMENT +apreciando I-TREATMENT +inflamación I-TREATMENT +macroscópica I-TREATMENT +del I-TREATMENT +apéndice, I-TREATMENT +sin I-TREATMENT +líquido. I-TREATMENT +Exploración B-EXPLORATION +ileal I-EXPLORATION +normal. I-EXPLORATION + I-EXPLORATION El I-EXPLORATION +estudio I-EXPLORATION +histopatológico, I-EXPLORATION +confirmó I-EXPLORATION +el I-EXPLORATION diagnóstico I-EXPLORATION de I-EXPLORATION -síndrome I-EXPLORATION -de I-EXPLORATION -Susac I-EXPLORATION -se I-EXPLORATION -basó I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -asociación I-EXPLORATION +AA, I-EXPLORATION +visualizándose I-EXPLORATION +células I-EXPLORATION de I-EXPLORATION -encefalopatía I-EXPLORATION -con I-EXPLORATION -hallazgos I-EXPLORATION -típicos I-EXPLORATION -en I-EXPLORATION +inflamación I-EXPLORATION +aguda I-EXPLORATION +invadiendo I-EXPLORATION la I-EXPLORATION -RMN, I-EXPLORATION -microangiopatía I-EXPLORATION -retiniana I-EXPLORATION +pared I-EXPLORATION +apendicular I-EXPLORATION y I-EXPLORATION -pérdida I-EXPLORATION -auditiva I-EXPLORATION -neurosensorial. I-EXPLORATION +oxiuros I-EXPLORATION +ocluyendo I-EXPLORATION +la I-EXPLORATION +luz. I-EXPLORATION I-EXPLORATION -Debido B-TREATMENT -a I-TREATMENT -la I-TREATMENT -evidente I-TREATMENT -isquemia I-TREATMENT -retiniana I-TREATMENT -periférica I-TREATMENT -apreciada I-TREATMENT -en I-TREATMENT -la I-TREATMENT -AGF, I-TREATMENT +Ante B-TREATMENT +estos I-TREATMENT +hallazgos, I-TREATMENT se I-TREATMENT -le I-TREATMENT -realizó I-TREATMENT -fotocoagulación I-TREATMENT -retiniana I-TREATMENT +contactó I-TREATMENT con I-TREATMENT -láser I-TREATMENT -en I-TREATMENT -las I-TREATMENT -áreas I-TREATMENT -isquémicas I-TREATMENT -de I-TREATMENT -forma I-TREATMENT -profiláctica, I-TREATMENT -manteniéndose I-TREATMENT -estable I-TREATMENT -el I-TREATMENT -cuadro I-TREATMENT -visual I-TREATMENT -desde I-TREATMENT -entonces. I-TREATMENT -Al B-EVOLUTION -cabo I-EVOLUTION -de I-EVOLUTION -dos I-EVOLUTION -años I-EVOLUTION -no I-EVOLUTION -ha I-EVOLUTION -habido I-EVOLUTION -variaciones I-EVOLUTION -significativas I-EVOLUTION -tanto I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -estado I-EVOLUTION -neurológico I-EVOLUTION -como I-EVOLUTION -auditivo. I-EVOLUTION - I-EVOLUTION +la I-TREATMENT +familia I-TREATMENT +para I-TREATMENT +iniciar I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +mebendazol. I-TREATMENT + I-TREATMENT -Varón, B-PRESENT_ILLNESS -hijo B-PAST_MEDICAL_HISTORY -único, I-PAST_MEDICAL_HISTORY -nacido I-PAST_MEDICAL_HISTORY +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +55 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +que B-PAST_MEDICAL_HISTORY +trabaja I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +auxiliar I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +enfermería I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +38 I-PAST_MEDICAL_HISTORY +años. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Entre I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +encontramos: I-PAST_MEDICAL_HISTORY +alérgica I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +Paracetamol, I-PAST_MEDICAL_HISTORY +hipotiroidismo, I-PAST_MEDICAL_HISTORY +microapneas. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +quirúrgicos I-PAST_MEDICAL_HISTORY +CIN3 I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +varices I-PAST_MEDICAL_HISTORY +MMII. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Como I-PAST_MEDICAL_HISTORY +factores I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +riesgo I-PAST_MEDICAL_HISTORY +cardiovascular I-PAST_MEDICAL_HISTORY +destacan: I-PAST_MEDICAL_HISTORY +Hipertensión I-PAST_MEDICAL_HISTORY +arterial I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +12 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +evolución I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento, I-PAST_MEDICAL_HISTORY +dislipemia, I-PAST_MEDICAL_HISTORY +fibrilación I-PAST_MEDICAL_HISTORY +auricular I-PAST_MEDICAL_HISTORY +paroxística I-PAST_MEDICAL_HISTORY +revertida I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +2012. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Existe I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +conflicto I-PAST_MEDICAL_HISTORY +laboral I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +compañera, I-PAST_MEDICAL_HISTORY +conocido I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +valorado I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +nuestro I-PAST_MEDICAL_HISTORY +Servicio I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Prevención I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +2005. I-PAST_MEDICAL_HISTORY +Entonces I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +recomendó I-PAST_MEDICAL_HISTORY +separar I-PAST_MEDICAL_HISTORY a I-PAST_MEDICAL_HISTORY las I-PAST_MEDICAL_HISTORY -cuarenta I-PAST_MEDICAL_HISTORY -semanas I-PAST_MEDICAL_HISTORY +partes I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +conflicto I-PAST_MEDICAL_HISTORY +si I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +podían I-PAST_MEDICAL_HISTORY +garantizar I-PAST_MEDICAL_HISTORY +unas I-PAST_MEDICAL_HISTORY +condiciones I-PAST_MEDICAL_HISTORY +óptimas I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -gestación I-PAST_MEDICAL_HISTORY +trabajo. I-PAST_MEDICAL_HISTORY +Se I-PAST_MEDICAL_HISTORY +ofertó I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +cambio I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +puesto I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +trabajo, I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +rechazado I-PAST_MEDICAL_HISTORY por I-PAST_MEDICAL_HISTORY -cesárea. I-PAST_MEDICAL_HISTORY -Como B-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -destacar I-FAMILY_HISTORY -que I-FAMILY_HISTORY -su I-FAMILY_HISTORY -madre I-FAMILY_HISTORY -presentaba I-FAMILY_HISTORY -diabetes I-FAMILY_HISTORY -mellitus I-FAMILY_HISTORY -no I-FAMILY_HISTORY -insulinodependiente I-FAMILY_HISTORY -desde I-FAMILY_HISTORY -los I-FAMILY_HISTORY -17 I-FAMILY_HISTORY -años I-FAMILY_HISTORY -y I-FAMILY_HISTORY -no I-FAMILY_HISTORY -existir I-FAMILY_HISTORY -consaguinidad I-FAMILY_HISTORY -entre I-FAMILY_HISTORY -los I-FAMILY_HISTORY -padres. I-FAMILY_HISTORY - I-FAMILY_HISTORY -A B-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -cuatro I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -vida, I-PRESENT_ILLNESS -sufre I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -parada I-PRESENT_ILLNESS -cardiorrespiratoria, I-PRESENT_ILLNESS -(diagnosticado I-PRESENT_ILLNESS +la I-PAST_MEDICAL_HISTORY +trabajadora. I-PAST_MEDICAL_HISTORY +El I-PAST_MEDICAL_HISTORY +servicio I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Prevención I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Riesgos I-PAST_MEDICAL_HISTORY +Laborales I-PAST_MEDICAL_HISTORY +le I-PAST_MEDICAL_HISTORY +ofreció I-PAST_MEDICAL_HISTORY +entonces I-PAST_MEDICAL_HISTORY +comenzar I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +trabajar I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +técnicas I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +afrontamiento I-PAST_MEDICAL_HISTORY +asertivo I-PAST_MEDICAL_HISTORY +para I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +manejo I-PAST_MEDICAL_HISTORY +adaptativo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +situación. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +julio I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +2012, I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +produce I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +nueva I-PAST_MEDICAL_HISTORY +situación I-PAST_MEDICAL_HISTORY +estresante I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +compañera I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +mantenía I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +conflicto. I-PAST_MEDICAL_HISTORY +Acude B-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +precordial, I-PRESENT_ILLNESS +llanto I-PRESENT_ILLNESS +intenso I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +disnea, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +produce I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +relatar I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +sus I-PRESENT_ILLNESS +compañeras, I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +situación I-PRESENT_ILLNESS +vital I-PRESENT_ILLNESS +estresante I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +acababa I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -cardiomiopatía I-PRESENT_ILLNESS -dilatada) I-PRESENT_ILLNESS -(1). I-PRESENT_ILLNESS -Durante B-EVOLUTION -su I-EVOLUTION -ingreso I-EVOLUTION -hospitalario I-EVOLUTION -comienza I-EVOLUTION -con I-EVOLUTION -fotofobia I-EVOLUTION -y I-EVOLUTION -nistagmus I-EVOLUTION -intermitente, I-EVOLUTION -y B-EXPLORATION -se I-EXPLORATION -recomienda I-EXPLORATION -revisión I-EXPLORATION -oftalmológica I-EXPLORATION -en I-EXPLORATION +ocurrirle, I-PRESENT_ILLNESS +tras I-PRESENT_ILLNESS +conflicto I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +compañera. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Exploración B-EXPLORATION +física I-EXPLORATION +a I-EXPLORATION su I-EXPLORATION -lugar I-EXPLORATION -de I-EXPLORATION -origen. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -niño I-EXPLORATION -presenta I-EXPLORATION -un I-EXPLORATION -retraso I-EXPLORATION -psicomotor I-EXPLORATION +ingreso I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +urgencia: I-EXPLORATION +TA: I-EXPLORATION +160/110 I-EXPLORATION +mmHg. I-EXPLORATION +Disneica. I-EXPLORATION +Crepitantes I-EXPLORATION +bibasales, I-EXPLORATION por I-EXPLORATION lo I-EXPLORATION que I-EXPLORATION se I-EXPLORATION -solicita I-EXPLORATION +le I-EXPLORATION +realiza I-EXPLORATION una I-EXPLORATION -Resonancia I-EXPLORATION -Magnética I-EXPLORATION -Nuclear I-EXPLORATION -(RMN) I-EXPLORATION -y B-TREATMENT -comienza I-TREATMENT -desde I-TREATMENT -el I-TREATMENT -año I-TREATMENT +gasometría, I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +objetiva I-EXPLORATION +insuficiencia I-EXPLORATION +respiratoria I-EXPLORATION +aguda, I-EXPLORATION +con I-EXPLORATION +saturación I-EXPLORATION +del I-EXPLORATION +82%, I-EXPLORATION +PO2 I-EXPLORATION +de I-EXPLORATION +40 I-EXPLORATION +e I-EXPLORATION +hiperlactacidemia I-EXPLORATION +de I-EXPLORATION +3. I-EXPLORATION +Se B-TREATMENT +administran I-TREATMENT +dos I-TREATMENT +ampollas I-TREATMENT de I-TREATMENT -vida I-TREATMENT -con I-TREATMENT -tratamiento I-TREATMENT +Furosemida I-TREATMENT +intravenosa, I-TREATMENT +se I-TREATMENT +inicia I-TREATMENT +perfusión I-TREATMENT de I-TREATMENT -estimulación I-TREATMENT -precoz, I-TREATMENT -consiguiendo I-TREATMENT -en I-TREATMENT -ocho I-TREATMENT -meses I-TREATMENT -los I-TREATMENT -objetivos I-TREATMENT -propuestos. I-TREATMENT -En B-EXPLORATION +nitroglicerina I-TREATMENT +intravenosa I-TREATMENT +y I-TREATMENT +ventilación I-TREATMENT +con I-TREATMENT +mascarilla I-TREATMENT +reservorio, I-TREATMENT +con B-EVOLUTION +mejoría I-EVOLUTION +clínica I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +y I-EVOLUTION +control I-EVOLUTION +de I-EVOLUTION +cifras I-EVOLUTION +tensionales. I-EVOLUTION + I-EVOLUTION +ECG B-EXPLORATION +realizado I-EXPLORATION +al I-EXPLORATION +ingreso: I-EXPLORATION +ritmo I-EXPLORATION +sinusal I-EXPLORATION +a I-EXPLORATION +92 I-EXPLORATION +lpm, I-EXPLORATION +eje I-EXPLORATION +desviado I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -RMN I-EXPLORATION -se I-EXPLORATION -observan I-EXPLORATION -pequeñas I-EXPLORATION -áreas I-EXPLORATION +izquierda, I-EXPLORATION +PR I-EXPLORATION +200 I-EXPLORATION +mseg, I-EXPLORATION +HBAI; I-EXPLORATION +pobre I-EXPLORATION +progresión I-EXPLORATION de I-EXPLORATION -aumento I-EXPLORATION +derivaciones I-EXPLORATION +en I-EXPLORATION +V1-V3 I-EXPLORATION +y I-EXPLORATION +dudosa I-EXPLORATION +supradesnivelación I-EXPLORATION de I-EXPLORATION -señal I-EXPLORATION +ST I-EXPLORATION en I-EXPLORATION -T2 I-EXPLORATION +V1-V2, I-EXPLORATION +T I-EXPLORATION +picuda I-EXPLORATION +en I-EXPLORATION +V3-V6 I-EXPLORATION y I-EXPLORATION -FLAIR I-EXPLORATION +negativa I-EXPLORATION en I-EXPLORATION -las I-EXPLORATION -regiones I-EXPLORATION -periatriales I-EXPLORATION +I I-EXPLORATION y I-EXPLORATION -sustancia I-EXPLORATION -blanca I-EXPLORATION -temporal. I-EXPLORATION +AVL I-EXPLORATION +(ECG, I-EXPLORATION +figuras I-EXPLORATION +1 I-EXPLORATION +y I-EXPLORATION +2, I-EXPLORATION +una I-EXPLORATION +vez I-EXPLORATION +desaparece I-EXPLORATION +el I-EXPLORATION +dolor). I-EXPLORATION I-EXPLORATION -A B-DERIVED_FROM/TO -los I-DERIVED_FROM/TO -dos I-DERIVED_FROM/TO -años I-DERIVED_FROM/TO -es I-DERIVED_FROM/TO -remitido I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -Hospital I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -estudio I-DERIVED_FROM/TO -ecográfico I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -oftalmológico. I-DERIVED_FROM/TO -Se B-EXPLORATION -solicita I-EXPLORATION -un I-EXPLORATION -ERG I-EXPLORATION -que I-EXPLORATION -muestra I-EXPLORATION -ausencia I-EXPLORATION +Rx I-EXPLORATION de I-EXPLORATION -respuestas, I-EXPLORATION -y I-EXPLORATION -Potenciales I-EXPLORATION -Evocados I-EXPLORATION -Visuales I-EXPLORATION -(PEV) I-EXPLORATION -normales. I-EXPLORATION -Oftalmoscópicamente I-EXPLORATION -muestra I-EXPLORATION -nistagmus I-EXPLORATION +tórax: I-EXPLORATION +insuficiencia I-EXPLORATION +cardíaca. I-EXPLORATION + I-EXPLORATION +Ecocardiografía I-EXPLORATION +transtorácica: I-EXPLORATION +ventrículo I-EXPLORATION +izquierdo I-EXPLORATION +esférico I-EXPLORATION con I-EXPLORATION -fotofobia I-EXPLORATION -intensa. I-EXPLORATION -El I-EXPLORATION +acinesia I-EXPLORATION +septal, I-EXPLORATION +hipocinesia I-EXPLORATION +de I-EXPLORATION segmento I-EXPLORATION -anterior I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -fondo I-EXPLORATION +medio I-EXPLORATION de I-EXPLORATION -ojo I-EXPLORATION -son I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -Como I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -clínico I-EXPLORATION -es I-EXPLORATION -sugestivo I-EXPLORATION +cara I-EXPLORATION +inferior I-EXPLORATION +y I-EXPLORATION +FEVI I-EXPLORATION +estimada I-EXPLORATION +en I-EXPLORATION +torno I-EXPLORATION +al I-EXPLORATION +20-25% I-EXPLORATION +e I-EXPLORATION +IM I-EXPLORATION +leve. I-EXPLORATION +Con B-TREATMENT +la I-TREATMENT +sospecha I-TREATMENT +de I-TREATMENT +Sd. I-TREATMENT +De I-TREATMENT +takotsubo, I-TREATMENT +discinesia I-TREATMENT +apical I-TREATMENT +transitoria I-TREATMENT +sin I-TREATMENT +aumento I-TREATMENT +del I-TREATMENT +valor I-TREATMENT +enzimático, I-TREATMENT +se I-TREATMENT +administran I-TREATMENT +300 I-TREATMENT +mg I-TREATMENT +de I-TREATMENT +AAS I-TREATMENT +y I-TREATMENT +600 I-TREATMENT +de I-TREATMENT +clopidogrel I-TREATMENT +y B-EXPLORATION +se I-EXPLORATION +traslada I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +sala I-EXPLORATION de I-EXPLORATION -Síndrome I-EXPLORATION +hemodinámica I-EXPLORATION +para I-EXPLORATION +la I-EXPLORATION +realización I-EXPLORATION de I-EXPLORATION -Alström, I-EXPLORATION +la I-EXPLORATION +coronariografía. I-EXPLORATION +Esta I-EXPLORATION se I-EXPLORATION -solicita I-EXPLORATION +realiza I-EXPLORATION +vía I-EXPLORATION +femoral I-EXPLORATION +izquierda I-EXPLORATION +y I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +evidencian I-EXPLORATION +lesiones I-EXPLORATION +angiográficamente I-EXPLORATION +significativas, I-EXPLORATION +aunque I-EXPLORATION +la I-EXPLORATION +DA I-EXPLORATION +muestra I-EXPLORATION un I-EXPLORATION -estudio I-EXPLORATION -genético I-EXPLORATION +flujo I-EXPLORATION +TIMI I-EXPLORATION +I. I-EXPLORATION +La I-EXPLORATION +ventriculografía I-EXPLORATION +muestra I-EXPLORATION +un I-EXPLORATION +VI I-EXPLORATION +ovoide I-EXPLORATION +con I-EXPLORATION +FEVI I-EXPLORATION +del I-EXPLORATION +25% I-EXPLORATION +y I-EXPLORATION +acinesia I-EXPLORATION en I-EXPLORATION +banda I-EXPLORATION +de I-EXPLORATION +todo I-EXPLORATION el I-EXPLORATION -que I-EXPLORATION -tras I-EXPLORATION -analizar I-EXPLORATION -los I-EXPLORATION -exones I-EXPLORATION -10, I-EXPLORATION -16 I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION segmento I-EXPLORATION -del I-EXPLORATION -exón I-EXPLORATION -8 I-EXPLORATION -del I-EXPLORATION -gen I-EXPLORATION -ALMS-1 I-EXPLORATION -(3) I-EXPLORATION -donde I-EXPLORATION +medial, I-EXPLORATION +hipocinesia I-EXPLORATION +leve I-EXPLORATION +de I-EXPLORATION +segmento I-EXPLORATION +basal I-EXPLORATION +y I-EXPLORATION +ápex. I-EXPLORATION + I-EXPLORATION +Permanece B-EVOLUTION +durante I-EVOLUTION +4 I-EVOLUTION +días I-EVOLUTION +ingresada, I-EVOLUTION +en I-EVOLUTION +UCOR I-EVOLUTION +(Unidad I-EVOLUTION +Coronaria), I-EVOLUTION +hemodinámicamente I-EVOLUTION +estable I-EVOLUTION +y I-EVOLUTION +asintomática. I-EVOLUTION +En B-EXPLORATION +el I-EXPLORATION +último I-EXPLORATION +ecocardiograma I-EXPLORATION +realizado I-EXPLORATION +durante I-EXPLORATION +su I-EXPLORATION +ingreso I-EXPLORATION se I-EXPLORATION -encuentran I-EXPLORATION -las I-EXPLORATION -mutaciones I-EXPLORATION -descritas I-EXPLORATION -hasta I-EXPLORATION +obtiene I-EXPLORATION +un I-EXPLORATION +FEVI I-EXPLORATION +75%, I-EXPLORATION el I-EXPLORATION -momento, I-EXPLORATION -amplificado I-EXPLORATION +resto I-EXPLORATION +de I-EXPLORATION +pruebas I-EXPLORATION +realizadas I-EXPLORATION +son I-EXPLORATION +normales, I-EXPLORATION por I-EXPLORATION -PCR I-EXPLORATION -y I-EXPLORATION -secuenciación I-EXPLORATION -automatizada, I-EXPLORATION -no I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION se I-EXPLORATION -detectan I-EXPLORATION -mutaciones, I-EXPLORATION -sin I-EXPLORATION -embargo, I-EXPLORATION -estos I-EXPLORATION -resultados I-EXPLORATION -no I-EXPLORATION -excluyen I-EXPLORATION -el I-EXPLORATION -diagnóstico. I-EXPLORATION +procede I-EXPLORATION +al I-EXPLORATION +alta I-EXPLORATION +hospitalaria. I-EXPLORATION I-EXPLORATION +El B-EVOLUTION +Servicio I-EVOLUTION +de I-EVOLUTION +Prevención I-EVOLUTION +confirma I-EVOLUTION +los I-EVOLUTION +desencadenantes I-EVOLUTION +emocionales I-EVOLUTION +de I-EVOLUTION +origen I-EVOLUTION +laboral I-EVOLUTION +y I-EVOLUTION +descarta I-EVOLUTION +otros I-EVOLUTION +factores I-EVOLUTION +extralaborales. I-EVOLUTION +Valorada I-EVOLUTION +la I-EVOLUTION +determinación I-EVOLUTION +de I-EVOLUTION +contingencia I-EVOLUTION +del I-EVOLUTION +proceso I-EVOLUTION +este I-EVOLUTION +se I-EVOLUTION +reconocería I-EVOLUTION +finalmente I-EVOLUTION +como I-EVOLUTION +accidente I-EVOLUTION +de I-EVOLUTION +trabajo. I-EVOLUTION + I-EVOLUTION Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -28 I-PRESENT_ILLNESS +53 I-PRESENT_ILLNESS años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -«Síndrome I-PAST_MEDICAL_HISTORY +miope B-PAST_MEDICAL_HISTORY +magna, I-PAST_MEDICAL_HISTORY +intervenida I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -múltiples I-PAST_MEDICAL_HISTORY -puntos I-PAST_MEDICAL_HISTORY -blancos I-PAST_MEDICAL_HISTORY -evanescentes» I-PAST_MEDICAL_HISTORY +cristalino I-PAST_MEDICAL_HISTORY +transparente I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY ambos I-PAST_MEDICAL_HISTORY -ojos I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -7 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -buena I-PAST_MEDICAL_HISTORY -respuesta I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -corticoterapia I-PAST_MEDICAL_HISTORY -oral. I-PAST_MEDICAL_HISTORY -Acude B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS +ojos, I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +junio I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +2000. I-PAST_MEDICAL_HISTORY +Un I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +después I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +le I-PAST_MEDICAL_HISTORY +realizó I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +capsulotomía I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +ojo I-PAST_MEDICAL_HISTORY +derecho I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +láser I-PAST_MEDICAL_HISTORY +YAG. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +2003 I-PAST_MEDICAL_HISTORY +presentó I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +DR I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +OD, I-PAST_MEDICAL_HISTORY +intervenido I-PAST_MEDICAL_HISTORY +mediante I-PAST_MEDICAL_HISTORY +vitrectomía I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +inyección I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +aceite I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +silicona I-PAST_MEDICAL_HISTORY +(AS), I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +retiró I-PAST_MEDICAL_HISTORY +seis I-PAST_MEDICAL_HISTORY +meses I-PAST_MEDICAL_HISTORY +después. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +En B-PRESENT_ILLNESS +mayo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2004 I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +episodio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS disminución I-PRESENT_ILLNESS +brusca I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -agudeza I-PRESENT_ILLNESS -visual I-PRESENT_ILLNESS -bilateral I-PRESENT_ILLNESS +visión I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -cefalea I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -15 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -oftalmológica I-EXPLORATION -presenta I-EXPLORATION +dolor I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +OD. I-PRESENT_ILLNESS +En B-EXPLORATION +urgencias I-EXPLORATION +se I-EXPLORATION +objetivó I-EXPLORATION una I-EXPLORATION agudeza I-EXPLORATION visual I-EXPLORATION +(AV) I-EXPLORATION de I-EXPLORATION -3/10 I-EXPLORATION -con I-EXPLORATION -reacción I-EXPLORATION -inflamatoria I-EXPLORATION -en I-EXPLORATION -cámara I-EXPLORATION -anterior I-EXPLORATION -y I-EXPLORATION -desprendimiento I-EXPLORATION -de I-EXPLORATION -retina I-EXPLORATION -exudativo I-EXPLORATION -bilateral. I-EXPLORATION -Se B-TREATMENT -inicia I-TREATMENT -tratamiento I-TREATMENT -corticoideo I-TREATMENT -oral I-TREATMENT -a I-TREATMENT -altas I-TREATMENT -dosis I-TREATMENT -(80 I-TREATMENT -mg I-TREATMENT -de I-TREATMENT -prednisona), I-TREATMENT -constatándose I-TREATMENT -una I-TREATMENT -buena I-TREATMENT -respuesta I-TREATMENT -inicial. I-TREATMENT -Al B-EVOLUTION -mes I-EVOLUTION -del I-EVOLUTION -tratamiento I-EVOLUTION -se I-EVOLUTION -observa I-EVOLUTION -una I-EVOLUTION -recidiva I-EVOLUTION -del I-EVOLUTION -desprendimiento I-EVOLUTION -de I-EVOLUTION -retina I-EVOLUTION -foveal I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -ojo I-EVOLUTION -izquierdo, I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -asocia I-EVOLUTION -a I-EVOLUTION -su I-EVOLUTION -tratamiento I-EVOLUTION -CyA I-EVOLUTION -(dosis I-EVOLUTION -inicial I-EVOLUTION -de I-EVOLUTION -4 I-EVOLUTION -mg/kg/día). I-EVOLUTION -Tras I-EVOLUTION -nueve I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -seguimiento, I-EVOLUTION -presenta I-EVOLUTION -una I-EVOLUTION -agudeza I-EVOLUTION -visual I-EVOLUTION -de I-EVOLUTION -unidad I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -ojo I-EVOLUTION -derecho I-EVOLUTION -y I-EVOLUTION -de I-EVOLUTION -8/10 I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -ojo I-EVOLUTION -izquierdo I-EVOLUTION -con I-EVOLUTION -movilización I-EVOLUTION -pigmentaria I-EVOLUTION -en I-EVOLUTION -cuatro I-EVOLUTION -cuadrantes I-EVOLUTION -y I-EVOLUTION -fibrosis I-EVOLUTION -subretiniana. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -67 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -remitida B-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -otro I-DERIVED_FROM/TO -centro I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -tratamiento I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -carcinoma I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -células I-DERIVED_FROM/TO -sebáceas I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -ojo I-DERIVED_FROM/TO -derecho I-DERIVED_FROM/TO -intervenido I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -seis I-DERIVED_FROM/TO -ocasiones. I-DERIVED_FROM/TO -Debutó B-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -lesión I-PRESENT_ILLNESS -pediculada I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -conjuntiva I-PRESENT_ILLNESS -tarsal I-PRESENT_ILLNESS -superior. I-PRESENT_ILLNESS -La B-EXPLORATION -biopsia I-EXPLORATION -realizada I-EXPLORATION -se I-EXPLORATION -informó I-EXPLORATION -como I-EXPLORATION -carcinoma I-EXPLORATION -sebáceo. I-EXPLORATION -Se B-TREATMENT -hicieron I-TREATMENT -varias I-TREATMENT -ampliaciones I-TREATMENT -de I-TREATMENT -márgenes I-TREATMENT -quirúrgicos I-TREATMENT -de I-TREATMENT -lamela I-TREATMENT -posterior I-TREATMENT -de I-TREATMENT -párpado I-TREATMENT -superior I-TREATMENT -derecho, I-TREATMENT -hasta I-TREATMENT -encontrar I-TREATMENT -límites I-TREATMENT -libre I-TREATMENT -de I-TREATMENT -tumor. I-TREATMENT -Las B-EXPLORATION -piezas I-EXPLORATION -se I-EXPLORATION -informaron I-EXPLORATION -como I-EXPLORATION -carcinoma I-EXPLORATION -sebáceo I-EXPLORATION -con I-EXPLORATION -diseminación I-EXPLORATION -pagetoide. I-EXPLORATION - I-EXPLORATION -La B-EVOLUTION -paciente I-EVOLUTION -refería I-EVOLUTION -inflamación I-EVOLUTION -crónica I-EVOLUTION -palpebral I-EVOLUTION -y I-EVOLUTION -conjuntival. I-EVOLUTION -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -destacaba I-EXPLORATION -leve I-EXPLORATION -engrosamiento I-EXPLORATION +0, I-EXPLORATION +1, I-EXPLORATION +un I-EXPLORATION +tyndall I-EXPLORATION de I-EXPLORATION -tercio I-EXPLORATION -externo I-EXPLORATION -del I-EXPLORATION -borde I-EXPLORATION -libre I-EXPLORATION +3+, I-EXPLORATION +una I-EXPLORATION +cámara I-EXPLORATION +anterior I-EXPLORATION +amplia I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +presión I-EXPLORATION +intraocular I-EXPLORATION +(PIO) I-EXPLORATION de I-EXPLORATION -párpado I-EXPLORATION -superior I-EXPLORATION -derecho. I-EXPLORATION +48 I-EXPLORATION +mmHg. I-EXPLORATION En I-EXPLORATION la I-EXPLORATION -biomicroscopía I-EXPLORATION -presentaba: I-EXPLORATION -conjuntiva I-EXPLORATION -bulbar I-EXPLORATION -superior I-EXPLORATION -irregular I-EXPLORATION -y I-EXPLORATION -muy I-EXPLORATION -eritematosa, I-EXPLORATION -área I-EXPLORATION -de I-EXPLORATION -6 I-EXPLORATION -mm I-EXPLORATION +exploración I-EXPLORATION +del I-EXPLORATION +fondo I-EXPLORATION de I-EXPLORATION -amplitud I-EXPLORATION -en I-EXPLORATION +ojo I-EXPLORATION la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -observaba I-EXPLORATION -una I-EXPLORATION -desestructuración I-EXPLORATION -de I-EXPLORATION +retina I-EXPLORATION +estaba I-EXPLORATION +aplicada, I-EXPLORATION la I-EXPLORATION -arquitectura I-EXPLORATION -limbar, I-EXPLORATION -con I-EXPLORATION -infiltración I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -empalizadas I-EXPLORATION -de I-EXPLORATION -Vogt I-EXPLORATION -por I-EXPLORATION -cordones I-EXPLORATION -amarillentos I-EXPLORATION +excavación I-EXPLORATION +papilar I-EXPLORATION +era I-EXPLORATION de I-EXPLORATION -aspecto I-EXPLORATION -sebáceo I-EXPLORATION +0, I-EXPLORATION +8, I-EXPLORATION y I-EXPLORATION -conjuntivalización I-EXPLORATION -del I-EXPLORATION -epitelio I-EXPLORATION -corneal I-EXPLORATION -superior, I-EXPLORATION -acortamiento I-EXPLORATION +no I-EXPLORATION +había I-EXPLORATION +restos I-EXPLORATION de I-EXPLORATION -fórnix I-EXPLORATION -superior I-EXPLORATION -y I-EXPLORATION -simbléfaron I-EXPLORATION +silicona I-EXPLORATION en I-EXPLORATION -zona I-EXPLORATION -del I-EXPLORATION -canto I-EXPLORATION -externo. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -afectación I-EXPLORATION -ganglionar I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación. I-EXPLORATION -La I-EXPLORATION -TC I-EXPLORATION -de I-EXPLORATION -cráneo, I-EXPLORATION -abdomen I-EXPLORATION -y I-EXPLORATION -tórax I-EXPLORATION -era I-EXPLORATION -normal. I-EXPLORATION -La I-EXPLORATION -gammagrafía I-EXPLORATION -ósea I-EXPLORATION -era I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION +el I-EXPLORATION +polo I-EXPLORATION +posterior. I-EXPLORATION Se B-TREATMENT -realizó I-TREATMENT -blefarectomía I-TREATMENT -en I-TREATMENT -cuña I-TREATMENT +pautó I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +dexametasona I-TREATMENT +alcohol I-TREATMENT +(maxidex®; I-TREATMENT +Alcon I-TREATMENT +Cusí, I-TREATMENT +S. I-TREATMENT +A.; I-TREATMENT +Barcelona; I-TREATMENT +España) I-TREATMENT +1 I-TREATMENT +gota I-TREATMENT +cada I-TREATMENT +2 I-TREATMENT +horas, I-TREATMENT +atropina I-TREATMENT +1% I-TREATMENT +cada I-TREATMENT +12 I-TREATMENT +horas, I-TREATMENT +maleato I-TREATMENT de I-TREATMENT -la I-TREATMENT -zona I-TREATMENT -engrosada I-TREATMENT -del I-TREATMENT -párpado I-TREATMENT -superior I-TREATMENT -derecho I-TREATMENT +timolol I-TREATMENT +0, I-TREATMENT +5% I-TREATMENT +(timoftol® I-TREATMENT +0, I-TREATMENT +5%; I-TREATMENT +Merck I-TREATMENT +Sharp I-TREATMENT +& I-TREATMENT +Dohme, I-TREATMENT +S.A.; I-TREATMENT +Madrid; I-TREATMENT +España) I-TREATMENT +cada I-TREATMENT +12 I-TREATMENT +horas I-TREATMENT y I-TREATMENT -mapeo I-TREATMENT -de I-TREATMENT -biopsias I-TREATMENT -conjuntivales. I-TREATMENT -La B-EXPLORATION -pieza I-EXPLORATION -principal I-EXPLORATION +acetazolamida I-TREATMENT +vía I-TREATMENT +oral I-TREATMENT +(edemox®; I-TREATMENT +Chiesi I-TREATMENT +Wasserman I-TREATMENT +S. I-TREATMENT +A.; I-TREATMENT +Barcelona; I-TREATMENT +España) I-TREATMENT +250 I-TREATMENT +mg I-TREATMENT +cada I-TREATMENT +12 I-TREATMENT +horas. I-TREATMENT + I-TREATMENT +Una B-EVOLUTION +semana I-EVOLUTION +después I-EVOLUTION +acudió I-EVOLUTION +a I-EVOLUTION +nuestra I-EVOLUTION +consulta I-EVOLUTION +sin I-EVOLUTION +mejoría I-EVOLUTION +a I-EVOLUTION +pesar I-EVOLUTION +del I-EVOLUTION +tratamiento. I-EVOLUTION +A B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +la I-EXPLORATION +AV I-EXPLORATION se I-EXPLORATION -informó I-EXPLORATION +mantenía I-EXPLORATION +en I-EXPLORATION +0, I-EXPLORATION +1 I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +PIO I-EXPLORATION +en I-EXPLORATION +33 I-EXPLORATION +mmHg. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +figura I-EXPLORATION +1 I-EXPLORATION +se I-EXPLORATION +muestra I-EXPLORATION +el I-EXPLORATION +aspecto I-EXPLORATION +del I-EXPLORATION +segmento I-EXPLORATION +anterior. I-EXPLORATION +Lo I-EXPLORATION +que I-EXPLORATION +inicialmente I-EXPLORATION +se I-EXPLORATION +habían I-EXPLORATION +identificado I-EXPLORATION como I-EXPLORATION -carcinoma I-EXPLORATION -sebáceo. I-EXPLORATION -Las I-EXPLORATION -muestras I-EXPLORATION -conjuntivales I-EXPLORATION -estaban I-EXPLORATION -libres I-EXPLORATION +células I-EXPLORATION +inflamatorias I-EXPLORATION +resultaron I-EXPLORATION +ser I-EXPLORATION +microburbujas I-EXPLORATION de I-EXPLORATION -tumor. I-EXPLORATION +aceite I-EXPLORATION +de I-EXPLORATION +silicona I-EXPLORATION +emulsificadas I-EXPLORATION +en I-EXPLORATION +cámara I-EXPLORATION +anterior, I-EXPLORATION +responsables I-EXPLORATION +del I-EXPLORATION +glaucoma I-EXPLORATION +secundario. I-EXPLORATION I-EXPLORATION -Ampliamos B-TREATMENT +Ante B-TREATMENT la I-TREATMENT -blefarectomía I-TREATMENT -y I-TREATMENT -esperamos I-TREATMENT -a I-TREATMENT -poder I-TREATMENT -instaurar I-TREATMENT -tratamiento I-TREATMENT +falta I-TREATMENT de I-TREATMENT +respuesta I-TREATMENT +al I-TREATMENT +tratamiento I-TREATMENT +médico I-TREATMENT +se I-TREATMENT +planteó I-TREATMENT la I-TREATMENT -superficie I-TREATMENT -ocular I-TREATMENT -con I-TREATMENT -colirio I-TREATMENT +implantación I-TREATMENT de I-TREATMENT -mitomicina I-TREATMENT -C. I-TREATMENT -No B-EVOLUTION -se I-EVOLUTION -pudo I-EVOLUTION -seguir I-EVOLUTION -la I-EVOLUTION -evolución I-EVOLUTION -del I-EVOLUTION -caso I-EVOLUTION -ya I-EVOLUTION -que I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -decidió I-EVOLUTION -seguir I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -en I-EVOLUTION -su I-EVOLUTION -ciudad I-EVOLUTION -de I-EVOLUTION -residencia. I-EVOLUTION - I-EVOLUTION +un I-TREATMENT +dispositivo I-TREATMENT +de I-TREATMENT +drenaje I-TREATMENT +que I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +rechazó, I-TREATMENT +no I-TREATMENT +acudiendo I-TREATMENT +a I-TREATMENT +las I-TREATMENT +revisiones I-TREATMENT +citadas I-TREATMENT +posteriormente. I-TREATMENT + I-TREATMENT -Un B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS varón I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -58 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -diplopía I-PRESENT_ILLNESS -binocular I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -instauración I-PRESENT_ILLNESS -subaguda I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -menos I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -atribuida I-PRESENT_ILLNESS -inicialmente I-PRESENT_ILLNESS +70 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +fue I-PRESENT_ILLNESS +trasladado I-PRESENT_ILLNESS a I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -efectos I-PRESENT_ILLNESS -secundarios I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS +bajo I-PRESENT_ILLNESS +intubación I-PRESENT_ILLNESS +orotraqueal I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +traumatismo I-PRESENT_ILLNESS +facial I-PRESENT_ILLNESS +severo I-PRESENT_ILLNESS +tras I-PRESENT_ILLNESS +intento I-PRESENT_ILLNESS +autolítico I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +arma I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -quimioterapia. I-PRESENT_ILLNESS -El B-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -tratado I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -ciclos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -carboxiplatino/taxol I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -radioterapia I-PAST_MEDICAL_HISTORY -concomitante I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -carcinoma I-PAST_MEDICAL_HISTORY -pulmonar I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -células I-PAST_MEDICAL_HISTORY -grandes I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -estadio I-PAST_MEDICAL_HISTORY -T2N3M0 I-PAST_MEDICAL_HISTORY -diagnosticado I-PAST_MEDICAL_HISTORY -hacía I-PAST_MEDICAL_HISTORY -7 I-PAST_MEDICAL_HISTORY -meses. I-PAST_MEDICAL_HISTORY +fuego. I-PRESENT_ILLNESS En B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION -oftalmológica, I-EXPLORATION -la I-EXPLORATION -AV I-EXPLORATION -mejor I-EXPLORATION -corregida I-EXPLORATION -era I-EXPLORATION +física I-EXPLORATION +se I-EXPLORATION +objetivó I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +traumática I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION de I-EXPLORATION -0, I-EXPLORATION -9 I-EXPLORATION -en I-EXPLORATION -ojo I-EXPLORATION -derecho I-EXPLORATION -(OD) I-EXPLORATION +tercios I-EXPLORATION +medio I-EXPLORATION +e I-EXPLORATION +inferior I-EXPLORATION +faciales, I-EXPLORATION +con I-EXPLORATION +pérdida I-EXPLORATION +de I-EXPLORATION +tejidos I-EXPLORATION +óseos I-EXPLORATION y I-EXPLORATION +blandos I-EXPLORATION +(pérdida I-EXPLORATION +total I-EXPLORATION de I-EXPLORATION -0, I-EXPLORATION -8 I-EXPLORATION -en I-EXPLORATION -ojo I-EXPLORATION -izquierdo I-EXPLORATION -(OI). I-EXPLORATION -Ambas I-EXPLORATION -pupilas I-EXPLORATION -estaban I-EXPLORATION -en I-EXPLORATION -midriasis I-EXPLORATION -media I-EXPLORATION -con I-EXPLORATION -escasa I-EXPLORATION -reactividad I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -luz I-EXPLORATION +espesor I-EXPLORATION +completo I-EXPLORATION +del I-EXPLORATION +labio I-EXPLORATION +inferior, I-EXPLORATION +región I-EXPLORATION +perioral, I-EXPLORATION +mentoniana I-EXPLORATION y I-EXPLORATION -convergencia. I-EXPLORATION -Respecto I-EXPLORATION +pérdida I-EXPLORATION +parcial I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +de I-EXPLORATION +labio I-EXPLORATION +superior). I-EXPLORATION +Se I-EXPLORATION +procedió I-EXPLORATION a I-EXPLORATION la I-EXPLORATION -motilidad I-EXPLORATION -ocular I-EXPLORATION -extrínseca, I-EXPLORATION -se I-EXPLORATION -objetivaba I-EXPLORATION +realización I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +tomografía I-EXPLORATION +computerizada I-EXPLORATION +(TC) I-EXPLORATION +craneofacial, I-EXPLORATION +que I-EXPLORATION +descartó I-EXPLORATION +daño I-EXPLORATION +cerebral I-EXPLORATION +y I-EXPLORATION +mostró I-EXPLORATION una I-EXPLORATION -exotropía I-EXPLORATION +pérdida I-EXPLORATION +extensa I-EXPLORATION de I-EXPLORATION --50 I-EXPLORATION -dp I-EXPLORATION -(dioptrías I-EXPLORATION -prismátricas) I-EXPLORATION -con I-EXPLORATION -dominancia I-EXPLORATION -OD I-EXPLORATION -pero I-EXPLORATION +sustancia I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +mandibular, I-EXPLORATION con I-EXPLORATION -capacidad I-EXPLORATION +fracturas I-EXPLORATION +múltiples I-EXPLORATION +maxilares, I-EXPLORATION +fractura I-EXPLORATION de I-EXPLORATION -fijación I-EXPLORATION -alternante. I-EXPLORATION -En I-EXPLORATION +suelos I-EXPLORATION +orbitarios, I-EXPLORATION +fractura I-EXPLORATION +de I-EXPLORATION +huesos I-EXPLORATION +propios I-EXPLORATION +y I-EXPLORATION +tabique I-EXPLORATION +nasal I-EXPLORATION +óseo. I-EXPLORATION +El B-TREATMENT +paciente I-TREATMENT +fue I-TREATMENT +trasladado I-TREATMENT +a I-TREATMENT +quirófano, I-TREATMENT +donde I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +traqueostomía I-TREATMENT +reglada, I-TREATMENT +limpieza I-TREATMENT +y I-TREATMENT +hemostasia I-TREATMENT +de I-TREATMENT +heridas I-TREATMENT +faciales I-TREATMENT +y I-TREATMENT +retirada I-TREATMENT +de I-TREATMENT +fragmentos I-TREATMENT +óseos I-TREATMENT +conminutos I-TREATMENT +y I-TREATMENT +cuerpos I-TREATMENT +extraños. I-TREATMENT +Seguidamente I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +puenteo I-TREATMENT +del I-TREATMENT +defecto I-TREATMENT +óseo I-TREATMENT +mediante I-TREATMENT +una I-TREATMENT +placa I-TREATMENT +de I-TREATMENT +reconstrucción I-TREATMENT +mandibular I-TREATMENT +de I-TREATMENT +2, I-TREATMENT +5mm I-TREATMENT +y I-TREATMENT +cierre I-TREATMENT +primario I-TREATMENT +de I-TREATMENT +tejidos I-TREATMENT +blados. I-TREATMENT +Se I-TREATMENT +comprobó I-TREATMENT +la I-TREATMENT +estabilidad I-TREATMENT +de I-TREATMENT +fracturas I-TREATMENT +en I-TREATMENT +tercio I-TREATMENT +medio, I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +adoptó I-TREATMENT +una I-TREATMENT +actitud I-TREATMENT +expectante. I-TREATMENT +Se I-TREATMENT +realizó I-TREATMENT +reducción I-TREATMENT +nasal I-TREATMENT +cerrada. I-TREATMENT +El B-EVOLUTION +paciente I-EVOLUTION +permaneció I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +Unidad I-EVOLUTION +de I-EVOLUTION +Cuidados I-EVOLUTION +Intensivos I-EVOLUTION +durante I-EVOLUTION +cuatro I-EVOLUTION +días. I-EVOLUTION + I-EVOLUTION +Diez B-TREATMENT +días I-TREATMENT +más I-TREATMENT +tarde I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +la I-TREATMENT +reconstrucción I-TREATMENT +secundaria, I-TREATMENT +con I-TREATMENT +retirada I-TREATMENT +de I-TREATMENT +la I-TREATMENT +placa I-TREATMENT +de I-TREATMENT +reconstrucción I-TREATMENT +mandibular, I-TREATMENT +tallado I-TREATMENT +de I-TREATMENT +colgajo I-TREATMENT +osteofasciocutáneo I-TREATMENT +microvascularizado I-TREATMENT +de I-TREATMENT +peroné I-TREATMENT +izquierdo I-TREATMENT +y I-TREATMENT +preformado I-TREATMENT +in I-TREATMENT +situ I-TREATMENT +por I-TREATMENT +medio I-TREATMENT +de I-TREATMENT +adaptación I-TREATMENT +a I-TREATMENT +la I-TREATMENT +placa I-TREATMENT +de I-TREATMENT +reconstrucción I-TREATMENT +mandibular I-TREATMENT +previamente I-TREATMENT +retirada, I-TREATMENT +y I-TREATMENT +fijación I-TREATMENT +a I-TREATMENT +remanentes I-TREATMENT +mandibulares I-TREATMENT +a I-TREATMENT +nivel I-TREATMENT +de I-TREATMENT +ambos I-TREATMENT +ángulos I-TREATMENT +goniacos I-TREATMENT +y I-TREATMENT +ramas I-TREATMENT +mandibulares. I-TREATMENT +La I-TREATMENT +cobertura I-TREATMENT +externa I-TREATMENT +del I-TREATMENT +peroné I-TREATMENT +fue I-TREATMENT +realizada I-TREATMENT +mediante I-TREATMENT +su I-TREATMENT +paleta I-TREATMENT +cutánea, I-TREATMENT +dispuesta I-TREATMENT +a I-TREATMENT +nivel I-TREATMENT +mentoniano I-TREATMENT +y I-TREATMENT +submental, I-TREATMENT +y I-TREATMENT +la I-TREATMENT +cobertura I-TREATMENT +interna I-TREATMENT +mediante I-TREATMENT +despegamiento I-TREATMENT +y I-TREATMENT +avance I-TREATMENT +de I-TREATMENT +mucosa I-TREATMENT +del I-TREATMENT +suelo I-TREATMENT +de I-TREATMENT +la I-TREATMENT +boca I-TREATMENT +anterior. I-TREATMENT +Finalmente, I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +la I-TREATMENT +microanastomosis I-TREATMENT +de I-TREATMENT +vasos I-TREATMENT +peroneos I-TREATMENT +a I-TREATMENT +vasos I-TREATMENT +faciales. I-TREATMENT +Se I-TREATMENT +levantaron I-TREATMENT +colgajos I-TREATMENT +de I-TREATMENT +espesor I-TREATMENT +completo I-TREATMENT +a I-TREATMENT +nivel I-TREATMENT +del I-TREATMENT +remanente I-TREATMENT +de I-TREATMENT +mentón I-TREATMENT +pediculados I-TREATMENT +de I-TREATMENT +base I-TREATMENT +superior I-TREATMENT +a I-TREATMENT +modo I-TREATMENT +de I-TREATMENT +colgajos I-TREATMENT +de I-TREATMENT +Karapandzic I-TREATMENT +modificado, I-TREATMENT +con I-TREATMENT +preservación I-TREATMENT +del I-TREATMENT +pedículo I-TREATMENT +facial, I-TREATMENT +y I-TREATMENT +tallado I-TREATMENT +de I-TREATMENT +colgajos I-TREATMENT +de I-TREATMENT +avance I-TREATMENT +de I-TREATMENT +mucosa I-TREATMENT +para I-TREATMENT +creación I-TREATMENT +de I-TREATMENT +neo-bermellón. I-TREATMENT +Ambos I-TREATMENT +colgajos I-TREATMENT +mucocutáneos I-TREATMENT +fueron I-TREATMENT +rotados I-TREATMENT +medialmente I-TREATMENT +para I-TREATMENT +su I-TREATMENT +unión I-TREATMENT +a I-TREATMENT +nivel I-TREATMENT +central, I-TREATMENT +neoformando I-TREATMENT +el I-TREATMENT +labio I-TREATMENT +inferior I-TREATMENT +de I-TREATMENT +espesor I-TREATMENT +completo I-TREATMENT +y I-TREATMENT +creando I-TREATMENT +el I-TREATMENT +vestíbulo I-TREATMENT +labial I-TREATMENT +inferior. I-TREATMENT +Seguidamente I-TREATMENT +se I-TREATMENT +empleó I-TREATMENT +un I-TREATMENT +colgajo I-TREATMENT +de I-TREATMENT +Webster I-TREATMENT +izquierdo I-TREATMENT +para I-TREATMENT +la I-TREATMENT +reconstrucción I-TREATMENT +del I-TREATMENT +defecto I-TREATMENT +labial I-TREATMENT +superior. I-TREATMENT +Además I-TREATMENT +de I-TREATMENT +la I-TREATMENT +reconstrucción I-TREATMENT +de I-TREATMENT +tejidos I-TREATMENT +blandos I-TREATMENT +y I-TREATMENT +óseos, I-TREATMENT +en I-TREATMENT +nuestro I-TREATMENT +caso I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +presentaba I-TREATMENT +una I-TREATMENT +macroglosia I-TREATMENT +constitucional, I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +realizamos I-TREATMENT +una I-TREATMENT +glosectomía I-TREATMENT +media I-TREATMENT +(resecando I-TREATMENT +el I-TREATMENT +tercio I-TREATMENT +medio I-TREATMENT +de I-TREATMENT +lengua I-TREATMENT +libre) I-TREATMENT +como I-TREATMENT +procedimiento I-TREATMENT +complementario I-TREATMENT +con I-TREATMENT +el I-TREATMENT +objetivo I-TREATMENT +de I-TREATMENT +facilitar I-TREATMENT +la I-TREATMENT +competencia I-TREATMENT +labial, I-TREATMENT +deglución I-TREATMENT +y I-TREATMENT +fonación. I-TREATMENT + I-TREATMENT +Durante B-EXPLORATION el I-EXPLORATION -OD I-EXPLORATION -se I-EXPLORATION -observaba I-EXPLORATION -una I-EXPLORATION -limitación I-EXPLORATION +postoperatorio, I-EXPLORATION +los I-EXPLORATION +resultados I-EXPLORATION +fueron I-EXPLORATION +evaluados I-EXPLORATION +en I-EXPLORATION +términos I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -supraducciones I-EXPLORATION -(+++) I-EXPLORATION +competencia I-EXPLORATION +labial, I-EXPLORATION +habla, I-EXPLORATION +alimentación I-EXPLORATION y I-EXPLORATION +estética. I-EXPLORATION +La I-EXPLORATION +competencia I-EXPLORATION +labial I-EXPLORATION +fue I-EXPLORATION +óptima, I-EXPLORATION +sin I-EXPLORATION +conseguir I-EXPLORATION +el I-EXPLORATION +cierre I-EXPLORATION +hermético I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -aducción I-EXPLORATION -(++) I-EXPLORATION +los I-EXPLORATION +labios, I-EXPLORATION pero I-EXPLORATION -con I-EXPLORATION -conservación I-EXPLORATION +sin I-EXPLORATION +pérdida I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -abducción. I-EXPLORATION +líquidos I-EXPLORATION +al I-EXPLORATION +beber. I-EXPLORATION El I-EXPLORATION -OI I-EXPLORATION -presentaba I-EXPLORATION -un I-EXPLORATION -ptosis I-EXPLORATION -palpebral I-EXPLORATION -casi I-EXPLORATION -total I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -severa I-EXPLORATION -limitación I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -supraducciones I-EXPLORATION -(+++), I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -aducción I-EXPLORATION -(++) I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -infraducciones I-EXPLORATION -(+++) I-EXPLORATION -con I-EXPLORATION -conservación I-EXPLORATION +habla I-EXPLORATION +fue I-EXPLORATION +evaluada I-EXPLORATION +en I-EXPLORATION +función I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -abducción. I-EXPLORATION -La I-EXPLORATION -biomicroscopía I-EXPLORATION +inteligibilidad I-EXPLORATION del I-EXPLORATION -segmento I-EXPLORATION -anterior I-EXPLORATION -era I-EXPLORATION -normal I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -la I-EXPLORATION -tensión I-EXPLORATION -ocular I-EXPLORATION -de I-EXPLORATION -ambos I-EXPLORATION -ojos I-EXPLORATION -(AO). I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -fondo I-EXPLORATION -de I-EXPLORATION -ojo I-EXPLORATION -tampoco I-EXPLORATION -se I-EXPLORATION -hallaron I-EXPLORATION -alteraciones I-EXPLORATION -patológicas. I-EXPLORATION +paciente I-EXPLORATION +por I-EXPLORATION +teléfono, I-EXPLORATION +que I-EXPLORATION +resultó I-EXPLORATION +positiva. I-EXPLORATION En I-EXPLORATION +cuanto I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -neurológica I-EXPLORATION +capacidad I-EXPLORATION +de I-EXPLORATION +alimentarse, I-EXPLORATION el I-EXPLORATION paciente I-EXPLORATION -no I-EXPLORATION -mostraba I-EXPLORATION -ninguna I-EXPLORATION -alteración I-EXPLORATION -clínica. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION +tiene I-EXPLORATION una I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -(RM) I-EXPLORATION -cerebral I-EXPLORATION -que I-EXPLORATION -evidenció I-EXPLORATION +dieta I-EXPLORATION +normal I-EXPLORATION +(triturada I-EXPLORATION +por I-EXPLORATION la I-EXPLORATION -existencia I-EXPLORATION +falta I-EXPLORATION +de I-EXPLORATION +dentición). I-EXPLORATION +El I-EXPLORATION +resultado I-EXPLORATION +estético I-EXPLORATION +fue I-EXPLORATION +aceptable. I-EXPLORATION +Durante B-EVOLUTION +los I-EVOLUTION +6 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +seguimiento I-EVOLUTION +posterior I-EVOLUTION +no I-EVOLUTION +se I-EVOLUTION +ha I-EVOLUTION +producido I-EVOLUTION +ninguna I-EVOLUTION +complicación I-EVOLUTION +y I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +se I-EVOLUTION +encuentra I-EVOLUTION +en I-EVOLUTION +seguimiento I-EVOLUTION +y I-EVOLUTION +tratamiento I-EVOLUTION +por I-EVOLUTION +parte I-EVOLUTION +de I-EVOLUTION +psiquiatría. I-EVOLUTION +En I-EVOLUTION +un I-EVOLUTION +futuro I-EVOLUTION +próximo I-EVOLUTION +se I-EVOLUTION +prevee I-EVOLUTION +la I-EVOLUTION +necesidad I-EVOLUTION +de I-EVOLUTION +realizar I-EVOLUTION +alguna I-EVOLUTION +intervención I-EVOLUTION +adicional I-EVOLUTION +(refinamiento I-EVOLUTION +estético I-EVOLUTION +labial, I-EVOLUTION +rehabilitación I-EVOLUTION +protésica I-EVOLUTION +dental, I-EVOLUTION +etc.). I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +79 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que, I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +relación I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +artritis I-PRESENT_ILLNESS +metacarpofalángica, I-PRESENT_ILLNESS +recibe I-PRESENT_ILLNESS +amoxilicina-clavulánico I-PRESENT_ILLNESS +durante I-PRESENT_ILLNESS +10 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +posteriormente I-PRESENT_ILLNESS +ciprofloxacino I-PRESENT_ILLNESS +durante I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +semana. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Dos I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +después I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +finalización I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +antibiótico, I-PRESENT_ILLNESS +comienza I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +deposiciones I-PRESENT_ILLNESS +diarreicas I-PRESENT_ILLNESS +acuosas I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +productos I-PRESENT_ILLNESS +patológicos I-PRESENT_ILLNESS +(tanto I-PRESENT_ILLNESS +diurnas I-PRESENT_ILLNESS +como I-PRESENT_ILLNESS +nocturnas), I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +hasta I-PRESENT_ILLNESS +39 I-PRESENT_ILLNESS +oC, I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +decaimiento I-PRESENT_ILLNESS +progresivo. I-PRESENT_ILLNESS +Acude B-EVOLUTION +en I-EVOLUTION +varias I-EVOLUTION +ocasiones I-EVOLUTION +al I-EVOLUTION +Servicio I-EVOLUTION +de I-EVOLUTION +Urgencias, I-EVOLUTION +realizándose I-EVOLUTION +coprocultivos I-EVOLUTION +y I-EVOLUTION +determinación I-EVOLUTION +de I-EVOLUTION +toxina I-EVOLUTION +de I-EVOLUTION +Clostridium I-EVOLUTION +difficile I-EVOLUTION +que I-EVOLUTION +resultan I-EVOLUTION +negativos I-EVOLUTION +con I-EVOLUTION +posterior I-EVOLUTION +alta I-EVOLUTION +por I-EVOLUTION +mejoría I-EVOLUTION +tras I-EVOLUTION +medidas I-EVOLUTION +astringentes I-EVOLUTION +(aunque I-EVOLUTION +sin I-EVOLUTION +resolución I-EVOLUTION +del I-EVOLUTION +cuadro). I-EVOLUTION +Una I-EVOLUTION +semana I-EVOLUTION +después I-EVOLUTION +reingresa I-EVOLUTION +por I-EVOLUTION +continuar I-EVOLUTION +con I-EVOLUTION +abundantes I-EVOLUTION +diarreas I-EVOLUTION +acuosas, I-EVOLUTION +dolor I-EVOLUTION +abdominal, I-EVOLUTION +febrícula I-EVOLUTION +y I-EVOLUTION +decaimiento. I-EVOLUTION +Analíticamente B-EXPLORATION +solo I-EXPLORATION +destaca I-EXPLORATION una I-EXPLORATION -lesión I-EXPLORATION -solitaria I-EXPLORATION -en I-EXPLORATION +ligera I-EXPLORATION +anemia I-EXPLORATION +normocítica I-EXPLORATION +normocrómica. I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -región I-EXPLORATION -posterior I-EXPLORATION -del I-EXPLORATION -suelo I-EXPLORATION -del I-EXPLORATION -III I-EXPLORATION -ventrículo. I-EXPLORATION -Dicha I-EXPLORATION -lesión I-EXPLORATION -tenía I-EXPLORATION -un I-EXPLORATION -aspecto I-EXPLORATION -anular I-EXPLORATION -hiperintenso, I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -porción I-EXPLORATION -central I-EXPLORATION -hipointensa I-EXPLORATION -sugestiva I-EXPLORATION -de I-EXPLORATION -necrosis, I-EXPLORATION -y I-EXPLORATION -afectaba I-EXPLORATION -bilateralmente I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -núcleos I-EXPLORATION +colonoscopia I-EXPLORATION +realizada I-EXPLORATION +se I-EXPLORATION +aprecian I-EXPLORATION +úlceras I-EXPLORATION +de I-EXPLORATION +diferentes I-EXPLORATION +tamaños I-EXPLORATION y I-EXPLORATION -fascículos I-EXPLORATION -del I-EXPLORATION -III I-EXPLORATION -nervio I-EXPLORATION -craneal I-EXPLORATION -en I-EXPLORATION +profundidad, I-EXPLORATION +con I-EXPLORATION +fondo I-EXPLORATION +blanquecino I-EXPLORATION +y I-EXPLORATION +halo I-EXPLORATION +enrojecido, I-EXPLORATION +de I-EXPLORATION +forma I-EXPLORATION +difusa I-EXPLORATION +hasta I-EXPLORATION +colon I-EXPLORATION +ascendente. I-EXPLORATION +Las I-EXPLORATION +biopsias I-EXPLORATION +confirmaron I-EXPLORATION el I-EXPLORATION -mesencéfalo I-EXPLORATION -central. I-EXPLORATION - I-EXPLORATION +diagnóstico. I-EXPLORATION +Se I-EXPLORATION +extrajeron I-EXPLORATION +hemocultivos I-EXPLORATION +por I-EXPLORATION +fiebre I-EXPLORATION +que I-EXPLORATION +fueron I-EXPLORATION +positivos I-EXPLORATION +para I-EXPLORATION +Clostridium I-EXPLORATION +ramosum. I-EXPLORATION +Tras B-TREATMENT +la I-TREATMENT +sospecha I-TREATMENT +endoscópica, I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +metronidazol, I-TREATMENT +el I-TREATMENT +cual I-TREATMENT +se I-TREATMENT +mantuvo I-TREATMENT +durante I-TREATMENT +15 I-TREATMENT +días I-TREATMENT +con I-TREATMENT +buena I-TREATMENT +evolución I-TREATMENT +posterior. I-TREATMENT + I-TREATMENT -Mujer B-PRESENT_ILLNESS -hispana I-PRESENT_ILLNESS +Hombre B-PRESENT_ILLNESS de I-PRESENT_ILLNESS 33 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY +con B-PAST_MEDICAL_HISTORY +residencia I-PAST_MEDICAL_HISTORY +urbana I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +Región I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +Araucanía, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY +mórbidos I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY +importancia, I-PAST_MEDICAL_HISTORY que B-PRESENT_ILLNESS -queja I-PRESENT_ILLNESS +ingresa I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +Hospital I-PRESENT_ILLNESS +Dr. I-PRESENT_ILLNESS +Hernán I-PRESENT_ILLNESS +Henríquez I-PRESENT_ILLNESS +Aravena I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Temuco I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS una I-PRESENT_ILLNESS -disminución I-PRESENT_ILLNESS -progresiva I-PRESENT_ILLNESS +semana I-PRESENT_ILLNESS +antes I-PRESENT_ILLNESS +anorexia, I-PRESENT_ILLNESS +astenia, I-PRESENT_ILLNESS +mialgias I-PRESENT_ILLNESS +generalizadas, I-PRESENT_ILLNESS +cefalea, I-PRESENT_ILLNESS +náuseas I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +disnea I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -visión I-PRESENT_ILLNESS +esfuerzos I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +últimos I-PRESENT_ILLNESS +tres I-PRESENT_ILLNESS +días, I-PRESENT_ILLNESS +refiriendo I-PRESENT_ILLNESS +haber I-PRESENT_ILLNESS +habitado I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -ojo I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -(OI). I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -destaca I-EXPLORATION -una I-EXPLORATION -agudeza I-EXPLORATION -visual I-EXPLORATION -(AV) I-EXPLORATION -de I-EXPLORATION -0, I-EXPLORATION -05 I-EXPLORATION -en I-EXPLORATION -OI. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -fondo I-EXPLORATION +un I-PRESENT_ILLNESS +sector I-PRESENT_ILLNESS +rural I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +región I-PRESENT_ILLNESS +recientemente. I-PRESENT_ILLNESS +Los B-EXPLORATION +exámenes I-EXPLORATION de I-EXPLORATION -ojo I-EXPLORATION -(FO) I-EXPLORATION -del I-EXPLORATION -OI I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -papilar I-EXPLORATION -elevada, I-EXPLORATION -polipoidea, I-EXPLORATION -intensamente I-EXPLORATION -pigmentada I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -ristras I-EXPLORATION +ingreso I-EXPLORATION +mostraban I-EXPLORATION +hematocrito I-EXPLORATION de I-EXPLORATION -pigmento I-EXPLORATION -móvil I-EXPLORATION +47%, I-EXPLORATION +leucocitos I-EXPLORATION +5.600/mm3 I-EXPLORATION +y I-EXPLORATION +plaquetas I-EXPLORATION +60.000/mm3 I-EXPLORATION +con I-EXPLORATION +infiltrados I-EXPLORATION +intersticiales I-EXPLORATION +difusos I-EXPLORATION +bilaterales I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -cavidad I-EXPLORATION -vítrea. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION +radiografía I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -oftalmológica I-EXPLORATION -es I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -angiofluoresceingrafía I-EXPLORATION -(AFG) I-EXPLORATION +tórax. I-EXPLORATION +Dado I-EXPLORATION +el I-EXPLORATION +cuadro I-EXPLORATION +clínico I-EXPLORATION +y I-EXPLORATION +los I-EXPLORATION +antecedentes I-EXPLORATION +epidemiológicos I-EXPLORATION se I-EXPLORATION -apreció I-EXPLORATION +planteó I-EXPLORATION un I-EXPLORATION -efecto I-EXPLORATION -pantalla. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -sólida. I-EXPLORATION -En I-EXPLORATION -modo I-EXPLORATION -A I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -una I-EXPLORATION -reflectividad I-EXPLORATION -interna I-EXPLORATION -muy I-EXPLORATION -elevada I-EXPLORATION -sin I-EXPLORATION -movimiento I-EXPLORATION -vascular I-EXPLORATION -espontáneo. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -aquel I-EXPLORATION -momento I-EXPLORATION -fueron I-EXPLORATION -consultados I-EXPLORATION -varios I-EXPLORATION -expertos. I-EXPLORATION -Unos I-EXPLORATION -se I-EXPLORATION -inclinaron I-EXPLORATION +síndrome I-EXPLORATION +cardiopulmonar I-EXPLORATION por I-EXPLORATION -un I-EXPLORATION -diagnóstico I-EXPLORATION +hantavirus I-EXPLORATION +confirmándose I-EXPLORATION +la I-EXPLORATION +sospecha I-EXPLORATION +diagnóstica I-EXPLORATION +mediante I-EXPLORATION +test I-EXPLORATION +rápido I-EXPLORATION +específico I-EXPLORATION +(inmunocromatografía I-EXPLORATION +para I-EXPLORATION +IgM). I-EXPLORATION +Se B-TREATMENT +inició I-TREATMENT +manejo I-TREATMENT +de I-TREATMENT +soporte I-TREATMENT +e I-TREATMENT +indicó I-TREATMENT +1 I-TREATMENT +g/día I-TREATMENT +de I-TREATMENT +metilprednisolona I-TREATMENT +iv I-TREATMENT +durante I-TREATMENT +5 I-TREATMENT +días. I-TREATMENT +Evolucionó B-EVOLUTION +con I-EVOLUTION +disfunción I-EVOLUTION +miocárdica, I-EVOLUTION +requiriendo B-TREATMENT +altas I-TREATMENT +dosis I-TREATMENT +de I-TREATMENT +fármacos I-TREATMENT +vasoactivos. I-TREATMENT +Desarrolló I-TREATMENT +durante I-TREATMENT +su I-TREATMENT +estadía I-TREATMENT +hospitalaria I-TREATMENT +una I-TREATMENT +neumonía I-TREATMENT +asociada I-TREATMENT +a I-TREATMENT +ventilación I-TREATMENT +mecánica I-TREATMENT +tratada I-TREATMENT +inicialmente I-TREATMENT +con I-TREATMENT +imipenem, I-TREATMENT +vancomicina I-TREATMENT +y I-TREATMENT +amikacina. I-TREATMENT +En B-EXPLORATION +el I-EXPLORATION +cultivo I-EXPLORATION de I-EXPLORATION -melanoma I-EXPLORATION -maligno I-EXPLORATION -y I-EXPLORATION -otros I-EXPLORATION +secreción I-EXPLORATION +bronquial I-EXPLORATION +se I-EXPLORATION +aisló I-EXPLORATION +Staphylococcus I-EXPLORATION +aureus I-EXPLORATION +resistente I-EXPLORATION +a I-EXPLORATION +meticilina, I-EXPLORATION +cambiándose I-EXPLORATION +vancomicina I-EXPLORATION por I-EXPLORATION -melanocitoma. I-EXPLORATION +linezolid. I-EXPLORATION I-EXPLORATION -La B-TREATMENT -decisión I-TREATMENT -adoptada I-TREATMENT -fue I-TREATMENT -seguir I-TREATMENT -observando I-TREATMENT -a I-TREATMENT -la I-TREATMENT -paciente. I-TREATMENT -A B-EVOLUTION -lo I-EVOLUTION -largo I-EVOLUTION +Al B-EVOLUTION +sexto I-EVOLUTION +día I-EVOLUTION de I-EVOLUTION -diecinueve I-EVOLUTION -años I-EVOLUTION +hospitalización I-EVOLUTION +inició I-EVOLUTION +un I-EVOLUTION +cuadro I-EVOLUTION +de I-EVOLUTION +ictericia I-EVOLUTION +progresiva I-EVOLUTION +con I-EVOLUTION +hiperbilirrubinemia I-EVOLUTION +(13, I-EVOLUTION +9 I-EVOLUTION +mg/dL) I-EVOLUTION +de I-EVOLUTION +predominio I-EVOLUTION +directa I-EVOLUTION +(12, I-EVOLUTION +4 I-EVOLUTION +mg/dL), I-EVOLUTION +aumento I-EVOLUTION +de I-EVOLUTION +fosfatasas I-EVOLUTION +alcalinas I-EVOLUTION +(854 I-EVOLUTION +U/l) I-EVOLUTION +y B-EXPLORATION +una I-EXPLORATION +ecotomografía I-EXPLORATION +abdominal I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +colecistitis I-EXPLORATION +aguda I-EXPLORATION +alitiásica, I-EXPLORATION +la B-TREATMENT +que I-TREATMENT +fue I-TREATMENT +resuelta I-TREATMENT +quirúrgicamente I-TREATMENT +el I-TREATMENT +mismo I-TREATMENT +día. I-TREATMENT + I-TREATMENT +Durante B-EVOLUTION la I-EVOLUTION -lesión I-EVOLUTION -aumentó I-EVOLUTION -paulatinamente I-EVOLUTION -de I-EVOLUTION -tamaño I-EVOLUTION -sin I-EVOLUTION -cambios I-EVOLUTION -rápidos I-EVOLUTION -en I-EVOLUTION -su I-EVOLUTION -configuración I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION +segunda I-EVOLUTION +y I-EVOLUTION +tercera I-EVOLUTION +semana, I-EVOLUTION el I-EVOLUTION -diagnóstico I-EVOLUTION +paciente I-EVOLUTION +continuó I-EVOLUTION +febril I-EVOLUTION +con I-EVOLUTION +aparición I-EVOLUTION de I-EVOLUTION -melanocitoma I-EVOLUTION -seguía I-EVOLUTION -siendo I-EVOLUTION +lesiones I-EVOLUTION +costrosas I-EVOLUTION +en I-EVOLUTION el I-EVOLUTION -más I-EVOLUTION -apropiado. I-EVOLUTION -La I-EVOLUTION -paciente I-EVOLUTION -acabó I-EVOLUTION -por I-EVOLUTION -perder I-EVOLUTION -completamente I-EVOLUTION -la I-EVOLUTION -visión I-EVOLUTION -del I-EVOLUTION -OI I-EVOLUTION +tronco I-EVOLUTION y I-EVOLUTION la I-EVOLUTION -funduscopia I-EVOLUTION -llegó I-EVOLUTION -a I-EVOLUTION -ser I-EVOLUTION -impracticable, I-EVOLUTION -al I-EVOLUTION -principio I-EVOLUTION -a I-EVOLUTION -causa I-EVOLUTION -del I-EVOLUTION -pigmento I-EVOLUTION -vítreo I-EVOLUTION -y I-EVOLUTION -posteriormente I-EVOLUTION -por I-EVOLUTION +cara, I-EVOLUTION una I-EVOLUTION -catarata. I-EVOLUTION - I-EVOLUTION -A I-EVOLUTION +de I-EVOLUTION +ellas I-EVOLUTION +de I-EVOLUTION +localización I-EVOLUTION +nasal. I-EVOLUTION +Se B-EXPLORATION +obtuvieron I-EXPLORATION +cultivos I-EXPLORATION +de I-EXPLORATION +sangre I-EXPLORATION +y I-EXPLORATION +aspirado I-EXPLORATION +endotraqueal, I-EXPLORATION +los I-EXPLORATION +que I-EXPLORATION +fueron I-EXPLORATION +informados I-EXPLORATION +como I-EXPLORATION +positivos I-EXPLORATION +para I-EXPLORATION +Candida I-EXPLORATION +albicans I-EXPLORATION +y I-EXPLORATION +Pseudomonas I-EXPLORATION +aeruginosa I-EXPLORATION +respectivamente, I-EXPLORATION +agregándose I-EXPLORATION +al I-EXPLORATION +esquema I-EXPLORATION +antimicrobiano I-EXPLORATION +cobertura I-EXPLORATION +con I-EXPLORATION +anidulafungina I-EXPLORATION +para I-EXPLORATION +C. I-EXPLORATION +albicans I-EXPLORATION +y I-EXPLORATION +cefoperazona/sulbactam I-EXPLORATION +para I-EXPLORATION +Pseudomonas I-EXPLORATION +aeruginosa. I-EXPLORATION +Permaneció B-EVOLUTION +grave, I-EVOLUTION +aunque I-EVOLUTION +afebril I-EVOLUTION +y, I-EVOLUTION +desde I-EVOLUTION +el I-EVOLUTION +punto I-EVOLUTION +de I-EVOLUTION +vista I-EVOLUTION +cardiopulmonar, I-EVOLUTION +requiriendo I-EVOLUTION +menor I-EVOLUTION +apoyo I-EVOLUTION +ventilatorio, I-EVOLUTION +con I-EVOLUTION +modificación I-EVOLUTION +de I-EVOLUTION los I-EVOLUTION -19 I-EVOLUTION -años I-EVOLUTION +parámetros I-EVOLUTION +de I-EVOLUTION +soporte I-EVOLUTION +y I-EVOLUTION de I-EVOLUTION +aminas I-EVOLUTION +vasoactivas. I-EVOLUTION +Durante I-EVOLUTION la I-EVOLUTION -primera I-EVOLUTION -visita I-EVOLUTION +cuarta I-EVOLUTION +semana I-EVOLUTION +de I-EVOLUTION +hospitalización I-EVOLUTION +se I-EVOLUTION +describió I-EVOLUTION la I-EVOLUTION -paciente I-EVOLUTION -empezó I-EVOLUTION -a I-EVOLUTION -aquejar I-EVOLUTION -intenso I-EVOLUTION -dolor I-EVOLUTION -debido I-EVOLUTION -a I-EVOLUTION -un I-EVOLUTION -glaucoma I-EVOLUTION -agudo I-EVOLUTION -con I-EVOLUTION -inflamación I-EVOLUTION +aparición I-EVOLUTION +de I-EVOLUTION +una I-EVOLUTION +lesión I-EVOLUTION +ulcerada I-EVOLUTION en I-EVOLUTION -cámara I-EVOLUTION -anterior I-EVOLUTION +el I-EVOLUTION +dorso I-EVOLUTION +nasal, I-EVOLUTION +de I-EVOLUTION +fondo I-EVOLUTION +necrótico I-EVOLUTION y I-EVOLUTION -seclusión I-EVOLUTION -pupilar I-EVOLUTION -sin I-EVOLUTION -rubeosis I-EVOLUTION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT +bordes I-EVOLUTION +irregulares, I-EVOLUTION +además I-EVOLUTION +de I-EVOLUTION +una I-EVOLUTION +escara I-EVOLUTION +sacra I-EVOLUTION +y I-EVOLUTION +otras I-EVOLUTION +en I-EVOLUTION +los I-EVOLUTION +talones. I-EVOLUTION + I-EVOLUTION +Continuó I-EVOLUTION +afebril I-EVOLUTION +y B-TREATMENT +en I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +cefoperazona/ I-TREATMENT +sulbactam I-TREATMENT +y I-TREATMENT +anidulafungina. I-TREATMENT +Un B-EXPLORATION +cultivo I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +lesión I-EXPLORATION +nasal I-EXPLORATION +fue I-EXPLORATION +informado I-EXPLORATION +como I-EXPLORATION +positivo I-EXPLORATION +para I-EXPLORATION +C. I-EXPLORATION +albicans. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +biopsia I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +misma I-EXPLORATION +lesión I-EXPLORATION +se I-EXPLORATION +apreciaban I-EXPLORATION +abundantes I-EXPLORATION +elementos I-EXPLORATION +micóticos I-EXPLORATION +tipo I-EXPLORATION +hifas I-EXPLORATION +no I-EXPLORATION +septadas, I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION +mucor, I-EXPLORATION +en I-EXPLORATION +un I-EXPLORATION +fragmento I-EXPLORATION +del I-EXPLORATION +ala I-EXPLORATION +nasal. I-EXPLORATION +Con B-TREATMENT +estos I-TREATMENT +resultados I-TREATMENT se I-TREATMENT -decidió I-TREATMENT +suspendió I-TREATMENT la I-TREATMENT -enucleación. I-TREATMENT - I-TREATMENT -En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -anatomopatológico I-EXPLORATION -del I-EXPLORATION -globo I-EXPLORATION -ocular I-EXPLORATION -: I-EXPLORATION -el I-EXPLORATION -ángulo I-EXPLORATION -camerular I-EXPLORATION -está I-EXPLORATION -abierto, I-EXPLORATION -contiene I-EXPLORATION -abundantes I-EXPLORATION -macrófagos I-EXPLORATION -llenos I-EXPLORATION +anidulafungina I-TREATMENT +e I-TREATMENT +inició I-TREATMENT +terapia I-TREATMENT +con I-TREATMENT +anfotericina I-TREATMENT +B I-TREATMENT +desoxicolato I-TREATMENT +en I-TREATMENT +dosis I-TREATMENT +ajustada I-TREATMENT +según I-TREATMENT +función I-TREATMENT +renal I-TREATMENT +(creatininemia: I-TREATMENT +3 I-TREATMENT +mg/dL). I-TREATMENT +El B-EXPLORATION +estudio I-EXPLORATION +con I-EXPLORATION +fondo I-EXPLORATION de I-EXPLORATION -pigmento I-EXPLORATION -que I-EXPLORATION -infiltran I-EXPLORATION +ojo, I-EXPLORATION +tomografía I-EXPLORATION +axial I-EXPLORATION +computada I-EXPLORATION +(TAC) I-EXPLORATION +cerebral I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +cavidades I-EXPLORATION +paranasales I-EXPLORATION +no I-EXPLORATION +demostró I-EXPLORATION la I-EXPLORATION -malla I-EXPLORATION -trabecular, I-EXPLORATION -rodean I-EXPLORATION -el I-EXPLORATION -canal I-EXPLORATION +concomitancia I-EXPLORATION +de I-EXPLORATION +lesiones I-EXPLORATION +profundas. I-EXPLORATION + I-EXPLORATION +Permaneció B-EVOLUTION +grave, I-EVOLUTION +con I-EVOLUTION +ictericia I-EVOLUTION +intensa I-EVOLUTION +(bilirrubinemia I-EVOLUTION +total: I-EVOLUTION +21 I-EVOLUTION +mg/dL, I-EVOLUTION +bilirrubinemia I-EVOLUTION +directa: I-EVOLUTION +19 I-EVOLUTION +mg/dL, I-EVOLUTION +fosfatasas I-EVOLUTION +alcalinas: I-EVOLUTION +854 I-EVOLUTION +U/l, I-EVOLUTION +GOT: I-EVOLUTION +83 I-EVOLUTION +U/L, I-EVOLUTION +GPT: I-EVOLUTION +8 I-EVOLUTION +U/L). I-EVOLUTION +La B-EXPLORATION +TAC I-EXPLORATION +de I-EXPLORATION +abdomen-pélvis I-EXPLORATION +demostró I-EXPLORATION +hepatomegalia I-EXPLORATION +difusa I-EXPLORATION +sin I-EXPLORATION +abscedación, I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +vía I-EXPLORATION +biliar I-EXPLORATION +de I-EXPLORATION +estructura I-EXPLORATION +conservada. I-EXPLORATION +Una I-EXPLORATION +TAC I-EXPLORATION de I-EXPLORATION -Schlemm, I-EXPLORATION -tapizan I-EXPLORATION +tórax I-EXPLORATION +comprobó I-EXPLORATION la I-EXPLORATION -superficie I-EXPLORATION -anterior I-EXPLORATION -del I-EXPLORATION -iris, I-EXPLORATION +existencia I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +extensa I-EXPLORATION +efusión I-EXPLORATION +pleural I-EXPLORATION +a I-EXPLORATION +izquierda I-EXPLORATION y I-EXPLORATION -aparecen I-EXPLORATION -sobre I-EXPLORATION +el I-EXPLORATION +colapso I-EXPLORATION +pulmonar I-EXPLORATION +ipsilateral. I-EXPLORATION +La I-EXPLORATION +punción I-EXPLORATION +de I-EXPLORATION +esta I-EXPLORATION +efusión I-EXPLORATION +dio I-EXPLORATION +salida I-EXPLORATION +a I-EXPLORATION +líquido I-EXPLORATION +hemático I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +coagulaba I-EXPLORATION +y B-TREATMENT +se I-TREATMENT +instaló I-TREATMENT +un I-TREATMENT +tubo I-TREATMENT +de I-TREATMENT +drenaje I-TREATMENT +pleural. I-TREATMENT + I-TREATMENT +En B-EVOLUTION +los I-EVOLUTION +días I-EVOLUTION +posteriores I-EVOLUTION +evolucionó I-EVOLUTION +febril, I-EVOLUTION +en I-EVOLUTION +anuria, I-EVOLUTION +con I-EVOLUTION +altos I-EVOLUTION +requerimientos I-EVOLUTION +de I-EVOLUTION +apoyo I-EVOLUTION +ventilatorio I-EVOLUTION +y I-EVOLUTION +hemodinámico. I-EVOLUTION +El I-EVOLUTION +paciente I-EVOLUTION +falleció, I-EVOLUTION +habiendo B-TREATMENT +completado I-TREATMENT +cinco I-TREATMENT +días I-TREATMENT +de I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +anfotericina I-TREATMENT +B I-TREATMENT +y I-TREATMENT +luego I-TREATMENT +de I-TREATMENT +efectuarse I-TREATMENT +dos I-TREATMENT +aseos I-TREATMENT +quirúrgicos I-TREATMENT +de I-TREATMENT +la I-TREATMENT +lesión I-TREATMENT +nasal. I-TREATMENT + I-TREATMENT + +Se B-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +53 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tipo I-PRESENT_ILLNESS +cólico I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +hemiabdomen I-PRESENT_ILLNESS +inferior I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +24 I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +acompañado I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +39 I-PRESENT_ILLNESS +oC, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +otra I-PRESENT_ILLNESS +sintomatología I-PRESENT_ILLNESS +asociada. I-PRESENT_ILLNESS +El B-EXPLORATION +paciente I-EXPLORATION +presenta I-EXPLORATION +dolor I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -cápsula I-EXPLORATION -posterior I-EXPLORATION -del I-EXPLORATION -cristalino, I-EXPLORATION -entre I-EXPLORATION -los I-EXPLORATION -procesos I-EXPLORATION -ciliares I-EXPLORATION -y I-EXPLORATION +palpación I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -vítreo I-EXPLORATION -anterior. I-EXPLORATION -El I-EXPLORATION -cristalino I-EXPLORATION -es I-EXPLORATION -cataratoso. I-EXPLORATION -Emergiendo I-EXPLORATION +hemiabdomen I-EXPLORATION +inferior, I-EXPLORATION +más I-EXPLORATION +intenso I-EXPLORATION +en I-EXPLORATION +fosa I-EXPLORATION +iliaca I-EXPLORATION +derecha, I-EXPLORATION +con I-EXPLORATION +defensa I-EXPLORATION +y I-EXPLORATION +signo I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -cabeza I-EXPLORATION -del I-EXPLORATION -nervio I-EXPLORATION -óptico I-EXPLORATION +Blumberg I-EXPLORATION +positivo. I-EXPLORATION +Se I-EXPLORATION +solicitó I-EXPLORATION +una I-EXPLORATION +analítica I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +mostró I-EXPLORATION +leucocitosis I-EXPLORATION +ni I-EXPLORATION +neutrofilia I-EXPLORATION +(leucocitos I-EXPLORATION +8, I-EXPLORATION +8 I-EXPLORATION +x I-EXPLORATION +109/L, I-EXPLORATION +neutrófilos I-EXPLORATION +70%) I-EXPLORATION y I-EXPLORATION -extendiéndose I-EXPLORATION -por I-EXPLORATION +una I-EXPLORATION +radiografía I-EXPLORATION +abdominal I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -retina I-EXPLORATION -yuxtapapilar I-EXPLORATION +que I-EXPLORATION +únicamente I-EXPLORATION se I-EXPLORATION -aprecia I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -densamente I-EXPLORATION -pigmentado I-EXPLORATION -compuesto I-EXPLORATION -por I-EXPLORATION -células I-EXPLORATION -grandes I-EXPLORATION -poliédricas I-EXPLORATION -con I-EXPLORATION -citoplasma I-EXPLORATION -abundante I-EXPLORATION -y I-EXPLORATION -núcleos I-EXPLORATION -picnóticos I-EXPLORATION -pequeños. I-EXPLORATION -La I-EXPLORATION -mayoría I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -células I-EXPLORATION -son I-EXPLORATION -anucleoladas I-EXPLORATION -pero I-EXPLORATION -unas I-EXPLORATION -pocas I-EXPLORATION -tienen I-EXPLORATION -nucléolos I-EXPLORATION -pequeños. I-EXPLORATION -El I-EXPLORATION -tumor I-EXPLORATION -muestra I-EXPLORATION -focos I-EXPLORATION +observó I-EXPLORATION +dilatación I-EXPLORATION de I-EXPLORATION -necrosis I-EXPLORATION +asas I-EXPLORATION +intestinales. I-EXPLORATION +Se I-EXPLORATION +solicita I-EXPLORATION +una I-EXPLORATION +TC I-EXPLORATION +abdominal I-EXPLORATION +que I-EXPLORATION +evidencia I-EXPLORATION +un I-EXPLORATION +apéndice I-EXPLORATION +cecal I-EXPLORATION en I-EXPLORATION -su I-EXPLORATION -superficie, I-EXPLORATION +disposición I-EXPLORATION +pélvica, I-EXPLORATION +discretamente I-EXPLORATION +engrosado, I-EXPLORATION con I-EXPLORATION -siembra I-EXPLORATION -de I-EXPLORATION -macrófagos I-EXPLORATION -llenos I-EXPLORATION -de I-EXPLORATION -pigmento I-EXPLORATION -sobre I-EXPLORATION +mínimos I-EXPLORATION +cambios I-EXPLORATION +inflamatorios I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -membrana I-EXPLORATION -limitante I-EXPLORATION -interna I-EXPLORATION +grasa I-EXPLORATION +adyacente I-EXPLORATION y I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -vítreo. I-EXPLORATION -En I-EXPLORATION -algunas I-EXPLORATION -áreas I-EXPLORATION -se I-EXPLORATION -observan I-EXPLORATION -células I-EXPLORATION -fusiformes I-EXPLORATION -intensamente I-EXPLORATION -pigmentadas. I-EXPLORATION -Las I-EXPLORATION -células I-EXPLORATION -pigmentadas I-EXPLORATION -en I-EXPLORATION -muchas I-EXPLORATION -áreas I-EXPLORATION -se I-EXPLORATION -extienden I-EXPLORATION -a I-EXPLORATION -lo I-EXPLORATION -largo I-EXPLORATION +una I-EXPLORATION +pequeña I-EXPLORATION +colección I-EXPLORATION +líquida I-EXPLORATION de I-EXPLORATION +12 I-EXPLORATION +x I-EXPLORATION +9 I-EXPLORATION +mm I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -membrana I-EXPLORATION -limitante I-EXPLORATION -interna I-EXPLORATION +punta, I-EXPLORATION +sin I-EXPLORATION +líquido I-EXPLORATION +libre I-EXPLORATION +intraabdominal, I-EXPLORATION +pneumoperitoneo I-EXPLORATION +ni I-EXPLORATION +adenopatías I-EXPLORATION +retroperitoneales I-EXPLORATION +o I-EXPLORATION +pélvicas I-EXPLORATION +significativas. I-EXPLORATION + I-EXPLORATION +Con B-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT +de I-TREATMENT +presunción I-TREATMENT +de I-TREATMENT +apendicitis I-TREATMENT +aguda I-TREATMENT +se I-TREATMENT +realiza I-TREATMENT +una I-TREATMENT +apendicectomía I-TREATMENT +laparotómica, I-TREATMENT +hallando I-TREATMENT +un I-TREATMENT +apéndice I-TREATMENT +gangrenoso I-TREATMENT +perforado I-TREATMENT +con I-TREATMENT +líquido I-TREATMENT +libre I-TREATMENT +intraabdominal. I-TREATMENT +El B-EVOLUTION +curso I-EVOLUTION +postoperatorio I-EVOLUTION +transcurre I-EVOLUTION +sin I-EVOLUTION +incidencias. I-EVOLUTION +La B-EXPLORATION +anatomía I-EXPLORATION +patológica I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -retina I-EXPLORATION -llegando I-EXPLORATION -hasta I-EXPLORATION -la I-EXPLORATION -ora I-EXPLORATION -serrata. I-EXPLORATION -Las I-EXPLORATION -preparaciones I-EXPLORATION -decoloradas I-EXPLORATION -del I-EXPLORATION -tumor I-EXPLORATION -muestran I-EXPLORATION -características I-EXPLORATION -citológicas I-EXPLORATION -benignas I-EXPLORATION -propias I-EXPLORATION +pieza I-EXPLORATION +quirúrgica I-EXPLORATION +identifica I-EXPLORATION +una I-EXPLORATION +neoplasia I-EXPLORATION +mucinosa I-EXPLORATION +apendicular I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -células I-EXPLORATION -del I-EXPLORATION -melanocitoma. I-EXPLORATION -El I-EXPLORATION -tumor I-EXPLORATION -no I-EXPLORATION -revela I-EXPLORATION -actividad I-EXPLORATION -mitótica, I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -evidencia I-EXPLORATION +bajo I-EXPLORATION +grado I-EXPLORATION +de I-EXPLORATION +malignidad I-EXPLORATION +con I-EXPLORATION +extravasación I-EXPLORATION +de I-EXPLORATION +mucina I-EXPLORATION +y I-EXPLORATION +ausencia I-EXPLORATION +de I-EXPLORATION +epitelio I-EXPLORATION +extraapendicular, I-EXPLORATION +con I-EXPLORATION +margen I-EXPLORATION de I-EXPLORATION -melanoma I-EXPLORATION -maligno I-EXPLORATION -ni I-EXPLORATION +resección I-EXPLORATION +libre I-EXPLORATION +y I-EXPLORATION +cambios I-EXPLORATION +típicos I-EXPLORATION de I-EXPLORATION -extensión I-EXPLORATION -extraocular. I-EXPLORATION +apendicitis I-EXPLORATION +aguda I-EXPLORATION +sobreañadidos. I-EXPLORATION I-EXPLORATION -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -70 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -remitido I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -disminución I-PRESENT_ILLNESS -progresiva I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -visión I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -ojo I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -(OD) I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -escotoma I-PRESENT_ILLNESS -central I-PRESENT_ILLNESS -relativo, I-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS +masculino I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS +45 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -Sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -oftalmológicos I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -familiares I-PAST_MEDICAL_HISTORY -conocidos. I-PAST_MEDICAL_HISTORY -Diabetes I-PAST_MEDICAL_HISTORY -mellitus I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -2, I-PAST_MEDICAL_HISTORY +edad, I-PRESENT_ILLNESS +producto B-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -tres I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +tercera I-PAST_MEDICAL_HISTORY +gestación I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +madre I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +34 I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +padre I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +40 I-PAST_MEDICAL_HISTORY años I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -evolución, I-PAST_MEDICAL_HISTORY +edad, I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +consanguíneos; I-PAST_MEDICAL_HISTORY +con B-FAMILY_HISTORY +dos I-FAMILY_HISTORY +hermanos I-FAMILY_HISTORY +aparentemente I-FAMILY_HISTORY +sanos; I-FAMILY_HISTORY +sin I-FAMILY_HISTORY +antecedentes I-FAMILY_HISTORY +familiares I-FAMILY_HISTORY +de I-FAMILY_HISTORY +importancia. I-FAMILY_HISTORY +Durante I-FAMILY_HISTORY +todo I-FAMILY_HISTORY +el I-FAMILY_HISTORY +embarazo I-FAMILY_HISTORY +la I-FAMILY_HISTORY +madre I-FAMILY_HISTORY +cursó I-FAMILY_HISTORY +con I-FAMILY_HISTORY +tos I-FAMILY_HISTORY +productiva, I-FAMILY_HISTORY +persistente, I-FAMILY_HISTORY +sin I-FAMILY_HISTORY +predominio I-FAMILY_HISTORY +de I-FAMILY_HISTORY +horario, I-FAMILY_HISTORY +tratada I-FAMILY_HISTORY +con I-FAMILY_HISTORY +nebulizaciones I-FAMILY_HISTORY +con I-FAMILY_HISTORY +salbutamol I-FAMILY_HISTORY +y, I-FAMILY_HISTORY +en I-FAMILY_HISTORY +el I-FAMILY_HISTORY +segundo I-FAMILY_HISTORY +trimestre I-FAMILY_HISTORY +de I-FAMILY_HISTORY +gestación, I-FAMILY_HISTORY +con I-FAMILY_HISTORY +infecciones I-FAMILY_HISTORY +vaginales I-FAMILY_HISTORY +reiteradas I-FAMILY_HISTORY +cuyo I-FAMILY_HISTORY +manejo I-FAMILY_HISTORY +se I-FAMILY_HISTORY +desconoce. I-FAMILY_HISTORY +El B-PAST_MEDICAL_HISTORY +producto I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +obtenido I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +cesárea I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +36 I-PAST_MEDICAL_HISTORY +semanas I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +gestación; I-PAST_MEDICAL_HISTORY +peso: I-PAST_MEDICAL_HISTORY +2800 I-PAST_MEDICAL_HISTORY +g, I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -buen I-PAST_MEDICAL_HISTORY -control I-PAST_MEDICAL_HISTORY -metabólico, I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY +atresia I-PAST_MEDICAL_HISTORY +bilateral I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +coanas I-PAST_MEDICAL_HISTORY +(ABC), I-PAST_MEDICAL_HISTORY +encefalocele, I-PAST_MEDICAL_HISTORY +hidrocefalia, I-PAST_MEDICAL_HISTORY +microftalmía I-PAST_MEDICAL_HISTORY +derecha I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +restos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +bandas I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +constricción I-PAST_MEDICAL_HISTORY +oscuras I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -tratamiento. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -La B-EXPLORATION -mejor I-EXPLORATION -agudeza I-EXPLORATION -visual I-EXPLORATION -con I-EXPLORATION -corrección I-EXPLORATION -en I-EXPLORATION +dedos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +manos I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +pies; I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +datos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +características I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +placenta. I-PAST_MEDICAL_HISTORY +Al I-PAST_MEDICAL_HISTORY +5to I-PAST_MEDICAL_HISTORY +día I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +vida I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +le I-PAST_MEDICAL_HISTORY +colocó I-PAST_MEDICAL_HISTORY +válvula I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +derivación I-PAST_MEDICAL_HISTORY +ventriculoperitoneal I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +realizó I-PAST_MEDICAL_HISTORY +plastia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +encefalocele; I-PAST_MEDICAL_HISTORY +a B-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +semanas I-PRESENT_ILLNESS +desarrolla I-PRESENT_ILLNESS +neumonía I-PRESENT_ILLNESS +nosocomial. I-PRESENT_ILLNESS +A B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION -inicial I-EXPLORATION -era I-EXPLORATION +física I-EXPLORATION +actual, I-EXPLORATION +peso: I-EXPLORATION +3150 I-EXPLORATION +g I-EXPLORATION +(percentil I-EXPLORATION +3); I-EXPLORATION +talla: I-EXPLORATION +52 I-EXPLORATION +cm I-EXPLORATION +(percentil I-EXPLORATION +20); I-EXPLORATION +plagiocefalia I-EXPLORATION +frontotemporal I-EXPLORATION +izquierda, I-EXPLORATION +dolicocefalia, I-EXPLORATION +cicatriz I-EXPLORATION de I-EXPLORATION -4/10 I-EXPLORATION -en I-EXPLORATION -OD I-EXPLORATION -(+1, I-EXPLORATION -75; I-EXPLORATION --1.00×95o) I-EXPLORATION -y I-EXPLORATION -8/10 I-EXPLORATION +plastia I-EXPLORATION en I-EXPLORATION -ojo I-EXPLORATION -izquierdo I-EXPLORATION -(OI) I-EXPLORATION -(+1, I-EXPLORATION -75; I-EXPLORATION --1, I-EXPLORATION -50×85o). I-EXPLORATION -La I-EXPLORATION -biomicroscopia I-EXPLORATION -del I-EXPLORATION -polo I-EXPLORATION -anterior I-EXPLORATION -era I-EXPLORATION -normal. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -fondo I-EXPLORATION +región I-EXPLORATION +occipital I-EXPLORATION de I-EXPLORATION -ojo I-EXPLORATION -se I-EXPLORATION -observaba I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION +10 I-EXPLORATION +cm I-EXPLORATION de I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -amarillenta, I-EXPLORATION -sobreelevada I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -área I-EXPLORATION -macular I-EXPLORATION -del I-EXPLORATION -OD I-EXPLORATION +longitud I-EXPLORATION y I-EXPLORATION -alteración I-EXPLORATION -pigmentaria I-EXPLORATION -macular I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -OI. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -encontraron I-EXPLORATION -signos I-EXPLORATION +válvula I-EXPLORATION de I-EXPLORATION -retinopatía I-EXPLORATION -diabética I-EXPLORATION +pudens I-EXPLORATION en I-EXPLORATION -ninguno I-EXPLORATION +región I-EXPLORATION +temporal I-EXPLORATION +derecha, I-EXPLORATION +frontal I-EXPLORATION +prominente; I-EXPLORATION +ausencia I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -ojos. I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION +cejas; I-EXPLORATION +microftalmía I-EXPLORATION +derecha; I-EXPLORATION +puente I-EXPLORATION +nasal I-EXPLORATION +deprimido; I-EXPLORATION +hiperplasia I-EXPLORATION +gingival; I-EXPLORATION +paladar I-EXPLORATION +ojival; I-EXPLORATION +pectus I-EXPLORATION +excavatum; I-EXPLORATION +hernia I-EXPLORATION +umbilical; I-EXPLORATION +marca I-EXPLORATION de I-EXPLORATION -coherencia I-EXPLORATION -óptica I-EXPLORATION -(OCT) I-EXPLORATION -mostraba, I-EXPLORATION +constricción I-EXPLORATION +circular I-EXPLORATION +por I-EXPLORATION +bandas I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -área I-EXPLORATION -macular I-EXPLORATION -del I-EXPLORATION -OD, I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION +región I-EXPLORATION +distal I-EXPLORATION de I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION +antebrazo I-EXPLORATION +derecho I-EXPLORATION +y I-EXPLORATION +dedos I-EXPLORATION +2, I-EXPLORATION +3 I-EXPLORATION +y I-EXPLORATION +4; I-EXPLORATION +además I-EXPLORATION de I-EXPLORATION -reflectividad I-EXPLORATION -media, I-EXPLORATION -por I-EXPLORATION -encima I-EXPLORATION +aplasia I-EXPLORATION +ungueal I-EXPLORATION +y I-EXPLORATION +acrosindactilia I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -banda I-EXPLORATION -del I-EXPLORATION -epitelio I-EXPLORATION -pigmentario, I-EXPLORATION +éstos; I-EXPLORATION +mano I-EXPLORATION +izquierda I-EXPLORATION con I-EXPLORATION -levantamiento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -retina I-EXPLORATION -neurosensorial, I-EXPLORATION -sin I-EXPLORATION -evidencia I-EXPLORATION +marca I-EXPLORATION de I-EXPLORATION -fluido I-EXPLORATION -intrarretiniano I-EXPLORATION -ni I-EXPLORATION -subretiniano. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -angiografía I-EXPLORATION -fluoresceínica I-EXPLORATION -(AGF) I-EXPLORATION -podía I-EXPLORATION -comprobarse I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION +constricción I-EXPLORATION +circular I-EXPLORATION +por I-EXPLORATION +bandas I-EXPLORATION +en I-EXPLORATION +4to I-EXPLORATION +dedo I-EXPLORATION +y I-EXPLORATION +acrosindactilia I-EXPLORATION +con I-EXPLORATION +ausencia I-EXPLORATION +ungueal I-EXPLORATION de I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -hiperfluorescente I-EXPLORATION +dedos I-EXPLORATION +2do I-EXPLORATION +y I-EXPLORATION +3ro; I-EXPLORATION +pie I-EXPLORATION +derecho I-EXPLORATION con I-EXPLORATION -centro I-EXPLORATION +acrosindactilia I-EXPLORATION de I-EXPLORATION -hipofluorescencia, I-EXPLORATION -que I-EXPLORATION -aumentaba I-EXPLORATION +dedos I-EXPLORATION +2do I-EXPLORATION +y I-EXPLORATION +3ro; I-EXPLORATION +pie I-EXPLORATION +izquierdo I-EXPLORATION +ausencia I-EXPLORATION de I-EXPLORATION -intensidad I-EXPLORATION -en I-EXPLORATION -fases I-EXPLORATION -tardías I-EXPLORATION -pero I-EXPLORATION -sin I-EXPLORATION -difusión I-EXPLORATION -del I-EXPLORATION -contraste, I-EXPLORATION -que I-EXPLORATION -confirmaría I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION +dedos I-EXPLORATION +1ro, I-EXPLORATION +2do I-EXPLORATION +y I-EXPLORATION +3ro, I-EXPLORATION +acrosindactilia I-EXPLORATION +y I-EXPLORATION +marca I-EXPLORATION de I-EXPLORATION -DFVA. I-EXPLORATION -Las I-EXPLORATION -pruebas I-EXPLORATION -electrofisiológicas, I-EXPLORATION -tanto I-EXPLORATION -el I-EXPLORATION -electrorretinograma I-EXPLORATION -como I-EXPLORATION -el I-EXPLORATION -electrooculograma, I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION +banda I-EXPLORATION +de I-EXPLORATION +constricción I-EXPLORATION +de I-EXPLORATION +5to I-EXPLORATION +dedo. I-EXPLORATION I-EXPLORATION -A I-EXPLORATION -partir I-EXPLORATION +Los I-EXPLORATION +estudios I-EXPLORATION de I-EXPLORATION -ese I-EXPLORATION -momento I-EXPLORATION -se I-EXPLORATION -establecieron I-EXPLORATION -controles I-EXPLORATION -oftalmológicos I-EXPLORATION -periódicos, I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -que I-EXPLORATION +laboratorio I-EXPLORATION se I-EXPLORATION -evidenció I-EXPLORATION -la I-EXPLORATION -regresión I-EXPLORATION -progresiva I-EXPLORATION +encontraron I-EXPLORATION +dentro I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -lesión I-EXPLORATION -viteliforme I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -evolución I-EXPLORATION -hacia I-EXPLORATION -la I-EXPLORATION -atrofia I-EXPLORATION -del I-EXPLORATION -epitelio I-EXPLORATION -pigmentario I-EXPLORATION -macular I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -OD. I-EXPLORATION -La I-EXPLORATION -visión I-EXPLORATION -en I-EXPLORATION +parámetros I-EXPLORATION +normales; I-EXPLORATION el I-EXPLORATION -OI I-EXPLORATION -se I-EXPLORATION -mantuvo I-EXPLORATION -estable I-EXPLORATION -(7/10), I-EXPLORATION -a I-EXPLORATION -pesar I-EXPLORATION -de I-EXPLORATION -que I-EXPLORATION -las I-EXPLORATION -alteraciones I-EXPLORATION -pigmentarias I-EXPLORATION -maculares I-EXPLORATION -eran I-EXPLORATION -cada I-EXPLORATION -vez I-EXPLORATION -más I-EXPLORATION -evidentes. I-EXPLORATION - I-EXPLORATION -Dos B-EVOLUTION -años I-EVOLUTION -y I-EVOLUTION -medio I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -primera I-EVOLUTION -visita, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -consulta I-EVOLUTION -por I-EVOLUTION -disminución I-EVOLUTION -brusca I-EVOLUTION -de I-EVOLUTION -visión I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -OI I-EVOLUTION -(2/10), I-EVOLUTION -coincidiendo I-EVOLUTION -con I-EVOLUTION -la I-EVOLUTION -aparición I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -desprendimiento I-EVOLUTION -macular I-EVOLUTION -serohemorrágico I-EVOLUTION -en I-EVOLUTION -dicho I-EVOLUTION -ojo. I-EVOLUTION -La B-EXPLORATION -OCT I-EXPLORATION -mostraba I-EXPLORATION -un I-EXPLORATION -importante I-EXPLORATION -levantamiento I-EXPLORATION -macular I-EXPLORATION +cariotipo I-EXPLORATION con I-EXPLORATION -desprendimiento I-EXPLORATION -del I-EXPLORATION -epitelio I-EXPLORATION -pigmentario, I-EXPLORATION -quistes I-EXPLORATION -intrarretinianos I-EXPLORATION +resolución I-EXPLORATION +de I-EXPLORATION +550 I-EXPLORATION +bandas I-EXPLORATION y I-EXPLORATION -presencia I-EXPLORATION +técnica I-EXPLORATION de I-EXPLORATION -líquido I-EXPLORATION -subretiniano I-EXPLORATION -(LSR) I-EXPLORATION +bandeo I-EXPLORATION +G I-EXPLORATION en I-EXPLORATION -los I-EXPLORATION -bordes I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lesión. I-EXPLORATION -Mediante I-EXPLORATION -AGF I-EXPLORATION +40 I-EXPLORATION +metafases I-EXPLORATION se I-EXPLORATION -comprobó I-EXPLORATION +informó: I-EXPLORATION +46, I-EXPLORATION +XY; I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +radiografías I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +ausencia I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -existencia I-EXPLORATION +2da I-EXPLORATION +falange I-EXPLORATION +distal I-EXPLORATION de I-EXPLORATION -una I-EXPLORATION -membrana I-EXPLORATION -neovascular I-EXPLORATION -oculta I-EXPLORATION -con I-EXPLORATION -difusión I-EXPLORATION -tardía I-EXPLORATION -del I-EXPLORATION -colorante. I-EXPLORATION -En B-TREATMENT -este I-TREATMENT -momento I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -realizar I-TREATMENT -tratamiento I-TREATMENT -en I-TREATMENT -el I-TREATMENT -OI I-TREATMENT -con I-TREATMENT -ranibizumab I-TREATMENT -intravítreo, I-TREATMENT -a I-TREATMENT -la I-TREATMENT -dosis I-TREATMENT -habitualmente I-TREATMENT -utilizada I-TREATMENT -para I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -de I-TREATMENT -la I-TREATMENT -degeneración I-TREATMENT -macular I-TREATMENT -exudativa I-TREATMENT -(0,5mg/0,05ml). I-TREATMENT - I-TREATMENT -A B-EVOLUTION -las I-EVOLUTION -4 I-EVOLUTION -semanas I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -inyección I-EVOLUTION -la I-EVOLUTION -agudeza I-EVOLUTION -visual I-EVOLUTION -había I-EVOLUTION -mejorado I-EVOLUTION -a I-EVOLUTION -3/10 I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -OI, I-EVOLUTION -con I-EVOLUTION -reabsorción I-EVOLUTION -prácticamente I-EVOLUTION -completa I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -hemorragia I-EVOLUTION -macular, I-EVOLUTION -apreciándose I-EVOLUTION -una I-EVOLUTION -mínima I-EVOLUTION -cantidad I-EVOLUTION -de I-EVOLUTION -LSR I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -tomografía. I-EVOLUTION -Tras I-EVOLUTION -8 I-EVOLUTION -semanas, I-EVOLUTION -la I-EVOLUTION -AV I-EVOLUTION -era I-EVOLUTION -de I-EVOLUTION -4/10, I-EVOLUTION -comprobándose I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -OCT I-EVOLUTION -una I-EVOLUTION -disminución I-EVOLUTION -importante I-EVOLUTION -del I-EVOLUTION -grosor I-EVOLUTION -macular I-EVOLUTION -central I-EVOLUTION -con I-EVOLUTION -mínima I-EVOLUTION -fibrosis I-EVOLUTION -subretiniana. I-EVOLUTION -En I-EVOLUTION -el I-EVOLUTION -control I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -3 I-EVOLUTION -meses, I-EVOLUTION -la I-EVOLUTION -visión I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -OI I-EVOLUTION -había I-EVOLUTION -descendido I-EVOLUTION -(2/10), I-EVOLUTION -evidenciándose I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -OCT I-EVOLUTION -un I-EVOLUTION -aumento I-EVOLUTION -del I-EVOLUTION -espesor I-EVOLUTION -macular I-EVOLUTION -superior I-EVOLUTION -a I-EVOLUTION -100micras, I-EVOLUTION -con I-EVOLUTION -presencia I-EVOLUTION -de I-EVOLUTION -líquido I-EVOLUTION -subretiniano, I-EVOLUTION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -realizar I-TREATMENT -segunda I-TREATMENT -inyección I-TREATMENT -de I-TREATMENT -ranibizumab. I-TREATMENT -La B-EVOLUTION -respuesta I-EVOLUTION -a I-EVOLUTION -esta I-EVOLUTION -segunda I-EVOLUTION -inyección I-EVOLUTION -fue I-EVOLUTION -favorable, I-EVOLUTION -y I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -12 I-EVOLUTION -semanas I-EVOLUTION -se I-EVOLUTION -pudo I-EVOLUTION -comprobar I-EVOLUTION -la I-EVOLUTION -reabsorción I-EVOLUTION -completa I-EVOLUTION -del I-EVOLUTION -fluido I-EVOLUTION -subretiniano, I-EVOLUTION -quedando I-EVOLUTION -una I-EVOLUTION -mínima I-EVOLUTION -fibrosis I-EVOLUTION -subretiniana I-EVOLUTION -como I-EVOLUTION -resultado I-EVOLUTION -del I-EVOLUTION -cierre I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -membrana I-EVOLUTION -neovascular. I-EVOLUTION - I-EVOLUTION -Doce I-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -última I-EVOLUTION -inyección I-EVOLUTION -la I-EVOLUTION -agudeza I-EVOLUTION -visual I-EVOLUTION -se I-EVOLUTION -mantiene I-EVOLUTION -estable I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -OI I-EVOLUTION -(6/10), I-EVOLUTION -sin I-EVOLUTION -signos I-EVOLUTION -de I-EVOLUTION -reactivación I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -membrana I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -complicaciones I-EVOLUTION -derivadas I-EVOLUTION -del I-EVOLUTION -tratamiento I-EVOLUTION -intravítreo. I-EVOLUTION - I-EVOLUTION +mano I-EXPLORATION +derecha I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +2da I-EXPLORATION +y I-EXPLORATION +3era I-EXPLORATION +falanges I-EXPLORATION +distales I-EXPLORATION +en I-EXPLORATION +mano I-EXPLORATION +izquierda; I-EXPLORATION +pie I-EXPLORATION +derecho, I-EXPLORATION +pérdida I-EXPLORATION +de I-EXPLORATION +falanges I-EXPLORATION +medias I-EXPLORATION +y I-EXPLORATION +distales; I-EXPLORATION +en I-EXPLORATION +pie I-EXPLORATION +izquierdo I-EXPLORATION +ausencia I-EXPLORATION +de I-EXPLORATION +todas I-EXPLORATION +las I-EXPLORATION +falanges I-EXPLORATION +distales. I-EXPLORATION +Ecocardiograma I-EXPLORATION +normal. I-EXPLORATION +La I-EXPLORATION +tomografía I-EXPLORATION +axial I-EXPLORATION +computada I-EXPLORATION +simple I-EXPLORATION +de I-EXPLORATION +cráneo I-EXPLORATION +reveló: I-EXPLORATION +microftalmía I-EXPLORATION +derecha, I-EXPLORATION +encefalocele I-EXPLORATION +frontoparietal I-EXPLORATION +y I-EXPLORATION +megaventrículo I-EXPLORATION +derecho. I-EXPLORATION +La I-EXPLORATION +ABC I-EXPLORATION +con I-EXPLORATION +placa I-EXPLORATION +atrésica I-EXPLORATION +mixta I-EXPLORATION +se I-EXPLORATION +confirmó I-EXPLORATION +por I-EXPLORATION +tomografía I-EXPLORATION +axial I-EXPLORATION +computada, I-EXPLORATION +realizándose I-EXPLORATION +corrección I-EXPLORATION +vía I-EXPLORATION +endoscópica I-EXPLORATION +a I-EXPLORATION +los I-EXPLORATION +10 I-EXPLORATION +meses I-EXPLORATION +de I-EXPLORATION +edad. I-EXPLORATION + I-EXPLORATION -Embarazada B-PRESENT_ILLNESS +Se B-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -40 I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +18 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -multípara B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tres, I-PAST_MEDICAL_HISTORY -serología I-PAST_MEDICAL_HISTORY -VIH I-PAST_MEDICAL_HISTORY -negativo, I-PAST_MEDICAL_HISTORY -cursó I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -sífilis I-PAST_MEDICAL_HISTORY -latente I-PAST_MEDICAL_HISTORY -precoz I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -semana I-PAST_MEDICAL_HISTORY -28 I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -embarazo I-PAST_MEDICAL_HISTORY -(VDRL I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -reactivo I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -12 I-PAST_MEDICAL_HISTORY -semanas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -gestación, I-PAST_MEDICAL_HISTORY -VDRL I-PAST_MEDICAL_HISTORY -1: I-PAST_MEDICAL_HISTORY -128 I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -28 I-PAST_MEDICAL_HISTORY -semanas I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -VDRL I-PAST_MEDICAL_HISTORY -1: I-PAST_MEDICAL_HISTORY -32 I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -31 I-PAST_MEDICAL_HISTORY -semanas, I-PAST_MEDICAL_HISTORY -MHA-TP I-PAST_MEDICAL_HISTORY -(microhemagglutination-Treponema I-PAST_MEDICAL_HISTORY -pallidum I-PAST_MEDICAL_HISTORY -test) I-PAST_MEDICAL_HISTORY -positivo. I-PAST_MEDICAL_HISTORY -Tratada I-PAST_MEDICAL_HISTORY -junto I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -pareja I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -semanas I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -inicio I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -trabajo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -parto. I-PAST_MEDICAL_HISTORY -Sin I-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +natural I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Perú, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +ingresó I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +nuestro I-PRESENT_ILLNESS +Centro I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +mayo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2012. I-PRESENT_ILLNESS +En B-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +reconocimiento I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -sífilis I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -embarazos I-PAST_MEDICAL_HISTORY -previos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -pareja I-PAST_MEDICAL_HISTORY -estable I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY +ingresos I-PAST_MEDICAL_HISTORY +negó I-PAST_MEDICAL_HISTORY +haber I-PAST_MEDICAL_HISTORY +presentado I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +patológicos I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -Ingresó B-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS +interés. I-PAST_MEDICAL_HISTORY +Dentro B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -Urgencia I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -rotura I-PRESENT_ILLNESS -prematura I-PRESENT_ILLNESS -ovular I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +hábitos I-PRESENT_ILLNESS +tóxicos I-PRESENT_ILLNESS +refirió I-PRESENT_ILLNESS +consumo I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -30 I-PRESENT_ILLNESS -h I-PRESENT_ILLNESS +150 I-PRESENT_ILLNESS +gr. I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -administrándose B-TREATMENT -corticoides I-TREATMENT -y I-TREATMENT -6 I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -ampicilina. I-TREATMENT -Se B-EXPLORATION -realizó I-EXPLORATION -RPR I-EXPLORATION -en I-EXPLORATION -parto I-EXPLORATION -que I-EXPLORATION -resultó I-EXPLORATION -no I-EXPLORATION -reactivo I-EXPLORATION -(no I-EXPLORATION +alcohol I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +fines I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +semana I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +heroína I-PRESENT_ILLNESS +fumada I-PRESENT_ILLNESS +ocasional. I-PRESENT_ILLNESS +En I-PRESENT_ILLNESS +cuanto I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +prácticas I-PRESENT_ILLNESS +sexuales I-PRESENT_ILLNESS +manifestó I-PRESENT_ILLNESS +ser I-PRESENT_ILLNESS +heterosexual I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +haber I-PRESENT_ILLNESS +tenido I-PRESENT_ILLNESS +múltiples I-PRESENT_ILLNESS +parejas, I-PRESENT_ILLNESS +frecuentemente I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +contexto I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +intoxicación I-PRESENT_ILLNESS +enólica I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +tomar I-PRESENT_ILLNESS +medidas I-PRESENT_ILLNESS +preventivas. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +A B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION se I-EXPLORATION -realizó I-EXPLORATION -VDRL). I-EXPLORATION - I-EXPLORATION -Nació B-EVOLUTION -RN I-EVOLUTION -por I-EVOLUTION -parto I-EVOLUTION -vaginal I-EVOLUTION -de I-EVOLUTION -34 I-EVOLUTION -semanas, I-EVOLUTION -pequeño I-EVOLUTION -para I-EVOLUTION -la I-EVOLUTION -edad I-EVOLUTION -gestacional I-EVOLUTION -(PEG) I-EVOLUTION -peso I-EVOLUTION -de I-EVOLUTION -1.920 I-EVOLUTION -g, I-EVOLUTION -con I-EVOLUTION -cianosis I-EVOLUTION -generalizada, I-EVOLUTION -sin I-EVOLUTION -esfuerzo I-EVOLUTION -respiratorio, I-EVOLUTION -APGAR I-EVOLUTION -6-8, I-EVOLUTION -requiriendo B-TREATMENT -ventilación I-TREATMENT -a I-TREATMENT -presión I-TREATMENT -positiva. I-TREATMENT -Cursó I-TREATMENT -con I-TREATMENT -enfermedad I-TREATMENT -de I-TREATMENT -membrana I-TREATMENT -hialina I-TREATMENT -(EMH) I-TREATMENT -administrándose I-TREATMENT -surfactante, I-TREATMENT -sin I-TREATMENT -embargo, I-TREATMENT -por I-TREATMENT -compromiso I-TREATMENT -respiratorio I-TREATMENT -progresivo I-TREATMENT -debió I-TREATMENT -conectarse I-TREATMENT -a I-TREATMENT -ventilación I-TREATMENT -mecánica. I-TREATMENT -Evolucionó B-EVOLUTION -grave I-EVOLUTION -con I-EVOLUTION -altos I-EVOLUTION -requerimientos I-EVOLUTION -de I-EVOLUTION -oxígeno, I-EVOLUTION -con I-EVOLUTION -deterioro I-EVOLUTION -del I-EVOLUTION -estado I-EVOLUTION -general, I-EVOLUTION -se I-EVOLUTION -agregó I-EVOLUTION -ictericia I-EVOLUTION -generalizada, I-EVOLUTION -petequias I-EVOLUTION -múltiples, I-EVOLUTION -sangrado I-EVOLUTION -en I-EVOLUTION -sitios I-EVOLUTION -de I-EVOLUTION -punción I-EVOLUTION -e I-EVOLUTION -hipertensión I-EVOLUTION -pulmonar I-EVOLUTION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -debió I-TREATMENT -iniciarse I-TREATMENT -drogas I-TREATMENT -vasoactivas. I-TREATMENT -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -destacaba: I-EXPLORATION -abdomen I-EXPLORATION -globuloso, I-EXPLORATION -hepato-esplenomegalia I-EXPLORATION -(ambos I-EXPLORATION -en I-EXPLORATION -3 I-EXPLORATION -cm I-EXPLORATION -bajo I-EXPLORATION -reborde I-EXPLORATION -costal), I-EXPLORATION -petequias, I-EXPLORATION -edema I-EXPLORATION -de I-EXPLORATION -pared I-EXPLORATION -abdominal I-EXPLORATION -y I-EXPLORATION -extremidades, I-EXPLORATION -y I-EXPLORATION -descamación I-EXPLORATION -palmo-plantar. I-EXPLORATION -Inició B-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -penicilina I-TREATMENT -sódica I-TREATMENT -y I-TREATMENT -gentamicina I-TREATMENT -i.v. I-TREATMENT -por I-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -sepsis I-TREATMENT -precoz. I-TREATMENT - I-TREATMENT -Se B-EXPLORATION -recibió I-EXPLORATION -resultado I-EXPLORATION -del I-EXPLORATION -VDRL I-EXPLORATION +observaron I-EXPLORATION +numerosas I-EXPLORATION +lesiones I-EXPLORATION +cutáneas I-EXPLORATION +maculares I-EXPLORATION +de I-EXPLORATION +predominio I-EXPLORATION en I-EXPLORATION -sangre I-EXPLORATION -del I-EXPLORATION -RN I-EXPLORATION -1: I-EXPLORATION -64, I-EXPLORATION -no I-EXPLORATION +tórax, I-EXPLORATION +que I-EXPLORATION se I-EXPLORATION +orientó I-EXPLORATION +como I-EXPLORATION +pitiriasis I-EXPLORATION +rosada. I-EXPLORATION +Se I-EXPLORATION realizó I-EXPLORATION -punción I-EXPLORATION -lumbar I-EXPLORATION -(PL) I-EXPLORATION -en I-EXPLORATION -ese I-EXPLORATION -momento I-EXPLORATION -por I-EXPLORATION -gravedad I-EXPLORATION -y I-EXPLORATION -trombocitopenia I-EXPLORATION -marcada. I-EXPLORATION -Los I-EXPLORATION -exámenes I-EXPLORATION +analítica I-EXPLORATION +dentro I-EXPLORATION +del I-EXPLORATION +protocolo I-EXPLORATION de I-EXPLORATION -laboratorio I-EXPLORATION -iniciales I-EXPLORATION -se I-EXPLORATION -muestran I-EXPLORATION +ingresos: I-EXPLORATION +hemograma, I-EXPLORATION +bioquímica I-EXPLORATION +y I-EXPLORATION +serologías I-EXPLORATION +VIH, I-EXPLORATION +hepatitis I-EXPLORATION +y I-EXPLORATION +lues, I-EXPLORATION +detectándose I-EXPLORATION +Treponema I-EXPLORATION +pallidum I-EXPLORATION +anticuerpos I-EXPLORATION +reagínicos I-EXPLORATION +1/8, I-EXPLORATION +Treponema I-EXPLORATION +pallidum I-EXPLORATION +anticuerpos I-EXPLORATION +treponémicos I-EXPLORATION +positivos, I-EXPLORATION +sin I-EXPLORATION +alteraciones I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -tabla I-EXPLORATION -1. I-EXPLORATION +el I-EXPLORATION +resto I-EXPLORATION +de I-EXPLORATION +resultados I-EXPLORATION +analíticos. I-EXPLORATION I-EXPLORATION -Se I-EXPLORATION -asumió I-EXPLORATION -diagnóstico I-EXPLORATION -probable I-EXPLORATION +Reinterrogado, I-EXPLORATION +el I-EXPLORATION +paciente I-EXPLORATION +negó I-EXPLORATION +haber I-EXPLORATION +presentado I-EXPLORATION +ninguna I-EXPLORATION +manifestación I-EXPLORATION de I-EXPLORATION sífilis I-EXPLORATION -congénita I-EXPLORATION -y I-EXPLORATION -sepsis I-EXPLORATION -precoz, I-EXPLORATION +primaria, I-EXPLORATION +si I-EXPLORATION +bien, I-EXPLORATION se I-EXPLORATION -decidió I-EXPLORATION -completar I-EXPLORATION -estudio I-EXPLORATION -para I-EXPLORATION -pesquisa I-EXPLORATION +observaron I-EXPLORATION +numerosas I-EXPLORATION +placas I-EXPLORATION +alopécicas I-EXPLORATION +en I-EXPLORATION +cuero I-EXPLORATION +cabelludo I-EXPLORATION de I-EXPLORATION -daño I-EXPLORATION -multisistémico. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -ecocardiografía, I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -y I-EXPLORATION -ecografía I-EXPLORATION -cerebral I-EXPLORATION -que I-EXPLORATION -resultaron I-EXPLORATION -normales. I-EXPLORATION -Los I-EXPLORATION -hemocultivos I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -Completó B-EVOLUTION -tratamiento I-EVOLUTION -antibiótico I-EVOLUTION -con I-EVOLUTION -7 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -gentamicina I-EVOLUTION -iv I-EVOLUTION -y I-EVOLUTION -14 I-EVOLUTION -de I-EVOLUTION -penicilina I-EVOLUTION -sódica I-EVOLUTION -iv., I-EVOLUTION -lográndose I-EVOLUTION -disminuir I-EVOLUTION -progresivamente I-EVOLUTION -las I-EVOLUTION -drogas I-EVOLUTION -vasoactivas I-EVOLUTION -hasta I-EVOLUTION -su I-EVOLUTION -suspensión. I-EVOLUTION - I-EVOLUTION -En B-EXPLORATION -contexto I-EXPLORATION +distribución I-EXPLORATION +irregular, I-EXPLORATION de I-EXPLORATION -transaminasas I-EXPLORATION -elevadas I-EXPLORATION -y I-EXPLORATION -hepatomegalia I-EXPLORATION -se I-EXPLORATION -completó I-EXPLORATION -estudio I-EXPLORATION -con I-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -Hepatitis I-EXPLORATION -B I-EXPLORATION -y I-EXPLORATION -C I-EXPLORATION -que I-EXPLORATION -resultaron I-EXPLORATION -negativas. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -estudio I-EXPLORATION +características I-EXPLORATION +no I-EXPLORATION +cicatriciales, I-EXPLORATION +sin I-EXPLORATION +signos I-EXPLORATION +inflamatorios I-EXPLORATION +ni I-EXPLORATION +descamación, I-EXPLORATION +menores I-EXPLORATION de I-EXPLORATION -citomegalovirus I-EXPLORATION -(CMV). I-EXPLORATION -Se I-EXPLORATION -logró I-EXPLORATION -realizar I-EXPLORATION -PL I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -28 I-EXPLORATION -días I-EXPLORATION +un I-EXPLORATION +centímetro I-EXPLORATION de I-EXPLORATION -vida, I-EXPLORATION -resultando I-EXPLORATION -citoquímico I-EXPLORATION +diámetro, I-EXPLORATION de I-EXPLORATION -líquido I-EXPLORATION -cefalorraquídeo I-EXPLORATION -(LCR) I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -VDRL I-EXPLORATION +bordes I-EXPLORATION +mal I-EXPLORATION +definidos, I-EXPLORATION no I-EXPLORATION -reactivo, I-EXPLORATION -con I-EXPLORATION -VDRL I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION +desprovistas I-EXPLORATION +completamente I-EXPLORATION de I-EXPLORATION -1: I-EXPLORATION -32. I-EXPLORATION -Radiografía I-EXPLORATION -de I-EXPLORATION -huesos I-EXPLORATION -largos I-EXPLORATION +pelo, I-EXPLORATION y I-EXPLORATION -fondo I-EXPLORATION de I-EXPLORATION -ojo I-EXPLORATION -no I-EXPLORATION -mostraron I-EXPLORATION -alteraciones. I-EXPLORATION -Durante B-EVOLUTION +predominio I-EXPLORATION +en I-EXPLORATION +región I-EXPLORATION +temporo-occipital. I-EXPLORATION + I-EXPLORATION +Esta I-EXPLORATION +manifestación I-EXPLORATION +la I-EXPLORATION +había I-EXPLORATION +observado I-EXPLORATION +el I-EXPLORATION +propio I-EXPLORATION +paciente I-EXPLORATION +hacía I-EXPLORATION +cinco I-EXPLORATION +días, I-EXPLORATION +coincidiendo I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +corte I-EXPLORATION +de I-EXPLORATION +pelo, I-EXPLORATION +sin I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +hubiese I-EXPLORATION +percatado I-EXPLORATION +antes. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +lesión I-EXPLORATION +dermatológica I-EXPLORATION +descrita I-EXPLORATION +es I-EXPLORATION +coincidente I-EXPLORATION +con I-EXPLORATION +la I-EXPLORATION +denominada I-EXPLORATION +alopecia I-EXPLORATION +apolillada, I-EXPLORATION +un I-EXPLORATION +signo I-EXPLORATION +infrecuente I-EXPLORATION +de I-EXPLORATION +secundarismo I-EXPLORATION +luético. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +trató I-TREATMENT +con I-TREATMENT +penicilina I-TREATMENT +G I-TREATMENT +benzatina I-TREATMENT +2.400.000 I-TREATMENT +UI. I-TREATMENT +en I-TREATMENT +dosis I-TREATMENT +única. I-TREATMENT +Posteriormente B-EVOLUTION +se I-EVOLUTION +procedió I-EVOLUTION +a I-EVOLUTION +seguimiento I-EVOLUTION +clínico I-EVOLUTION +y I-EVOLUTION +serológico. I-EVOLUTION + I-EVOLUTION +Se I-EVOLUTION +considera I-EVOLUTION +que I-EVOLUTION +la I-EVOLUTION +alopecia I-EVOLUTION +se I-EVOLUTION +resuelve I-EVOLUTION +totalmente I-EVOLUTION +y I-EVOLUTION +sin I-EVOLUTION +secuelas I-EVOLUTION +hacia I-EVOLUTION el I-EVOLUTION -primer I-EVOLUTION +tercer I-EVOLUTION mes I-EVOLUTION +después I-EVOLUTION +del I-EVOLUTION +tratamiento1. I-EVOLUTION + I-EVOLUTION +La I-EVOLUTION +incidencia I-EVOLUTION de I-EVOLUTION -hospitalización I-EVOLUTION -evolucionó I-EVOLUTION -favorablemente I-EVOLUTION +la I-EVOLUTION +infección I-EVOLUTION +por I-EVOLUTION +sífilis I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +medio I-EVOLUTION +penitenciario I-EVOLUTION +es I-EVOLUTION +más I-EVOLUTION +alta I-EVOLUTION +que I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +población I-EVOLUTION +general2. I-EVOLUTION +La I-EVOLUTION +alopecia I-EVOLUTION +en I-EVOLUTION +cuero I-EVOLUTION +cabelludo I-EVOLUTION +es I-EVOLUTION +una I-EVOLUTION +manifestación I-EVOLUTION +poco I-EVOLUTION +común I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +sífilis I-EVOLUTION +secundaria3, I-EVOLUTION +se I-EVOLUTION +estima I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +presenta I-EVOLUTION +entre I-EVOLUTION +el I-EVOLUTION +4 I-EVOLUTION +y I-EVOLUTION +el I-EVOLUTION +11% I-EVOLUTION +según I-EVOLUTION +diversos I-EVOLUTION +estudios I-EVOLUTION +publicados4, I-EVOLUTION +5, I-EVOLUTION +pudiendo I-EVOLUTION +tratarse I-EVOLUTION +tanto I-EVOLUTION +de I-EVOLUTION +alopecias I-EVOLUTION +difusas I-EVOLUTION +como I-EVOLUTION +de I-EVOLUTION +aspecto I-EVOLUTION +apolillado6. I-EVOLUTION + I-EVOLUTION +Si I-EVOLUTION +bien I-EVOLUTION +la I-EVOLUTION +sífilis I-EVOLUTION +es I-EVOLUTION +poco I-EVOLUTION +habitual I-EVOLUTION +dentro I-EVOLUTION del I-EVOLUTION -punto I-EVOLUTION +diagnóstico I-EVOLUTION +diferencial I-EVOLUTION de I-EVOLUTION -vista I-EVOLUTION -clínico, I-EVOLUTION -con I-EVOLUTION -mejoría I-EVOLUTION +alopecia, I-EVOLUTION +debe I-EVOLUTION +ser I-EVOLUTION +tenido I-EVOLUTION +en I-EVOLUTION +cuenta I-EVOLUTION +el I-EVOLUTION +secundarismo I-EVOLUTION +luético, I-EVOLUTION +en I-EVOLUTION +un I-EVOLUTION +contexto I-EVOLUTION +epidemiológico I-EVOLUTION de I-EVOLUTION -pruebas I-EVOLUTION -hepáticas I-EVOLUTION -pero I-EVOLUTION -con I-EVOLUTION -mal I-EVOLUTION -incremento I-EVOLUTION -ponderal. I-EVOLUTION +riesgo. I-EVOLUTION I-EVOLUTION -Adolescente B-PRESENT_ILLNESS +Lactante B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -16 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -procedente B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -zona I-PAST_MEDICAL_HISTORY -rural I-PAST_MEDICAL_HISTORY -lejana, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -altura I-PAST_MEDICAL_HISTORY -superior I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -2.500 I-PAST_MEDICAL_HISTORY -m I-PAST_MEDICAL_HISTORY -sobre I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -nivel I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -mar, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -Departamento I-PAST_MEDICAL_HISTORY +47 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -Nariño-Colombia, I-PAST_MEDICAL_HISTORY -con B-PRESENT_ILLNESS +interés I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +pediatra I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS cuadro I-PRESENT_ILLNESS -clínico I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS +tos I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +mucosidad I-PRESENT_ILLNESS +nasal I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -consistente I-PRESENT_ILLNESS +cuatro I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +habiéndose I-PRESENT_ILLNESS +hecho I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +tos I-PRESENT_ILLNESS +más I-PRESENT_ILLNESS +persistente I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -aparición I-PRESENT_ILLNESS +forma I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -masa I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS +accesos I-PRESENT_ILLNESS +repetidos I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -hipocondrio I-PRESENT_ILLNESS -izquierdo. I-PRESENT_ILLNESS -El B-EXPLORATION -paciente I-EXPLORATION -nunca I-EXPLORATION -antes I-EXPLORATION -había I-EXPLORATION -tenido I-EXPLORATION -contacto I-EXPLORATION -con I-EXPLORATION +los I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +le I-PRESENT_ILLNESS +han I-PRESENT_ILLNESS +observado I-PRESENT_ILLNESS +cianosis I-PRESENT_ILLNESS +perioral I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +ocasionalmente I-PRESENT_ILLNESS +terminan I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +vómito; I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +encuentra I-PRESENT_ILLNESS +afebril I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +reducción I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +ingesta I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +leche I-PRESENT_ILLNESS +materna. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +se I-EXPLORATION +objetiva I-EXPLORATION un I-EXPLORATION -servicio I-EXPLORATION -de I-EXPLORATION -salud. I-EXPLORATION - I-EXPLORATION -Ingresó I-EXPLORATION -al I-EXPLORATION -Hospital I-EXPLORATION +buen I-EXPLORATION +estado I-EXPLORATION +general, I-EXPLORATION con I-EXPLORATION -disnea I-EXPLORATION +buena I-EXPLORATION +coloración I-EXPLORATION +y I-EXPLORATION +perfusión I-EXPLORATION +periférica, I-EXPLORATION +sin I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -pequeños I-EXPLORATION -esfuerzos, I-EXPLORATION -cianosis I-EXPLORATION -peribucal, I-EXPLORATION -conjuntivas I-EXPLORATION -hipercrómicas I-EXPLORATION +dificultad I-EXPLORATION +respiratoria I-EXPLORATION y I-EXPLORATION -soplo I-EXPLORATION -holosistólico I-EXPLORATION +auscultación I-EXPLORATION +cardiopulmonar I-EXPLORATION +normal; I-EXPLORATION +se I-EXPLORATION +decide I-EXPLORATION +dejar I-EXPLORATION en I-EXPLORATION -todos I-EXPLORATION -los I-EXPLORATION -focos I-EXPLORATION -grado I-EXPLORATION -IV/VI, I-EXPLORATION +observación, I-EXPLORATION +durante I-EXPLORATION +la I-EXPLORATION +cual I-EXPLORATION +se I-EXPLORATION +objetiva I-EXPLORATION +uno I-EXPLORATION de I-EXPLORATION -predominio I-EXPLORATION -tricuspídeo, I-EXPLORATION +estos I-EXPLORATION +episodios I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +que I-EXPLORATION +presenta I-EXPLORATION +un I-EXPLORATION +acceso I-EXPLORATION con I-EXPLORATION -reforzamiento I-EXPLORATION +varios I-EXPLORATION +golpes I-EXPLORATION de I-EXPLORATION -segundo I-EXPLORATION -ruido. I-EXPLORATION -En I-EXPLORATION -abdomen, I-EXPLORATION -masa I-EXPLORATION -no I-EXPLORATION -móvil, I-EXPLORATION -con I-EXPLORATION -bordes I-EXPLORATION -definidos, I-EXPLORATION +tos I-EXPLORATION +durante I-EXPLORATION +la I-EXPLORATION +espiración I-EXPLORATION +y I-EXPLORATION con I-EXPLORATION -diámetro I-EXPLORATION -de I-EXPLORATION -14 I-EXPLORATION -x I-EXPLORATION -15 I-EXPLORATION -cm, I-EXPLORATION -indolora, I-EXPLORATION -localizada I-EXPLORATION -en I-EXPLORATION -dorso I-EXPLORATION -izquierdo I-EXPLORATION -llegando I-EXPLORATION -hasta I-EXPLORATION -hipogastrio. I-EXPLORATION -Dedos I-EXPLORATION +una I-EXPLORATION +inspiración I-EXPLORATION +ruidosa I-EXPLORATION en I-EXPLORATION -palillo I-EXPLORATION +forma I-EXPLORATION de I-EXPLORATION -tambor I-EXPLORATION -y I-EXPLORATION -extremidades I-EXPLORATION -inferiores I-EXPLORATION -con I-EXPLORATION -edema I-EXPLORATION -grado I-EXPLORATION -I. I-EXPLORATION +gallo I-EXPLORATION +al I-EXPLORATION +finalizar I-EXPLORATION +el I-EXPLORATION +acceso, I-EXPLORATION +acompañado I-EXPLORATION +de I-EXPLORATION +cianosis I-EXPLORATION +facial. I-EXPLORATION I-EXPLORATION -Se I-EXPLORATION -decidió I-EXPLORATION -hospitalizar I-EXPLORATION -para I-EXPLORATION +Se B-TREATMENT +decide I-TREATMENT +ingresarlo I-TREATMENT +bajo I-TREATMENT +la I-TREATMENT +sospecha I-TREATMENT +de I-TREATMENT +síndrome I-TREATMENT +pertusoide, I-TREATMENT +con I-TREATMENT +monitorización I-TREATMENT +continua I-TREATMENT +de I-TREATMENT +saturación I-TREATMENT +de I-TREATMENT +oxígeno, I-TREATMENT +frecuencia I-TREATMENT +cardiaca I-TREATMENT +y I-TREATMENT +respiratoria. I-TREATMENT +Durante B-EVOLUTION +su I-EVOLUTION +ingreso I-EVOLUTION +aumenta I-EVOLUTION +la I-EVOLUTION +frecuencia I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +accesos I-EVOLUTION +de I-EVOLUTION +tos I-EVOLUTION +de I-EVOLUTION +tipo I-EVOLUTION +pertusoide, I-EVOLUTION +se I-EVOLUTION +objetiva I-EVOLUTION +repercusión I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +frecuencia I-EVOLUTION +cardiaca I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +saturación I-EVOLUTION +de I-EVOLUTION +oxígeno I-EVOLUTION +durante I-EVOLUTION +dichos I-EVOLUTION +accesos I-EVOLUTION +e, I-EVOLUTION +incluso, I-EVOLUTION +en I-EVOLUTION +los I-EVOLUTION +periodos I-EVOLUTION +intercríticos I-EVOLUTION +presenta I-EVOLUTION +pausas I-EVOLUTION +de I-EVOLUTION +apnea I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +recuperan I-EVOLUTION +con I-EVOLUTION +estimulación, I-EVOLUTION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +le I-TREATMENT +administra I-TREATMENT +oxigenoterapia I-TREATMENT +con I-TREATMENT +gafas I-TREATMENT +nasales I-TREATMENT +y I-TREATMENT +también I-TREATMENT +sueroterapia I-TREATMENT +intravenosa I-TREATMENT +hasta I-TREATMENT +que I-TREATMENT +recupera I-TREATMENT +una I-TREATMENT +alimentación I-TREATMENT +enteral I-TREATMENT +suficiente; I-TREATMENT +se I-TREATMENT +trata I-TREATMENT +con I-TREATMENT +azitromicina I-TREATMENT +al I-TREATMENT +paciente I-TREATMENT +y I-TREATMENT +a I-TREATMENT +los I-TREATMENT +contactos I-TREATMENT +cercanos. I-TREATMENT + I-TREATMENT +Durante B-EXPLORATION +su I-EXPLORATION +ingreso I-EXPLORATION +hospitalario, I-EXPLORATION +se I-EXPLORATION +realiza I-EXPLORATION +un I-EXPLORATION estudio I-EXPLORATION -de I-EXPLORATION +serológico I-EXPLORATION +para I-EXPLORATION +Bordetella I-EXPLORATION +pertussis I-EXPLORATION +que I-EXPLORATION +resulta I-EXPLORATION +negativo I-EXPLORATION +tanto I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -masa I-EXPLORATION -abdominal, I-EXPLORATION -diagnóstico I-EXPLORATION -y I-EXPLORATION -compensación I-EXPLORATION -de I-EXPLORATION -patología I-EXPLORATION -cardiovascular. I-EXPLORATION +determinación I-EXPLORATION +inicial I-EXPLORATION +como I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +siguiente, I-EXPLORATION +un I-EXPLORATION +mes I-EXPLORATION +después. I-EXPLORATION I-EXPLORATION -El I-EXPLORATION -hemograma I-EXPLORATION -de I-EXPLORATION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +18 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +sana, I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +semanas I-PRESENT_ILLNESS +previas I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +ingreso I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +ictericia, I-PRESENT_ILLNESS +astenia, I-PRESENT_ILLNESS +adinamia I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +compromiso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +conciencia I-PRESENT_ILLNESS +progresivo. I-PRESENT_ILLNESS +Al B-EXPLORATION ingreso I-EXPLORATION -mostró I-EXPLORATION -marcado I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -glóbulos I-EXPLORATION -rojos I-EXPLORATION -(9.320.000/mm3), I-EXPLORATION -hemoglobina I-EXPLORATION -de I-EXPLORATION -19, I-EXPLORATION -9 I-EXPLORATION -g/dL, I-EXPLORATION -hematocrito I-EXPLORATION +hubo I-EXPLORATION +elevación I-EXPLORATION de I-EXPLORATION -66%, I-EXPLORATION -glóbulos I-EXPLORATION -blancos I-EXPLORATION -3.500/mm3, I-EXPLORATION -plaquetas I-EXPLORATION -48.000/mm3, I-EXPLORATION -ácido I-EXPLORATION -úrico I-EXPLORATION -10, I-EXPLORATION -5 I-EXPLORATION -mg/dL. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -ecocardiograma I-EXPLORATION -reportó I-EXPLORATION -dilatación I-EXPLORATION -severa I-EXPLORATION +transaminasas, I-EXPLORATION +gamaglutamiltranspeptidasas, I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION -cavidades I-EXPLORATION -derechas, I-EXPLORATION -insuficiencia I-EXPLORATION -tricuspídea I-EXPLORATION +INR I-EXPLORATION +y I-EXPLORATION +disfunción I-EXPLORATION +renal. I-EXPLORATION +No B-PAST_MEDICAL_HISTORY +hubo I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +consumo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +fármacos I-PAST_MEDICAL_HISTORY +y B-EXPLORATION +los I-EXPLORATION +marcadores I-EXPLORATION +virales I-EXPLORATION e I-EXPLORATION -hipertensión I-EXPLORATION -pulmonar I-EXPLORATION -(HTP) I-EXPLORATION -severa I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -suprasistémico, I-EXPLORATION -(presión I-EXPLORATION -sistólica I-EXPLORATION -arterial I-EXPLORATION -pulmonar- I-EXPLORATION -PSAP: I-EXPLORATION -115 I-EXPLORATION -mmHg). I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION +inmunológicos I-EXPLORATION +fueron I-EXPLORATION +negativos I-EXPLORATION +exceptuando, I-EXPLORATION +un I-EXPLORATION +título I-EXPLORATION +de I-EXPLORATION +intensidad I-EXPLORATION +menor I-EXPLORATION +para I-EXPLORATION +virus I-EXPLORATION +hepatitis I-EXPLORATION +A. I-EXPLORATION +Evolucionó B-TREATMENT +rápidamente I-TREATMENT +a I-TREATMENT +sopor I-TREATMENT +profundo, I-TREATMENT +requirió I-TREATMENT +ventilación I-TREATMENT +mecánica I-TREATMENT +invasiva I-TREATMENT +y B-EXPLORATION +estudio I-EXPLORATION +con I-EXPLORATION tomografía I-EXPLORATION computarizada I-EXPLORATION -(TC) I-EXPLORATION de I-EXPLORATION -abdomen I-EXPLORATION +encéfalo I-EXPLORATION +(TC) I-EXPLORATION +que I-EXPLORATION +evidenció I-EXPLORATION +edema I-EXPLORATION +encefálico I-EXPLORATION con I-EXPLORATION -medio I-EXPLORATION +elementos I-EXPLORATION +sugerentes I-EXPLORATION de I-EXPLORATION -contraste I-EXPLORATION -endovenoso, I-EXPLORATION -que I-EXPLORATION +HIC. I-EXPLORATION +La I-EXPLORATION +monitorización I-EXPLORATION +electroencefalográfica I-EXPLORATION mostró I-EXPLORATION -grandes I-EXPLORATION -masa I-EXPLORATION -tumoral I-EXPLORATION -intrarrenales I-EXPLORATION -bilaterales, I-EXPLORATION -de I-EXPLORATION -mayor I-EXPLORATION -tamaño I-EXPLORATION -gran I-EXPLORATION -tamaño I-EXPLORATION +ritmos I-EXPLORATION +lentos I-EXPLORATION y I-EXPLORATION +simétricos I-EXPLORATION +bilaterales. I-EXPLORATION +El I-EXPLORATION +INR I-EXPLORATION +inicial I-EXPLORATION de I-EXPLORATION -crecimiento I-EXPLORATION -exofítico I-EXPLORATION +5, I-EXPLORATION +0 I-EXPLORATION +se I-EXPLORATION +corrigió I-EXPLORATION a I-EXPLORATION -izquierda I-EXPLORATION -y I-EXPLORATION +1, I-EXPLORATION +6 I-EXPLORATION con I-EXPLORATION -marcado I-EXPLORATION -adelgazamiento I-EXPLORATION -del I-EXPLORATION -parénquima I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -riñones. I-EXPLORATION -El I-EXPLORATION -examen I-EXPLORATION -mostró I-EXPLORATION -además I-EXPLORATION -adenopatías I-EXPLORATION -retroperitoneales I-EXPLORATION -múltiples I-EXPLORATION -y I-EXPLORATION -lesiones I-EXPLORATION -osteolíticas I-EXPLORATION -vertebrales. I-EXPLORATION -La I-EXPLORATION -TC I-EXPLORATION +40 I-EXPLORATION +ug/kg I-EXPLORATION de I-EXPLORATION -tórax I-EXPLORATION -no I-EXPLORATION -mostró I-EXPLORATION -alteraciones I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -parénquima I-EXPLORATION -pulmonar. I-EXPLORATION - I-EXPLORATION -Por B-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -HTP I-TREATMENT -severa I-TREATMENT -con I-TREATMENT -signos I-TREATMENT -clínicos I-TREATMENT -de I-TREATMENT -hipoxia I-TREATMENT -crónica, I-TREATMENT -se I-TREATMENT -le I-TREATMENT -administró I-TREATMENT -sildenafil I-TREATMENT -y I-TREATMENT -oxígeno I-TREATMENT -como I-TREATMENT -vasodilatadores I-TREATMENT -pulmonares, I-TREATMENT -furosemida I-TREATMENT -para I-TREATMENT -manejo I-TREATMENT -de I-TREATMENT -su I-TREATMENT -sobrecarga I-TREATMENT -hídrica I-TREATMENT -y I-TREATMENT -alopurinol I-TREATMENT -como I-TREATMENT -tratamiento I-TREATMENT -de I-TREATMENT -hiperuricemia I-TREATMENT -para I-TREATMENT -prevenir I-TREATMENT -lesión I-TREATMENT -renal. I-TREATMENT - I-TREATMENT -La B-EXPLORATION -biopsia I-EXPLORATION +Factor I-EXPLORATION +VII I-EXPLORATION +activado I-EXPLORATION +recombinante I-EXPLORATION +(rFVIIa) I-EXPLORATION +previo I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +instalación I-EXPLORATION de I-EXPLORATION -médula I-EXPLORATION -ósea I-EXPLORATION -reportó I-EXPLORATION -hiperplasia I-EXPLORATION -eritroide I-EXPLORATION -sin I-EXPLORATION -evidencia I-EXPLORATION +catéter I-EXPLORATION +intraparenquimatoso I-EXPLORATION +Raudemic® I-EXPLORATION +para I-EXPLORATION +medición I-EXPLORATION de I-EXPLORATION -infiltración, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -descartó I-EXPLORATION -linfoma. I-EXPLORATION -Por I-EXPLORATION -riesgo I-EXPLORATION -anestésico, I-EXPLORATION -secundario I-EXPLORATION -a I-EXPLORATION -HTP, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -biopsia I-EXPLORATION -renal I-EXPLORATION +la I-EXPLORATION +presión I-EXPLORATION +intracraneana I-EXPLORATION +(PIC) I-EXPLORATION +y I-EXPLORATION +temperatura I-EXPLORATION +encefálica. I-EXPLORATION +Los I-EXPLORATION +valores I-EXPLORATION +iniciales I-EXPLORATION +de I-EXPLORATION +PIC I-EXPLORATION +fluctuaron I-EXPLORATION +entre I-EXPLORATION +20 I-EXPLORATION +y I-EXPLORATION +25 I-EXPLORATION +mmHg, I-EXPLORATION con I-EXPLORATION -Trucut I-EXPLORATION -guiada I-EXPLORATION -por I-EXPLORATION -Ecografía, I-EXPLORATION -cuyo I-EXPLORATION -reporte I-EXPLORATION +temperatura I-EXPLORATION +cerebral I-EXPLORATION de I-EXPLORATION -patología I-EXPLORATION -confirmó I-EXPLORATION -diagnóstico I-EXPLORATION +37°C. I-EXPLORATION +El I-EXPLORATION +Doppler I-EXPLORATION +transcraneano I-EXPLORATION +determinó I-EXPLORATION +velocidad I-EXPLORATION +sistólica I-EXPLORATION +e I-EXPLORATION +índice I-EXPLORATION de I-EXPLORATION -HEM. I-EXPLORATION - I-EXPLORATION -Se B-EVOLUTION -ha I-EVOLUTION -realizado I-EVOLUTION -seguimiento I-EVOLUTION -durante I-EVOLUTION -8 I-EVOLUTION -meses, I-EVOLUTION -sin I-EVOLUTION -cambios I-EVOLUTION -significativos I-EVOLUTION -en I-EVOLUTION -su I-EVOLUTION -evolución. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -femenino I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -epilepsia I-PAST_MEDICAL_HISTORY -secundaria I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -extensa I-PAST_MEDICAL_HISTORY -alteración I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -desarrollo I-PAST_MEDICAL_HISTORY -cortical I-PAST_MEDICAL_HISTORY -hemisférico I-PAST_MEDICAL_HISTORY -derecho. I-PAST_MEDICAL_HISTORY -Presentó B-PRESENT_ILLNESS -estatus I-PRESENT_ILLNESS -epiléptico I-PRESENT_ILLNESS -refractario I-PRESENT_ILLNESS -que B-TREATMENT -re I-TREATMENT -quirió I-TREATMENT -ingreso I-TREATMENT +pulsatibilidad I-EXPLORATION +normales; I-EXPLORATION +siendo I-EXPLORATION +enlistada I-EXPLORATION +para I-EXPLORATION +trasplante I-EXPLORATION +hepático I-EXPLORATION +de I-EXPLORATION +acuerdo I-EXPLORATION +a I-EXPLORATION +los I-EXPLORATION +criterios I-EXPLORATION +del I-EXPLORATION +King's I-EXPLORATION +College8. I-EXPLORATION + I-EXPLORATION +La B-TREATMENT +HIC I-TREATMENT +se I-TREATMENT +tornó I-TREATMENT +refractaria I-TREATMENT a I-TREATMENT -Unidad I-TREATMENT -de I-TREATMENT -Cuidados I-TREATMENT -Intensivos I-TREATMENT -para I-TREATMENT -soporte I-TREATMENT -vital I-TREATMENT -y I-TREATMENT -tratamiento, I-TREATMENT -el I-TREATMENT -que I-TREATMENT -incluyó I-TREATMENT -como I-TREATMENT -terapia I-TREATMENT +medidas I-TREATMENT de I-TREATMENT -tercera I-TREATMENT -línea I-TREATMENT +primera I-TREATMENT +línea, I-TREATMENT +iniciándose I-TREATMENT +hipotermia I-TREATMENT +intravascular I-TREATMENT +mediante I-TREATMENT +catéter I-TREATMENT +tipo I-TREATMENT +ICY® I-TREATMENT +vía I-TREATMENT +femoral I-TREATMENT +con I-TREATMENT +máquina I-TREATMENT +Alsius I-TREATMENT +CoolGard®, I-TREATMENT +disminuyendo I-TREATMENT +la I-TREATMENT +temperatura I-TREATMENT +encefálica I-TREATMENT +a I-TREATMENT +33oC. I-TREATMENT +Recibió I-TREATMENT +sedación I-TREATMENT +con I-TREATMENT +opiáceos I-TREATMENT +(Fentanyl) I-TREATMENT +e I-TREATMENT infusión I-TREATMENT -intravenosa I-TREATMENT continua I-TREATMENT de I-TREATMENT -propofol I-TREATMENT -en I-TREATMENT -dosis I-TREATMENT -progresivas I-TREATMENT -hasta I-TREATMENT -alcanzar I-TREATMENT -una I-TREATMENT -tasa I-TREATMENT -10 I-TREATMENT -mg/kg/h. I-TREATMENT -Cursó B-EVOLUTION -con I-EVOLUTION -compromiso I-EVOLUTION -hemodinámico I-EVOLUTION +relajante I-TREATMENT +muscular I-TREATMENT +(vecuronium) I-TREATMENT +para I-TREATMENT +prevenir I-TREATMENT +escalofríos; I-TREATMENT +en B-EVOLUTION +3, I-EVOLUTION +5 I-EVOLUTION +h I-EVOLUTION +se I-EVOLUTION +logró I-EVOLUTION +la I-EVOLUTION +meta I-EVOLUTION +de I-EVOLUTION +33oC. I-EVOLUTION +A B-TREATMENT +las I-TREATMENT +72 I-TREATMENT +h, I-TREATMENT +se I-TREATMENT +le I-TREATMENT +ofreció I-TREATMENT +un I-TREATMENT +injerto I-TREATMENT +hepático I-TREATMENT +de I-TREATMENT +donante I-TREATMENT +cadavérico I-TREATMENT +y I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +un I-TREATMENT +trasplante I-TREATMENT +ortotópico I-TREATMENT +bajo I-TREATMENT +hipotermia I-TREATMENT +intravascular I-TREATMENT +activa. I-TREATMENT +Posteriormente B-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +unidad I-EVOLUTION +de I-EVOLUTION +cuidados I-EVOLUTION +intensivos, I-EVOLUTION y I-EVOLUTION +luego I-EVOLUTION +de I-EVOLUTION +comprobar I-EVOLUTION +la I-EVOLUTION +perfusión I-EVOLUTION +del I-EVOLUTION +injerto, I-EVOLUTION +se I-EVOLUTION +reinició I-EVOLUTION +recalentamiento I-EVOLUTION +lento I-EVOLUTION +controlado I-EVOLUTION +alcanzando I-EVOLUTION +la I-EVOLUTION +normotermia I-EVOLUTION a I-EVOLUTION las I-EVOLUTION -24 I-EVOLUTION +76 I-EVOLUTION h I-EVOLUTION +con I-EVOLUTION +mejoría I-EVOLUTION +continua I-EVOLUTION +en I-EVOLUTION +las I-EVOLUTION +pruebas I-EVOLUTION de I-EVOLUTION -iniciado I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -se I-EVOLUTION -observó I-EVOLUTION -alza I-EVOLUTION +función I-EVOLUTION +hepática, I-EVOLUTION +completando I-EVOLUTION de I-EVOLUTION -la I-EVOLUTION -creatinifosfokinasa I-EVOLUTION -(CK), I-EVOLUTION -acidosis I-EVOLUTION -metabólica I-EVOLUTION +esta I-EVOLUTION +manera I-EVOLUTION +122 I-EVOLUTION +h I-EVOLUTION +de I-EVOLUTION +hipotermia I-EVOLUTION +a I-EVOLUTION +33oC. I-EVOLUTION +Desarrolló I-EVOLUTION +mioneuropatía I-EVOLUTION +del I-EVOLUTION +paciente I-EVOLUTION +crítico I-EVOLUTION y I-EVOLUTION -lactacidemia I-EVOLUTION -elevada, I-EVOLUTION -y B-TREATMENT -luego I-TREATMENT +permaneció I-EVOLUTION +en I-EVOLUTION +ventilación I-EVOLUTION +mecánica I-EVOLUTION +durante I-EVOLUTION +15 I-EVOLUTION +días, I-EVOLUTION +requiriendo B-TREATMENT de I-TREATMENT -descartar I-TREATMENT -otras I-TREATMENT -causas I-TREATMENT -se I-TREATMENT -planteó I-TREATMENT +traqueostomía I-TREATMENT +percutánea I-TREATMENT +para I-TREATMENT +facilitar I-TREATMENT el I-TREATMENT -dianóstico I-TREATMENT +destete I-TREATMENT +del I-TREATMENT +ventilador I-TREATMENT +mecánico. I-TREATMENT + I-TREATMENT +Luego I-TREATMENT de I-TREATMENT -SIP I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT +un I-TREATMENT +despertar I-TREATMENT +lento, I-TREATMENT se I-TREATMENT -suspendió I-TREATMENT +retiró I-TREATMENT la I-TREATMENT -droga, I-TREATMENT -logrando B-EVOLUTION -esta I-EVOLUTION -bilización I-EVOLUTION -hemodinámica I-EVOLUTION +cánula I-TREATMENT +de I-TREATMENT +traqueostomía I-TREATMENT +al I-TREATMENT +día I-TREATMENT +37. I-TREATMENT +Recibió B-EVOLUTION +el I-EVOLUTION +alta I-EVOLUTION +luego I-EVOLUTION +de I-EVOLUTION +69 I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +hospitalización I-EVOLUTION +en I-EVOLUTION +buenas I-EVOLUTION +condiciones I-EVOLUTION +generales, I-EVOLUTION +nutritivas, I-EVOLUTION +neurológicas I-EVOLUTION +y I-EVOLUTION +ligada I-EVOLUTION a I-EVOLUTION -las I-EVOLUTION -24 I-EVOLUTION -h. I-EVOLUTION +un I-EVOLUTION +programa I-EVOLUTION +de I-EVOLUTION +rehabilitación I-EVOLUTION +física. I-EVOLUTION +Actualmente I-EVOLUTION +asiste I-EVOLUTION +a I-EVOLUTION +sus I-EVOLUTION +estudios I-EVOLUTION +secundarios I-EVOLUTION +y I-EVOLUTION +se I-EVOLUTION +mantiene I-EVOLUTION +en I-EVOLUTION +control I-EVOLUTION +ambulatorio. I-EVOLUTION I-EVOLUTION Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -58 I-PRESENT_ILLNESS +48 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -que B-PAST_MEDICAL_HISTORY -presentaba I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -base I-PAST_MEDICAL_HISTORY -leucemia I-PAST_MEDICAL_HISTORY +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +artritis I-PAST_MEDICAL_HISTORY +reumatoide I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -4 I-PAST_MEDICAL_HISTORY +10 I-PAST_MEDICAL_HISTORY años I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -evolución, I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -precisaba I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -transfusiones I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -derivados I-PAST_MEDICAL_HISTORY -hemáticos I-PAST_MEDICAL_HISTORY +evolución I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -cierta I-PAST_MEDICAL_HISTORY -frecuencia. I-PAST_MEDICAL_HISTORY -Tras B-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -constitucional I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -últimos I-PRESENT_ILLNESS -meses, I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -detectado I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -masa I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -pared I-PRESENT_ILLNESS -costal I-PRESENT_ILLNESS -derecha I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -cm I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -diámetro, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -diagnosticada I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -múcor. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Planteamos B-TREATMENT -intervención I-TREATMENT -quirúrgica I-TREATMENT -para I-TREATMENT -resecar I-TREATMENT -la I-TREATMENT -lesión I-TREATMENT +leflunomida, I-PAST_MEDICAL_HISTORY +deflazacort I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +antiinflamatorios I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +esteroideos I-PAST_MEDICAL_HISTORY +(AINEs), I-PAST_MEDICAL_HISTORY +es B-DERIVED_FROM/TO +remitida I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +Unidad I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Inflamación I-DERIVED_FROM/TO +Ocular I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +cuadro I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +ojo I-DERIVED_FROM/TO +derecho I-DERIVED_FROM/TO +rojo I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +doloroso I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +dos I-DERIVED_FROM/TO +semanas I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +evolución I-DERIVED_FROM/TO +asociado I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +empeoramiento I-DERIVED_FROM/TO +clínico I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +laboratorio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +enfermedad I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +base. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +La B-EXPLORATION +agudeza I-EXPLORATION +visual I-EXPLORATION +inicial I-EXPLORATION +era I-EXPLORATION +de I-EXPLORATION +0, I-EXPLORATION +6 I-EXPLORATION +en I-EXPLORATION +ojo I-EXPLORATION +derecho I-EXPLORATION +(OD) I-EXPLORATION +y I-EXPLORATION +1 I-EXPLORATION +en I-EXPLORATION +ojo I-EXPLORATION +izquierdo I-EXPLORATION +(OI). I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +biomicroscopía I-EXPLORATION +destacaba I-EXPLORATION +una I-EXPLORATION +ingurgitación I-EXPLORATION +vascular I-EXPLORATION +con I-EXPLORATION +edema I-EXPLORATION +y I-EXPLORATION +engrosamiento I-EXPLORATION +escleral I-EXPLORATION +temporal I-EXPLORATION +superior I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +OD I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +escleritis I-EXPLORATION +anterior I-EXPLORATION +difusa I-EXPLORATION +severa. I-EXPLORATION +El I-EXPLORATION +resto I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +oftalmológica I-EXPLORATION +fue I-EXPLORATION +normal I-EXPLORATION +en I-EXPLORATION +AO. I-EXPLORATION +Se B-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +esteroideo I-TREATMENT +oral I-TREATMENT con I-TREATMENT -3 I-TREATMENT -cm I-TREATMENT -de I-TREATMENT -margen. I-TREATMENT -Al I-TREATMENT -estar I-TREATMENT -situada I-TREATMENT -en I-TREATMENT -la I-TREATMENT -proximidad I-TREATMENT -de I-TREATMENT -la I-TREATMENT -línea I-TREATMENT -axilar I-TREATMENT -anterior, I-TREATMENT -llevamos I-TREATMENT +prednisona I-TREATMENT a I-TREATMENT -cabo I-TREATMENT -la I-TREATMENT -reconstrucción I-TREATMENT -con I-TREATMENT -un I-TREATMENT -colgajo I-TREATMENT +dosis I-TREATMENT de I-TREATMENT -músculo I-TREATMENT -dorsal I-TREATMENT -ancho I-TREATMENT -con I-TREATMENT -isla I-TREATMENT +1 I-TREATMENT +mg/kg/día, I-TREATMENT +manteniendo I-TREATMENT +el I-TREATMENT +resto I-TREATMENT +del I-TREATMENT +tratamiento, I-TREATMENT +sin I-TREATMENT +obtener I-TREATMENT +mejoría I-TREATMENT +clínica I-TREATMENT +tras I-TREATMENT +tres I-TREATMENT +semanas I-TREATMENT de I-TREATMENT -piel I-TREATMENT -desepidermizada I-TREATMENT +seguimiento. I-TREATMENT +Una B-EXPLORATION +vez I-EXPLORATION +realizadas I-EXPLORATION +una I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +tórax I-EXPLORATION +y I-EXPLORATION +un I-EXPLORATION +test I-EXPLORATION +de I-EXPLORATION +Mantoux I-EXPLORATION +que I-EXPLORATION +fueron I-EXPLORATION +negativos, I-EXPLORATION +se B-TREATMENT +decidió I-TREATMENT +la I-TREATMENT +administración I-TREATMENT de I-TREATMENT -8 I-TREATMENT -por I-TREATMENT -12 I-TREATMENT -cm I-TREATMENT -; I-TREATMENT -se I-TREATMENT -anclaron I-TREATMENT -puntos I-TREATMENT +Infliximab I-TREATMENT +(Remicade®, I-TREATMENT +Schering-Plough, I-TREATMENT +Welwyn I-TREATMENT +Garden I-TREATMENT +City, I-TREATMENT +UK) I-TREATMENT +en I-TREATMENT +tres I-TREATMENT +dosis I-TREATMENT +intravenosas I-TREATMENT de I-TREATMENT -sutura I-TREATMENT -desde I-TREATMENT -los I-TREATMENT -bordes I-TREATMENT -costales I-TREATMENT -hasta I-TREATMENT -la I-TREATMENT -dermis I-TREATMENT -del I-TREATMENT -colgajo, I-TREATMENT -para I-TREATMENT -así I-TREATMENT -dar I-TREATMENT -continuidad I-TREATMENT -a I-TREATMENT -la I-TREATMENT -propia I-TREATMENT -pared I-TREATMENT -costal. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -recibió I-EVOLUTION -el I-EVOLUTION -alta I-EVOLUTION -hospitalaria I-EVOLUTION +3 I-TREATMENT +mg/kg/día I-TREATMENT +en I-TREATMENT +las I-TREATMENT +semanas I-TREATMENT +0, I-TREATMENT +2 I-TREATMENT +y I-TREATMENT +6. I-TREATMENT +Tras B-EVOLUTION +la I-EVOLUTION +segunda I-EVOLUTION +dosis I-EVOLUTION +se I-EVOLUTION +objetivó I-EVOLUTION una I-EVOLUTION -semana I-EVOLUTION -más I-EVOLUTION -tarde, I-EVOLUTION -sin I-EVOLUTION -problemas I-EVOLUTION -ventilatorios I-EVOLUTION -ni I-EVOLUTION -respiración I-EVOLUTION -paradójica. I-EVOLUTION -No I-EVOLUTION -han I-EVOLUTION -aparecido I-EVOLUTION -recidivas I-EVOLUTION -ni I-EVOLUTION -complicaciones I-EVOLUTION +reducción I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +ingurgitación I-EVOLUTION +vascular I-EVOLUTION +y I-EVOLUTION +del I-EVOLUTION +edema I-EVOLUTION +escleral I-EVOLUTION +y I-EVOLUTION tras I-EVOLUTION -24 I-EVOLUTION -meses I-EVOLUTION +la I-EVOLUTION +tercera I-EVOLUTION +se I-EVOLUTION +obtuvo I-EVOLUTION +una I-EVOLUTION +desaparición I-EVOLUTION +completa I-EVOLUTION de I-EVOLUTION -seguimiento I-EVOLUTION -postoperatorio. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -25 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -diagnosticada B-PAST_MEDICAL_HISTORY -clínicamente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -miocardiopatía I-PAST_MEDICAL_HISTORY -hipertrófica I-PAST_MEDICAL_HISTORY -obstructiva I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -farmacológico I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -antiarrítmicos I-PAST_MEDICAL_HISTORY -(Amiodarona) I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -betabloqueantes I-PAST_MEDICAL_HISTORY -(Propanolol). I-PAST_MEDICAL_HISTORY -La B-FAMILY_HISTORY -madre I-FAMILY_HISTORY -había I-FAMILY_HISTORY -fallecido I-FAMILY_HISTORY -súbitamente I-FAMILY_HISTORY -a I-FAMILY_HISTORY -los I-FAMILY_HISTORY -48 I-FAMILY_HISTORY -años I-FAMILY_HISTORY -por I-FAMILY_HISTORY -la I-FAMILY_HISTORY -misma I-FAMILY_HISTORY -enfermedad. I-FAMILY_HISTORY -Una B-PRESENT_ILLNESS -noche I-PRESENT_ILLNESS -salió I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -cenar I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -compañeros I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -trabajo I-PRESENT_ILLNESS -regresando I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -domicilio I-PRESENT_ILLNESS -sobre I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -madrugada. I-PRESENT_ILLNESS -No I-PRESENT_ILLNESS -manifestó I-PRESENT_ILLNESS -ninguna I-PRESENT_ILLNESS -sintomatología I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -acostó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -sofá I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -salón. I-PRESENT_ILLNESS -Poco I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -perro I-PRESENT_ILLNESS -comenzó I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -ladrar I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -padre I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -levantó I-PRESENT_ILLNESS -encontrándola I-PRESENT_ILLNESS -inconsciente. I-PRESENT_ILLNESS -Se B-EVOLUTION -avisó I-EVOLUTION -a I-EVOLUTION +la I-EVOLUTION +inflamación I-EVOLUTION +escleral, I-EVOLUTION +quedando I-EVOLUTION +un I-EVOLUTION +cierto I-EVOLUTION +adelgazamiento I-EVOLUTION +residual I-EVOLUTION +con I-EVOLUTION +transparencia I-EVOLUTION +del I-EVOLUTION +tejido I-EVOLUTION +uveal I-EVOLUTION +subyacente. I-EVOLUTION +Paralelamente, I-EVOLUTION +se I-EVOLUTION +observó I-EVOLUTION +una I-EVOLUTION +mejoría I-EVOLUTION +en I-EVOLUTION los I-EVOLUTION -servicios I-EVOLUTION +signos I-EVOLUTION +y I-EVOLUTION +síntomas I-EVOLUTION +articulares, I-EVOLUTION +con I-EVOLUTION +una I-EVOLUTION +disminución I-EVOLUTION de I-EVOLUTION -emergencia I-EVOLUTION -061 I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -limitaron I-EVOLUTION -a I-EVOLUTION -constatar I-EVOLUTION +la I-EVOLUTION +actividad I-EVOLUTION +global I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +enfermedad I-EVOLUTION +representada I-EVOLUTION +por I-EVOLUTION +el I-EVOLUTION +Disease I-EVOLUTION +Activity I-EVOLUTION +Score I-EVOLUTION +(DAS I-EVOLUTION +28), I-EVOLUTION +obteniéndose I-EVOLUTION +una I-EVOLUTION +mejoría I-EVOLUTION +de I-EVOLUTION +un I-EVOLUTION +40% I-EVOLUTION +en I-EVOLUTION el I-EVOLUTION -fallecimiento. I-EVOLUTION - I-EVOLUTION \ No newline at end of file +DAS I-EVOLUTION +28. I-EVOLUTION + I-EVOLUTION +Tras I-EVOLUTION +un I-EVOLUTION +período I-EVOLUTION +de I-EVOLUTION +seguimiento I-EVOLUTION +de I-EVOLUTION +6 I-EVOLUTION +meses I-EVOLUTION +no I-EVOLUTION +se I-EVOLUTION +han I-EVOLUTION +detectado I-EVOLUTION +recidivas I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +inflamación I-EVOLUTION +escleral. I-EVOLUTION +La B-EXPLORATION +agudeza I-EXPLORATION +visual I-EXPLORATION +es I-EXPLORATION +de I-EXPLORATION +1 I-EXPLORATION +en I-EXPLORATION +ambos I-EXPLORATION +ojos I-EXPLORATION +(AO). I-EXPLORATION +La B-TREATMENT +paciente I-TREATMENT +sigue I-TREATMENT +en I-TREATMENT +la I-TREATMENT +actualidad I-TREATMENT +tratamiento I-TREATMENT +sistémico I-TREATMENT +únicamente I-TREATMENT +con I-TREATMENT +prednisona I-TREATMENT +7, I-TREATMENT +5 I-TREATMENT +mg/día, I-TREATMENT +leflunomida I-TREATMENT +y I-TREATMENT +AINEs. I-TREATMENT + I-TREATMENT +