Cc Absceso Hepatico Oct2014

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Absceso Hepatico

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  Caso clínico: Absceso hepático. Dr Martín LópezDraDaniela Paciel.  ãSM 59 años, procedente de medio urbano.ãSin antecedentes personales a destacar.ã  EA: -1 semana de evolución dolor en hipocondrio y flanco derecho, intenso, opresivo, gravativo. -Agrega fiebre (hasta 38,5°C), y chuchos de frío, a predominio nocturno, astenia, anorexia. Concomitante ictericia y orinas hipercoloreadas, no hipocolia.-Niega consumo de tóxicos o fármacos, no ingesta de infusiones.  ã  EF: -Regular estado general, Tax: 38°C-Ictericia, no lesiones de piel, bien hidratado y perfundido.-CV: RR 96 cpm no soplos.-PP: MAV+ bilateral no estertores.-ABD: Dolor a la palpación de HD y FD, no defensa, hepatomegalia dolorosa, no elementos de insuficiencia hepatocítica.ã  PC al ingreso: -GB: 26.230 cel/ml, Neu:87 %-Azoemia: 1,3mg/dl Creatininemia: 1,99 mg/dl-BT: 3,32 BD: 2,85 TGO:116 TGP:171 GGT:168 FAL:315-TP: 59%  ã  EN SUMA 1: -SM 59 años-Dolor HD/FD-Ictericia-Fiebre.ã  PLANTEO: -Colangitis aguda séptica.ã  CONDUCTA: -Se solicita Ecografía de abdomen.
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