{"id":1424269,"date":"2024-09-24T00:00:00","date_gmt":"2024-09-23T21:00:00","guid":{"rendered":"https:\/\/analyse.optim.biz\/?p=1424269"},"modified":"2024-09-24T00:00:00","modified_gmt":"2024-09-23T21:00:00","slug":"serie-de-interventii-chirurgicale-pentru-o-pacienta-diagnosticata-cu-boala-crohn-la-spitalul-arcadia","status":"publish","type":"post","link":"https:\/\/analyse.optim.biz\/?p=1424269","title":{"rendered":"Serie de interven\u021bii chirurgicale pentru o pacient\u0103 diagnosticat\u0103 cu Boala Crohn, la Spitalul Arcadia"},"content":{"rendered":"<div class=\"entry-content\">\n<div id=\"attachment_316256\" class=\"wp-caption alignright\"><img decoding=\"async\" aria-describedby=\"caption-attachment-316256\" loading=\"lazy\" class=\"size-medium wp-image-316256\" src=\"https:\/\/analyse.optim.biz\/wp-content\/uploads\/2026\/01\/chichirau-dragos-300x197-1.png\" width=\"300\" height=\"197\" title=\"chichirau-dragos-300x197-1\"><\/p>\n<p id=\"caption-attachment-316256\" class=\"wp-caption-text\"><a href=\"https:\/\/www.arcadiamedical.ro\/echipa-medicala\/chichirau-dragos-iulian\"><strong>Dr. Drago\u0219 Iulian Chichir\u0103u<\/strong><\/a><strong>, medic specialist Chirurgie general\u0103, <\/strong><a href=\"http:\/\/www.arcadiamedical.ro\"><strong>Arcadia<\/strong><\/a><\/p>\n<\/div>\n<p>O pacient\u0103 t\u00e2n\u0103r\u0103, de 24 de ani, din Ia\u0219i, a fost diagnosticat\u0103 \u00een Arcadia, \u00een contextul explor\u0103rii unor dureri abdominale difuze, asociate cu rectoragii, pierderi de s\u00e2nge prin scaun \u0219i tulbur\u0103ri de tranzit intestinal, cu <strong>boala Crohn,<\/strong> dup\u0103 o colonoscopie \u0219i o endoscopie.<\/p>\n<p>\u00a0<\/p>\n<p>Boala Crohn este o <strong>afec\u021biune inflamatorie cronic\u0103 a tubului digestiv,<\/strong> put\u00e2nd afecta orice segment al acestuia, de la cavitatea bucal\u0103 p\u00e2n\u0103 la anus, mai pu\u021bin rectul, iar cel mai frecvent por\u021biunea terminal\u0103 a intestinului sub\u021bire (ileon) \u0219i colonul proximal. Inciden\u021ba ei este \u00een cre\u0219tere, fiind diagnosticat\u0103 \u00een special la tinerii cu v\u00e2rsta mai mic\u0103 de 30 de ani, dar \u0219i la v\u00e2rste ulterioare. <strong>Perioadele de activitate a bolii, caracterizate de simptome severe, alterneaz\u0103 cu perioade de remisiune, \u00een care pacientul este asimptomatic <\/strong>timp de luni de zile sau chiar ani. Tratamentul chirurgical este uneori necesar \u00een cazul unor complica\u021bii de genul stenozelor intestinale care produc ocluzie, \u00een caz de megacolon toxic ori pentru abcese sau fistule. Se poate ajunge la excizia unor por\u021biuni din intestin. Statistic, peste 50% dintre pacien\u021bi pot suferi cel pu\u021bin o interven\u021bie chirurgical\u0103 \u00een cursul evolu\u021biei afec\u021biunii.<\/p>\n<p>\u00a0<\/p>\n<p>La scurt timp dup\u0103 diagnosticare, pacienta s-a prezentat din nou la medicul gastroenterolog, cu <strong>dureri abdominale puternice, febr\u0103, frison, durere \u00een special \u00een fosa iliac\u0103 dreapt\u0103.<\/strong> A fost direc\u021bionat\u0103 c\u0103tre <a href=\"https:\/\/www.arcadiamedical.ro\/specialitati\/radiologie-si-imagistica-medicala\">Centrul de Imagistic\u0103 Medical\u0103 Arcadia<\/a>, unde a efectuat un computer tomograf cu substan\u021b\u0103 de contrast, <strong>diagnosticul fiind flegmon paraileal terminal, o colec\u021bie cu puroi l\u00e2ng\u0103 intestin.<\/strong> S-a instituit imediat tratamentul cu antibiotic. Evolu\u021bia pacientei a fost, \u00eens\u0103, nefavorabil\u0103, cu deteriorarea st\u0103rii generale de s\u0103n\u0103tate, motiv pentru care a fost internat\u0103 \u00een Spitalul Arcadia \u0219i a fost operat\u0103. <strong>Intraoperator s-a decelat prezen\u021ba unei fistule intestinale (ileon terminal) \u0219i un flegmon voluminos<\/strong> localizat \u00een mezenter \u0219i extins \u00een spa\u021biul parietocolic drept (\u00eentre peretele lateral al abdomenului \u0219i colonul ascendent). S-a intervenit \u00een sala de opera\u021bii \u0219i s-a realizat <strong>rezec\u021bia ileo-cecal\u0103 laparoscopic\u0103 cu anastomoz\u0103 ileocolic\u0103 mecanic\u0103.<\/strong> Evolu\u021bia postoperatorie a fost favorabil\u0103, iar pacienta s-a externat la 6 zile postoperator. La 12 zile postoperator, <strong>a ap\u0103rut o deformare parietal\u0103 \u00een flancul drept abdominal,<\/strong> cu extravazarea unei secre\u021bii tulburi printr-un orificiu tegumentar. Examenul CT efectuat \u00een urgen\u021be a certificat <strong>diagnosticul de fistul\u0103 enterocutanat\u0103 cu abces subtegumentar.<\/strong> Analizele de laborator efectuate au relevat prezen\u021ba leucocitozei, anemiei \u0219i trombocitozei. S-a intervenit chirurgical cu <strong>drenajul colec\u021biei \u0219i protezarea fistulei cu o pung\u0103 de iliostom\u0103.<\/strong> Intra-abdominal nu au fost g\u0103site alte colec\u021bii.<\/p>\n<p>Ulterior, pacienta a fost consiliat\u0103 din punct de vedere nutri\u021bional \u0219i a r\u0103mas \u00een observare periodic\u0103, \u00een scopul ob\u021binerii unei vindec\u0103ri spontane.<\/p>\n<p>\u00centruc\u00e2t <strong>dup\u0103 6 luni starea pacientei nu s-a ameliorat,<\/strong> s-a reintervenit chirurgical cu <strong>rezec\u021bia intestinului implicat \u0219i a traiectului fistulos, cu refacerea unei noi anastomoze mecanice ilio-colice.<\/strong> Evolu\u021bia a fost favorabil\u0103, iar pacienta s-a externat dup\u0103 o s\u0103pt\u0103m\u00e2n\u0103, \u00een stare general\u0103 foarte bun\u0103, cu recomandare c\u0103tre <a href=\"https:\/\/www.arcadiamedical.ro\/specialitati\/gastroenterologie\">Centrul de Gastroenterologie Arcadia<\/a>, pentru managerierea afec\u021biunii de baz\u0103, boala Crohn. Pacien\u021bii diagnostica\u021bi cu aceast\u0103 afec\u021biune pot avea o via\u021ba complet normal\u0103 dac\u0103 boala este supravegheat\u0103 \u0219i este tratat\u0103 corespunz\u0103tor de gastroenterolog.<\/p>\n<p>\u00a0<\/p>\n<p>Seria de interven\u021bii chirurgicale a fost realizat\u0103 \u00een siguran\u021b\u0103 \u00een Spitalul Arcadia de <a href=\"https:\/\/www.arcadiamedical.ro\/echipa-medicala\/chichirau-dragos-iulian\">Dr. Drago\u0219 Iulian Chichir\u0103u<\/a>, medic specialist Chirurgie general\u0103, al\u0103turi de <a href=\"https:\/\/www.arcadiamedical.ro\/echipa-medicala\/gavrilescu-madalina\">Dr. Mihaela \u2013 M\u0103d\u0103lina Gavrilescu<\/a>, medic specialist Chirurgie general\u0103 \u0219i <a href=\"https:\/\/www.arcadiamedical.ro\/echipa-medicala\/buna-arvinte-mihaela\">Dr. Mihaela Buna Arvinte<\/a>, medic specialist Chirurgie general\u0103.<\/p>\n<p>\u00a0<\/p>\n<p>Pentru program\u0103ri, pacien\u021bii au la dispozi\u021bie num\u0103rul de telefon <strong>0232 920, Call Center Arcadia.<\/strong><\/p>\n<p><a href=\"http:\/\/www.arcadiamedical.ro\">www.arcadiamedical.ro<\/a><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Dr. Drago\u0219 Iulian Chichir\u0103u, medic specialist Chirurgie general\u0103, Arcadia O pacient\u0103 t\u00e2n\u0103r\u0103, de 24 de ani, din Ia\u0219i, a fost diagnosticat\u0103 \u00een Arcadia, \u00een contextul explor\u0103rii unor dureri abdominale difuze, asociate cu rectoragii, pierderi de s\u00e2nge prin scaun \u0219i tulbur\u0103ri de tranzit intestinal, cu boala Crohn, dup\u0103 o colonoscopie \u0219i o endoscopie. \u00a0 Boala Crohn [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[89],"tags":[174],"class_list":["post-1424269","post","type-post","status-publish","format-standard","hentry","category-romania","tag-suceavanews-ro"],"_links":{"self":[{"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=\/wp\/v2\/posts\/1424269","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1424269"}],"version-history":[{"count":0,"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=\/wp\/v2\/posts\/1424269\/revisions"}],"wp:attachment":[{"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1424269"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1424269"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1424269"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}