This new entry photos history is especially hard for me because it brings memories away in time but close the heart. It was a fellow patient who was working at a health center near our hospital. As a result of weight loss and continuous epigastric pain an ultrasound was requested. The finding of a pancreatic mass triggered a study that ended in the operating room and tragedy for the patient, had a pancreatic neuroendocrine tumor occupying the entire gland also invaded the stomach and duodenum in a transmural.
The only surgical solution was the total pancreaticoduodenectomy and total gastrectomy with splenectomy.
first photos intervention
The patient had not complied 40 years and had already passed a traffic accident and viral encephalitis. As a doctor he knew the irreversible consequences that this operation entailed: diabetes difficult to control, severe nutritional problems and a life completely controlled regime, accepted the intervention and was performed without complications. He had the courage and strength to recover and return to work, was a dedicated and devoted care to their patients.
When everything seemed to go well in life and after 42 months of the first intervention, in a routine liver metastases were found 3 that were close to 2 of the 3 hepatic veins. He suggested that the best treatment was the resection but the liver due to nutritional disturbances had undergone degeneration fat with normal liver function that concerned us. Two days before the date of the timing of the surgery came to the emergency department with acute abdominal pain requiring morphine for pain control. Required an emergency intervention was found in the intestinal infarction of venous origin as a result of an internal hernia affecting the entire small intestine. Reduction was chosen, aspiration of intestinal contents and open abdomen. At 6 hours relaparotomy. Fortunately there was a recovery and did not require resection, at 14 days was discharged to be operated on the liver. Once recovered and past 2 months design a conservation strategy parenchyma resection with resection of segment VII and segments II-III and IVA retaining the right and middle hepatic vein.
The initial post was normal but developed an infection of the bed of resection required two reoperations without our being able to control, develop multiple complications and dying after a month and a half died. At all times he was able to convey their desire to live and we encouraged us to continue trying to cure fig. I still remember after more than 5 years my last conversation with her, which sent me your tired in the struggle to live but never lost the will to fight or be resigned, even encouraged us because he saw that we suffered for not being able to master the complications. Only I have the consolation that we offered 3 ½ years of life she intensely enjoyed despite its limitations, yes I have left in the memory.
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