Trauma genitourinario Paulo Portalier F

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],SITUACIÓN CIRUJANO

SITIOS DE TRAUMA GENITOURINARIO RIÑÓN 67% GENITAL 7% VEJIGA 22% URETER 1% URETRA 3%

MECANISMO DEL TRAUMA GU ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

TRAUMA POTENCIAL RIESGO VITAL RIESGO VITAL ABC EVALUACIÓN SECUNDARIA EVALUACIÓN PRIMARIA RX. CC RX. TÓRAX RX. PELVIS EX.LABORATORIO ECO FAST A.-CANULA INTUBACIÓN B.- PLEUROCENTESIS PLEUROSTOMÍA C.- VÍAS VENOSAS CRISTALOIDES SNG SONDA FOLEY RX ECOGRAFÍA. TAC ,[object Object],[object Object],[object Object],[object Object],TRASLADO

DIAGNÓSTICO DIFÍCIL ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],INDICE SOSPECHA-BUSCAR DIRIGIDAMENTE

SOSPECHA DE LESION GU ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

LESIONES SOSPECHOSAS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],lesión renal lesión vesical lesión uretral lesión de uretra bulbar o penenana lesión de cuerpos cavernosos lesión testicular

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],LESIONES SOSPECHOSAS

ESTUDIOS RUTINARIOS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

ESTUDIOS ESPECIALES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

PRIORIDADES EN LA ATENCIÓN ,[object Object],[object Object],[object Object],[object Object],[object Object]

TRAUMA RENAL ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

LESIONES SIGNIFICATIVAS RENALES ,[object Object],[object Object],[object Object],[object Object]

SIGNOS CLÍNICOS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

ESTUDIO IMAGENOLÓGICO ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

¿Cuál es mejor estudio de imagen? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

TAC ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

INDICACIONES DE EXPLORACIÓN RENAL ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Hematuria estable inestable TAC Lesiones asociadas Normal PEG Laparotomía PEG 1 disparo Anormal PEG Hematoma RP observación pulsátil estable G I-IV G V observación Trauma renal contuso

Hematuria estable inestable TAC Lesiones asociadaS Normal PEG Laparotomía PEG 1 disparo Anormal PEG Hematoma RP observación pulsátil estable G I-III G IV-V observación Trauma renal penetrante Exploración renal Exploración renal Exploración renal

¿ El control del pedículo es necesario? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],TRAUMA RENAL: RECOMENDABLE CONTROL PEDÍCULO PRECOZ

PRINCIPIOS DE RECONSTRUCCIÓN ,[object Object],[object Object],[object Object],[object Object],[object Object]

Lesiones renales ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Reconstrucción en trauma renal ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

LESIONES ASOCIADAS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

RESUMEN ,[object Object],[object Object]

Tipo de Lesión ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Epidemiología y patogénesis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Epidemiología y patogénesis ,[object Object],[object Object],[object Object],[object Object],[object Object]

Epidemiología y patogénesis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Presentación y evaluación ,[object Object],[object Object],[object Object],[object Object],[object Object]

Presentación y evaluación ,[object Object],[object Object],[object Object],[object Object]

Estudio por imágenes ,[object Object],[object Object],[object Object],[object Object],[object Object]

Evaluación intraoperatoria ,[object Object],[object Object],[object Object],[object Object]

Manejo: Técnica quirúrgica ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Flap de vejiga tubularizado tipo Boari

Técnica de Boari laparoscopico

Otras técnicas ,[object Object]

Complicaciones ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Complicaciones ,[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

LESIÓN VESICAL ,[object Object],[object Object],[object Object],[object Object],[object Object]

EPIDEMIOLOGÍA ,[object Object],[object Object],[object Object],[object Object],[object Object]

PRESENTACIÓN CLÍNICA ,[object Object],[object Object],[object Object]

TRAUMA VESICAL PENETRANTE ,[object Object],[object Object],[object Object],[object Object],[object Object]

CISTOGRAMA RETRÓGRADO ,[object Object],[object Object],[object Object]

QUIEN REQUIERE IMÁGENES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

RUPTURA VESICAL: DIAGNOSTICO ,[object Object],[object Object],[object Object],[object Object]

RUPTURA INTRAPERITONEAL: CARACTERÍSTICAS CLÍNICAS ,[object Object]

CONSIDERACIONES ESPECIALES ,[object Object],[object Object]

TRATAMIENTO: RUPTURA EXTRAPERITONEAL ,[object Object],[object Object],[object Object],[object Object],Penetrating Trauma However, in the occasional patient with extraperitoneal rupture, nonoperative management with Foley catheter drainage can be used successfully (Velmahos and Degiannis 1997).

RUPTURA INTRAPERITONEAL: EMERGENCIA QUIRÚRGICA ,[object Object]

TRAUMA DE URETRA ANTERIOR ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Trauma uretra anterior: hallazgos examen físico

URETROGRAFÍA RETRÓGRADA ,[object Object],[object Object],[object Object],[object Object]

ESTENOSIS DE URETRA ANTERIOR: EVALUACIÓN ,[object Object],[object Object],[object Object],[object Object],[object Object]

TRATAMIENTO INICIAL LESIONES DE URETRA ANTERIOR ,[object Object],[object Object],[object Object],[object Object],[object Object]

TRATAMIENTO ,[object Object],[object Object],[object Object],[object Object],[object Object]

LESION DE URETRA POSTERIOR: Hallazgos físicos ,[object Object],[object Object],[object Object],[object Object]

LESIÓN DE URETRA POSTERIOR: REALINEAMINTO ,[object Object],[object Object],[object Object],[object Object]

ESTENOSIS DE URETRA POSTERIOR : ,[object Object],[object Object],[object Object]

RECOSTRUCCIÓN ,[object Object],[object Object],[object Object],[object Object]

LESION DE URETRA POSTERIOR: RESUMEN ,[object Object],[object Object],[object Object],[object Object],[object Object]

MANEJO DE LAS LESIONES DE URETRA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

LESIONES ESCROTALES ,[object Object],[object Object],[object Object]

ECOGRAFÍA TESTICULAR ,[object Object],[object Object],[object Object],[object Object],[object Object]

FRACTURA DE PENE ,[object Object],[object Object],[object Object]

Trauma genitourinario Paulo Portalier F

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