Introducción. El enterocele es causado por un defecto herniario del piso pélvico, siendo el más común la hernia interrecto-vaginal. Se produce por un debilitamiento del piso pélvico, por diversos factores, entre ellos, las cirugías en la región pélvica, el estreñimiento crónico o las patologías que aumentan la presión intraabdominal, el antecedente de prolapso rectal o vaginal, y también, factores congénitos. Presentación de caso. Paciente femenina de 84 años de edad, con antecedentes de un parto eutócico y múltiples procedimientos quirúrgicos, entre ellos histerectomía hace 40 años y rectosigmoidectomía por enfermedad diverticular complicada hace 6 años, quien cuatro meses antes presenta constipación crónica, que empeora en los días previos a su ingreso, con dolor perineal intenso y salida de asas intestinales a nivel de la región perineal, que la obliga a consultar a Urgencias. Al encontrarse con asas intestinales expuestas, con cambios de coloración, es intervenida quirúrgicamente con resultado satisfactorio, postquirúrgico inmediato optimo y seguimiento por consulta externa por 3 meses sin evidencia de recidiva. Discusión. La hernia interrecto-vaginal tiene una incidencia baja y una presentación clínica variada. El único tratamiento es quirúrgico.
Introduction: In the last 30 years, scoring systems have been developed to determine patients’ illness severity or prognosis. In the present work, the role of the Mannheim Prognostic Index (MPI) to predict the risk of mortality, complications, prolonged hospital-stay, and the need for ICU was determined in all the patients who presented secondary peritonitis, and to validate the test as a useful and an easy tool to apply in the clinical practice of the surgeon and critical care physician. Materials and methods: An observational, retrospective, cross-sectional and analytical study was conducted. Results: The effectiveness of the MPI was compared to another widely used mortality prediction system such as Apache II; 279 patients from the Luis Vernaza were included. The prediction rate was 93.3% and 86.9%, respectively. Conclusions: Although Mannheim presents an excellent response as a predictor of mortality, its assessment is not infallible since other factors remain unconsidered; and these may cause a patient who was assessed as having a low risk of mortality to be deceased.
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