{"id":29909,"date":"2019-09-25T16:22:17","date_gmt":"2019-09-25T15:22:17","guid":{"rendered":"https:\/\/cram.org\/?page_id=29909"},"modified":"2019-09-25T17:38:47","modified_gmt":"2019-09-25T16:38:47","slug":"esofagotomia","status":"publish","type":"page","link":"https:\/\/cram.org\/ca\/clinica-i-rescat\/medicina-i-cirurgia\/esofagotomia\/","title":{"rendered":"Esofagotom\u00eda"},"content":{"rendered":"

ESOFAGOTOMIA<\/strong><\/h1>\n<\/div>
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DADES<\/strong><\/h2>\n<\/div>
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    Esp\u00e8cie: Caretta Caretta<\/span><\/div><\/li>
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    Longitud: 47.5 cm<\/span><\/div><\/li>
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    Pes: 14 kg<\/span><\/div><\/li>
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    Lloc de recollida: Blanes<\/span><\/div><\/li>
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    Data: 20\/07\/2002<\/span><\/div><\/li><\/ul>
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    HIST\u00d2RIA<\/strong><\/h2>\n<\/div>

    Animal capturat accidentalment per un vaixell de palangre de superf\u00edcie mentre pescava. L’animal va ser r\u00e0pidament tret de l’aigua amb ajuda d’un salabre, col\u00b7locat en una caixa, a\u00efllat i humitejat cont\u00ednuament fins a arribar a port, on membres de l’equip de rescat del CRAM ho van recollir i van portar al centre de recuperaci\u00f3.<\/p>\n<\/div><\/div><\/div>

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    EXAMEN F\u00cdSIC<\/strong><\/h2>\n<\/div>

    En l’examen f\u00edsic l’animal presentava esgotament moderat per la captura i el transport, per\u00f2 la condici\u00f3 corporal era bona i la respiraci\u00f3 regular i sense sons pulmonars anormals (crepitacions o sibil\u00e0ncies).
    \nNo presentava ferides externes ni hams clavats en el cos, boca ni es\u00f2fag proximal.<\/p>\n

    Es va realitzar una radiografia de rutina per a descartar hams en l’aparell digestiu. Es va trobar un, tipus J5 \u00abbec de lloro\u00bb en la porci\u00f3 distal de l’es\u00f2fag.<\/p>\n<\/div>

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    DIAGN\u00d2STIC<\/strong><\/h2>\n<\/div>

    Ham clavat en es\u00f2fag.<\/span><\/p>\n<\/div>

    TRACTAMENT<\/strong><\/h2>\n<\/div>

    A causa de la impossibilitat d’extreure l’ham des de la boca, es va optar per mantenir a l’animal en observaci\u00f3 per a veure si era capa\u00e7 de transitar-lo, controlant les constants vitals i realitzant anal\u00edtiques i radiografies seriades.
    \nL’animal va ser tractat inicialment amb fluidoterapia oral i antibioterapia de cobertura durant les 2 primeres setmanes. L’alimentaci\u00f3 era di\u00e0ria i en cap moment va deixar de menjar.<\/p>\n

    Passat aquest per\u00edode l’animal va ser allotjat en r\u00e8gim de manteniment, menjant en dies alterns una dieta el m\u00e9s variada possible.<\/p>\n<\/div>

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    EVOLUCI\u00d3<\/strong><\/h2>\n<\/div>

    Ja que l’ham no es movia del lloc on es va clavar inicialment, es va optar per realitzar una esofagotom\u00eda. Aquesta cirurgia consisteix en un abordatge ventral de l’es\u00f2fag cervical distal per a poder extreure l’ham per la incisi\u00f3 realitzada. Per a aix\u00f2 l’animal \u00e9s dormit completament i mantingut amb anest\u00e8sia inhalat\u00f2ria i ventilaci\u00f3 manual. Despr\u00e9s d’obrir per plans, s’arriba a la mucosa esof\u00e0gica i a l’ham, que es reclava completament per a ser extret. Finalment, es tanquen les diferents capes de l’es\u00f2fag, musculatura cervical i pell.<\/p>\n

    En finalitzar la cirurgia, l’animal va ser col\u00b7locat en un tanc despertador amb aigua temperada en aspersi\u00f3 i calor, per a despr\u00e9s ser incorporat al tanc de manteniment una vegada completament despert.<\/p>\n

    En pocs dies la tortuga estava menjant amb normalitat i en q\u00fcesti\u00f3 d’un mes va ser alliberat en perfecte estat de salut.<\/p>\n<\/div>

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    COMENTARIS<\/strong><\/h2>\n<\/div>

    M\u00e9s de 15000 tortugues s\u00f3n capturades de forma incidental pel palangre de superf\u00edcie de la flota espanyola. Els pescadors, en col\u00b7laboraci\u00f3 amb la Fundaci\u00f3, pugen a bord els animals capturats amb ajuda de salabres (per a evitar les lesions produ\u00efdes per l’hissat a pes) i tallen el sedal el m\u00e9s curt possible, perqu\u00e8 no hi hagi trams que puguin causar s\u00edndromes d’acordi\u00f3 en ser deglutits.
    \nEls animals que arriben al Centre de Recuperaci\u00f3 es realitza un examen f\u00edsic complet, anal\u00edtiques i radiografies per a descartar, entre altres coses, hams allotjats en l’aparell digestiu.<\/p>\n

    Quan una tortuga presenta un ham en la cavitat oral o en l’es\u00f2fag cervical \u00e9s possible l’extracci\u00f3 via oral. Per\u00f2 quan queda m\u00e9s profund en l’es\u00f2fag \u00e9s necess\u00e0ria la esofagotom\u00eda.<\/p>\n<\/div>

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    INFORMACI\u00d3 COMPLEMENT\u00c0RIA<\/strong><\/h2>\n<\/div>
    \"\"<\/div><\/div>
    <\/div>
    \n

    L’animal es col\u00b7loca en dec\u00fabit dorsal. Els pulmons no serien capa\u00e7os de funcionar correctament per si sols perqu\u00e8 els altres \u00f2rgans interns els comprimeixen en aquesta posici\u00f3. Per aix\u00f2 es mant\u00e9 la respiraci\u00f3 artificial.<\/p>\n<\/div><\/div><\/div>

    \"\"<\/div><\/div>
    <\/div>
    \n

    Una vegada obert per capes, s’exposa la mucosa esof\u00e0gica i es procedeix a l’extracci\u00f3 de l’ham clavat.<\/p>\n<\/div><\/div><\/div>

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    \"\"<\/div><\/div>
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    \n

    Per a tancar el defecte es realitza per capes fins a arribar a la pell, on es col\u00b7loquen punts d’alliberament de tensi\u00f3 perqu\u00e8 la sutura no l’estripi.<\/p>\n<\/div><\/div><\/div>

    \"\"<\/div><\/div>
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    \n

    L’animal pot passar diverses hores sense respirar regularment despr\u00e9s de l’anest\u00e8sia, per la qual cosa es mant\u00e9 humit i en ambient tranquil fins que \u00e9s capa\u00e7 de nedar per si mateix.<\/p>\n<\/div><\/div><\/div>

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