{"id":20057,"date":"2025-04-23T06:30:00","date_gmt":"2025-04-23T06:30:00","guid":{"rendered":"https:\/\/endoscopiaterapeutica.net\/pt\/?p=20057"},"modified":"2025-04-21T00:46:12","modified_gmt":"2025-04-21T00:46:12","slug":"quiz-9","status":"publish","type":"post","link":"https:\/\/endoscopiaterapeutica.net\/pt\/quiz\/quiz-9\/","title":{"rendered":"Quiz!"},"content":{"rendered":"\n

Colabora\u00e7\u00e3o: Ygor Rocha Fernandes, Mateus Pereira Funari<\/strong><\/p>\n\n\n\n

Paciente do sexo feminino, 44 anos, com antecedente de cirurgia bari\u00e1trica (Bypass G\u00e1strico em Y de Roux) realizada em 2012, e diagn\u00f3stico pr\u00e9vio de hipotireoidismo. Desde o final de 2022, evoluiu com dor abdominal progressiva, epis\u00f3dios de n\u00e1useas e v\u00f4mitos, al\u00e9m de perda de peso significativa.<\/p>\n\n\n\n

Uma endoscopia digestiva alta (EDA) realizada em junho de 2023 identificou uma estenose na anastomose gastrojejunal, com achados sugestivos de isquemia. A paciente foi submetida a revis\u00e3o cir\u00fargica da anastomose, no entanto, os sintomas persistiram.<\/p>\n\n\n\n

Em janeiro de 2024, uma tomografia computadorizada (TC) de abdome revelou perfura\u00e7\u00e3o bloqueada da anastomose e uma cole\u00e7\u00e3o perianastom\u00f3tica, al\u00e9m de uma les\u00e3o polipoide de 2,5 cm na segunda por\u00e7\u00e3o do duodeno, na regi\u00e3o periampular. Diante desses achados, foi solicitada uma resson\u00e2ncia magn\u00e9tica (RM) de abdome superior, que confirmou uma les\u00e3o polipoide intraluminal de 3,2 cm na parede lateral da segunda por\u00e7\u00e3o do duodeno, com realce heterog\u00eaneo.<\/p>\n\n\n\n

Ap\u00f3s discuss\u00e3o multidisciplinar, optou-se por nova cirurgia para drenagem da cole\u00e7\u00e3o, revis\u00e3o da anastomose e EDA intra-operat\u00f3ria para avaliar a les\u00e3o polipoide em duodeno, em mar\u00e7o de 2024. Durante o ato cir\u00fargico, foi realizada uma gastrotomia para acesso endosc\u00f3pico ao duodeno. A endoscopia revelou uma les\u00e3o pediculada, com superf\u00edcie vilosa, localizada na parede lateral da segunda por\u00e7\u00e3o do duodeno, oposta \u00e0 papila maior (seta). A base do ped\u00edculo media 15 mm de comprimento por 12 mm de espessura, e a por\u00e7\u00e3o cef\u00e1lica da les\u00e3o apresentava di\u00e2metro de 30 mm.<\/p>\n\n\n

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

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Colabora\u00e7\u00e3o: Ygor Rocha Fernandes, Mateus Pereira Funari Paciente do sexo feminino, 44 anos, com…<\/p>\n","protected":false},"author":3493,"featured_media":20058,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"categories":[143],"tags":[292],"ano":[783],"tipo":[153],"volume":[263],"class_list":["post-20057","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-quiz","tag-endoscopia","ano-783","tipo-endoscopia-digestiva-alta","volume-volume-i"],"yoast_head":"\nQuiz! • Endoscopia Terapeutica<\/title>\n<meta name=\"description\" content=\"Quiz!\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/endoscopiaterapeutica.net\/pt\/quiz\/quiz-9\/\" \/>\n<meta property=\"og:locale\" content=\"pt_BR\" \/>\n<meta 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