Apendectomías negativas en el servicio de cirugía general del Hospital Dr. Rafael Hernández L.

Marco Antonio Achurra Olmos; María G. Della Sera

doi:10.37980/im.journal.rmdp.20232218

Resumen

Introducción la apendicitis aguda corresponde a la presencia de cambios inflamatorios a nivel del apéndice cecal o vermiforme. Representa uno de los principales motivos de consulta de dolor abdominal a nivel mundial. Los mecanismos fisiopatológicos de esta entidad confluyen en una vía común que desencadena la obstrucción del lumen del apéndice cecal, comprometiendo su circulación y consecuentes cambios inflamatorios. Según estos cambios podemos encontrar diferentes fases en el apéndice cecal denominadas: catarral, flegmonosa, necrótica, perforada. El diagnóstico de esta patología se obtiene mediante la integración de anamnesis, examen físico y laboratorios, siendo los estudios de imagen reservados para casos con clínica dudosa. El manejo de elección es la resección quirúrgica. Metodología: Se realizó un estudio retrospectivo. El universo de estudio fueron todos los pacientes ingresados con diagnóstico de apendicitis aguda en el Hospital Dr. Rafael Hernández L., de enero a diciembre 2018. Se contemplaron un total de 388 expedientes, se revisaron 200 de los cuales se excluyeron 7 por falta de información. Resultados: 100 pacientes fueron de sexo masculino y 93 del sexo femenino, la mediana de edad fue 27 años. El abordaje más utilizado fue el abierto 73% y luego laparoscópico 16% Con 1.6%. Conversión: La mediana de estancia hospitalaria fue 1 día. El análisis histopatológico revelo 15% de apendicectomías negativas. Conclusión: El porcentaje de apendicectomías negativas en el servicio de cirugía general fue muy similar al publicado en otras revisiones. Tomando en cuenta las escalas de valoración diagnostica y los estudios de imagen, estas tasas pueden ser aún menor.

Abstract

Introduction: Acute appendicitis corresponds to the presence of inflammatory changes at the level of the cecal or vermiform appendix. It represents one of the main reasons for consultation of abdominal pain worldwide. The pathophysiological mechanisms of this entity converge in a common pathway that triggers the obstruction of the lumen of the cecal appendix, compromising its circulation and consequent inflammatory changes. According to these changes we can find different phases in the cecal appendix called: catarrhal, phlegmonous, necrotic, perforated. The diagnosis of this pathology is obtained through the integration of anamnesis, physical examination and laboratories, being imaging studies reserved for cases with doubtful clinical symptoms. The management of choice is surgical resection. Methodology: A retrospective study was performed. The study universe was all patients admitted with a diagnosis of acute appendicitis at the Hospital Dr. Rafael Hernández L., from January to December 2018. A total of 388 records were contemplated, 200 were reviewed of which 7 were excluded due to lack of information. Results: 100 patients were male and 93 females, the median age was 27 years. The most used approach was open 73% and then laparoscopic 16% with 1.6%. Conversion. The median hospital stay was 1 day. Histopathological analysis revealed 15% of negative appendectomies. Conclusion: The percentage of negative appendectomies in the general surgery service was very similar to that published in other reviews. Considering the diagnostic evaluation scales and imaging studies, these rates may be even lower.

Citas

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Apendectomías negativas en el servicio de cirugía general del Hospital Dr. Rafael Hernández L.

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