Características diagnósticas de la apendicitis aguda en el hospital regional de Duitama, Colombia en el periodo de Enero-Marzo de 2010
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Ospina Diaz, Juan Manuel
Barrera Sánchez, Lina Fernanda
Buendía Palacios, Diana Cristina
García Martínez, Iván Mauricio
Avellaneda Suárez, Fabio Andrés
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Universidad Industrial de Santander
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Introducción: la apendicitis aguda sigue siendo la enfermedad que con mayor frecuencia obliga a una intervención quirúrgica;la historia clínica y el examen físico son considerados como las herramientas más útiles en el diagnóstico. Objetivo: describirlos signos y síntomas registrados en una serie de casos de apendicitis aguda, diagnosticados en el Hospital regional de Duitama,Boyacá, Colombia. Materiales y Métodos: se realizó un estudio observacional, analítico, de corte transversal. Se revisaronlos registros clínicos de 99 casos de apendicitis operados en la institución durante el período Enero-Marzo de 2010. Losprincipales signos y síntomas se registraron según la frecuencia de presentación. Se establecieron las medias para variablescontinuas y los porcentajes para las discretas, con intervalos de confianza del 95%. Se realizó análisis estratificado por edad,género, tiempo de evolución y diagnóstico histopatológico. Resultados: el 56,6% de los casos se presentaron en varones(n=56) y el promedio de edad fue de 27,9 años (SD=16,4). Los síntomas relevantes encontrados fueron: dolor abdominal(94,5%), migración del dolor (65,6%) y emesis (53,5%). Respecto a los hallazgos clínicos, fueron predominantes el signo deBlumberg positivo (59,4%), leucocitosis (74,7%) y neutrofilia (70,7%). La necrosis se encontró asociada con cuadro mayor de48 horas de evolución, leucocitosis superior a 15 000/mm3, y frecuencia cardíaca superior a 85 lat/min. Conclusión: existensíntomas y signos de alto valor para el diagnóstico correcto de la apendicitis: dolor abdominal, migración del dolor, signo deBlumberg, leucocitosis y neutrofilia. Es recomendable que las instituciones educativas en el área de medicina fortalezcan elentrenamiento médico en los mecanismos y conocimientos adecuados para realizar oportunamente el diagnostico, con mirasa minimizar el riesgo de perforación. Esto es debido a que el diagnóstico temprano, depende de la facilidad de acceso a unaatención especializada, a la vez que esta es eminentemente clínica. (MÉD.UIS.2011; 24(2):151-7).Palabras clave: Abdomen agudo. Apendicitis. Diagnóstico clínico.
Diagnostic characteristics of acute appendicitis at the regional hospital of Duitama, Colombia during the period ofJanuary-March in year 2010.Introduction: acute appendicitis remains as the most common disease that requires surgery. Medical record and physicalexamination are considered the most useful tools in diagnosis. Objective: to describe the main signs and symptoms registeredin a list of cases diagnosed as acute appendicitis at the Hospital of Duitama, Boyacá, Colombia. Materials and Methods:analytical, observational, cross sectional study. It was reviewed the medical records of 99 cases of appendicitis operated atthe Duitama Regional Hospital during the period from January to March 2010. The main signs and symptoms were recordedby frequency of presentation, means for continuous variables and percentages for the discrete ones, with their respectiveconfidence intervals at 95%. There were carried out a stratified analysis by age, gender, tipe of diagnosis and histopathologicaldiagnosis. Results: 56.6% were males, mean age 27.9 years (SD=16.4); The most important symptoms found were abdominalpain (94.5%), migration of pain (65.6% ), vomiting (53.5%); as predominant signs: blumberg (59.4%), WBC> 12000 / mm3, andneutrophils >70 (70.7%); necrosis was associated with progression time greater than 48 hours, leukocytosis greater than 15 000/ mm3 and heart rate above 85 per minute. Conclusion: there are symptoms and signs of high value for the correct diagnosisof appendicitis: abdominal pain, migration of pain, rebound tenderness, leukocytosis and neutrophilia. It is recommended fortraining institutions, to establish mechanisms that emphasize medical training, for to obtain early diagnoses and to minimizethe risk of perforation, because early diagnosis depends on the ease of access to specialist care and diagnosis is mainlyclinical. (MÉD.UIS.2011; 24(2):151-7).Key words: Acute abdomen. Appendicitis. Clinical diagnosis.
Diagnostic characteristics of acute appendicitis at the regional hospital of Duitama, Colombia during the period ofJanuary-March in year 2010.Introduction: acute appendicitis remains as the most common disease that requires surgery. Medical record and physicalexamination are considered the most useful tools in diagnosis. Objective: to describe the main signs and symptoms registeredin a list of cases diagnosed as acute appendicitis at the Hospital of Duitama, Boyacá, Colombia. Materials and Methods:analytical, observational, cross sectional study. It was reviewed the medical records of 99 cases of appendicitis operated atthe Duitama Regional Hospital during the period from January to March 2010. The main signs and symptoms were recordedby frequency of presentation, means for continuous variables and percentages for the discrete ones, with their respectiveconfidence intervals at 95%. There were carried out a stratified analysis by age, gender, tipe of diagnosis and histopathologicaldiagnosis. Results: 56.6% were males, mean age 27.9 years (SD=16.4); The most important symptoms found were abdominalpain (94.5%), migration of pain (65.6% ), vomiting (53.5%); as predominant signs: blumberg (59.4%), WBC> 12000 / mm3, andneutrophils >70 (70.7%); necrosis was associated with progression time greater than 48 hours, leukocytosis greater than 15 000/ mm3 and heart rate above 85 per minute. Conclusion: there are symptoms and signs of high value for the correct diagnosisof appendicitis: abdominal pain, migration of pain, rebound tenderness, leukocytosis and neutrophilia. It is recommended fortraining institutions, to establish mechanisms that emphasize medical training, for to obtain early diagnoses and to minimizethe risk of perforation, because early diagnosis depends on the ease of access to specialist care and diagnosis is mainlyclinical. (MÉD.UIS.2011; 24(2):151-7).Key words: Acute abdomen. Appendicitis. Clinical diagnosis.