CRITERIOS CLÍNICOS Y LABORATORIALES PARA EL DIAGNÓSTICO DE APENDICITIS AGUDA EN EL COMPLEJO HOSPITALARIO VIEDMA LOS ANOS 2003 - 2004
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Gac Med Bol
Abstract
Se analizan retrospectivamente 241 historias clínicas en el complejo hospitalario Viedma, con diagnóstico de apendicitis aguda durante un periodo comprendido de enero del 2003 a diciembre del 2004. Se halló que los síntomas mas frecuentes son el dolor abdominal en todos los casos, refiriendo como cólico-opresivo en el 62% de los casos, nauseas, vómitos y anorexia en 61% de los pacientes; al examen físico, se describieron signos de irritación peritoneal en un 55%, la fiebre y taquicardia en un 46% , signo de psoas en un 44%, de Mc Burney en un 44%, obturador en un 35%, y signo de Rovsing en un 18%. Los exámenes laboratoriales reportaron, leucocitosis a predominio de neutrófilos en un 62%, examen de orina, radiografía , y ecografía de abdomen reportaron resultados que no apoyan de manera significativa al diagnóstico como lo hace el hemograma. Se concluye que debe sospechar de apendicitis aguda en todo paciente con dolor abdominal cólico - opresivo, con nauseas, vómitos, anorexia, y alzas térmicas, la ausencia de algunos signos semiológicos no descarta la patología. Los diagnósticos diferenciales, según este estudio deben hacerse especialmente con colecistitis, fiebre tifoidea, infección urinaria, amebiasis, y quiste de ovario.
We analyzed 241 clinical histories retrospectively in the Viedma Hospital, with diagnosis of appendicitis sharp during in one period understood among January of the 2003 to December of the 2004. The more frequent symptoms, was the abdominal pain in all the cases, refered as colic-oppressive in 62% of the cases, nauseate, vomits and anorexia in 61% the patients, to the physical exam, signs of peritoneal irritation was described in 55%, the fever and tachycardia in 46%, sign of psoas in 44%, of Me Burney in 44%, Choke in 35%, and sign of Rovsing in un 18%. The hemogram reported, leucocytes to neutrophiles prevalence in 62%, uriñe exam. x-rays, and abdomen ecography reported results that they don't support for the diagnosis. We concluded to make the suspicion diagnostic of appendicitis sharp in all patient with pain abdominal colic-oppressive.with nauseates, vomits, anorexia, and thermal rises, the absence of some signs and symptoms, doesn't discard the pathology. The diagnosses differential , according to this study should be made especially with colecistitis, typhoid fever, urinary infection, amebiasis, and ovary cyst.
We analyzed 241 clinical histories retrospectively in the Viedma Hospital, with diagnosis of appendicitis sharp during in one period understood among January of the 2003 to December of the 2004. The more frequent symptoms, was the abdominal pain in all the cases, refered as colic-oppressive in 62% of the cases, nauseate, vomits and anorexia in 61% the patients, to the physical exam, signs of peritoneal irritation was described in 55%, the fever and tachycardia in 46%, sign of psoas in 44%, of Me Burney in 44%, Choke in 35%, and sign of Rovsing in un 18%. The hemogram reported, leucocytes to neutrophiles prevalence in 62%, uriñe exam. x-rays, and abdomen ecography reported results that they don't support for the diagnosis. We concluded to make the suspicion diagnostic of appendicitis sharp in all patient with pain abdominal colic-oppressive.with nauseates, vomits, anorexia, and thermal rises, the absence of some signs and symptoms, doesn't discard the pathology. The diagnosses differential , according to this study should be made especially with colecistitis, typhoid fever, urinary infection, amebiasis, and ovary cyst.
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Vol. 28, No. 2