Correlación de los diagnósticos histopatológicos con la hiperbilirrubinemia como factor pronóstico de apendicitis : estudio a realizar en pacientes mayores de 15 años en el Hospital Dr, Teodoro Maldonado Carbo en el período enero 2013 - agosto 2014
Fecha
2015
Autores
Título de la revista
ISSN de la revista
Título del volumen
Editor
Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Medicina
Resumen
Antecedentes: A nivel mundial el 25% de los cuadros dolorosos abdominales corresponde a una Apendicitis Aguda, siendo la condición quirúrgica más común del abdomen, el retraso o mal diagnóstico en estos pacientes puede resultar en la perforación y por consiguiente aumento de la morbimortalidad. Con ayuda de las investigaciones surgió que la Hiperbilirrubinemia puede ser un marcador útil para la apendicitis simple y perforada. Objetivo: Fue determinar la correlación de la Hiperbilirrubinemia como factor pronóstico en pacientes con apendicitis diagnosticados por histopatología. Material y Métodos: Es un estudio retrospectivo de 112 pacientes que fueron diagnosticados con Apendicitis aguda, después de excluir los que tenían otras causas de Hiperbilirrubinemia, realizado en el Hospital Dr. Teodoro Maldonado Carbo. Se realizó revisión de las historias clínicas, resultados de laboratorio e histológicas. Se utilizaron fórmulas de sensibilidad y especificidad. Resultados: De los 112 casos estudiados, 65 fueron hombres y 47 mujeres. Su edad oscilaba entre 15 y 45 años. 44 casos presentaron elevación de bilirrubina de 1.1 – 1.9mg/dL y resulto ser significativamente mayor en la apendicitis gangrenosa / perforado con un 20% en comparación con los pacientes con apendicitis sin perforación. La hiperbilirrubinemia presento mayor Sensibilidad 81.5% y Especificidad 52.9% en los pacientes con apendicitis perforada y con apendicitis gangrenosa presento una Sensibilidad= 76.0% y Especificidad= 50.6%. Conclusión: Esta medida se puede utilizar como un complemento en el diagnóstico de la presencia de apendicitis gangrenosa / perforado.
Background: Worldwide 25% of abdominal pain syndromes correspond to an acute appendicitis, being this, the most common abdominal surgical condition, the delay or the wrong diagnosis in these patients can result in perforation hence and as result, the raise of the morbidity and mortality. With help of some of the investigations, it resulted that hyperbilirubinemia may be a useful marker for the simple and perforated appendicitis. Objectives: It was to establish the relation of hyperbilirubinemia as a prognostic fact in patients with appendicitis diagnosed by hispatology. Material and Methods: Is a retrospective study of 112 patients who were diagnosed with acute appendicitis, after excluding those with other causes of hyperbilirubinemia, made at the ‘Dr. Teodoro Maldonado Carbo’ Hospital. It has done a review of medical records, laboratory and histological results. It has been used sensitivity and specificity formulas. Results: From the 112 cases studied, 65 were men and 47 were women. Their ages ranged between 15 and 45 years old. 44 cases showed elevation of bilirubin from 1.1 to 1.9mg / dL, and it resulted to be more significantly higher in the gangrenous appendicitis with a 20% compared to patients without appendicitis perforation. Hyperbilirubinemia presented a higher sensitivity 81.5% and specificity 52.9% in patients with perforated appendicitis and with gangrenous appendicitis presented Sensitivity = 76.0% and Specificity = 50.6%. Conclusion: This measurement can be used as a complement in the diagnosis of the presence of gangrene / perforation appendicitis.
Background: Worldwide 25% of abdominal pain syndromes correspond to an acute appendicitis, being this, the most common abdominal surgical condition, the delay or the wrong diagnosis in these patients can result in perforation hence and as result, the raise of the morbidity and mortality. With help of some of the investigations, it resulted that hyperbilirubinemia may be a useful marker for the simple and perforated appendicitis. Objectives: It was to establish the relation of hyperbilirubinemia as a prognostic fact in patients with appendicitis diagnosed by hispatology. Material and Methods: Is a retrospective study of 112 patients who were diagnosed with acute appendicitis, after excluding those with other causes of hyperbilirubinemia, made at the ‘Dr. Teodoro Maldonado Carbo’ Hospital. It has done a review of medical records, laboratory and histological results. It has been used sensitivity and specificity formulas. Results: From the 112 cases studied, 65 were men and 47 were women. Their ages ranged between 15 and 45 years old. 44 cases showed elevation of bilirubin from 1.1 to 1.9mg / dL, and it resulted to be more significantly higher in the gangrenous appendicitis with a 20% compared to patients without appendicitis perforation. Hyperbilirubinemia presented a higher sensitivity 81.5% and specificity 52.9% in patients with perforated appendicitis and with gangrenous appendicitis presented Sensitivity = 76.0% and Specificity = 50.6%. Conclusion: This measurement can be used as a complement in the diagnosis of the presence of gangrene / perforation appendicitis.
Descripción
Palabras clave
Patología, Hiperbilirrubinemia, Apendicitis, Pronóstico, Estudios retrospectivos, Hospital de Especialidades Dr. Teodoro Maldonado Carbo, Cantón Guayaquil, Ecuador