Factores de riesgo de las complicaciones postquirúrgicas de la apendicitis aguda, estudio a realizar en el Hospital Teodoro Maldonado Carbo durante el período 2015
No hay miniatura disponible
Fecha
2016
Autores
Título de la revista
ISSN de la revista
Título del volumen
Editor
Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Medicina
Resumen
La apendicitis aguda es la urgencia quirúrgica abdominal más frecuente en las salas de emergencia de los hospitales de todo el mundo, según la Organización Mundial de la Salud, constituye el 60% del abdomen agudo quirúrgico. La máxima incidencia ocurre en la segunda y tercera década de la vida, presentándose la perforación en el 19-35% de los pacientes con apendicitis.
El síntoma más importante es el dolor abdominal. Inicialmente es de tipo visceral por distensión apendicular, poco intensa y mal localizado en epigastrio. Posteriormente en 4 o 6 horas; el dolor se localiza en la fosa iliaca derecha y es de carácter somático, continuo, de mayor intensidad; La temperatura suele alterarse 4-8 h después de iniciarse el cuadro y se eleva ligeramente, entre 37,5°C y 38°C. El diagnóstico se fundamenta principalmente en la clínica compatible con la enfermedad, y se ayuda de las diferentes herramientas diagnósticas como los exámenes de la Laboratorio y estudios de imágenes.
En las apendicitis agudas sin perforación en 5% de casos hay complicaciones. En las apendicitis agudas con perforación las complicaciones se presentan en un 30% de casos, las complicaciones postquirúrgicas más frecuentes son: infección de la herida quirúrgica, dehiscencia, Abscesos intrabdominales, de pared, evisceración, fistula cecal, seroma, piliflebitis, íleo paralitico, dehiscencia del muñón apendicular, hemorragias y Los factores de riesgo sistémicos son en general los relacionados con el paciente como edad, obesidad, inmunodepresión, diabetes, obesidad, desnutrición, estancia preoperatoria prolongada. Y el tratamiento de esta patología es quirúrgico.
OBJETIVO: Determinar los factores de riesgo en complicaciones postquirúrgicas de pacientes apendicectomizados a través de la revisión de historias clínicas para disminuir la morbimortalidad de esta enfermedad. METODO
Es un estudio descriptivo, retrospectivo y estadístico de corte transversal donde tomamos como referencia todos los pacientes sometidos a apendicectomía en el Servicio de cirugía del Hospital Dr. Teodoro Maldonado Carbo se analizó el índice de morbimortalidad y su relación con los factores de riesgo, enfermedades asociadas, tiempo de duración de la cirugía, tiempo de estancia hospitalaria, clasificación y complicaciones.
RESULTADOS: La presencia de uno o dos factores de riesgo se asocia con el desarrollo de complicaciones en los pacientes apendicectomizados.
Acute appendicitis is the abdominal surgical emergency more frequently in the emergency rooms of hospitals around the world, according to the World Health Organization, constitutes 60% of surgical acute abdomen. The maximum incidence occurs in the second and third decades of life, presenting the drilling in 19-35% of patients with appendicitis. The most important symptom is abdominal pain. Initially it is visceral appendicular, little intense bloating and mal located in epigastrium. Then in 4-6 hours; the pain is located in the right iliac Fossa and somatic, continuous character, of greater intensity; The temperature is usually altered 4-8 h after starting the picture and rises slightly, between 37.5 ° C and 38 ° C. Diagnosis is mainly based on compatible with disease clinic, and support of different diagnostic tools such as tests in the laboratory and research studies. There are complications in the acute appendicitis without perforation in 5% of cases. In the acute appendicitis with perforation complications occur in 30% of cases, the most frequent post-operative complications are: infection of the surgical wound dehiscence, abscess intra-abdominal, of wall, evisceration, fistula caecal, seroma, piliflebitis, ileus paralytic, dehiscence of the appendicular stump, hemorrhages and systemic risk factors are in general related to the patient such as age, obesity, immunosuppression , diabetes, obesity, malnutrition, preoperative prolonged. And the treatment of this pathology is surgical. OBJECTIVE: To determine the risk factors in postoperative complications of patients apendicectomizados through the review of case histories to decrease morbidity and mortality from this disease. METHOD Is a descriptive, retrospective and statistical cross-section where we take as a reference all patients undergoing appendectomy in surgery of the Hospital Dr. Teodoro Maldonado Carbo was analyzed morbidity and mortality index and its relationship with the risk factors, associated disorders, duration of surgery, time of hospital stay, classification, and complications. RESULTS: The presence of one or two risk factors is associated with the development of complications in patients with appendicitis.
Acute appendicitis is the abdominal surgical emergency more frequently in the emergency rooms of hospitals around the world, according to the World Health Organization, constitutes 60% of surgical acute abdomen. The maximum incidence occurs in the second and third decades of life, presenting the drilling in 19-35% of patients with appendicitis. The most important symptom is abdominal pain. Initially it is visceral appendicular, little intense bloating and mal located in epigastrium. Then in 4-6 hours; the pain is located in the right iliac Fossa and somatic, continuous character, of greater intensity; The temperature is usually altered 4-8 h after starting the picture and rises slightly, between 37.5 ° C and 38 ° C. Diagnosis is mainly based on compatible with disease clinic, and support of different diagnostic tools such as tests in the laboratory and research studies. There are complications in the acute appendicitis without perforation in 5% of cases. In the acute appendicitis with perforation complications occur in 30% of cases, the most frequent post-operative complications are: infection of the surgical wound dehiscence, abscess intra-abdominal, of wall, evisceration, fistula caecal, seroma, piliflebitis, ileus paralytic, dehiscence of the appendicular stump, hemorrhages and systemic risk factors are in general related to the patient such as age, obesity, immunosuppression , diabetes, obesity, malnutrition, preoperative prolonged. And the treatment of this pathology is surgical. OBJECTIVE: To determine the risk factors in postoperative complications of patients apendicectomizados through the review of case histories to decrease morbidity and mortality from this disease. METHOD Is a descriptive, retrospective and statistical cross-section where we take as a reference all patients undergoing appendectomy in surgery of the Hospital Dr. Teodoro Maldonado Carbo was analyzed morbidity and mortality index and its relationship with the risk factors, associated disorders, duration of surgery, time of hospital stay, classification, and complications. RESULTS: The presence of one or two risk factors is associated with the development of complications in patients with appendicitis.
Descripción
PDF
Palabras clave
Apendicitis, Complicaciones posoperatorias, Epidemiología descriptiva, Estudios retrospectivos, Hospital de Especialidades Dr. Teodoro Maldonado Carbo, Cantón Guayaquil, Ecuador