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2017, Número 1

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Rev Med Inst Mex Seguro Soc 2017; 55 (1)


Apendicitis aguda. Manejo quirúrgico y no quirúrgico

Souza-Gallardo LM, Martínez-Ordaz JL

Idioma: Español
Referencias bibliográficas: 44
Paginas: 76-81
Archivo PDF: 248.05 Kb.


RESUMEN

La apendicitis es una urgencia común para el cirujano. El riesgo estimado para presentarla es de 7-8%. Se pensaba que la apendicitis era un continuo donde, mientras más tiempo pasaba entre el inicio de síntomas y el tratamiento, el riesgo de complicaciones (necrosis, perforación y formación de abscesos) era mayor; sin embargo, la evolución es variable por lo que se han propuesto estrategias terapéuticas como el uso de antibióticos, cirugía de intervalo o tratamiento endoscópico. El objetivo de este estudio es hacer una revisión de la literatura acerca del manejo de apendicitis comparando manejo quirúrgico y conservador.
Es sabido que el manejo tradicional para apendicitis es la apendicectomía, con tasa de complicación del 2.5 hasta el 48%. El abordaje ha cambiado de abierto a laparoscópico y han surgido nuevas técnicas invasivas como el manejo endoscópico con endoprótesis y la cirugía ambulatoria.
El manejo antibiótico es esencial en apendicitis y su uso como terapia única en apendicitis tiene como objetivo disminuir la morbilidad asociada al evento quirúrgico, a la resección del órgano y a disminuir costos.
Nuestra conclusión es que el manejo adecuado de la apendicitis es controversial y dependerá del estado clínico del paciente y de los recursos con que se dispongan.


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