medigraphic.com
SPANISH

Gaceta Médica de México

ISSN 0016-3813 (Print)
  • Contents
  • View Archive
  • Information
    • General Information        
    • Directory
  • Publish
    • Instructions for authors        
  • medigraphic.com
    • Home
    • Journals index            
    • Register / Login
  • Mi perfil

2018, Number 4

<< Back Next >>

Gac Med Mex 2018; 154 (4)

Presentación clínica de la apendicitis aguda en pacientes inmunocomprometidos por diabetes o VIH/sida

Ponce de León-Ballesteros G, Pérez-Soto R, Zúñiga-Posselt K, Velázquez-Fernández D
Full text How to cite this article

Language: Spanish
References: 10
Page: 473-479
PDF size: 262.20 Kb.


Key words:

Acute appendicitis, HIV, Diabetes mellitus, Immunocompromised, Surgical complications.

ABSTRACT

Introduction: Immunocompromised patients experience limited inflammatory response, which can delay acute appendicitis (AA) diagnosis. Objective: To assess if immunosuppression can affect AA clinical course and evolution. Method: Comparative, retrospective analysis of patients with HIV or type 2 diabetes mellitus (DM2) or with no other pathology who underwent appendectomy for AA. Results: A total of 128 patients with AA who were surgically intervened were assessed (53.6% were of the female gender); mean age was 42.5 years, 15 (11.7%) had been diagnosed with HIV infection, 47 (36.7%) with DM2 and 66 (51.6%) had no other disease. The proportion of leukocytosis was lower in the HIV group (66.7%; p = 0.007). Patients with HIV and DM2 had longer evolution time (HIV 66.9 ± 61.2, DM2 90.1 ± 144 hours; p ≤ 0.001), longer hospital length of stay (HIV 11.1 ± 17.1, DM2 6.5 ± 4.1 days; p ≤ 0.0001), and a higher rate of complications (HIV 20%, DM2 23.8%; p = 0.036). The most common complication was superficial and deep surgical site infection. Right hemicolectomy was more common in the HIV group (20%; p = 0.017). There was no mortality registered. Conclusions: Immunosuppression affects AA clinical course and evolution.


REFERENCES

  1. Giiti G, Mazigo H, Heukelbach J, Mahalu W. HIV, appendectomy and postoperative complications at a reference hospital in Northwest Tanzania: cross-sectional study. AIDS Res Ther. 2010;7:47.

  2. Mueller GP, Williams RA. Surgical infections in AIDS patients. Am J Surg. 1995;169:34S-38S.

  3. Crum-Cianflone N, Weekes J, Bavaro M. Appendicitis in HIV-infected patients during the era of highly active antiretroviral therapy. HIV Med. 2008;9:421-426.

  4. Whitney TM, Macho JR, Russell TR, Bossart KJ, Heer FW, Schecter WP. Appendicitis in acquired inmmunodeficiency syndrome. Am J Surg. 1992;164:467-470.

  5. Liu K, Shyu J, Uen YH, Chen TH, Shyr YM, Su CH, et al. Acute apendicitis in patients with acquired immunodeficiency syndrome. J Chin Med Assoc. 2005;68:226-229.

  6. Cooperman M. Complication of appendectomy. Surg Clin North Am. 1983;63:1233-1247.

  7. Tsai S, Hsu C, Chen S, Lin YY, Chu SJ. Complicated acute appendicitis in diabetic patients. Am J Surg. 2008;196:34-39.

  8. Salzman DJ, Williams RA, Gelfand DV, Wilson SE. The surgeon and AIDS: twenty years later. Arch Surg. 2005;140:961-967.

  9. Aldeen T, Horgan M, Macallan DC, Thomas V, Hay P. Is acute appendicitis another inflammatory condition associated with highly active antiretroviral therapy (HAART)? HIV Med. 2000;10:252-255.

  10. Sivrikoz E, Karamanos E, Beale E, Teixeira P, Inaba K, Demetriades D. The effect of diabetes on outcomes following emergency appendectomy in patients without comorbidities: a propensity score-matched analysis of National Surgical Quality Improvement Program database. Am J Surg. 2015;209:206-211.




2020     |     www.medigraphic.com

Mi perfil

C?MO CITAR (Vancouver)

Gac Med Mex. 2018;154