2001, Number 1
Abscess in the omental transcavity secondary to perforated appendicitis. Presentation of one patient
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ABSTRACTObjective: To describe the case of a patient with an atypical clinical course of acute appendicitis.
Setting: Third level health care hospital.
Description of the case: Woman of 22 years of age with clinical symptoms of 32 days of evolution, characterized by pain in the hypogastrium and both iliac fossas, hyporexia, chills. Six days before being admitted, she also experienced a progressive increase in abdominal volume at the mesogastrium and epigastrium, more severe pain, fever up to 38.5ºC, without being able to evacuate gases or fecal matter; during this symptomatology she was administered antimicrobial agents, trimethoprim-sufamethoxasole, and Paracetamol as analgesic. Laboratory test at admittance revealed a leukocyte count of 16000, thoracic teleradiography revealed: suspicion of pleural effusion. Plain abdominal X ray revealed opacity at the upper hemiabdomen and air levels in the small intestinal loops, blurring of the left Psoas image. Abdominal ultrasound revealed the presence of a liquid collection measuring approximately 160 mm x 115 mm, and computed tomography defined a collection located in the left hypocondrium and epigastrium, behind the stomach, measuring 150 mm. Laparotomy revealed a mass of 15 cm in the omental transcavity, from which 2500 ml of purulent material was drained, and another collection of approximately 500 ml at the left parieto-colic fold, both collections were drained and a left hemicolectomy with proximal colostomy was performed due to the conditions of the colon at that level. The patient evolved well.
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