Vargas DA, López RS, Ramírez TD, Rodríguez BA, Fernández HE

Language: Spanish
References: 26
Page: 154-157
PDF size: 32.48 Kb.

ABSTRACT

Objective: To analyze the factors cansing delay in the surgical treatment of appendicitis. Setting: Third level health care hospital.
Design: Observational, prospective, longitudinal, descriptive study without control group.
Patients and method: We studied 78 patients subjected to surgery with pre or post-operative diagnosis of appendicitis. Variables: evolution since pain initiation, number of hours elapsed before surgery, pre hospital treatment, initial diagnosis out or in the hospital and post-operative diagnosis, therapeutics and complications.
Results: From the 78 patients, 18 (23%) had a definitive diagnosis different from the one made before surgery; 12 (16%) patients had normal appendices and 6 (7.6%) were false negatives. Average time between pain initiation and surgery was of 64.6 hours (2.7 days); 44% was operated after 48 hours fifty (64%) were advanced appendicitis, six (7.6%) coursed with generalized peritonitis, with an average time of 76 hours = 3,29 days. Purulent material was found in 28 (37%), perforation of the appendix in 17 (22% Pres-surgery time for women was 3.2 days, for men it was 2.2 days. Wound infection occurred in 15 (19%). Sixty patients (77%) had seen a physician before admittance to the hospital; in 24 (40%), appendicitis had been diagnosed, in 32 (53%), diagnosis failed.
Drugs prescribed by the physician or self. Medicated had been taken by 98%.
Conclusion: Five out of 10 physicians erred the pre-hospital diagnosis, 98% of patients received medication before reaching the hospital. Errors in diagnosis and automedication were factors that delayed surgery.

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