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>Journals >Cirujano General >Year 2017, Issue 4


Padrón AG
Acute abdomen and appendectomies in fertile women: the role of the general surgeon
Cir Gen 2017; 39 (4)

Language: Espańol
References: 20
Page: 209-213
PDF: 4. Kb.


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ABSTRACT

Background: Gynecological disorders related to general surgery may fall in one of five categories: 1) acute abdomen, 2) unexpected gynecological disorders discovered during exploratory laparotomy, 3) pain during pregnancy, 4) pregnancy and urinary disorders, and 5) cancer of gynecological cause. The first two disorders are the ones most often faced by a general surgeon. Material and methods: In order to determine the incidence of gynecological disorders treated by general surgeons and the resulting iterative appendectomies in cases of acute abdomen in fertile women, a retrospective, observational cohort analysis was conducted on women with exploratory laparotomy and clinical symptoms of acute abdomen and/or probable acute appendicitis, over a period of four years in a newly created secondary hospital. Results: During the study period, 126 women of childbearing age (between 11 and 45 years of age) with acute abdomen and probable acute appendicitis were surgically intervened, of which 19 met the criteria for admission to the study due to gynecoobstetric disease without acute appendicitis. There was only one case of morbidity (textiloma) and no mortality. Discussion: In our work, we found an incidence of 15% of acute appendicitis diagnostic fails, which is below international standards; it is known that from 6 to 25% of the surgeries for acute appendicitis reveal a normal appendix, and this number rises to 30 to 40% in women of childbearing age.


Key words: Acute abdomen, appendectomy, fertile women, general surgeon.


REFERENCIAS

  1. Philipp EE. Victor Bonney: the Gynaecological Surgeon of the Twentieth Century. J R Soc Med. 2001; 94: 311-312.

  2. Cameron M. Gynaecology and general surgery. Ann R Coll Surg Engl. 1975; 56: 115-123.

  3. Hatipoglu S, Hatipoglu F, Abdullayev R. Acute right lower abdominal pain in women of reproductive age: clinical clues. World J Gastroenterol. 2014; 20: 4043-4049.

  4. Howell JM, Eddy OL, Lukens TW, Thiessen ME, Weingart SD, Decker WW, et al. Clinical policy: Critical issues in the evaluation and management of emergency department patients with suspected appendicitis. Ann Emerg Med. 2010; 55: 71-116.

  5. Wray CJ, Kao LS, Millas SG, Tsao K, Ko TC. Acute appendicitis: controversies in diagnosis and management. Curr Probl Surg. 2013; 50: 54-86.

  6. Ma KW, Chia NH, Yeung HW, Cheung MT. If not appendicitis, then what else can it be? A retrospective review of 1492 appendectomies. Hong Kong Med J. 2010; 16: 12-17.

  7. Evsen MS, Soydinc HE. Emergent gynecological operations: A report of 105 cases. J Clin Exp Invest. 2010; 1: 12-15.

  8. Paulson EK, Kalady MF, Pappas TN. Clinical practice. Suspected appendicitis. N Engl J Med. 2003; 348: 236-242.

  9. Flum DR, Koepsell T. The clinical and economic correlates of misdiagnosed appendicitis: nationwide analysis. Arch Surg. 2002; 137: 799-804; discussion 804.

  10. Singhal V, Jadhav V. Acute appendicitis: are we over diagnosing it? Ann R Coll Surg Engl. 2007; 89: 766-769.

  11. Dueholm S, Bagi P, Bud M. Laboratory aid in the diagnosis of acute appendicitis. A blinded, prospective trial concerning diagnostic value of leukocyte count, neutrophil differential count, and C-reactive protein. Dis Colon Rectum. 1989; 32: 855-859.

  12. Yang HR, Wang YC, Chung PK, Chen WK, Jeng LB, Chen RJ. Laboratory tests in patients with acute appendicitis. ANZ J Surg. 2006; 76: 71-74.

  13. Roche O, Chavan N, Aquilina J, Rockall A. Radiological appearances of gynaecological emergencies. Insights Imaging. 2012; 3: 265-275.

  14. 14.Mazzei MA, Guerrini S, Cioffi Squitieri N, Cagini L, Macarini L, Coppolino F, et al. The role of US examination in the management of acute abdomen. Crit Ultrasound J. 2013; 5 Suppl 1: S6.

  15. Tabbara M, Evangelopoulos N, Raio L, Banz V, Zimmermann H, Kim-Fuchs C, et al. Transvaginal ultrasound in fertile patients with suspected appendicitis: an experience report of current practice. Emerg Med Int. 2012; 2012: 481797.

  16. Bondi M, Miller R, Zbar A, Hazan Y, Appelman Z, Caspi B, et al. Improving the diagnostic accuracy of ultrasonography in suspected acute appendicitis by the combined transabdominal and transvaginal approach. Am Surg. 2012; 78: 98-103.

  17. Larsson PG, Henriksson G, Olsson M, Boris J, Ströberg P, Tronstad SE, et al. Laparoscopy reduces unnecessary appendicectomies and improves diagnosis in fertile women. A randomized study. Surg Endosc. 2001; 15: 200-202.

  18. Aulestia SN, Cantele H, Leyba JL, Navarrete M, Llopla SN. Laparoscopic diagnosis and treatment in gynecologic emergencies. JSLS. 2003; 7: 239-242.

  19. Van den Broek WT, Bijnen AB, de Ruiter P, Gouma DJ. A normal appendix found during diagnostic laparoscopy should not be removed. Br J Surg. 2001; 88: 251-254.

  20. Khairy G. Acute appendicitis: is removal of a normal appendix still existing and can we reduce its rate? Saudi J Gastroenterol. 2009; 15: 167-170.






>Journals >Cirujano General >Year 2017, Issue 4
 

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