Abstract
to identify the main risk factors associated with the development of complications in patients with acute appendicitis. we conducted a case-control study of 402 patients with acute appendicitis hospitalized in a secondary hospital, divided into two groups: the control group, with 373 patients who progressed without postoperative complications (Group 1) and the study group, with 29 patients who presented complications (Group 2). We evaluated demographic data, signs and symptoms of the disease, imaging tests and hospitalization data. factors associated with complications were fever, radiological and sonographic changes, abrupt positive decompression and diarrhea. Migration of pain, nausea, vomiting and abrupt positive decompression were the findings that were significantly more frequent in both groups (p = 0.05). The duration of signs and symptoms in days in group 2 was significantly higher than in group 1, with a median of three days for the group with complications (p = 0.05). alterations in imaging, fever, diarrhea, positive abrupt decompression, duration of symptoms and lower age are associated with a higher frequency of complications in acute appendicitis, which reinforces the importance of anamnesis, physical examination and indication of complementary exams in the approach of these patients.
Highlights
The acute inflammatory abdomen encompasses the major conditions seen by surgeons working in emergency services around the world
This study aims to evaluate the main risk factors associated with the development of complications in patients with acute appendicitis
We studied 402 patients, divided into two groups: control group (Group 1), with patients who presented no postoperative complications (n=373), and study group (Group 2), composed of patients presenting with complications (n=29)
Summary
The acute inflammatory abdomen encompasses the major conditions seen by surgeons working in emergency services around the world. It is a clinical picture ranging from simple, self-limiting, benign diagnoses to those that threaten life and require rapid surgical intervention. The signs and symptoms are usually anorexia, periumbilical colic, nausea and vomiting, followed by moderate fever (38° C) and signs of peritoneal inflammation in the lower right quadrant of the abdomen[4,5] Many of these findings, may occur in other clinical or surgical conditions, such as mesenteric lymphadenitis, intraperitoneal hemorrhage, acute salpingitis, endometriosis, Meckel’s diverticulitis, among others. The complications resulting from the evolution of the acute inflammatory process, such as suppuration, perforation with or without hemorrhage, and gangrene of the appendix are serious, making early surgery fundamental to contain the evolution of the condition[5]
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