Acceso usuarios
Luciano Jonathan Delgado Plasencia, Antonio Boluda Aparicio, Sara González García, Desiré Rodríguez Castellano, Patricia Marrero Marrero
INTRODUCCIÓN. La apendagitis epiploica (AE) es una patología infrecuente que suele presentarse con dolor abdominal agudo en cuadrantes inferiores del abdomen. Su presentación conlleva la realización de un diagnóstico diferencial con múltiples patologías urgentes. MATERIAL Y MÉTODO. Estudio retrospectivo de serie de casos diagnosticados de AE. Todos los pacientes fueron atendidos en el servicio de urgencias, de un hospital terciario, con seguimiento a 2 años. RESULTADOS. Se incluyeron 17 pacientes, con una edad media de 56,53 ± 18,39 años. El tiempo de evolución de la clínica fue de < 24 horas en 5 casos (29,4%) y > 48 horas en 9 casos (52,9%). La localización de la AE fue en el colon sigmoide en el (29,4%), colon descendente (23,5%), colon ascendente (11,7%), ciego (29,4%), y colon transverso (5,8%). Tres pacientes (17,6%) fueron tratados quirúrgicamente, 8 (47,1%) recibieron tratamiento ambulatorio con analgesia oral y 5 (29,3%) fueron hospitalizados para tratamiento analgésico endovenoso. Ningún caso presentó recidiva en los 2 años de seguimiento. DISCUSIÓN. La AE es un cuadro autolimitado que se resuelve habitualmente con tratamiento sintomático. Es importante tenerla en cuenta como causa de dolor abdominal por la posibilidad de realizar intervenciones quirúrgicas innecesarias.
BACKGROUND. Epiploic appendagitis (EA) is an uncommon condition that typically presents with acute abdominal pain in the lower half of the abdomen. The differential diagnosis of the cause of pain requires urgent consideration of multiple conditions. Computed tomography is usually required for diagnosis. MATERIAL AND METHODS. This is a retrospective case series of patients diagnosed with epiploic appendagitis. All were diagnosed in the emergency department after suspicion of acute abdomen. RESULTS. Seventeen patients were included in the series. The mean (SD) age at presentation was 56.53 (18.39) years. Symptoms were present for less than 24 hours in 5 patients (29.4%) and more than 48 hours in 9 (52.9%). Abdominal pain as the presenting symptom was in the left lower quadrant (6 patients), the right lower quadrant (8 patients); mesogastric in 1 patient, and epigastric in 2 patients. EA was diagnosed based on imaging in all cases. The location was the sigmoid colon in 5 cases (29.4%), the descending colon in 4 (23.5%), the ascending colon in 2 (11.7%), the cecum in 5 (29.4%), and the transverse colon in 1 (5.8%). Three patients (17.6%) were treated surgically. Outpatient treatment with an oral analgesic was prescribed for 8 patients (47.1%), and 5 patients (29.3%) were admitted to receive IV analgesia. Symptoms resolved without surgery after 1 week. Recurrence within 2 years has not been reported in any of the cases. CONCLUSIONS. EA is a self limited condition that normally resolves within 2 weeks with treatment of symptoms. Physicians should consider EA as a possible cause of abdominal pain given that a late or erroneous diagnosis can lead to prolonged hospitalization, unnecessary prescription of antibiotics, unnecessary surgery, and higher health care costs.
