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ISSN 0185-3252 (Print)
Revista de la Asociación Médica del Centro Médico ABC

2010, Number 3

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An Med Asoc Med Hosp ABC 2010; 55 (3)

Optimizing the management of patients with acute appendicitis. The role of C reactive protein and medical management

Kunz MW, Cervantes MF

Language: Spanish
References: 20
Page: 116-121
PDF size: 56.45 Kb.


ABSTRACT

Acute appendicitis is the most common cause for surgical abdominal pain. In México, acute appendicitis is diagnosed primarily by clinical methods in spite of their known limited sensibility and specificity; its treatment is almost always surgical, even though the compelling evidence supporting medical treatment for initial stages of this condition. The consequences are the overload of the limited resources available and increased expenses both direct and indirect. In order to illustrate this trend, we present a series of 123 patients with acute abdominal pain to determine the factors more commonly associated with in-patient management, surgical treatment and intraoperative findings in two general hospitals in Mexico City. Between 50-70% of patients with acute appendicitis might be offered medical treatment based upon C-reactive protein levels. We projected the estimated costs of our current practice in two series of patients to illustrate the consequences of not letting old dogmas die. In conclusion, if we add C-reactive protein determination to the management of patients with acute abdominal pain we could reduce costs optimizing medical management and limiting surgical procedures.


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