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2014, Number 2

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Anales de Radiología México 2014; 13 (2)

Atypical appendicitis in adults

Motta-Ramírez GA, Méndez-Colín E, Martínez-Utrera MJ, Bastida-Alquicira J, Aragón-Flores M, Garrido-Sánchez GA, Meza-Robles JE

Language: Spanish
References: 85
Page: 143-165
PDF size: 759.67 Kb.


ABSTRACT

Acute appendicitis is the condition that most frequently requires emergency abdominal surgery; atypical symptoms appear in 44.6% of patients, which can delay diagnosis. Atypical manifestations account for the largest group in differential diagnosis: extreme ages, prior treatment, atypical location of the appendix: retrocaecal-retrocolonic, subcaecal and pelvic and pre ileal and post ileal, complicated, chronic, appendicular tumor, atypical clinical manifestation, appendicular diverticulitis, appendicitis of the appendicular stump, recurrent appendicitis, appendicitis which resolves spontaneously, and tip appendicitis. In atypical cases the predictive model of the Alvarado scale, combined with computed tomography as a complementary tool, has proven more valuable when combined with a complete clinical history and exhaustive physical exploration. The diagnosis of acute appendicitis is predominantly clinical and no symptom, sign, or finding, alone, is sufficient to establish or exclude the diagnosis. The purpose of this review is to draw the attention of radiologists and surgeons to the diversity of clinical possibilities that condition atypical clinical manifestations of acute appendicitis, and insist on the role of imaging methods in establishing the diagnosis.


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