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Boletín Médico del Hospital Infantil de México

2005, Number 3

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Bol Med Hosp Infant Mex 2005; 62 (3)

Appendicitis in pediatric age:clinico-pathologic correlation

Flores-Nava G, Jamaica-Balderas ML, Landa-García RA, Parraguirre-Martínez S, Lavalle-Villalobos A

Language: Spanish
References: 20
Page: 195-201
PDF size: 102.24 Kb.


ABSTRACT

Introduction.The surgeon has a classification for appendicitis based in a macroscopic view,but the pathologistreports the histopathologic features.Sometimes there are differences between those classifications.Objec-tive:to compare the clinic macroscopic appendicitis classification with the histopatologic classification.Material and methods.Design:in a retrospective study,we reviewed the charts of children with the diag-nosis of appendicitis in a 4 year and a half period.We analyze the age,sex,clinical picture,hematic cyto-logy,x ray studies,complications,use of antibiotics,and compare the clinical diagnosis of the surgeonsagainst the diagnosis of pathologist.Results.We reviewed 311 charts.The patient’s age was 10 ± 12 years (mean ± sd),56.2% were male,male/female ratio 1.2:1.The clinical picture was abdominal pain in 100%,vomiting in 81.3% and fever in57.5% with 1.9 ± 1.5 days of evolution.In the hematic cytology 83.9% of they presented leucocytosis,neu-trofilia in 98% and bandemia in 53.6%.The x ray findings were intestinal ileus 53.7% and psoas erased in44%.The surgeon diagnosis was;normal appendices in 4.8%,acute appendicitis grade I en 11.2%,II in25.7%,III in 12.2% and grade IV in 45.9%.In the hystopatologic diagnosis;normal 0.9%,incipient 4.1%,phlegmonous 8.3%,fibrin purulent 25.7%,gangrenous 15.7%,perforated 45.9%,with abscess 58.1%,withperitonitis 80.7%,fecalith 31.8%,follicular hyperplasic 6.1% and mesenteric adenitis in 3.2%.Conclusion.The correlation of the grade of appendicitis between the surgeon and the pathologist isgood,however in any cases the surgeon underrated the grade of gravity of the appendicitis than thepathologist,but there are not more cases complicated.


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