Paciente de 70 años con dolor en fosa ilíaca izquierda y crepitación a la palpación profunda abdominal

Guillén, M. J. Menduiña; García, P. Alaminos; Barranco, M. Valenzuela

doi:10.4321/s1130-01082007001000009

Cited by 2 publications

(3 citation statements)

References 4 publications

(1 reference statement)

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“…La localización del dolor en fosa iliaca derecha establece una pequeña relación con respecto a la apendicitis aguda, presentando una exactitud de 76,5%, siendo el índice J de Jouden de 0,6 y la razón de verosimilitud (CPP o LR+) de 5,98 con un IC al 95% (2,(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)68). Con respecto a la relación entre la localización del dolor en hipocondrio y la colecistitis esta presenta un incremento amplio con LR+ de 26.14 con IC al 95% (6,.…”

Section: Resultsunclassified

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Validity of tests performed to diagnose acute abdominal pain in patients admitted at an emergency department

Fernandez

López

Montes

et al. 2009

Rev. esp. enferm. dig.

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Objective: to determine the real importance of anamnesis, physical examination, and various tests in the assessment of acute abdominal pain.Methods: a retrospective observational study with patients complaining of abdominal pain at the Emergency Department, Altiplano Health Area (Murcia) was performed. In our study we considered the following variables: socio-demographic data, history of previous surgery, symptoms, place and type of pain. Imaging tests were labeled as positive, negative, or inconclusive for assumed diagnoses, which were retrospectively assessed by an external radiologist who was unaware of the patient's final diagnosis.Results: our study includes 292 patients with a mean age of 45.49 years; 56.8% of these patients were women. Regarding the frequency of the different acute abdomen diagnoses, appendicitis was the main cause (approx. 25%), followed by cholecystitis (10%). We found a significant diagnostic correlation between pain location in the right hypochondrium (RHC) and a diagnosis with cholecystitis. This location was also significant for acute appendicitis (up to 74%). Regarding clinical signs, we only observed a significant correlation between fever and viscera perforation, and between Murphy's sign and cholecystitis. Sensitivity and specificity found in relation to the psoas sign were similar to those seen in other series, 16 and 95% respectively, and slightly lower than the Blumberg or rebound sign, which we found to be around 50 and 23%, respectively.Conclusions: a) anamnesis and physical examination offer limited accuracy when assessing acute abdomen; b) ultrasound scans offer a low diagnostic agreement index for appendicitis; and c) laparoscopy may prove useful for diagnosis, and is also a possible treatment for acute abdominal pain despite its low diagnostic efficiency.

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“…We carried out and calculated data analyses with CASPe (11). This was also used to calculate agreement, Kappa value, and the rest of diagnostic efficacy indices by applying a 95% level of confidence (α < 0.05) (12)(13)(14)(15)(16)(17)(18).…”

Section: Operational Definitionsmentioning

confidence: 99%

Validity of tests performed to diagnose acute abdominal pain in patients admitted at an emergency department

Fernandez

López

Montes

et al. 2009

Rev. esp. enferm. dig.

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“…However colon carcinoma very rarely presents with subcutaneous, retroperitoneal, or abdominal wall abscess. Abscess of the anterior abdominal wall developing as a result of direct invasion and perforation of the colon by cancer has been rarely described [5–7]. Our patient's tumor was deeply penetrating into the abdominal wall and created an enterocutaneous fistula.…”

Section: Discussionmentioning

confidence: 83%

Matching Biological Mesh and Negative Pressure Wound Therapy in Reconstructing an Open Abdomen Defect

Caviggioli

Klinger

Lisa

et al. 2014

Case Reports in Medicine

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Reconstruction of open abdominal defects is a clinical problem which general and plastic surgeons have to address in cooperation. We report the case of a 66-year-old man who presented an abdominal dehiscence after multiple laparotomies for a sigmoid-rectal adenocarcinoma that infiltrated into the abdominal wall, subsequently complicated by peritonitis and enteric fistula. A cutaneous dehiscence and an incontinent abdominal wall resulted after the last surgery. The abdominal wall was reconstructed using a biological porcine cross-linked mesh Permacol (Covidien Inc., Norwalk, CT). Negative Pressure Wound Therapy (NPWT), instead, was used on the mesh in order to reduce wound dimensions, promote granulation tissue formation, and obtain secondary closure of cutaneous dehiscence which was finally achieved with a split-thickness skin graft. Biological mesh behaved like a scaffold for the granulation tissue that was stimulated by the negative pressure. The biological mesh was rapidly integrated in the abdominal wall restoring abdominal wall continence, while the small dehiscence, still present in the central area, was subsequently covered with a split-thickness skin graft. The combination of these different procedures led us to solve this complicated case obtaining complete wound closure after less than 2 months.

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Paciente de 70 años con dolor en fosa ilíaca izquierda y crepitación a la palpación profunda abdominal

Cited by 2 publications

References 4 publications

Validity of tests performed to diagnose acute abdominal pain in patients admitted at an emergency department

Validity of tests performed to diagnose acute abdominal pain in patients admitted at an emergency department

Matching Biological Mesh and Negative Pressure Wound Therapy in Reconstructing an Open Abdomen Defect

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