Resumo

LOBO-MACHIN, Irene et al. Appendiceal diverticulitis and acute appendicitis: differences and similarities. Rev. esp. enferm. dig. [online]. 2014, vol.106, n.7, pp.452-458. ISSN 1130-0108.

Introduction: Acute appendiceal diverticulitis is an unusual cause of acute abdomen, considered clinically indistinguishable from acute appendicitis. Material and methods: In a historic cohort study with 27 cases of appendiceal diverticulitis and 54 cases of acute appendicitis, we compared clinical characteristics, diagnostic tests and pathology findings of the two processes. Results: Mean age at presentation was lower in acute appendicitis (37.24 ± 19.98 vs. 54.81 ± 17.55 years, p < 0.001), with significant differences between men (33.33 ± 15.89 vs. 57 ± 18.02 years, p < 0.001) but not between women (41.76 ± 24.87 vs. 50.44 ± 16.69 years, p = 0.34). In the diverticulitis group, 48.15 % had leukocytosis vs. 81.48 % in the appendicitis group (p = 0.02); there was no difference in leukocyte count (13770.37 ± 4382.55 vs. 14279.63 ± 4268.59, p = 0.61). Patients with appendiceal diverticulitis had a higher incidence of appendiceal mucocele (p = 0.01) and a lower proportion of appendiceal gangrene (p = 0.03). There were no differences in appendiceal perforation or ulceration. Symptom duration before emergency department attendance (71.61 ± 85.25 hours vs. 36.84 ± 33.59 hours; Z = -3.1 p = 0.002), duration of surgery (85 ± 40 minutes vs. 60 ± 21 minutes, Z = -3.2, p = 0.001) and the presence of appendicular plastron was higher in patients with diverticulitis vs. appendicitis (8 vs. 5 patients (p = 0.01, Odds ratio 2.2)). Conclusions: Appendiceal diverticulitis presents a series of clinical, epidemiological and pathological differences with respect to acute appendicitis. The former shows a more indolent course with delayed diagnosis.

Palavras-chave : Acute appendiceal diverticulitis; Acute appendicitis; Acute abdomen; Mucinous cystadenoma; Appendiceal mucocele; Colorectal cancer.

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