Sintomatología atípica en 140 pacientes con apendicitis

SUMMARY The classic clinical picture of appendicitis is widely known. An association between this so-called classic clinical picture and atypical symptoms has been described. The aim of this study was to determinate the frequency and influence of these atypical symptoms in the clinical diagnosis of appendicitis. From march 2002 to march 2003, 457 patients older than 15 years old were operated for appendicitis. One hundred and sixty eight (36.7%) presented atypical symptoms, 28 were discharged, therefore 140 patients (83.3%) were included. There were 47 female patients, age 29 ± 2.54 (33.6%) and 93 male patients, age 32 ± 3.95 (66.4% p< 0.05). The most common classical symptom was anorexia (74.2%). No classical symptoms of acute appendicitis were reported in 8.5% patients (p< 0.05). The most frequent atypical symptoms were diarrhea (40%) and supra pubic pain (25.7%). Acute appendicitis was established as a diagnosis during the first 24 hours in 67.1%. The intraoperative diagnosis most commonly reported was edematous appendicitis (66.4%), the appendix appeared macroscopically perforated in 24.8%. The pathology revealed 83.5% of early appendicitis and 15% (p< 0.05) of perforated appendicitis. The frequency of atypical symptoms that contaminate the classic clinical picture of appendicitis is 37%. The occurrence of these atypical symptoms