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APENDICITIS AGUDA EN NIÑOS DE EDAD PREESCOLAR
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TRATAMIENTO CON ANTIBIÓTICOS O APENDICECTOMÍA LAPAROSCÓPICA DE URGENCIA EN NIÑOS CON APENDICITIS AGUDA NO COMPLICADA
Annals of Internal Medicine 173(2):120-136
Difundido en siicsalud: 7 jun 2021
TRATAMIENTO NO QUIRÚRGICO PARA LA APENDICITIS NO PERFORADA EN NIÑOS
Pediatric Surgery International 36(3):261-269
Difundido en siicsalud: 7 jun 2021

APENDICITIS AGUDA EN NIÑOS DE EDAD PREESCOLAR

(especial para SIIC © Derechos reservados)
El objetivo de este estudio fue la revisión de la estrategia diagnóstica y el enfoque de la apendicitis aguda en niños en edad preescolar para mejorar el índice de sospecha entre médicos de atención primaria, emergentólogos y jóvenes cirujanos, con el fin de reconocer los signos y síntomas precoces y efectuar un enfoque apropiado.
sakellaris9_52115.gif Autor:
George Sakellaris
Columnista Experto de SIIC

Institución:
University Hospital Heraklio


Artículos publicados por George Sakellaris
Coautores
Nikolaos Partalis* Dimitra Dimopoulou* 
MD, University Hospital Heraklio, Heraklio, Grecia*
Recepción del artículo
5 de Mayo, 2015
Aprobación
4 de Abril, 2015
Primera edición
22 de Mayo, 2015
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
La apendicitis aguda en una de las causas más frecuentes de abdomen agudo que requiere cirugía de urgencia en pacientes pediátricos. Los niños más pequeños, en especial aquellos en edad preescolar, presentan una mayor incidencia de perforación y abscesos al momento del diagnóstico, dado que el diagnóstico de apendicitis aguda puede demorarse como consecuencia de los síntomas atípicos e inespecíficos en estos pacientes. El diagnóstico preciso de la apendicitis aguda en los niños de edad preescolar es aún difícil. A pesar de los avances en el diagnóstico por imágenes y en el tratamiento de la apendicitis aguda, en este grupo etario es común el diagnóstico erróneo, lo que se asocia con elevada incidencia de complicaciones, mayor morbimortalidad e internaciones prolongadas. La apendicectomía a cielo abierto o por laparoscopia es la terapia convencional de la apendicitis no complicada. En las formas complicadas, ha crecido el papel de la apendicetomía laparoscópica en los últimos años, en función de la capacitación y experiencia de los cirujanos. El objetivo de este estudio fue la revisión de la estrategia diagnóstica y el enfoque de la apendicitis aguda en niños en edad preescolar para mejorar el índice de sospecha entre médicos de atención primaria, emergentólogos y jóvenes cirujanos, con el fin de reconocer los signos y síntomas precoces y efectuar un enfoque apropiado, que motive una reducción de la tasa de morbilidad en este grupo específico de pacientes.

Palabras clave
apendicitis, aguda, preescolares, niños


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Abstract
Acute appendicitis is one of the most common causes of acute abdominal pain requiring emergent surgery in childhood. Younger children and in particular, preschool-aged children present an increased incidence of perforation and abscess at the time of diagnosis, because the diagnosis of acute appendicitis may be delayed due to the atypical and nonspecific presentation of the symptoms in this population. The accurate diagnosis of acute appendicitis in preschool-age children is still a clinical challenge. Despite the advances in medical imaging and therapeutics of acute appendicitis, this age group is often misdiagnosed, resulting in a high incidence of complications, greater morbidity and mortality and prolonged hospitalization. Open or laparoscopic appendectomy is the standard treatment of simple appendicitis. In complicated appendicitis, the role of laparoscopic appendectomy has gained widespread acceptance in the last years and it depends on the surgeon's training and experience. The aim of our study is to review the diagnostic approach and the management of acute appendicitis in preschool-age children and help primary care physicians, emergency room physicians and young surgeons to be able to have a high index of suspicion of this disease, recognize the symptoms and signs of early appendicitis and manage it appropriately, resulting in decreased rate of morbidity in this specific population.

Key words
appendicitis, acute, preschool, children


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Especialidades
Principal: Cirugía, Pediatría
Relacionadas: Diagnóstico por Imágenes, Emergentología, Gastroenterología, Medicina Familiar



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George Sakellaris, Department of Paediatric Surgery, University Hospital of Heraklio, Greece, 70014, El.Venizelou 105, P. Hersonisou, Heraklio, Croacia
Bibliografía del artículo
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