Abdomen agudo quirúrgico

  1. Caínzos Fernández, M.A. 1
  2. Domínguez Comesaña, E. 1
  3. González Rodríguez, F.J. 1
  4. Blanco Freire, M.N. 1
  5. Parada Gozález, P. 1
  6. Lesquereux Martínez, L. 1
  7. Fernández López, F. 1
  1. 1 Departamento de Cirugía. Servicio de Cirugía General. Complejo Hospitalario Universitario de Santiago de Compostela. Universidad de Santiago de Compostela. Santiago de Compostela. A Coruña, España
Revista:
Medicine: Programa de Formación Médica Continuada Acreditado

ISSN: 0304-5412

Ano de publicación: 2020

Título do exemplar: Enfermedades del aparato digestivo (X)Patología urgente y quirúrgica abdominal

Serie: 13

Número: 10

Páxinas: 523-540

Tipo: Artigo

DOI: 10.1016/J.MED.2020.06.001 DIALNET GOOGLE SCHOLAR

Outras publicacións en: Medicine: Programa de Formación Médica Continuada Acreditado

Obxectivos de Desenvolvemento Sustentable

Resumo

El término abdomen agudo engloba una serie de cuadros clínicos que tienen en común el dolor abdominal intenso, a menudo de aparición súbita, la alteración del tránsito intestinal y la afectación del estado general, y que suelen requerir cirugía urgente. Existen enfermedades no quirúrgicas que pueden cursar con sintomatología parecida; por ello, lo más importante es establecer si es necesaria o no la cirugía y si esta debe ser urgente o diferida. El abdomen agudo quirúrgico puede ser, fundamentalmente, de origen inflamatorio (apendicitis, colecistitis, diverticulitis), perforativo (perforación de úlcera péptica, perforación intestinal), obstructivo (oclusión de intestino delgado o colon) y hemorrágico (traumatismo, embarazo ectópico). En esta actualización se revisan los cuadros más frecuentes de cada tipo (apendicitis, perforación de víscera hueca, obstrucción por neoplasia de colon y traumatismo abdominal) y una situación especial, la de la mujer embarazada que necesita un manejo con ciertas peculiaridades, tanto para el diagnóstico como para el tratamiento.

Referencias bibliográficas

  • Caínzos M, Rodríguez-Segade F. Abdomen agudo. En: Tamames Escobar M, Martínez Ramos C, editores. Cirugía. Aparato digestivo. Aparato cir-culatorio. Aparato respiratorio. Madrid: Editorial Médica Panamericana, S.A.; 2000. p. 274-80.
  • Henry MM, Thompson JN, editores. Cirugía clínica. Barcelona: Masson, S.A.; 2005.
  • Henry M, Rong LQ, Wingo M, Rahouma M, Girardi LN, Gaudino M. The evidence of the ten most common surgical interventions in the Uni-ted States from 1970 to 2018. Ann Surg. 2019;270:e16-e17.
  • Havens JM, Neiman PU, Campbell BL, Croce MA, Spain DA, Napoli-tano LM. The future of emergency general surgery. Ann Surg. 2019; 270:221-2.
  • Britton J. The acute abdomen. En: Morris PJ, Malt RA, editores. Oxford Textbook of Surgery. New York: Oxford University Press New York Oxford Tokyo; 1994. Vol. I. p. 1377-95.
  • Lumley JSP, editor. Demonstrations of physical signs in clinical surgery. Oxford: Butterworth Heinemann; 1997.
  • Schein M, Marshall JC, editors. Source Control: a guide to the management of surgical infections. Berlin, Heidelberg, New York: Springer-Verlag; 2002.
  • Schein M, Rogers PN, Leppäniemi A, Rosin D, Efrom JE, editores. Schein’s common sense emergency abdominal surgery. 4th ed. Harley: Springer; 2016.
  • Glanc P, Maxwell C. Acute abdomen in pregnancy: role of sonography. J Ultrasound Med. 2010;29:1457-68.
  • Germain A, Brunaud L. Visceral surgery and pregnancy. J Visc Surg. 2010;147:e129-e135.
  • Bouyou J, Gaujoux S, Marcellin L, LeconteM, Goffinet F, Chapron C, et al. Abdominal emergencies during pregnancy. J Visc Surg. 2015;152(6)Suppl:S105-15
  • Selzer DJ, Stefanidis D. Surgical emergencies in the pregnant patient. Adv Surg. 2019;53:161-77.
  • Pearl JP, Price RR, Tonkin AE, Richardson WS, Stefanidis D. SAGES guidelines for the use of laparoscopy during pregnancy. Surg Endosc. 2017;31:3767-82.
  • Committee on Obstetric Practice and the American Society of Anesthe-siologists. Committee Opinion No. 696: Nonobstetric surgery during pregnancy. Obstet Gynecol. 2017; 129:777-8.
  • ACOG. Committee Opinion No. 775: Nonobstetric surgery during pregnancy. Obstet Gynecol. 2019;133:e285-e286
  • Agresta F, Ansaloni L, Baiocchi GL, Bergamini C, Campanile FC, Car-lucci M, et al. Laparoscopic approach to acute abdomen from the Con-sensus Development Conference of the Società Italiana di Chirurgia Endoscopica e nuove tecnologie (SICE), Associazione Chirurghi Ospeda-lieri Italiani (ACOI), Societá Italiana di Chirurgia (SIC), Societá Italiana di Chirurgia d’Urgenza e del Trauma (SICUT), Societá Italiana di Chi-rurgia nell’Ospedalitá Privata (SICOP), and the European Association for Endoscopic Surgery (EAES). Surg Endosc. 2012;26:2134-64.
  • Mazze RI, Källén B. Reproductive outcome after anesthesia and opera-tion during pregnancy: a registry study of 5405 cases. Am J Obstet Gyne-col. 1989;161:1178-85.
  • Guyatt GH, Akl EA, Crowther M, Gutterman DD, Schuünemann HJ; American College of Chest Physicians Antithrombotic Therapy and Prevention of Thrombosis Panel. Executive summary: an-tithrombotic therapy and prevention of thrombosis. 9th ed: Ameri-can College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2)Suppl:S7-47.
  • Calis H. Morbidity and mortality in appendicitis in the elderly. J Coll Physicians Surg Pak. 2018;28:875-8.
  • Cohen-Arazi O, Dabour K, Bala M, Haran A, Almogy G. Management, treatment and outcomes of acute appendicitis in an elderly population: a single-center experience. Eur J Trauma Emerg Surg. 2017;43:723-7.
  • Segev L, Keidar A, Schrier I, Rayman S, Wasserberg N, Sadot E. Acute appendicitis in the elderly in the twenty-first century. J Gastrointest Surg. 2015;19:730-5.
  • Kirshtein B, Perry ZH, Mizrahi S, Lantsberg L. Value of laparoscopic appendectomy in the elderly patient. World J Surg. 2009;33:918-22.
  • Lietzen E, Salminen P, Rinta-Kiikka I, Paajanen H, Rautio T, NordstömP, et al. The accuracy of the computed tomography diagnosis of acute ap-pendicitis: does the experience of the radiologist matter? Scand J Surg. 2018;107:43-7.
  • Zbierska K, Kenig J, Lasek A, Rubinkiewicz M, Walega P. Differences in the clinical course of acute appendicitis in the elderly in comparison to younger population. Pol Przegl Chir. 2016;88:142-6.
  • Becker P, Fichtner-Feigl S, Schilling D. Clinical management of appendicitis. Visc Med. 2018;34:453-8.
  • Podda M, Cillara N, Di Saverio S, Lai A, Feroci F, Luridiana G, et al. Antibiotics-first strategy for uncomplicated acute appendicitis in adults is associated with increased rates of peritonitis at surgery. A systematic re-view with meta-analysis of randomized controlled trials comparing ap-pendectomy and non-operative management with antibiotics. Surgeon. 2017;15:303-14.
  • Nirula R. Esophageal perforation. Surg Clin North Am. 2014;94: 35-41.
  • Sdralis EIK, Petousis S, Rashid F, Lorenzi B, Charalabopoulos A. Epide-miology, diagnosis, and management of esophageal perforations: syste-matic review. Dis Esophagus. 2017;30:1-6.
  • Chirica M, Kelly MD, Siboni S, Aiolfi A, Riva CG, Asti E, et al. Esophageal emergencies: WSES guidelines. World J Emerg Surg. 2019;14:26.
  • Wahed S, Dent B, Jones R, Griffin SM. Spectrum of oesophageal perfo-rations and their influence on management. Br J Surg. 2014;101:e156-62.
  • Loske G. Endoscopic negative pressure therapy of the upper gastrointes-tinal tract. Chirurg. 2019;90Suppl1:1-6
  • Persson S, Rouvelas I, Irino T, Lundell L. Outcomes following the main treatment options in patients with a leaking esophagus: a systematic literature review. Dis Esophagus. 2017;30:1-10.
  • Cho JS, Kim YD, Kim JW, Kim MS. Thoracoscopic primary esophageal repair in patients with Boerhaave’s syndrome. Ann Thorac Surg. 2011; 91:1552-5.
  • Ong GKB, Freeman RK. Endoscopic management of esophageal leaks. J Thorac Dis. 2017;9Suppl2:S135-145.
  • Nirula R. Gastroduodenal perforation. Surg Clin North Am. 2014; 94:31-34.
  • Lanas A, Chan FKL. Peptic ulcer disease. Lancet. 2017;390:613-24.
  • Paspatis GA, Dumonceau JM, Barthet M, Meisner S, Repici A, Saunders BP, et al. Diagnosis and management of iatrogenic endoscopic perfora-tions: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Endoscopy. 2014;46:693-711.
  • Rahman AA, Loi K. Gastric perforation as a complication of intragastric balloon. Surg Obes Relat Dis. 2018;14:719-22.
  • Revell MA, Pugh MA, McGhee M. Gastrointestinal traumatic injuries: gastrointestinal perforation. Crit Care Nurs Clin North Am. 2018;30: 157-66.
  • Søreide K, Thorsen K, Søreide JA. Strategies to improve the outcome of emergency surgery for perforated peptic ulcer. Br J Surg. 2014;101: 51-64.
  • Arnold M, Sierra MS, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global patterns and trends in colorectal cancer incidence and mortality. Gut. 2017;66:683-91.
  • Kim JS, Hur H, Min BS, Sohn SK, Cho CH, Kim NK. Oncologic outco-mes of self-expanding metallic stent insertion as a bridge to surgery in the management of left-sided colon cancer obstruction: comparison with nonobstructing elective surgery. World J Surg. 2009;33:1281-6.
  • Kleespies A, Füessl KE, Seeliger H, Eichhorn ME, Müller MH, Rentsch M, et al. Determinants of morbidity and survival after elective non-cura-tive resection of stage IV colon and rectal cancer. Int J Colorectal Dis. 2009;24:1097-109.
  • Markogiannakis H, Messaris E, Dardamanis D, Pararas N, Tzertzemelis D, Giannopoulos P, et al. Acute mechanical bowel obstruction: clinical presentation, etiology, management and outcome. World J Gastroente-rol. 2007;13:432-7.
  • Hsu J, Sevak S. Management of malignant large-bowel obstruc-tion. Dis Colon Rectum. 2019;62:1028-30.
  • Pisano M, Zorcolo L, Merli C, Cimbanassi S, Poiasina E, CeresoliM, et al. 2017 WSES guidelines on colon and rectal cancer emergencies: obs-truction and perforation. World J Emerg Surg. 2018;13:36.
  • Frasson M, Flor-Lorente B, Rodríguez JL, Granero-Castro P, Hervás D, Álvarez-Rico MA, et al. Risk factors for anastomotic leak after colon re-section for cancer: multivariate analysis and nomogram from a multicen-tric, prospective, national study with 3193 patients. Ann Surg. 2015;262: 321-30.
  • Van Hooft JE, van Halsema EE, Vanbiervliet G, Beets-Tan RG, DeWitt JM, Donnellan F, et al. Self-expandable metal stents for obstructing co-lonic and extracolonic cancer: European Society of Gastrointestinal En-doscopy (ESGE) Clinical Guideline. Endoscopy. 2014;46:990-1053.
  • Zmora O, Mahajna A, Bar-Zakai B, Hershko D, Shabtai M, Krausz MM, et al. Is mechanical bowel preparation mandatory for left-sided colonic anastomosis? Results of a prospective randomized trial. Tech Coloproc-tol. 2006;10:131-5.
  • Ince M, Stocchi L, Khomvilai S, Kwon DS, Hammel JP, Kiran RP. Mor-bidity and mortality of the Hartmann procedure for diverticular disease over 18 years in a single institution. Colorectal Dis. 2012;14:e492-8.
  • Tasse JL, Janzen ML, Ahmed NA, Chung RS. Screening laboratory and radiology panels for trauma patients have low utility and are not cost effective. J Trauma. 2008;65:1114-6.
  • Feliciano DV. Abdominal trauma revisited. Am Surg. 2017;83: 1193-202.
  • Chestovich PJ, Browder TD, Morrissey SL, Fraser DR, Ingalls NK, Fil-des JJ. Minimally invasive is maximally effective: diagnostic and therapeu-tic laparoscopy for penetrating abdominal injuries. J Trauma Acute Care Surg. 2015;78:1076-83.
  • Jones EL, Stovall RT, Jones TS, Bensard DD, Burlew CC, Johnson JL, et al. Intra-abdominal injury following blunt trauma becomes clinically apparent within 9 hours. J Trauma Acute Care Surg. 2014;76:1020-3.
  • Navsaria PH, Nicol AJ, Edu S, Gandhi R, Ball CG. Selective nonopera-tive management in 1106 patients with abdominal gunshot wounds: con-clusions on safety, efficacy, and the role of selective CT imaging in a prospective single-center study. Ann Surg. 2015;261:760-4.
  • Peponis T, Kasotakis G, Yu J, Alouidor R, Burkott B, Maung AA, et al. Selective nonoperative management of abdominal gunshot wounds from heresy to adoption: a multicenter study of the Research Consortium of New England Centers for Trauma (ReCoNECT). J Am Coll Surg. 2017;224:1036-45.
  • Roberts DJ, Bobrovitz N, Zygun DA, Ball CG, Kirkpatrick AW, Faris Pd, et al. Indications for use of damage control surgery in civilian trauma patients: a content analysis and expert appropriateness rating study. Ann Surg. 2016;263:1018-27.
Fonte de datos: Dialnet