Asunto(s)
Traumatismos por Explosión/terapia , Servicios Médicos de Urgencia/organización & administración , Explosiones , Incidentes con Víctimas en Masa , Traumatismos Abdominales/etiología , Traumatismos Abdominales/terapia , Quemaduras/etiología , Quemaduras/terapia , Síndromes Compartimentales/etiología , Síndromes Compartimentales/terapia , Traumatismos Craneocerebrales/etiología , Traumatismos Craneocerebrales/terapia , Lesiones por Aplastamiento/etiología , Lesiones por Aplastamiento/terapia , Descontaminación/métodos , Fluidoterapia/métodos , Humanos , Lesión Pulmonar/etiología , Lesión Pulmonar/terapia , Sistema Musculoesquelético/lesiones , Resucitación/métodos , Administración de la Seguridad/métodos , Lesión por Inhalación de Humo/etiología , Lesión por Inhalación de Humo/terapia , Triaje/organización & administración , Perforación de la Membrana Timpánica/etiología , Perforación de la Membrana Timpánica/terapiaRESUMEN
In this article we provide an evidence-based review of appendicitis, which is one of the most challenging conditions to diagnose in patients presenting with abdominal pain. Almost all clinicians are faced with the diagnostic work-up of these patients, and missing the diagnosis can result in patient decompensation. We review the literature from the initial description of McBurney's point to the clinical presentation, as well as the most appropriate imaging testing. Additionally, we review the usefulness of specific diagnostic laboratory tests. The use of computed tomography scans has reduced negative appendectomy rates when combined with a physical examination, and assists in ruling out appendicitis. Computed tomography scans with no contrast or just rectal contrast are becoming the standard in many institutions. It is essential that when the diagnosis of abdominal pain of unclear etiology is suspected, the clinician's discussion with the patient is well documented on the patient's chart.