Implicaciones clínicas de la enfermedad diverticular del apéndice. Experiencia en los últimos 10 años / Clinical implications of diverticular disease of the appendix. Experience over the past 10 years

INTRODUCCIÓN: La enfermedad diverticular del apéndice es infrecuente, con una incidencia que varía desde 0,004 a 2,1%. Suele presentarse entre la cuarta o quinta década de vida, con ausencia de síntomas gastrointestinales y dolor abdominal insidioso. Los pacientes habitualmente consultan de forma tardía, con el consiguiente aumento de morbimortalidad. El objetivo de este estudio fue determinar las características clínicas de la enfermedad diverticular del apéndice. MÉTODOS: Se realizó un estudio retrospectivo de todos los pacientes operados de apendicectomía en un hospital terciario desde septiembre de 2003 hasta septiembre de 2013. RESULTADOS: Durante este periodo se realizaron 7.044 apendicectomías, encontrándose 42 casos de enfermedad diverticular del apéndice, que representa una incidencia de 0,59%. De ellos, 27 pacientes fueron de sexo masculino. La edad media fue de 46,6 ± 21 años. El promedio de la estancia hospitalaria fue de 4,5 días. El 46% de los casos presentaban perforación del apéndice. En el 80% de los casos se realizó una prueba de imagen complementaria. La incidencia de neoplasia asociada a enfermedad diverticular fue de 7,1%. CONCLUSIONES: La enfermedad diverticular del apéndice es un hallazgo incidental. En la fase aguda presenta síntomas indiferenciables de la apendicitis aguda. El tratamiento de elección es la apendicectomía. Presenta una mayor probabilidad de desarrollar neoplasias del apéndice

BACKGROUND: Diverticular disease of the appendix is an uncommon condition, with an incidence from 0.004 to 2.1%. It usually occurs between the fourth or fifth decades of life, does not present gastrointestinal symptoms but only insidious abdominal pain. Patients usually delay consultation, leading to increased morbidity and mortality. The aim of this study was to determine the clinical features of diverticular disease of the appendix. METHODS: A retrospective study of all patients undergoing appendectomy in a tertiary hospital between September 2003 and September 2013 was performed. RESULTS: During this period, 7,044 appendectomies were performed, and 42 cases of diverticular disease of the appendix were found, which represents an incidence of 0.59%. A total of 27 patients were male. The mean age was 46.6 ± 21 years. The average hospital stay was 4.5 days. A perforated appendix was identified in 46% of patients. In 80% of the cases, a complementary imaging test was performed. The incidence of neoplastic disease with diverticulum of the appendix was 7.1%. CONCLUSIONS: Diverticular disease of the appendix is an incidental finding. In its acute phase, it presents as an acute appendicitis. The treatment of choice is appendectomy. It presents a higher risk of developing neoplastic disease of the appendix

Clinical implications of diverticular disease of the appendix. Experience over the past 10 years.

BACKGROUND: Diverticular disease of the appendix is an uncommon condition, with an incidence from 0.004 to 2.1%. It usually occurs between the fourth or fifth decades of life, does not present gastrointestinal symptoms but only insidious abdominal pain. Patients usually delay consultation, leading to increased morbidity and mortality. The aim of this study was to determine the clinical features of diverticular disease of the appendix. METHODS: A retrospective study of all patients undergoing appendectomy in a tertiary hospital between September 2003 and September 2013 was performed. RESULTS: During this period, 7,044 appendectomies were performed, and 42 cases of diverticular disease of the appendix were found, which represents an incidence of 0.59%. A total of 27 patients were male. The mean age was 46.6±21 years. The average hospital stay was 4.5 days. A perforated appendix was identified in 46% of patients. In 80% of the cases, a complementary imaging test was performed. The incidence of neoplastic disease with diverticulum of the appendix was 7.1%. CONCLUSIONS: Diverticular disease of the appendix is an incidental finding. In its acute phase, it presents as an acute appendicitis. The treatment of choice is appendectomy. It presents a higher risk of developing neoplastic disease of the appendix.