A carregar...
Publicação
Diverticulite aguda cólica com ar extraluminal : sinónimo de cirurgia?
| Nome: | Descrição: | Tamanho: | Formato: | |
|---|---|---|---|---|
| 562.17 KB | Adobe PDF |
Autores
Orientador(es)
Resumo(s)
A Diverticulose cólica é uma patologia comum nos países desenvolvidos, afetando maioritariamente a população idosa. A diverticulite aguda é a sua complicação mais frequente, atingindo 10 a 25% dos doentes com diverticulose.
O Ar extraluminal é um dos achados que pode ser visível na Tomografia Computorizada, exame gold standard para o diagnóstico e caracterização da diverticulite, podendo estar associado ou não à presença de pneumoperitoneu.
Pretende-se analisar se o grupo de doentes com diverticulite aguda e ar extraluminal é diferente do grupo de doentes com diverticulite aguda e sem ar extra-luminal e, ainda, perceber se existem diferenças nas abordagens terapêuticas adoptadas entre os que têm bolhas de ar extraluminal isoladas e os que têm pneumoperitoneu associado.
Estudo retrospetivo de 114 doentes internados com o diagnóstico de diverticulite aguda entre Janeiro de 2012 e Dezembro de 2013. Analisaram-se os processos clínicos, as tomografias computorizadas realizadas à admissão, os exames laboratoriais, as intervenções realizadas, a duração de internamento e as complicações decorridas, os antecedentes de doença diverticular e o seguimento após a alta clínica. Confirmou-se a presença de ar extraluminal em 27 doentes e verificou-se que estes têm geralmente maior tempo de internamento, mais intercorrências, classificações de Hinchey em estadios mais elevados, cursam com parâmetros analíticos inflamatórios mais elevados, desenvolvem frequentemente abcessos concomitantes, necessitando de cirurgia especialmente se pneumoperitoneu associado.
The colic diverticulosis is a common disease in developed countries, mainly affecting the elderly population. Acute diverticulitis is the most common complication, affecting 10-25% of patients with diverticulosis. The extraluminal air is one of the findings that can be visible on CT, gold standard for the diagnosis and characterization of diverticulitis, which can be with or without the presence of pneumoperitoneum. We intend to analyze the group of patients with acute diverticulitis and extraluminal air is different from the group of patients with acute diverticulitis and no extra-luminal air and also see if there are differences in therapeutic approaches among those isolated extraluminal air bubbles and those with pneumoperitoneum associated. Retrospective study of 114 patients admitted with a diagnosis of acute diverticulitis between January 2012 and December 2013. The clinical processes were analyzed, the CT scans performed on admission, laboratory tests, interventions, duration of hospitalization and complications elapsed, the history of diverticular disease and follow-up after discharge clinic. It was confirmed air extraluminal presence in 27 patients and found that they have greater hospitalization time, more complications, higher stages in Hinchey ratings, higher analytical inflammatory parameters, often concomitant abscesses develop, requiring surgery often develop concurrent abscesses, requiring surgery especially if associated with pneumoperitoneum.
The colic diverticulosis is a common disease in developed countries, mainly affecting the elderly population. Acute diverticulitis is the most common complication, affecting 10-25% of patients with diverticulosis. The extraluminal air is one of the findings that can be visible on CT, gold standard for the diagnosis and characterization of diverticulitis, which can be with or without the presence of pneumoperitoneum. We intend to analyze the group of patients with acute diverticulitis and extraluminal air is different from the group of patients with acute diverticulitis and no extra-luminal air and also see if there are differences in therapeutic approaches among those isolated extraluminal air bubbles and those with pneumoperitoneum associated. Retrospective study of 114 patients admitted with a diagnosis of acute diverticulitis between January 2012 and December 2013. The clinical processes were analyzed, the CT scans performed on admission, laboratory tests, interventions, duration of hospitalization and complications elapsed, the history of diverticular disease and follow-up after discharge clinic. It was confirmed air extraluminal presence in 27 patients and found that they have greater hospitalization time, more complications, higher stages in Hinchey ratings, higher analytical inflammatory parameters, often concomitant abscesses develop, requiring surgery often develop concurrent abscesses, requiring surgery especially if associated with pneumoperitoneum.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2015
Palavras-chave
Diverticulite aguda Tomografia computadorizada Ar extraluminal Pneumoperitoneu