Espinoza R, Ohmke J, García-Huidobro I, Guzmán S, Azocar M
Departamento de Cirugía Digestiva, Hospital Clínico, P Universidad Católica, Santiago, Chile.
Rev Med Chil. 1998 Jan;126(1):75-80.
Acute appendicitis still constitutes a difficult diagnostic problem.
To assess the experience of an University Hospital in the diagnosis of acute appendicitis and to determine the rates of negative appendectomies.
The charts of 1,075 patients operated with the diagnosis of acute appendicitis, between 1993 and 1995, were retrospectively reviewed. All resected appendices were pathologically examined. Those cases in whom pathology did not confirm the clinical diagnosis were considered as a negative appendectomy.
There was a 12.2% rate of negative appendectomies (18.9% in women and 6.2% in men). The difference between sexes disappears in patients over 40 years old. In 49% of patients, no abnormality was detected during the laparotomy. The most frequent differential diagnosis were gynecological illnesses or diseases of the colon.
The rate of negative appendectomies can be reduced with a close clinical observation of patients during their hospitalization and the judicious use of diagnostic laparoscopy.
急性阑尾炎仍然是一个诊断难题。
评估一家大学医院在急性阑尾炎诊断方面的经验，并确定阴性阑尾切除术的发生率。
回顾性分析1993年至1995年间1075例诊断为急性阑尾炎并接受手术治疗的患者病历。所有切除的阑尾均进行病理检查。病理检查未证实临床诊断的病例被视为阴性阑尾切除术。
阴性阑尾切除术的发生率为12.2%（女性为18.9%，男性为6.2%）。40岁以上患者的性别差异消失。49%的患者在剖腹手术中未发现异常。最常见的鉴别诊断是妇科疾病或结肠疾病。
通过住院期间对患者进行密切临床观察以及合理使用诊断性腹腔镜检查，可以降低阴性阑尾切除术的发生率。
