Diferenças nas características clínicas e complementares de apêndices normais e inflamados com diagnóstico de apendicite.

Abstract

INTRODUCTION: Despite the great advances in diagnostic methods, the incidence of removal of a morphologically normal appendix in patients with clinical and complementary signs of acute appendicitis continues to exceed 20%. OBJECTIVE: To compare the clinical, laboratory, and ultrasound findings of inflammatory and noninflammatory appendiceal conditions diagnosed as acute appendicitis. METHOD: The medical records of a total of 208 patients with clinical, laboratory, and ultrasound findings indicative of acute appendicitis were studied. The patients were divided into two groups: group 1 comprising 94 patients whose histological results suggest a normal appendix and group 2 comprising 114 patients with histopathological tests confirming acute appendicitis. The analyzed variables were age at the time of surgery, sex, nausea and vomiting, inappetence, fever, pain migrating to the right iliac fossa, pain on palpation of the right iliac fossa, Blumberg’s sign, blood counts, ultrasound findings, and Alvarado score. RESULTS: The inflamed appendices were associated with inappetence, pain on palpation of the right iliac fossa, appendiceal diameter > 6 mm, and Alvarado score > 6 (p < 0.001). In contrast, fever was more frequently found in noninflammatory appendiceal conditions (p < 0.001). CONCLUSION: Inappetence, pain on palpation of the right iliac fossa, appendiceal diameter > 6 mm, and Alvarado score > 6 indicate an inflammatory appendiceal disease, whereas fever is more often present in noninflammatory appendiceal diseases.