Revisión bibliográfica sobre el manejo actual de plastrón apendicular

Abstract

Introduction: Acute appendicitis without timely treatment can progress to appendiceal perforation causing entities of greater severity such as localized peritonitis or generalized sepsis, however, in other less common cases the organism partially controls this process generating an appendicular plastron, constituted by adjacent tissues and delimiting the infectious process. Objective: To describe the proper diagnosis and the main complications that may develop in patients with appendicular plastron and to determine the most appropriate treatment modality for this pathology. Methods: A bibliographic review of the scientific literature was performed through English and Spanish language articles from 2017 to 2023 focusing on the diagnosis, complications and tr eatment modality for appendicular plastron. The search was performed in databases such as Pubmed, Science Direct, Medigraphic, Cochrane, Medline, ElSevier, Google Scholar, Scielo and New England Journal of Medicine. Results and discussion: Treatment modalities for appendicular plastron include immediate surgical intervention or conservative management, with the possibility of performing a delayed appendectomy when the acute condition is stabilized. However, there are currently studies that justify each trea tment modality, based on the length of hospital stay, risk of recurrence, possible complications, economic cost and adequate reincorporation to daily work. Conclusion: The clinical presentation and diagnostic methods are similar to the classic presentation of acute appendicitis. However, on physical examination it is common to palpate a mass at the level of the right iliac fossa, which can be confirmed by ultrasound or computed tomography, with the possibility of appendicular abscess formation as the main complication. However, the treatment modality is still a matter of debate, so it is important to carry out further studies in the future