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Differences in treatment strategies in the management of acute appendicitis in a county hospital in Guatemala and an academic teaching institution in the United States.
- Source :
-
Tropical doctor [Trop Doct] 2021 Apr; Vol. 51 (2), pp. 158-162. Date of Electronic Publication: 2020 Dec 23. - Publication Year :
- 2021
-
Abstract
- Laparoscopy and antibiotic-first (NOM) strategies have been introduced in the management of acute appendicitis in industrialised countries. Data regarding the feasibility of these strategies in low-income nations are sparse. A retrospective analysis of adult patients undergoing appendicectomy at a county non-teaching hospital in San Benito, Guatemala (Hospital Nacional (HNSB)) was compared to an academic, teaching institution in Dallas, USA (Veterans Medical Centre). Most patients at the VA (92%) underwent computed tomography prior to being operated upon while none did so at HNSB. Whilst all patients at HNSB underwent an open approach, 95% of VA patients underwent a laparoscopic appendicectomy with a 4.7% conversion rate. General anaesthesia was universally used at Veterans Medical Centre, whilst spinal anaesthesia was utilised in 88% of cases at HNSB. NOM of acute appendicitis was undertaken only rarely at the Veterans Medical Centre and never at HNSB, where it was not thought expedient.
Details
- Language :
- English
- ISSN :
- 1758-1133
- Volume :
- 51
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Tropical doctor
- Publication Type :
- Academic Journal
- Accession number :
- 33356919
- Full Text :
- https://doi.org/10.1177/0049475520981231